Pirri Carmelo, Biz Carlo, Pirri Nina, Macchi Veronica, Porzionato Andrea, De Caro Raffaele, Ruggieri Pietro, Stecco Carla
Department of Neurosciences, Institute of Human Anatomy, University of Padova, 35121 Padua, Italy.
Department of Orthopedics and Orthopedic Oncology, University of Padova, 35128 Padova, Italy.
J Clin Med. 2023 Jul 13;12(14):4664. doi: 10.3390/jcm12144664.
Crural fascia (CF) and plantar fascia (PF) are biomechanically crucial in the gait and in the proprioception, particularly in the propulsion phase of the foot during the gait cycle and in the dissipation of forces during weight-bearing activities. Recent studies have revealed an association between increases in PF thickness and diabetes. The purpose of this study was to measure and compare by ultrasound (US) imaging the thickness of the CF and PF at different regions/levels in chronic Charcot diabetic foot patients (group 1) and in healthy volunteers (group 2). A cross-sectional study was performed using US imaging to measure the CF with Pirri et al.'s protocol and PF with a new protocol in a sample of 31 subjects (15 patients and 16 healthy participants). The findings for CF and PF revealed statistically significant differences in the poster region of CF (Post 1: group 1 vs. group 2: = 0.03; Post 2: group 1 vs. group 2: = 0.03) and in PF at two different levels (PF level 1: group 1 vs. group 2: < 0.0001; PF level 2: group 1 vs. group 2: < 0.0001). These findings suggest that chronic Charcot diabetic foot patients have CF and PF thicker compared to healthy volunteers. The US examination suggests that fascial thicknesses behavior in these patients points out altered fascial remodeling due to diabetes pathology and biomechanical changes.
小腿筋膜（CF）和足底筋膜（PF）在步态和本体感觉中具有重要的生物力学作用，特别是在步态周期中足部的推进阶段以及负重活动中的力消散过程中。最近的研究表明，PF厚度增加与糖尿病之间存在关联。本研究的目的是通过超声（US）成像测量并比较慢性夏科氏糖尿病足患者（第1组）和健康志愿者（第2组）不同区域/水平的CF和PF厚度。采用US成像进行横断面研究，按照Pirri等人的方案测量CF，并采用新方案测量PF，样本包括31名受试者（15名患者和16名健康参与者）。CF和PF的研究结果显示，CF后区（Post 1：第1组与第2组： = 0.03；Post 2：第1组与第2组： = 0.03）以及PF在两个不同水平（PF水平1：第1组与第2组： < 0.0001；PF水平2：第1组与第2组： < 0.0001）存在统计学上的显著差异。这些结果表明，与健康志愿者相比，慢性夏科氏糖尿病足患者的CF和PF更厚。US检查表明，这些患者的筋膜厚度变化表明由于糖尿病病理和生物力学变化导致筋膜重塑改变。
