Ledoux William R, Shofer Jane B, Smith Douglas G, Sullivan Katrina, Hayes Shane G, Assal Mathieu, Reiber Gayle E
Department of Veterans Affairs (VA), Rehabilitation Research and Development Center of Excellence for Limb Loss Prevention and Prosthetic Engineering, VA Puget Sound Health Care System, Seattle, WA 98108, USA. wrledoux @u.washington.edu
J Rehabil Res Dev. 2005 Sep-Oct;42(5):665-72. doi: 10.1682/jrrd.2004.11.0144.
We hypothesized an association between foot type, foot deformity, and foot ulceration and conducted an analysis of a well-characterized, high-risk diabetic population of 398 subjects. The average age was 62 years of age and 74% of the study population were males. Foot-type distributions were 19.5% pes cavus (high arch), 51.5% neutrally aligned (normal arch), and 29.0% pes planus (low arch). We quantified the presence of hallux valgus (23.9%), hammer/claw toes (46.7%), and hallux limitus (24.4%). A significant association was found between foot type and hallux valgus (p = 0.003); pes planus feet had the highest prevalence as compared with neutrally aligned feet (odds ratio [OR] = 2.43, p = 0.0006). Foot type was also significantly associated with fixed hammer/claw toes (p = 0.01); pes cavus feet had the highest prevalence as compared with neutrally aligned feet (OR = 3.89, p = 0.001). Foot type was also significantly associated with hallux limitus (p = 0.006) with pes planus feet having the highest prevalence as compared with neutrally aligned feet (OR = 2.19, p = 0.003). However, foot type was not significantly related to any ulcer outcome (p = 0.7). Fixed hammer/claw toes (OR = 3.91, p = 0.003) and hallux limitus (OR = 3.02, p = 0.006) were associated with increased risk of any ulcer occurrence. This study affirms that foot type and foot deformity are related and that foot deformities are associated with ulcer occurrence.
我们假设足型、足部畸形与足部溃疡之间存在关联，并对398名特征明确的高危糖尿病患者进行了分析。平均年龄为62岁，研究人群中74%为男性。足型分布为：高弓足19.5%，正常足弓51.5%，扁平足29.0%。我们对拇外翻（23.9%）、锤状趾/爪形趾（46.7%）和拇趾僵硬（24.4%）的情况进行了量化。发现足型与拇外翻之间存在显著关联（p = 0.003）；与正常足弓的脚相比，扁平足的患病率最高（优势比[OR]=2.43，p = 0.0006）。足型与固定性锤状趾/爪形趾也存在显著关联（p = 0.01）；与正常足弓的脚相比，高弓足的患病率最高（OR = 3.89，p = 0.001）。足型与拇趾僵硬也存在显著关联（p = 0.006），与正常足弓的脚相比，扁平足的患病率最高（OR = 2.19，p = 0.003）。然而，足型与任何溃疡结局均无显著相关性（p = 0.7）。固定性锤状趾/爪形趾（OR = 3.91，p = 0.003）和拇趾僵硬（OR = 3.02，p = 0.006）与任何溃疡发生风险增加相关。本研究证实足型与足部畸形相关，且足部畸形与溃疡发生相关。
