Diabetic with metatarsal ulcers; most appropriate footwear?

• A. Heat-moldable healing shoe
• B. Heel rocker shoe
• C. Heel relief shoe
• D. Postoperative shoe

Answer: (B)

When a diabetic has a metatarsal ulcer, the main goal is to take pressure off the forefoot to promote healing and prevent worsening. A heel rocker shoe does this effectively by using a curved sole that tilts the rollover toward the heel. This reduces the load under the metatarsal heads during walking, lowering peak plantar pressures at the ulcer site and minimizing shear forces that can irritate the wound.

Other options don’t target forefoot off-loading as well. A heat-moldable healing shoe can be customized for fit and comfort but doesn’t inherently shift forefoot pressure. A heel relief shoe focuses on relieving pressure at the heel, not the forefoot. A postoperative shoe is designed for protection after surgery and isn’t appropriate for ongoing plantar ulcers.