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Altered heel‐pad mechanical properties in patients with Type 2 diabetes mellitus
Author(s) -
Hsu T. C.,
Wang C. L.,
Shau Y. W.,
Tang F. T.,
Li K. L.,
Chen C. Y.
Publication year - 2000
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2000.00394.x
Subject(s) - medicine , forefoot , heel , diabetes mellitus , type 2 diabetes mellitus , diabetic foot , surgery , complication , endocrinology , anatomy
SUMMARYAims To compare the heel‐pad mechanical properties in patients with Type 2 diabetes mellitus with forefoot ulceration, without forefoot ulceration and age‐matched healthy subjects. Methods Heel‐pad mechanical properties in 40 heels of 20 healthy subjects (group I) age‐matched with the other groups, 42 heels of 21 diabetic patients without forefoot ulceration (group II), and 14 heels of 12 diabetic patients with active forefoot ulceration (group III) were assessed using a self‐constructed loading–unloading device and a 10‐MHz linear‐array ultrasound transducer. Results There were no differences in the unloaded heel‐pad thickness, compressibility index and elastic modulus between the three groups. When compared with group I subjects (mean ± sd , 27.9 ± 6.1%), a significant increase ( P < 0.001) was found in both group II (36.1 ± 8.7%) and group III patients (43.2 ± 6.6%) for the energy dissipation ratio. This ratio was also significantly different ( P = 0.003) between groups II and III. Conclusions The higher impact energy dissipated in the heel‐pad may put patients with Type 2 diabetes at higher risk for developing foot ulceration.