TOE Study: Treatment and Gait Analysis fOllowing an Excised Lesser Toe

Summary of study The study will examine patients with Diabetes Mellitus (DM) who have had a lesser toe amputations (LTA) (toes 2nd3rd,4th or 5th). It is currently not understood how this affects the way patients walk and foot function. No previous studies have been undertaken to examine this and its potential for causing further ulceration risk. This study is a feasibility study. It is designed to see if it is possible to undertake a large, randomised trial. It will explore how participants are recruited, kept in the study and how easy it is to follow the study protocol. Aim of the study Establish the feasibility of a corresponding full scale investigation into to the effectiveness of a toe divider made from Otoform for patients with DM following an LTA. Study Design 1. Participants will be recruited from Mid Yorkshire NHS teaching Hospital. 2. Participants will be randomised to receive either standard care or an otoform toe divider. 3. Participants age, gender, medical history, medication and blood sugar levels will be recorded. 4. Vascular and neurological assessments, foot posture and toe deformities will be undertaken and recorded. 5. All participants will have pressures measured on the plantar aspects of both feet. 6. Follow up visits will be arranged every 6 weeks for12 months for all participants to monitor foot health and changes in walking pattern and pressure redistribution. 7. If an ulceration or other foot complication occurs, the participants will be removed from the study and appropriate treatment given (the rescue arm of the study).