A 5.07 (10-g) monofilament is used as a screening tool to assess for changes in a patient’s loss of protective sensation (fig. 1), particularly of large fiber nerve function. Step 1: after demonstrating the sensation on your arm, ask the patient to close their eyes. Step 2: ask patient to respond with “yes” and tell you the location when they feel the monofilament applied on that particular site. Step 3: place the monofilament perpendicular to the skin and apply pressure until the monofilament buckles into a c-shape. Step 4: Release the monofilament immediately after 1 second. Step 5: Move onto the next location (should be different locations on each foot, fig 2).
Andrew J.M. Boulton, David G. Armstrong, Stephen F. Albert, Robert G. Frykberg,Richard Hellman, M. Sue Kirkman, Lawrence A. Lavery, Joseph W. LeMaster, Joseph L. Mills, Michael J. Mueller, Peter Sheehan, Dane K. Wukich. “Comprehensive Foot Examination and Risk Assessment.” Diabetes Care Aug 2008, 31 (8) 1679-1685; DOI: 10.2337/dc08-9021