Case 88: Foot Ulcer Heals and Claudication in Both Legs Does Well for Twelve Years

This 58 year old man was an insulin-dependent diabetic and an active smoker. He could walk about one half block before both legs cramped. He had developed an ulcer on the dorsum of the right foot that had not responded to the care of his doctor over 11 weeks.

The right leg was more ruborous on dependency than the left. The ulcer penetrated deep into the subcutaneous tissue.

The Doppler signal over the Dorsalis Pedis at the ankle was low, broad and monophasic in both legs, May 23rd, 1979.

The ulcer is shown here to be healing; once healed no scar remained. The left foot now had equal or more rubor than the right.

His left leg, which was initially not treated and might be considered a control, become the symptomatic leg after a month of therapy. Therapy was thereafter directed to both legs.

The Doppler signals became taller and louder in the Dorsalis Pedis. He was satisfied with his walking distance and discharged from the office.

His legs never bothered him again. His family doctor provided occasional reports until his death twelve years later.

Comments: This man is included because his case is simple and straight forward. He does well and the benefit lasts. We were not privy to any change in life style he may have had. He was, of course, encouraged to stop smoking and control his diabetes.