The Efficacy of Orthopedic Shoes for Reduction of High Plantar Pressure and Prevention of Diabetic Gangrene in Patients with Diabetic Neuropathy and Foot Deformities. Usefulness of In-Shoe Plantar Pressures MeasurementSystem (F-SCAN).

DOI 7 Citations 28 References
  • Kanamori Akira
    Department of Internal Medicine, Kitasato University School of Medicine
  • Aoki Chikara
    Faculty of Rehabilitation, Kitasato University School of Allied Health Sciences
  • Umezawa Shinichi
    Department of Internal Medicine, Kitasato University School of Medicine
  • Jin Yasuyuki
    Department of Internal Medicine, Kitasato University School of Medicine
  • Yajima Yoshitada
    Department of Internal Medicine, Kitasato University School of Medicine

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Other Title
  • 糖尿病性足病変患者に対する足底圧分布測定に基づいた整形外科的矯正靴の作製と評価　　Ｆ‐ＳＣＡＮシステムの有用性
  • Usefulness of In-Shoe Plantar Pressures Measurement System (F-SCAN)
  • F-SCANシステムの有用性

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Abstract

Foot deformities in diabetic patients lead to high plantar pressure, which is a risk factor for foot gangrene in diabetic patients with neuropathy. Reduction and redistribution of these high plantar pressures is important in the prevention of diabetic gangrene.<BR>We measured in-shoe dynamic plantar pressures using the foot pressure measurement system, F-SCAN (Tek-Scan Inc., USA), in twelve healthy subjects and two patients with diabetic neuropathy and severely deformed foot shape. The two patients, both of whom had NIDDM, were a 48-year-old salesman with Charcot joint and a 52-year-old housewife with prominent metatarsal heads after amputation of a great toe. Dynamic plantar pressures were measured when the subjects walked wearing their own ordinary shoes with the F-SCAN sensors attached to the insoles.<BR>Plantar pressures were abnormally high in both patients and followed a pattern of distribution different from that observed in normal subjects. The orthopedic shoes were specially designed to reduce these high plantar pressures. The abnormal patterns of plantar pressures during walking were dramatically improved in the orthopedic shoes. The orthopedic shoes prevented diabetic gangrene in the male patient, but the female patient had recurrent gangrene despite the use of the orthopedic shoes. Wearing a pair of cushioned-slippers to reduce high pressures during walking and standing was useful for the suppression of callosities in the metatarsal heads. Diabetic patients with foot deformities, especially Japanese patients who usually do not wear shoes at home, should wear cushioned-footwear to reduce high plantar pressures.

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