Differences in the mechanical characteristics of plantar soft tissue between ulcerated and non-ulcerated foot

Naemi, Roozbeh; Chatzistergos, Panagiotis; Sundar, Lakshmi; Chockalingam, Nachiappan; Ramachandran, Ambadi

Abstract

Aims
The purpose of this study was to investigate the differences in mechanical properties of the plantar soft tissue between the ulcerated and non-ulcerated feet in patients with diabetic neuropathy.

Methods
Thirty nine patients who met the inclusion criteria participated in this study. Ten out of 39 participants had an active ulcer at a site other than the plantar heel and the first metatarsal head. Real time ultrasound elastography was performed to measure the soft tissue thickness and stiffness of the heel pad and sub-metatarsal fat pad. To account for the qualitative nature of conventional real time elastography, relative tissue stiffness was assessed against that of a standardised ultrasound standoff material.

Results
The results indicated that the ulcerated group had a significantly lower heel pad relative stiffness (t (37) = 2.559, P = 0.015, η2 = 0.150) in the left foot.

Conclusions
The observed difference in the stiffness of the heel pad between the ulcerated and non-ulcerated feet indicates a possible link between tissue mechanics and ulceration. Further analysis of the data proposed in this study provided a quantitative assessment of plantar fat pad deformability which can contribute to understanding the role of tissue biomechanics in ulceration.

Citation

Naemi, R., Chatzistergos, P., Sundar, L., Chockalingam, N., & Ramachandran, A. (2016). Differences in the mechanical characteristics of plantar soft tissue between ulcerated and non-ulcerated foot. Journal of Diabetes and its Complications, 30(7), 1293-1299. https://doi.org/10.1016/j.jdiacomp.2016.06.003

• Journal Article Type: Article
• Acceptance Date: Jun 6, 2016
• Online Publication Date: Aug 11, 2016
• Publication Date: 2016-09
• Deposit Date: Apr 14, 2024
• Journal: Journal of Diabetes and its Complications
• Print ISSN: 1056-8727
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 30
• Issue: 7
• Pages: 1293-1299
• DOI: https://doi.org/10.1016/j.jdiacomp.2016.06.003