Biomechanical Risk Factors Associated with Neuropathic Ulceration of the Hallux in People with Diabetes Mellitus

Journal of the American Podiatric Medical Association - Tập 96 Số 3 - Trang 189-197 - 2006
Vanessa L Nubé1,2, Lynda Molyneaux1, Dennis K. Yue1,2
1Diabetes Centre, Royal Prince Alfred Hospital, Sydney, Australia
2Discipline of Medicine, University of Sydney, Sydney, Australia

Tóm tắt

In this study of people with diabetes mellitus and peripheral neuropathy, it was found that the feet of patients with a history of hallux ulceration were more pronated and less able to complete a single-leg heel rise compared with the feet of patients with a history of ulceration elsewhere on the foot. The range of active first metatarsophalangeal joint dorsiflexion was found to be significantly lower in the affected foot. Ankle dorsiflexion, subtalar joint range of motion, and angle of gait differed from normal values but were similar to those found in other studies involving diabetic subjects and were not important factors in the occurrence of hallux ulceration. These data indicate that a more pronated foot type is associated with hallux ulceration in diabetic feet. Further studies are required to evaluate the efficacy of footwear and orthoses in altering foot posture to manage hallux ulceration. (J Am Podiatr Med Assoc 96(3): 189–197, 2006)

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Tài liệu tham khảo

Pecoraro RE, Reiber GE, Burgess EM: Pathways to diabetic limb amputation: basis for prevention. .Diabetes Care13::513. ,1990. .2351029

Reiber GE: “Epidemiology of Foot Ulcers and Amputations in the Diabetic Foot,” in The Diabetic Foot, 6th Ed, ed by JH Bowker and MA Pfeifer, p 13, CV Mosby, St Louis. ,2001. .10.1002/dme.1996.13.s1.6

Lavery LA, Armstrong DG, Quebedeaux TL, et al: Practical criteria for screening patients at high risk for diabetic foot ulceration. .Arch Intern Med158::157. ,1998. .9448554

Cavanagh PR, Ulbrecht JS, Caputo GM: Biomechanical aspects of diabetic foot disease: aetiology, treatment, and prevention. .Diabet Med13::S17. ,1996. .8741823

Armstrong DG, Lavery LA, Harkless LB: Validation of a diabetic wound classification system: the contribution of depth, infection, and ischaemia to risk of amputation. .Diabetes Care21::855. ,1998. .9589255

Lavery LA, Lavery DC, Quebedeax-Farnham TL: Increased foot pressures after great toe amputation in diabetes. .Diabetes Care18::1460. ,1995. .8722070

Quebedeaux TL, Lavery DC, Lavery LA: The development of foot deformities and ulcers after great toe amputation in diabetes. .Diabetes Care19::165. ,1996. .8718439

Murdoch DP, Armstrong DG, Dacus JB, et al: The natural history of great toe amputations. .J Foot Ankle Surg36::204. ,1997. .9232500

Greteman B, Dale S: Digital amputations in neuropathic feet. .JAPMA80::120. ,1990. .

Morag E, Cavanagh PR: Structural and functional predictors of regional peak pressures under the foot during walking. .J Biomech32::359. ,1999. .10213026

Payne C, Turner D, Miller K: Determinants of plantar pressures in the diabetic foot. .J Diabetes Complications16::277. ,2002. .12126786

Mueller MJ, Hastings M, Commean PK, et al: Forefoot structural predictors of plantar pressures during walking in people with diabetes and peripheral neuropathy. .J Biomech36::1009. ,2003. .12757810

Ledoux WR, Hillstrom HJ: The distributed plantar vertical force of neutrally aligned and pes planus feet. .Gait Posture15::1. ,2002. .11809575

Stacpoole-Shea S, Shea G, Lavery L: An examination of plantar pressure measurements to identify the location of diabetic foot ulceration. .J Foot Ankle Surg38::109. ,1999. .10334697

Bevans JS: Biomechanics and plantar ulcers in diabetes. .The Foot2::166. ,1992. .

Boffeli TG, Bean JK, Natwick JR: Biomechanical abnormalities and ulcers of the great toe in patients with diabetes. .J Foot Ankle Surg41::359. ,2002. .12500786

Dannels E: Neuropathic foot ulcer prevention in diabetic American Indians with hallux limitus. .JAPMA79::447. ,1989. .

Birke J, Cornwall MA, Jackson M: Relationship between hallux limitus and ulceration of the great toe. .Sports Phys Ther J Orthop10::172. ,1988. .

Rome K: Ankle joint dorsiflexion measurement studies: a review of the literature. .JAPMA86::205. ,1996. .

Diamond JE, Mueller MJ, Delitto A, et al: Reliability of a diabetic foot evaluation. .Phys Ther69::797. ,1989. .2780806

Baggett BD, Young G: Ankle dorsiflexion: establishment of a normal range. .JAPMA83::542. ,1993. .

Moseley AM, Crosbie J, Adams R: Normative data for the passive ankle plantarflexion-dorsiflexion flexibility. .Clin Biomech16::514. ,2001. .

Root ML, Orien WP, Weed JH, et al: Biomechanical Examination of the Foot, Vol 1, Clinical Biomechanics Corp, Los Angeles. ,1971. .

Astrom M, Arvidson T: Alignment and joint motion in the normal foot. .J Orthop Sports Phys Ther22::216. ,1995. .8580949

Buell T, Green DR, Risser J: Measurement of the first metatarsophalangeal joint range of motion. .JAPMA78::439. ,1988. .

Mann R: The function of toes in walking, jogging, and running. .Clin Orthop Relat Res142::24. ,1979. .

Bevans JS, Bowker P: Foot structure and function: aetiological risk factors for callus formation in diabetic and non-diabetic subjects. .The Foot9::120. ,1999. .

Wilkinson MJ, Menz HB: Measurement of gait parameters from footprints: a reliability study. .The Foot7::19. ,1997. .

Evans AM, Copper AW, Scharfbillig RW, et al: Reliability of the Foot Posture Index and traditional measures of foot position. .JAPMA93::203. ,2003. .

Scharfbillig R, Evans AM, Copper AW, et al: Criterion validation of four criteria of the Foot Posture Index. .JAPMA94::31. ,2004. .

Redmond A, Burns J, Ouvrier R, et al: An initial appraisal of the validity of a criterion based, observational clinical rating system for foot posture [abstract]. .J Orthop Sports Physiother31::160. ,2001. .

Johnson KA: Tibialis posterior tendon rupture. .Clin Orthop Relat Res177::140. ,1983. .

Johnson KA, Strom DE: Tibialis posterior tendon dysfunction. .Clin Orthop Relat Res239::196. ,1989. .

Messier SP, Davies AB, Moore DT, et al: Severe obesity: effects on foot mechanics during walking. .Foot Ankle Int15::29. ,1994. .7981793

Kohls-Gatzoulis J, Dishan Singh JA: Tibialis posterior dysfunction as a cause of flatfeet in elderly patients. .The Foot14::207. ,2004. .

Snook AG: The relationship between excessive pronation as measured by navicular drop and isokinetic strength of the ankle musculature. .Foot Ankle Int22::234. ,2001. .11310866

Hicks JH: The mechanics of the foot: part 2. The plantar aponeurosis and the arch. .J Anat88::25. ,1954. .13129168

Payne CB, Dananberg HJ: Sagittal plane facilitation of the foot. .Australas J Podiatr Med31::7. ,1997. .

Dananberg HJ: Sagittal plane biomechanics. .JAPMA90::47. ,2000. .

Shrader JA, Lohmann Siegel K: Nonoperative management of functional hallux limitus in a patient with rheumatoid arthritis. .Phys Ther83::831. ,2003. .12940769

Armstrong DG, Lavery LA, Vazquez JR, et al: Clinical efficacy of the first metatarsophalangeal joint arthroplasty as a curative procedure for hallux interphalangeal joint wounds in patients with diabetes. .Diabetes Care26::3248. ,2003. .

Rosenblum BI, Giurini JM, Habershaw GM: Preventing loss of the great toe with hallux interphalangeal joint arthroplasty. .J Foot Ankle Surg33::557. ,1994. .7894401

Mueller MJ, Sinacore DR, Hastings MK, et al: Effect of Achilles tendon lengthening on neuropathic plantar ulcers: a randomized clinical trial. .J Bone Joint Surg Am85::1436. ,2003. .12925622

Armstrong DG, Stacpoole-Shea S, Nguyen H, et al: Lengthening of the Achilles tendon in diabetic patients who are at high risk for ulceration of the foot. .J Bone Joint Surg Am81::535. ,1999. .10225799

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Journal of the American Podiatric Medical Association

Tập 96 Số 3

189-197

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