Ulcers of the Foot

An ulceration or ulcer is usually a painless sore at the bottom of the foot or top of the toes, resulting from excessive pressure at that site. Ulcers frequently underline a pre-existing corn or callus that was allowed to build up too thickly. Trauma from heat, cold, shoe pressure, or penetration by a sharp object are also potential causes. Neuropathy allows the lesions to develop because the normal warning sense of pain has been lost and they go unrecognized. Continued pressure or walking on the injured skin creates even further damage and the ulcer will worsen. The open sore will frequently become infected and may even penetrate to bone.
Treatment relies on early recognition of the ulceration by a podiatric surgeon, avoidance of weight bearing activities such as walking, avoidance of wearing "closed-in" shoes, and early intervention. Besides wound care, dressings and antibiotics, other measures may be necessary to adequately relieve pressure on the area. When use of crutches, a wheelchair, or rest is not feasible, plaster casts, braces, healing sandals, or orthoses (special shoe inserts) can be used to protect the foot while it heals. If circulation is inadequate to allow healing, your podiatric surgeon may refer you to a vascular surgeon for appropriate evaluation and possible vascular reconstructive surgery.
Once an ulcer has healed, it is important to continue to see your podiatric surgeon regularly. Special footwear and inserts may be recommended to protect your feet and prevent new or recurrent lesions from developing.