Hyperkeratosis and foot kinematics

NewsBot · Feb 10, 2011

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Foot kinematics in patients with two patterns of pathological plantar hyperkeratosis
Andrew H Findlow, Christopher J Nester and Peter Bowker
Journal of Foot and Ankle Research 2011, 4:7doi:10.1186/1757-1146-4-7
Published: 9 February 2011

Background
The Root paradigm of foot function continues to underpin the majority of clinical foot biomechanics practice and foot orthotic therapy. There are great number of assumptions in this popular paradigm, most of which have not been thoroughly tested. One component supposes that patterns of plantar pressure and associated hyperkeratosis lesions should be associated with distinct rearfoot, mid foot, first metatarsal and hallux kinematic patterns. Our aim was to investigate the extent to which this was true.

Methods
Twenty-seven subjects with planter pathological hyperkeratosis were recruited into one of two groups. Group 1 displayed pathological plantar hyperkeratosis only under metatarsal heads 2, 3 and 4 (n=14). Group 2 displayed pathological plantar hyperkeratosis only under the 1st and 5th metatarsal heads (n=13). Foot kinematics were measured using reflective markers on the leg, heel, midfoot, first metatarsal and hallux.

Results
The kinematic data failed to identify distinct differences between these two groups of subjects, however there were several subtle (generally <3degrees) differences in kinematic data between these groups. Group 1 displayed a less everted heel, a less externally rotated heel and a more plantarflexed heel compared to group 2, which is contrary to the Root paradigm.

Conclusions
There was some evidence of small differences between planter pathological hyperkeratosis groups. Nevertheless, there was too much similarity between the kinematic data displayed in each group to classify them as distinct foot types as the current clinical paradigm proposes.
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NewsBot · Jun 5, 2023

Correlation between the foot pressure index and the prevalence of plantar hyperkeratosis
Raquel Sánchez-Rodríguez et al
J Tissue Viability. 2023 May 29

Background: Plantar hyperkeratosis (HK) is a very prevalent foot lesion formed due to an alteration in the keratinisation process, thereby increasing keratynocites and accumulating multiple layers of the stratum corneum that leads to plantar pain. As foot shape and plantar pressures is related with their appearance, the aim of this study is to examine how foot posture and plantar pressure influence the appearance of this keratopathy.

Material and methods: On a sample of 400 subjects (201 men and 199 women), the plantar pressures were evaluated by the Footscan® platform in 10 zones. The clinical exploration consisted in the valuation of the Foot Posture Index (FPI), and the assessment of the appeerance (and location) or not of plantar calluses or hyperkeratosis.

Results: 6.3% of the feet presented a highly supinated FPI, 15.5% were supinated, 57.3% corresponded to neutral, 17.3% were pronated and 3.8% were highly pronated. The participants with HK on the hallux, on the 1st, 2nd, 3rd or 5th MTH or on the lateral heel had a significantly higher pressure index (p < 0.001), ranging from 24.3 to 44% higher than those with no such alteration. Of the highly pronated feet, 66.7% presented HK in the hallux, while 32.3% of the supinated feet and 60% of the highly supinated feet presented it beneath the first MTH.

Conclusion: Foot posture influences the appearance of HK, though its association with plantar pressures. The participants with HK presented a mean foot pressure that was 32.3% higher than in those with no such condition. These values can be considered predictive for the appearance of HK and should be indicative of the need for preventive treatment.
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