The use of wound healing casts, Böhler's iron and the biomechanics of offloading.

Total contact casting is the 'gold standard' form of pressure offloading in people with diabetic foot ulcers. Hybrid versions of total contact casts, also known as wound healing casts, are increasingly being used in practice. A Böhler's iron can be used in conjunction with a cast to provide axial offloading where appropriate. Studies have proven the efficacy of both interventions but there is a lack of studies comparing the benefits and drawbacks of different cast systems. Currently cast use is limited as many staff lack the biomechanical knowledge and skills to correctly apply and manage cast systems. As a result, despite proven benefits, casting is rarely used in practice. This article reviews the current forms of casting, its indications and contraindications and the basic biomechanics involved in offloading to encourage healing. [ABSTRACT FROM AUTHOR]