Pressure relief (offloading) and immobilization with total contact casting (TCC) are critical to helping ward off further joint destruction. TCC involves encasing the patients complete foot, including toes, and the lower leg in a specialist cast that redistributes weight and pressure in the lower leg and foot during everyday movements. This redistributes pressure from the foot into the leg, which is more able to bear weight, to protect the wound, letting it regenerate tissue and heal. TCC also keeps the ankle from rotating during walking, which prevents shearing and twisting forces that can further damage the wound. TCC aids maintenance of quality of life by helping patients to remain mobile.There are two scenarios in which the use of TCC is appropriate for managing neuropathic arthropathy (Charcot foot), according to the American Orthopaedic Foot and Ankle Society. First, during the initial treatment, when the breakdown is occurring, and the foot is exhibiting edema and erythema; the patient should not bear weight on the foot, and TCC can be used to control and support the foot. Second, when the foot has become deformed and ulceration has occurred; TCC can be used to stabilize and support the foot, and to help move the wound toward healing. Walking braces controlled by pneumatics are also used. In these patients, surgical correction of a joint is rarely successful in the long term. However, offloading alone does not translate to optimal outcomes without appropriate management of vascular disease and/or infection.
Melanosis is a form of hyperpigmentation associated with increased melanin.It can also refer to:

Melanism
Ocular melanosis
Smokers melanosis
Oral melanosis
Riehl melanosis

See also
List of cutaneous conditions

References


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