Dealing with hypertrophic scars on the dorsal aspect of the forefoot

A case to illustrate key points

Chen-Jui HSU, Occupational Therapist,

Taipei Rehabilitation Center, Sunshine Social Welfare Foundation

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Hypertrophic scars on the dorsal aspect of the forefoot can be challenging to deal with. This is because the foot combines flat, convex and concave surfaces. If not dealt properly, these scars can have a serious impact on ambulation. Scar growth and contracture can cause metatarsophalangeal joint hyperextension and webspace syndactyly. In severe cases, range of motion of toe joints will be affected, which may cause pain when walking or wearing shoes.

In this video, Chen-Jui HSU, Occupational Therapist at Sunshine’s Taipei Rehabilitation Center will use a patient’s case to illustrate how a pressure therapy intervention can be developed for this kind of problem.

Key point 1: Structural characteristics of the body will affect pressure distribution

Remember the Laplace Law when planning your pressure therapy intervention! The level of pressure will be determined by the radius of curvature. On an uneven surface like the foot, areas with smaller curvature like the side of the foot will receive more pressure, while areas with larger curvature like the instep or sole of the foot will receive lower pressure, and concave areas like toe webspace will receive no pressure at all.

Key point 2: To achieve optimal scar control, adjust the design of pressure garments and use a combination of other pressure therapy tool