Craig and George
Damn, you're sucking me into this one and exposing my huge ignorance in these
matters.
>Windlass dysfunction has big implications in the diabetic (or leprotic) foot.
The findings of yourself (Craig) and Talylor + Stansby et al are very
interesting.
Is the ruptured fascia caused by Windlass dysfunction?
Has anybody linked ruptured fascia (and windlass) to foot ulceration?
I would say from my experience that the main perception in the UK diabetes
foot world from journals and conferences is that foot ulceration is caused by
neuropathy + deformity + trauma (Reiber et al 1999). Dysfunctioning
Windlasses are not something that get aired.
Biomechanics in leprosy has been touched on by Hugh Cross and George Rendall,
but due to the lack of podiatric input in this field has not yet gained
momentum. Biomechanics in diabetes simply does not get promoted other than by
people such as Peter Cavenagh.
So, a well fitting shoe with a total contact insole and maybe a rocker sole
is the perceived goal by most of the diabetic foot world. How does this tie
in with windlass theories?
Finally (for today), could the identification and management of
dysfunctioning windlass by diabetes / leprosy clinicians lead to reduced
numbers of Charcot deformity or plantar foot ulceration?
Martin Fox
-----------------------------------------------------------------
This message was distributed by the Podiatry JISCmail list server
to leave the Podiatry email list send a message containing the text
leave podiatry
to [log in to unmask]
Please visit http://www.jiscmail.ac.uk for any further information
-----------------------------------------------------------------
|