Article

Diabetes mellitus causes a multitude of complications. Foot
ulceration is one complication with serious consequences, amputation. Foot
deformities contribute to ulcer development. It would be advantageous to
ascertain whether foot deformities are preventable as their presence increases
amputation risk. OBJECTIVES: The objectives were to understand the development of
foot deformities in diabetes and explore their biomechanical effects. STUDY DESIGN: Literature review. METHODS: In February 2014 CINAHL, Embase, Ovid and
Medline were searched. Studies in English of adults with Diabetes that reported
neuropathy, foot deformities or associated gait abnormalities were included for
review. All study designs were considered. The articles' quality was considered
high overall, assessed using SIGN and CARS. RESULTS: In total, 17 studies were
reviewed. The main themes identified in relation to foot deformities were nerve
function, intrinsic foot muscles, muscle weakness and limited joint mobility.
Nerve function and intrinsic foot muscle atrophy did not display definitive
associations with foot deformities. However, muscle weakness and limited joint
mobility were associated with foot deformities, although the relationship is
still unclear. CONCLUSION: The development of common foot deformities in diabetes
is not well understood. The literature did not support the common belief that
motor neuropathy, atrophy and muscle imbalance cause foot deformities. CLINICAL
RELEVANCE: An understanding of the aetiology of foot deformities in diabetes
mellitus may allow for pro-active management of the foot in anticipation of the
development of foot deformities and ulceration. If the aetiology of deformity was
established preventative treatment may reduce the incidence of foot deformities
and resultant ulcerations and amputations.
CI - (c) The International Society for Prosthetics and Orthotics 2015.

Langue : ANGLAIS