01691nas a2200205   4500000000100000008004100001260001300042653001800055653001100073653001200084653003900096653003200135653001500167100001500182245005500197300001100252490000700263520120100270022001401471       1989                            d  c1989 Jul10aFoot Diseases10aHumans10aleprosy10aPeripheral Nervous System Diseases10aPostoperative Complications10aSkin Ulcer1 aWarren A G00aThe surgical conservation of the neuropathic foot.  a236-420 v713 a<p>Basic surgical principles applied when caring for neuropathic limbs can result in the maintenance or restoration of a useful ulcer-free limb. It is possible to help many patients with neuropathy to become ulcer-free and to remain ulcer-free and mobile, with surgical procedures. Recommended methods of management are briefly outlined. These include the débridement of the osteomyelitic, metatarsal head in order to save the adjacent toe, removal of bony irregularities that predispose to ulceration, and the use of wedge osteotomies and arthrodeses to improve the functional shape of the affected foot. The emphasis is on the removal of high pressure points from the weight-bearing surface and to increase the total area available for weight-bearing. Adequate rest and protection are essential, and include the use of splints or total contact plaster casts in all cases of ulceration of weight-bearing surfaces. All patients with reduced sensory perception should learn daily self-examination and care to reduce the chances of recurrent ulceration. Healing after surgical reconstruction will occur, and the healed tissues, if adequately cared for, will maintain their integrity for years.</p>  a0035-8843