Yaser medical student 2nd year : a 50 years old patient 2 years ago he is paralyzed on left side, he has a wound on his right toe which does not heal?

Wound: This is far too complex to answer without a full work up and investigation into his vascular status, his pressure distribution and any type of bracing secondary to the paralysis and possibly infection.

Chronic toe ulcer: L-side hemiplegia causes rigid contracture of the great toe. The wound on the great toe doesn't heal b/c it keeps rubbing either on the shoebox or the floor, depending if it is on top or in the bottom. Tx would consist of offloading the foot or correction of the contracture (depending on the type of paralysis, umn or lmn). This can be done thru conservative tx or surgical tx (tal + toe fusion).