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Bulevar M. Lalića 4/18, Podgorica
RISK FACTORS FOR DIABETIC FOOT ULCERATION-FOOT DEFORMITY AND NEUROPATHY
Clinic for Physical Medicine and Rehabilitation, Clinical Center Crna Gora, Podgorica, Crna Gora
Interaction of the sequels of neuropathy in the foot leads to ulcers and leg amputations in individuals with diabetes mellitus. The purpose of this study was to explore the relationship between neuropathy, foot deformity, plantar pressure and limited joint mobility for predicting the occurrence of ulcers. A total of 20 patients, with mean age of 61 years and duration of diabetes type 2 of 12,5 (SD 6,54) years, participated in the prospective study. Inclusion factors were neuropathy, which was defined by electrophysiological examinations, and foot deformity. At follow-up, the patients were examined by performing: neuropathy disability score (NDS), measurement of the first metatarsophalangeal joint and ankle joint range of motion, estimation of foot deformity and application of 10-g monofilaments. Plantar foot pressure was measured using Rothbaler Scan System. We noted the NDS score 7,7 and SD 1,66.
A significant association was found between limited mobility of the first metatarsophalangeal joint ( MTPH 1) and claw great toe deformity (75%).
The loss of protective sensation is defined as insensitivity in the great toe, the first, the second and the third metatarsal heads (MTH 1, MTH 2, MTH 3). There was a significant interaction between peak plantar pressure and insensitivity in the region of the great toe and MTH 1 and MTH 3 (87%: 100%), p< 0,05.
Neuropathy, foot deformity, plantar pressure and limited joint mobility are significant risk factors for development of foot ulceration. Acta Medica Medianae 2010;49(4):19-22.
Key words: diabetes, plantar pressure, peripheral neuropathy