The goal of this clinical trial is to compare wound healing and foot related outcomes in people with plantar diabetic foot ulcer using Total contact cast (TCC) or Posterior slab cast (PSC). Ninety-nine people with neuropathic DFUs were randomized to use TCC (n=51) or PSC (n=48) together with standard of care for up to 6 months.

Researchers will compare rate of healing of ulcer at the end of 6 months, percentage reduction in the surface area, time taken to heal and patient satisfaction.

Participants will:

• Use TCC or PSC as off-loading till the ulcer heals for upto 6 months
• Visit the clinic once every 2 weeks for follow ups when inspection of the wound will be done for wound dressing, wound debridement and infection control when necessary

Inclusion Criteria:

• People with diabetes
• a single neuropathic plantar DFU
• Ulcer belonging to Wagner grade 2 and 3

Exclusion Criteria:

• Persons with bilateral DFUs
• gout
• peripheral arterial disease (ABPI <0.8)
• stage 4 and 5 chronic kidney disease [estimated glomerular filtration rate (eGFR) <30 ml/min/m2]
• active Charcot arthropathy
• history of steroid intake within the past 3 months