Vertical forces acting on the feet of diabetic patients with neuropathic ulceration

Author:

Ctercteko G C12,Dhanendran M12,Hutton W C12,Quesne L P Le12

Affiliation:

1. Department of Surgical Studies, The Middlesex Hospital, London

2. The Division of Engineering, Polytechnic of Central London, London

Abstract

Summary The vertical forces acting on the sole of the foot in walking have been measured in 24 diabetic patients with neuropathic ulceration of the foot using a load-sensitive surface divided into 128 load cells, and compared with those in two groups of controls: (a), 21 diabetic patients with peripheral neuropathy but no ulceration and (b) 47 normal individuals. The results showed that the patients with neuropathic ulceration were significantly heavier, that diabetic patients with neuropathy, with or without ulceration, transmitted proportionally less force through the toes than normal individuals, and showed a medial shift of the force transmitted through the metatarsal heads. All plantar ulcers occurred at the site of maximum loading. The absolute force at the site of maximum loading was significantly greater in the patients with ulcers than in both control groups, though there was a considerable overlap. A significant difference remained even when the absolute force had been corrected for differences in toe loading and body weight, indicating that a further factor (or factors) must contribute to the development of these localized areas of high loading.

Funder

Department of Health and Social Security

Medical Research Council

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference6 articles.

1. Neuropathy and diabetic pressure lesions;Barrett;Orthop. Clin. North Am.,1973

2. The neuropathic ulcer and loads on the foot in diabetic patients;Stokes;Acta Orthop. Scand.,1975

3. The distribution of force under the human foot. An on-line measuring system;Dhanendran;Measurement Control,1978

4. Method of measuring ‘shearing’ forces on the sole of the foot;Tappin;Clin. Phys. Physiol. Measurement,1980

5. Microangiopathy and diabetic gangrene;Farris;Br. Med. J.,1977

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