Nonwindowed nonremovable fiberglass off-loading cast versus removable pneumatic cast (AircastXP Diabetic Walker) in the treatment of neuropathic noninfected plantar ulcers: a randomized prospective trial.

N europathic plantar ulcers are classical lesions secondary to diabetic polyneuropathy (1,2). The worldwide gold standard treatment is the nonremovable off-loading cast (3–5). However, the device is not widely used due to concerns related to risk factors of the off-loading cast (i.e., joint rigidity, additional ulcer formation beneath the cast, and infection of the ulcer enclosed in the cast). Our group recently demonstrated that it is possible to reduce the risk of side effects reported in literature by constructing the off-loading cast using fiberglass bandages of different rigidity. Considering the device’s scarce application because of the side effects, we conducted a controlled, randomized, prospective trial to evaluate the safety and efficacy of a removable pneumatic cast walker in comparison with a nonremovable fiberglass off-loading cast.