Askø Andersen Jonas, Rasmussen Anne, Engberg Susanne, Bencke Jesper, Frimodt-Møller Marie, Kirketerp-Møller Klaus, Rossing Peter
Orthopedic Department, Nordsjaellands Hospital, Hillerød, Denmark
Steno Diabetes Center Copenhagen, Herlev, Denmark.
BMJ Open Diabetes Res Care. 2024 Dec 3;12(6):e004398. doi: 10.1136/bmjdrc-2024-004398.
The aim of this study was to evaluate the effects of flexor tendon tenotomy treatment of the diabetic hammertoe deformity on plantar pressure.
The study was a substudy including participants from a randomized study on tenotomy treatment of diabetic hammertoes. This study was conducted between December 20, 2019 and June 22, 2021. Participants were randomized to tenotomy and standard non-surgical treatment standard non-surgical treatment alone. Barefoot plantar pressure measurement was performed pre-intervention and 3 months post-intervention. Primary outcome was change in peak plantar pressure post tenotomy treatment.
Of the 95 participants screened in the original study, 45 (57.8% male) were included andcompleted this substudy. Of the 45 participants, 22 were randomized to intervention. The average age of participants was 65.6 ((SD±) 9.5) years and 30 (66.7%) had type 2 diabetes.The average peak plantar pressure (PPP) in toe regions of the participants in the intervention group was significantly (p<0.0001) reduced from 205.6 kPa ((Q1-Q3) 152.0-289.1) pre-intervention to 61.3 kPa (39.1-100.5) post-intervention. The average reduction in PPP of toe regions for participants in the intervention group (-145.3 kPa (-225.9 to -56.2)) was significantly (p=0.00017) higher than what was observed for participants in the control group (-1.6 kPa (-30.2 to 27.9)).
This study found that tenotomies of the diabetic hammertoe reduces plantar pressure affecting the treated toes. This likely explains the positive effects of tenotomy treatment on diabetic foot ulcers.
本研究的目的是评估屈肌腱切断术治疗糖尿病槌状趾畸形对足底压力的影响。
本研究是一项子研究，其参与者来自一项关于糖尿病槌状趾切断术治疗的随机研究。该研究于2019年12月20日至2021年6月22日进行。参与者被随机分为切断术组和标准非手术治疗组（仅标准非手术治疗）。在干预前和干预后3个月进行赤脚足底压力测量。主要结局是切断术治疗后足底峰值压力的变化。
在原研究中筛查的95名参与者中，45名（57.8%为男性）被纳入并完成了这项子研究。在这45名参与者中，22名被随机分配到干预组。参与者的平均年龄为65.6（标准差±9.5）岁，30名（66.7%）患有2型糖尿病。干预组参与者趾部区域的平均足底峰值压力（PPP）从干预前的205.6kPa（四分位距152.0 - 289.1）显著降低（p<0.0001）至干预后的61.3kPa（39.1 - 100.5）。干预组参与者趾部区域PPP的平均降低值（-145.3kPa（-225.9至-56.2））显著高于对照组参与者（-1.6kPa（-30.2至27.9））（p = 0.00017）。
本研究发现糖尿病槌状趾的切断术可降低影响治疗趾的足底压力。这可能解释了切断术治疗对糖尿病足溃疡的积极作用。
