Podiatry specialists, together with surgeons, play an important role in the multidisciplinary team in saving the diabetic foot.
Podiatry is a specialty that is licensed in the diagnosis and treatment of pathologies of the foot and ankle. Treatment includes both conservative and surgical methods – that’s why podiatrists must collaborate with a surgeon. Understanding the biomechanics of the lower extremity is primarily highlighted in the education and training of a podiatrist. This is particularly important in the context of the diabetic foot, as biomechanical abnormalities often precede ulcer development.
Ulcer prevention strategies used by a podiatrist include regular monitoring, routine callus care, and customized heel and shoe recommendations.
In addition, clinic-based ulcer care as well as surgical interventions that include prophylactic and acute intervention may translate into functional limb preservation. Finally, ongoing podiatry management can prevent ulcer recurrence through unloading strategies and diabetic foot education.
Each member of the multidisciplinary team brings a set of skills and knowledge that contribute to this effort.
The podiatrist brings a comprehensive understanding of foot and ankle biomechanics and a skill set to perform the necessary surgeries. The goal is to prevent injuries from developing in the first place. However, the main point of clinical intervention is most often in preventing the downward spiral of a chronic wound that can lead to limb loss.
A comprehensive medical and surgical plan that takes into account the underlying biomechanical instability, as well as an appreciation for the biomechanical change that occurs after surgery, can prevent re-injury and limb loss in this high-risk population.