Cold-weather warfare
Trench foot is a medical condition caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions at temperatures as warm as for as few as 13 hours. Exposure to these environmental conditions causes deterioration and destruction of the capillaries and leads to morbidity of the surrounding flesh. Affected feet may become numb, affected by erythema (turning red) or cyanosis (turning blue) as a result of poor blood supply, and may begin emanating a decaying odour if the early stages of necrosis (tissue death) set in. As the condition worsens, feet may also begin to swell. Advanced trench foot often involves blisters and open sores, which lead to fungal infections. If left untreated, trench foot usually results in gangrene, which may require amputation. If trench foot is treated properly, complete recovery is normal, though it is marked by severe short-term pain when feeling returns. Trench foot affected tens of thousands of soldiers engaged in trench warfare in World War I. Keeping feet warm and dry, or at least changing into warm and dry replacement footgear, is the best way to avoid trench foot.
MDP syndrome
There may be different problems associated with MDP syndrome in the feet. The lack of subcutaneous fat means that there is direct pressure on the skin resulting in callus (hard skin) on the heels and also the weight-bearing parts of the forefoot. This is best managed by trying to find insoles to support the foot but it’s difficult to avoid completely. There is no approach that will increase the subcutaneous fat. The second feature is clawed toes as a result of contraction of the long extender tendons. The contractured constrictions can get worse over time. It is worth considering a physiotherapy referral with an aim to establish exercises to try to keep the tendons stretched if possible.