By Jordana Bieze Foster
Scalpel debridement of plantar calluses in elderly patients does not reduce plantar pressures and is no more effective than sham treatment for relieving pain, according to an Australian study.
Researchers from La Trobe University in Bundoora, Victoria, analyzed 80 patients aged 65 years or older who had painful forefoot plantar calluses. All patients rated their pain at least 20 mm on a 100-mm visual analog scale (VAS).
Forty-one patients were randomized to scalpel debridement, while the remaining 39 patients underwent a sham procedure in which the scalpel was simply turned over and its blunt edge used to simulate debridement.
Barefoot plantar pressures did not differ significantly from baseline in either group and did not differ significantly between groups at any time point. Both groups experienced immediate significant decreases in pain (up to 41.9 mm) that had returned almost to baseline levels by five weeks. Pain reductions were slightly greater in the scalpel debridement group but the difference between groups was not statistically or clinically significant, according to Karl Landorf, PhD, a senior lecturer and research coordinator in the Department of Podiatry at the university, who presented the group’s findings at the i-FAB congress.
“There’s this remarkable ‘nonintervention effect’ that clinicians especially need to take into account,” Landorf said.
Landorf KB, Morrow A, Spink MJ, et al. Scalpel debridement has minimal effects on painful plantar calluses in older people: a randomized trial. Presented at 3rd International Foot and Ankle Biomechanics Congress, Sydney, April 2012.