Mr Cade Toe Case Study

The following, is a case study of a male patient, Mr Claude Toe, a 48 year old decorator. Mr Toe acquired a foot infection as the result of a penetrating injury caused by a nail that he stepped on while he was working. Furthermore, this provoked an infected ulcer of 0.8 cm in diameter on his right foot which has become slow to heal and according to case notes, is painful when standing.
This case study will outline how Mr Toe acquired this problem, how he can be treated, the precautions a practitioner should undertake to prevent cross infection in clinic and the advice that should be given to the patient about his care.
There are a multitude of factors that can contribute to foot ulcers and infection and each individual patient has a different
Research by Woong Sohn et al.(2011) found that the risk of ulceration increased with BMI. A study that followed up diabetic patients for 5 years reported a 20% increased risk in foot ulceration for every 20kg increase in body weight. These results can be explained as pedal stress can be 3 to 5 times body weight, so those with high BMI’s place a lot of pressure of their feet as opposed to those with a lower BMI. When this is applied to the case of Mr Toe, who has caused trauma to his foot, the pressure on the plantar surface of his foot is significant enough to slow down the healing process and cause the ulcer to worsen without
This can cause more loading and weight bearing on the lateral side of the foot creating an excessively pronated foot. The misalignment of the tibia can give rise to abnormal function of the ankle and subtalar joints, which begin to rotate in the frontal plane compensating for the abnormality. This mechanism causes more problems, one of these relevant to the case study is the effect on the 1st metatarsophalangeal joint, where the patient’s ulcer is, as it creates a limitation of mobility in the joint. (Ribbans ,