NEW YORK (Reuters Health) Mar 01 – Two structural complications are linked to the development of diabetic foot ulcers, but if corrected the problem can be minimized.
Researchers told attendees of the annual meeting of the American College of Foot and Ankle Surgeons, underway in Los Angeles, that by correcting a tight Achilles tendon and limited motion of the great toe, foot trauma and diabetic ulcers can be reduced or even eliminated.
Dr. Troy Boffeli, of Regions Hospital of St. Paul, reported that in the majority of cases of first diabetic ulcers, the problem is with abnormal biomechanics in the feet.
He and his colleagues selected 26 diabetic patients (33 feet) with a first ulcer on the first hallux. Nearly all ulcers were located on the medial plantar surface at the interphalangeal joint. The feet exhibited limited motion of the gastrocnemius and limited motion and some abduction of the hallux.
"The screening on first foot exam should include a biomechanical evaluation to identify the problem," Dr. Boffeli told Reuters Health. "You need to alleviate abnormal pressure [on the hallux] either conservatively or with surgery."
"Range of motion exercises are of limited benefit," Dr. Boffeli commented. "The patient needs modified foot gear or surgery." …
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