Clawed toes in the diabetic foot: neuropathy, intrinsic muscle volume, and plantar aponeurosis thickness

Abstract

Table 1: Intrinsic muscle volume (mean ± SD) claw toes yes claw toes no neuropathy yes 0.130 ± 0.037 0.191 ± 0.008 neuropathy no 0.198 ± 0.018 0.192 ± 0.034 Publish with Bio Med Central and every scientist can read your work free of charge "BioMed Central will be the most significant development for disseminating the results of biomedical researc h in our lifetime.

Intrinsic foot muscle and plantar tissue changes in type 2 diabetes mellitus

“…A study conducted by Ledoux et al . found that a neuropathic foot with claw toes has less intrinsic muscle volume than non‐neuropathic groups and suggested that both intrinsic muscle atrophy and plantar fascia dysfunction lead to the development of claw toes.…”

“…A study conducted by Ledoux et al 15 found that a neuropathic foot with claw toes has less intrinsic muscle volume than non-neuropathic groups and suggested that both intrinsic muscle atrophy and plantar fascia dysfunction lead to the development of claw toes. Even then, Bus et al 21 concluded that intrinsic muscle atrophy and muscle imbalance are significant for the development of claw toe deformity in the diabetic foot.…”

“…14 It has been shown that patients with T2DM present with intrinsic foot muscle atrophy, which further develops to claw toe deformity. 15 Several imaging techniques, such as conventional radiography, computed tomography, magnetic resonance imaging (MRI), and ultrasonography, have been used to study the diabetic foot. Ultrasonography is considered to be a less time-consuming, effective method for the evaluation of the thickness and cross-sectional area (CSA) of soft tissues in subjects with T2DM.…”

“…Therefore, maintaining adequate intrinsic foot muscle strength is really important for effective execution of natural processes of daily living . It has been shown that patients with T2DM present with intrinsic foot muscle atrophy, which further develops to claw toe deformity …”

Plantar Loading Reflects Ulceration Risks of Diabetic Foot with Toe Deformation

“…At least 15% of these ulcerations would lead to some forms of foot amputation. Previous study found that early diabetic foot tends to be toes deformities [ 7 – 9 ] and imbalance in the muscles to the foot or lower extremity [ 10 ], then causing abnormal plantar pressure [ 11 ]. When the lesion or dysfunction of the human foot structure and human locomotion ability deteriorated, plantar pressure and foot loading distribution would change consequently [ 12 , 13 ].…”