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

NewsBot · Jun 25, 2016

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Differences in the mechanical characteristics of plantar soft tissue between ulcerated and non-ulcerated foot.
Naemi R et al
J Diabetes Complications. 2016 Jun 8

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.
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NewsBot · Feb 24, 2022

A quantitative comparison of plantar soft tissue strainability distribution and homogeneity between ulcerated and non-ulcerated patients using ultrasound strain elastography
Mayank Patwari et al
Proc Inst Mech Eng H. 2022 Feb 24

The primary objective of this study was to develop a method that allows accurate quantification of plantar soft tissue stiffness distribution and homogeneity. The secondary aim of this study was to investigate if the differences in soft tissue stiffness distribution and homogeneity can be detected between ulcerated and non-ulcerated foot. Novel measures of individual pixel stiffness, named as quantitative strainability (QS) and relative strainability (RS) were developed. Strain Elastography data obtained from 39 (nine with active diabetic foot ulcers) patients with diabetic neuropathy. The patients with active diabetic foot ulcer had wound in parts of the foot other than the first metatarsal head and the heel where the elastography measures were conducted. RS was used to measure changes and gradients in the stiffness distribution of plantar soft tissues in participants with and without active diabetic foot ulcer. The plantar soft tissue homogeneity in superior-inferior direction in the left forefoot was found to be significantly (p < 0.05) higher in ulcerated group compared to non-ulcerated group. The assessment of homogeneity showed potentials to further explain the nature of the change in tissue that can increase internal stress. This can have implications in assessing the vulnerability to plantar soft tissue damage and ulceration in diabetes.
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