T. Brink et E. Chantelau, INDURATION OF THE DIABETIC FOOT PAD - ANOTHER RISK FACTOR FOR RECURRENT NEUROPATHIC PLANTAR ULCERS, Biomedizinische Technik, 40(7-8), 1995, pp. 205-209
Ten diabetic feet with polyneuropathy and a history of recurrent plant
ar ulcers were assessed for soft tissue abnormalities of the plantar p
ad, in comparison with non-diabetic control feet. Plantar pad thicknes
s and hardness were measured at the metatarsal heads. In addition, joi
nt mobility was assessed by measuring the passive dorsal flexion of th
e metatarsophalangeal joints, and peak plantar pressures were studied
during walking. The results showed slightly less joint mobility and th
inner plantar pads in the diabetics as compared with control subjects;
however, the differences failed to reach statistical significance. So
ft tissue hardness at the heel was also comparable in patients and con
trols. At the sites of previous plantar ulcers over the metatarsal joi
nts, soft tissue was significantly harder than at other sites in the s
ame feet or in the control feet; peak plantar pressure at two metatars
al heads was higher in the diabetic feet than in the control feet (p <
0.05). Induration of the periarticular soft tissue may predispose to
recurrent foot ulcers in diabetics by decreasing the shock-absorption
capacity of the plantar pad.