The effect of regular callus removal on foot pressures.

The optimum frequency of callus removal is unknown. This study shows that in-shoe dynamic plantar pressure measurement can quantify the effect of callus removal in relation with the frequency of podiatric treatment in diabetic ulcer patients. Three groups of diabetic neuropathic patients were studied. Group 0 consisted of six patients who presented for the first time ever for callus removal and who did not have a history of ulceration. The other two groups had a history of ulceration and required regular podiatry treatment: every 6-8 weeks for 10 patients in group A, and every 3-4 weeks for eight patients in group B. Peak plantar pressures were measured using the F-SCAN system, before and after removal of callus, which was weighed to further quantify the effect of podiatry. When callus was removed, peak pressures fell by 32.1 +/- 8.4% (p = .014) in group 0, by 30.9 +/- 4.5% (p < .005) in group A, and by 24.8 +/- 4.0% (p = .005) in group B. The mean weight of callus removed was not significantly different in the three groups. This suggests that the weight of callus is unlikely to be a reliable guide to assess the time intervals between podiatry appointments. However, the measurement of plantar pressures using a dynamic in-shoe plantar pressure device has proven to be a functional, objective, and quantifiable indicator in the assessment of podiatric treatment.