FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 343:787-793 September 14, 2000 Number 11 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Ulcers result from breaks in the dermal barrier, with subsequent erosion of underlying subcutaneous tissue. In severe cases, the breach may extend to muscle and bone. Primary care providers are often the first to evaluate nonhealing pedal ulcers. Early recognition of the cause and prompt management of ulcers are essential for a good functional outcome. In many cases, successful salvage of an extremity depends on a multidisciplinary team of specialists, and timely consultation is warranted.

Causes

Walking consists of a complex series of biomechanical events involving triplanar movements of the foot and ankle (Figure 1A). ² A variety of external . . . [Full Text of this Article]

Arterial Insufficiency

Neuropathy

Musculoskeletal Abnormalities

Diabetes Mellitus

Assessment and Management

Vascular Causes

Neurologic and Musculoskeletal Causes

Wound

Summary

Source Information

From the Department of Surgery (Vascular), Yale University School of Medicine, New Haven, Conn.

Address reprint requests to Dr. Sumpio at the Yale University School of Medicine, 333 Cedar St., New Haven, CT 06510, or at bauer.sumpio@yale.edu.

References

This article has been cited by other articles:

• Slovut, D. P., Sullivan, T. M (2008). Critical limb ischemia: medical and surgical management. Vasc Med 13: 281-291 [Abstract]  
• Orendurff, M. S., Rohr, E. S., Sangeorzan, B. J., Weaver, K., Czerniecki, J. M. (2006). An equinus deformity of the ankle accounts for only a small amount of the increased forefoot plantar pressure in patients with diabetes. J Bone Joint Surg Br 88-B: 65-68 [Abstract] [Full Text]  
• Clifft, J. K., Kasser, R. J., Newton, T. S., Bush, A. J. (2005). The Effect of Monochromatic Infrared Energy on Sensation in Patients With Diabetic Peripheral Neuropathy: A double-blind, placebo-controlled study. Diabetes Care 28: 2896-2900 [Abstract] [Full Text]  
• Rerkasem, K., Kosachunhanum, N., Chongruksut, W., Koiam, W., Limpijarnkit, L., Chimplee, K., Mangklabruks, A. (2004). A Hospital-Based Survey of Risk Factors for Diabetic Foot Ulceration in Northern Thailand. INT J LOW EXTREM WOUNDS 3: 220-222 [Abstract]  
• Bus, S. A., Maas, M., Cavanagh, P. R., Michels, R. P. J., Levi, M. (2004). Plantar Fat-Pad Displacement in Neuropathic Diabetic Patients With Toe Deformity: A magnetic resonance imaging study. Diabetes Care 27: 2376-2381 [Abstract] [Full Text]  
• Gregg, E. W., Sorlie, P., Paulose-Ram, R., Gu, Q., Eberhardt, M. S., Wolz, M., Burt, V., Curtin, L., Engelgau, M., Geiss, L. (2004). Prevalence of Lower-Extremity Disease in the U.S. Adult Population >=40 Years of Age With and Without Diabetes: 1999-2000 National Health and Nutrition Examination Survey. Diabetes Care 27: 1591-1597 [Abstract] [Full Text]  
• Smith, C. L. (2004). Pharmacotherapy of Diabetic Foot Ulcers. Journal of Pharmacy Practice 17: 66-74 [Abstract]  
• Krentz, A. J, Mani, R., Shearman, C. P (2003). Review: Peripheral arterial disease in diabetes: time for a co-ordinated approach to management. British Journal of Diabetes & Vascular Disease 3: 92-96 [Abstract]  
• Robertson, D. D., Mueller, M. J., Smith, K. E., Commean, P. K., Pilgram, T., Johnson, J. E. (2002). Structural Changes in the Forefoot of Individuals with Diabetes and a Prior Plantar Ulcer. JBJS 84: 1395-1404 [Abstract] [Full Text]  
• Beckman, J. A., Creager, M. A., Libby, P. (2002). Diabetes and Atherosclerosis: Epidemiology, Pathophysiology, and Management. JAMA 287: 2570-2581 [Abstract] [Full Text]  
• Ledermann, H. P., Morrison, W. B., Schweitzer, M. E. (2002). Is Soft-Tissue Inflammation in Pedal Infection Contained by Fascial Planes? MR Analysis of Compartmental Involvement in 115 Feet. Am. J. Roentgenol. 178: 605-612 [Abstract] [Full Text]  
• Ledermann, H. P., Schweitzer, M. E., Morrison, W. B. (2002). Nonenhancing Tissue on MR Imaging of Pedal Infection: Characterization of Necrotic Tissue and Associated Limitations for Diagnosis of Osteomyelitis and Abscess. Am. J. Roentgenol. 178: 215-222 [Abstract] [Full Text]  
• Chan, C. L H, Meyer, F. J, Hay, R. J, Burnand, K. G (2001). Toe ulceration associated with compression bandaging: observational study. BMJ 323: 1099-1099 [Full Text]  
• Webster, K. H., Martens, P. R., Murphy, M., Sumpio, B. E., Blume, P. A. (2001). Treatment of Foot Ulcers. NEJM 344: 139-140 [Full Text]