Ankle equinus deformity and its relationship to high plantar pressure in a large population with diabetes mellitus.
Abstract
The authors undertook a study to evaluate the prevalence of ankle equinus and its potential relationship to high plantar pressure in a large, urban population with diabetes mellitus. The first 1,666 consecutive people with diabetes (50.3% male; mean [+/-SD] age, 69.1 +/- 11.1 years) presenting to a large, urban, managed-care outpatient clinic were enrolled in this longitudinal, 2-year outcomes study. Patients received a standardized medical and musculoskeletal assessment at the time of enrollment, including evaluation at an onsite gait laboratory. Equinus was defined as less than 0 degrees of dorsiflexion at the ankle. The overall prevalence of equinus in this population was 10.3%. Patients with equinus had significantly higher peak plantar pressures than those without the deformity and were at nearly three times greater risk for presenting with elevated plantar pressures. There were no significant differences in age, weight, or sex between the two groups. However, patients with equinus had a significantly longer duration of diabetes than those without equinus. Having a high index of suspicion for this deformity and subsequently addressing it through conservative or surgical means may help to reduce the risk of foot ulceration and amputation.
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Among patients with a new diabetic foot ulcer, those who had been seen by a podiatrist for preventive care in the year before ulcer development had a lower risk of major lower extremity amputation relative to those who had not seen a podiatrist in the past year (1.20% vs 1.84%; OR, 0.61; 95% CI, 0.51-0.72).
“Among patients with a new diabetic foot ulcer, those who had been seen by a podiatrist for preventive care in the year before ulcer development had a lower risk of major lower extremity amputation relative to those who had not seen a podiatrist in the past year(1.20%vs1.84%;OR,0.61[95%CI,0.51-0.72];P< .001).27”
From Diabetic Foot Ulcers (2023) · cites this paper as [27]
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Deldar, R., Merle, C., Attinger, C. E., & Evans, K. K. (2022) · Plastic and Aesthetic Research · doi:10.20517/2347-9264.2021.100 · Cited by 13 · see citing works
Jenkins, D. W., Cooper, K. E., & Heigh, E. G. (2014) · The Foot · doi:10.1016/j.foot.2014.09.001 · Cited by 12 · see citing works
Is there still a place for Achilles tendon lengthening?
Tagoe, M., Reeves, N. D., & Bowling, F. L. (2015) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2745 · Cited by 12 · see citing works
Endoscopic Recession of the Gastrocnemius Tendon
Phisitkul, P., Barg, A., & Amendola, A. (2017) · Foot & Ankle International · doi:10.1177/1071100717695108 · Cited by 12 · see citing works
Pressure Redistribution Strategies for the Diabetic or At-Risk Foot: Part I
McGuire, J. (2006) · Advances in Skin & Wound Care · doi:10.1097/00129334-200605000-00015 · Cited by 12 · see citing works
Surgical management of Charcot foot – The advancements over the past decade
Khan, O., Kavarthapu, M., EDMONDS, M. E., & Kavarthapu, V. (2023) · Journal of Clinical Orthopaedics and Trauma · doi:10.1016/j.jcot.2023.102317 · Cited by 11 · see citing works
Niu, W., Chu, Z., Yao, J., Zhang, M., Fan, Y., & Zhao, Q. (2011) · Journal of Mechanics in Medicine and Biology · doi:10.1142/s0219519412005113 · Cited by 11 · see citing works
The Biomechanics of Diabetes Mellitus and Limb Preservation
Labovitz, J. M., & Day, D. (2019) · Clinics in Podiatric Medicine and Surgery · doi:10.1016/j.cpm.2019.08.011 · Cited by 11 · see citing works
Carl, T., & Barrett, S. L. (2005) · The Foot · doi:10.1016/j.foot.2005.05.001 · Cited by 11 · see citing works
Charcot Reconstruction: Outcomes in Patients With and Without Diabetes
Cates, N. K., Wagler, E. C., Bunka, T. J., Elmarsafi, T., Tefera, E. A., Kim, P. J., Liu, G. T., Evans, K. K., Steinberg, J. S., & Attinger, C. E. (2020) · The Journal of Foot & Ankle Surgery · doi:10.1053/j.jfas.2020.05.019 · Cited by 10 · see citing works
Complications and Salvage of Elective Central Metatarsal Osteotomies
Derner, R., & Meyr, A. J. (2009) · Clinics in Podiatric Medicine and Surgery · doi:10.1016/j.cpm.2008.09.003 · Cited by 10 · see citing works
Lepesis, V., Paton, J. S., Rickard, A., Latour, J. M., & Marsden, J. F. (2023) · Journal of Foot and Ankle Research · doi:10.1186/s13047-023-00690-4 · Cited by 9 · see citing works
Gatt, A., Giorgio, S. D., Chockalingam, N., & Formosa, C. (2017) · The Foot · doi:10.1016/j.foot.2017.01.002 · Cited by 9 · see citing works
Friction blisters on the feet: A critical assessment of current prevention strategies
Rushton, R., & Richie, D. H. (2023) · Journal of Athletic Training · doi:10.4085/1062-6050-0341.22 · Cited by 8 · see citing works
- Authors
- Lavery, L. A., Armstrong, D. G., & Boulton, A. J. M.
- Affiliations
- Loyola University Chicago (US)
- Manchester Royal Infirmary (GB)
- University of Miami (US)
- Venue
- Journal of the American Podiatric Medical Association
- Publisher
- MDPI AG
- Published
- 2002-10
- Volume
- 92
- Issue
- 9
- Pages
- 479-482
- ISSN
- 1930-8264 (ISSN-L)
- 8750-7315
- OpenAlex
- W2027846313
- Cited by
- 196
- References
- 12
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 3 · 2023: 8 · 2022: 14 · 2021: 5 · 2020: 11 · 2019: 15 · 2018: 9 · 2017: 9 · 2016: 8 · 2015: 15 · 2014: 8 · 2013: 8 · 2012: 12
- FWCI
- 1.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American Podiatric Medical Association (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Keywords
- plantar pressure, diabetes mellitus, prevalence, foot ulcer, amputation risk, ankle dorsiflexion, diabetes duration, gait analysis, diabetic foot
- MeSH terms
- Aged, Aged, 80 and over, Awards and Prizes, Diabetes Mellitus, Equinus Deformity, Female, Foot, Humans, Longitudinal Studies, Male, Pressure, Risk Factors, Prevalence, Diabetes Complications
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