Abstract
High plantar pressures lead to ulceration in the diabetic foot, particularly in the forefoot region around the metatarsal heads. High plantar pressures persist during gait due to factors such as peripheral neuropathy, foot deformities, limited ankle dorsi flexion range of motion and reduced plantar tissue thickness. Strategies impinging upon gait such as the use of appropriate therapeutic footwear, custom-moulded insoles and injectable silicone can help to reduce plantar pressures and attenuate the risk for ulceration. Shoes adapted with external rocker profiles facilitate plantar flexion and restrict sagittal plane motion of the metatarsophalangeal joint, reducing pressures in the region of the metatarsal heads. Insoles custom-moulded to patients feet help to reduce plantar pressures and minimise the risk of ulceration in the forefoot region. The loss of subcutaneous fat tissue in the diabetic foot enhances bony prominences and predisposes the foot to high-pressure areas. Silicone is a biocompatible material that can be safely injected into plantar soft tissue to augment tissue thickness and prevent the development of ulceration. This enhancement to the subcutaneous layer is remarkably well retained and is a generally well-adopted procedure in the clinical setting.
Keywords: Footwear, Gait, Injectable silicone, Insoles, Plantar pressure, Plantar ulceration, Plantar pressure, Plantar tissue thickness, Plantar tissue thickness, Diabetic foot, Hammer toe, Hammer toe, Implantable biomaterial, Implantable biomaterial
Current Diabetes Reviews
Title: Gait-Related Strategies for the Prevention of Plantar Ulcer Development in the High Risk Foot
Volume: 7 Issue: 3
Author(s): Frank L. Bowling, Neil D. Reeves and Andrew J. Boulton
Affiliation:
Keywords: Footwear, Gait, Injectable silicone, Insoles, Plantar pressure, Plantar ulceration, Plantar pressure, Plantar tissue thickness, Plantar tissue thickness, Diabetic foot, Hammer toe, Hammer toe, Implantable biomaterial, Implantable biomaterial
Abstract: High plantar pressures lead to ulceration in the diabetic foot, particularly in the forefoot region around the metatarsal heads. High plantar pressures persist during gait due to factors such as peripheral neuropathy, foot deformities, limited ankle dorsi flexion range of motion and reduced plantar tissue thickness. Strategies impinging upon gait such as the use of appropriate therapeutic footwear, custom-moulded insoles and injectable silicone can help to reduce plantar pressures and attenuate the risk for ulceration. Shoes adapted with external rocker profiles facilitate plantar flexion and restrict sagittal plane motion of the metatarsophalangeal joint, reducing pressures in the region of the metatarsal heads. Insoles custom-moulded to patients feet help to reduce plantar pressures and minimise the risk of ulceration in the forefoot region. The loss of subcutaneous fat tissue in the diabetic foot enhances bony prominences and predisposes the foot to high-pressure areas. Silicone is a biocompatible material that can be safely injected into plantar soft tissue to augment tissue thickness and prevent the development of ulceration. This enhancement to the subcutaneous layer is remarkably well retained and is a generally well-adopted procedure in the clinical setting.
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Cite this article as:
L. Bowling Frank, D. Reeves Neil and J. Boulton Andrew, Gait-Related Strategies for the Prevention of Plantar Ulcer Development in the High Risk Foot, Current Diabetes Reviews 2011; 7 (3) . https://dx.doi.org/10.2174/157339911795843159
DOI https://dx.doi.org/10.2174/157339911795843159 |
Print ISSN 1573-3998 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6417 |
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