Abstract: Comparison of Pedal Soft Tissue Thickness Between Diabetics and Non-Diabetics

INTRODUCTION: Diabetic foot ulceration is known to be the result of multiple factors, including neuropathy, plantar pressure, shoe fit, and pedal soft tissue thickness. Excessive pressure is recognized to play a role by inducing ischemic change. There is no standardized normal value for pedal soft tissue thickness. In this study, we aimed to investigate the degree of pedal soft tissue atrophy due to diabetes and aging. METHODS: This retrospective study enrolled patients who underwent magnetic resonance imaging (MRI) of the foot at Dongsan Hospital in Keimyung University between 2009 and 2016. The participants were divided into two groups: Group I, patients who had diabetes for more than 10 years, and Group II, patients who did not have diabetes. Sex, age, and body mass index (BMI) were compared between groups. The thickness of pedal soft tissues was measured below the metatarsal head using MRI and compared between groups. RESULTS: Group I included 52 patients (33 males, 19 females) and Group II included 47 patients (24 males, 23 females). There was no significant difference in sex, age, and BMI between the two groups. The thickness of pedal soft tissue below the first to fourth metatarsal heads was significantly lower in Group I than in Group II (first metatarsal head, 6.4 mm vs. 8.69 mm [p=0.002]; second metatarsal head, 8.85 mm vs. 10.64 mm [p=0.006]; third metatarsal head, 8.15 mm vs. 9.21 mm [p=0.021]; fourth metatarsal head, 7.38 mm vs. 8.54 mm [p=0.016]; fifth metatarsal head, not significant [p=0.068]). Changes in soft tissue thickness did not significantly correlate with age. CONCLUSION: These results demonstrate a procedure for the measurement of pedal soft tissue atrophy in patients with diabetes. This method can be applied to determine normal reference ranges and to evaluate the extent of atrophy and its effect on ulceration.

Abstract licence: CC BY-NC-ND

A person counts once a day per paper. We keep no cookie and no address: a reader is a hash that changes every day. Any month under five reads shows no number.