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Total Contact Casting (TCC)

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What Is a Total Contact Cast (TCC)?

A TCC is a rigid cast made of fiberglass and is specially designed to fit your leg. It is applied to the affected leg just below the knee to the end of the toes and is non-removable.

It is used to limit movement in the affected leg by:

Restricting motion of the foot and ankle joints

Redistributing pressure away from the sole of the foot to the leg

Why Do I Need A TCC and What Are the Benefits?

A TCC may be used for two medical conditions:

  1. Active Charcot Neuroarthropathy
    The purpose of a TCC for this condition is to limit movement and reduce pressure on the leg to allow the bones to heal.
  2. Neuropathic Diabetic Wound on Sole of Foot
    The purpose of a TCC for this condition is to reduce and redistribute pressure on the wound to allow it to heal.

Total Contact Casting 1.png

What Should I Do Before the TCC Is Applied?

  • Wear loose-fitting pants or shorts.
  •  Bring a companion or helper along to assist you after the TCC is applied.
  • You may be required to purchase a walking aid (e.g. crutches or walking frame) or bring along a mobility device (e.g. wheelchair) to improve your stability after the cast is applied.

How Is the TCC Applied?

  • Application will be performed by a podiatrist.
  • No anaesthesia or sedative will be used.
  • You will be seated while the cast is applied.
  • Application typically takes around 45 minutes, with an additional 15 minutes for the cast to dry and set.
  • A special surgical sandal will be fitted on your foot at first application. This is to help you to walk in a stable manner with the cast while preventing the cast from breaking.

Total Contact Casting 2.png 

What Is the Expected Length of Treatment?

  • After the first cast application, you will be scheduled an appointment one week later to review the cast.
  • Further reviews might be scheduled every week or every two weeks.
  • Depending on the severity of your condition, the entire course of the TCC application may range from three months to a year.

What Are the Risks and Complications of Having a TCC?

  • Skin reactions (such as maceration, fungal infection, abrasions, skin irritation)
  • Possible new wounds from abrasion within the cast
  • Increased risk of falling due to instability and imbalance
  • Loss of muscle bulk and strength in affected leg
  • Allergy to casting material
  • Thermal burns during cast removal
  • Claustrophobic-like response to the cast

Total Contact Casting 3.png

Warning Signs to Look Out for!

  • New pain in the leg or foot
  • Numbness and tingling in the toes or foot
  • Outbreak of rashes around the affected leg
  • Severe itchiness within the cast
  • Sensation of persistent pressure caused by the cast
  • Leg feels excessively warm and/or tight within the cast
  • Cast feels very loose
  • Cast is broken/cracked (e.g. from excessive weight-bearing activities)
  • Foot feels wet and/or fluid is coming out of cast
  • Strong odour or smell
  • Claustrophobic-like response to the cast

Urgent Removal of Cast

Office Hours (8am to 5pm, Monday to Friday):
Please call Central Hotline (6357 7000) and inform that there is a problem with the TCC applied by Podiatry.

After Office Hours:
Please take the memo/brochure provided by the podiatrist during your consultation to the Emergency Department for urgent cast removal.

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