Foot最新文献

{"title":"Risk factors associated with subtalar fusion within 5 years following calcaneal ORIF","authors":"Elisabeth White ,&nbsp;Sylvester Okoro ,&nbsp;Ameer Tabbaa ,&nbsp;Ariel N. Rodriguez ,&nbsp;Bhavya Sheth ,&nbsp;Andrew Horn ,&nbsp;Afshin E. Razi ,&nbsp;Amr A. Abdelgawad","doi":"10.1016/j.foot.2024.102154","DOIUrl":"10.1016/j.foot.2024.102154","url":null,"abstract":"<div><h3>Background</h3><div>Although most calcaneal fractures are managed with open reduction internal fixation (ORIF), they can ultimately lead to subtalar arthritis and pain requiring subtalar fusion when conservative treatments prove ineffective. Understanding the risk factors associated with subtalar fusion (STF) after calcaneal ORIF is crucial for optimizing patient outcomes and treatment strategies. This study aimed to comprehensively evaluate these risk factors and their association with the incidence of STF, including patient demographics, medical comorbidities, same day and 90-day reimbursement data.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed using the PearlDiver Mariner 157 national claims database from January 1st, 2010 to October 31st, 2021. Patients who underwent calcaneal ORIF, identified using Current Procedural Terminology (CPT) and ICD Procedure Codes were queried for 5-year rates of STF and reimbursement data. Patient demographics and comorbidities were recorded, and multivariate logistic regression was employed to determine the association of risk factors with STF.</div></div><div><h3>Results</h3><div>Patients with STF had a higher proportion of alcohol abuse (21.3 % vs. 16.2 %), depression (58.1 % vs. 43.1 %), drug abuse (29.1 % vs. 19.7 %), obesity (40.3 % vs. 28 %) and tobacco use (62.2 % vs. 50.3 %), all exhibiting a p-value of less than 0.001. Those with depression (OR: 1.54; 99 % CI:1.29–1.84; P &lt; 0.001) and obesity (OR:1.58; 99 % CI: 1.32–1.88; P &lt; 0.001) as comorbidities had a higher odds ratio of association with STF following calcaneal ORIF.</div></div><div><h3>Conclusion</h3><div>Patients who ultimately require STF within 5 years of calcaneal ORIF had higher rates of alcohol abuse, tobacco use, drug use, obesity, and depression. There was no significant difference observed between those with and without STF in average same-day and 90-day reimbursements and demographics.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"62 ","pages":"Article 102154"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of calcaneal pitch angle with recurrence of postoperative hallux valgus in patients with rheumatoid arthritis","authors":"Wataru Uehara,&nbsp;Toshifumi Fujiwara,&nbsp;Ryosuke Yamaguchi,&nbsp;Hidetoshi Tsushima,&nbsp;Daisuke Hara,&nbsp;Yukio Akasaki,&nbsp;Yasuharu Nakashima","doi":"10.1016/j.foot.2024.102155","DOIUrl":"10.1016/j.foot.2024.102155","url":null,"abstract":"<div><div>Hallux valgus (HV) and flatfoot deformities are frequently seen in patients with rheumatoid arthritis (RA). This study aimed to determine whether flatfoot deformity contributes to the recurrence of HV in RA patients. This study examined 62 feet from 45 RA patients who were diagnosed with HV and underwent the first metatarsal joint-preserving surgery between November 2010 and October 2021. Recorded data included age at surgery, sex, disease duration, body mass index [BMI], RA disease duration, medical treatment of RA, Larsen grade, blood test, pre/postoperative Japanese Society for Surgery of the Foot, HV angle, M1M2 angle, M1M5 angle, calcal pitch angle, and Meary’s angle. HV recurrence on radiography was defined as an HV angle exceeding 20°. HV recurrence was observed in 17 feet. Significant differences were observed due to risk factors such as BMI, disease duration, Larsen grade 4–5, and preoperative calcaneal pitch angle. Multivariate logistic regression analysis identified that lower BMI, a higher M1M2 angle, and a lower calcaneal pitch angle are preoperative risk factors for the recurrence of postoperative HV in RA patients.</div></div><div><h3>Level of evidence</h3><div>3</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"62 ","pages":"Article 102155"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture dislocation of the ankle joint in low energy trauma: Choosing between invasive damage control procedures and closed reduction in plaster","authors":"Emmanouil Theodorakis ,&nbsp;Georgios Touloupakis ,&nbsp;Fabrizio Ferrara ,&nbsp;Stefano Ghirardelli ,&nbsp;Venuti Angelo ,&nbsp;Guido Antonini","doi":"10.1016/j.foot.2024.102146","DOIUrl":"10.1016/j.foot.2024.102146","url":null,"abstract":"<div><h3>Introduction</h3><div>The purpose of this study is to identify significant differences in the clinical outcomes of patients who sustained a low energy trauma resulting into an ankle fracture-dislocation, treated with invasive (external fixation or skeletal traction) and conservative damage control procedures (closed reduction in plaster).</div></div><div><h3>Materials and methods</h3><div>This is a retrospective comparative study including 52 patients with low energy ankle fracture-dislocation, surgically treated between January 2015 and January 2017. Patients included in this study had a minimum 24 months follow-up (range 24–36 months). Patients were divided in 2 groups, group A (n = 21) initially treated with invasive damage control procedures to maintain reduction and group B (n = 31) treated with non-invasive damage control procedures. Patients were evaluated clinically and radiographically. Clinical assessment was performed by evaluating ankle range-of-motion and the Olerud - Molander ankle score at 6, 12 and 24 months as endpoints for both groups.</div></div><div><h3>Results</h3><div>Groups were assessed for homogeneity with a chi-squared test, and no statistical differences were found regarding Weber classification, type of dislocation, and Tscherne classification. A significant improvement in the Olerud-Molander score was noted between the 6- and 12-month follow-ups (p 0.01), but not between the 12- and 24-month follow-ups. This improvement was not observed between the 12 and 24 months follow-up. No statistically significant differences in the Olerud-Molander score were found between the two groups at both the 6- and 24-month follow-ups.</div></div><div><h3>Conclusions</h3><div>Closed reduction in plaster for fracture-dislocations of the ankle joint following low-energy trauma appears capable of maintaining reduction with outcomes comparable to more invasive damage control procedures.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102146"},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142707230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinematic coordination in the rearfoot, midfoot, and forefoot differs depending on subgroups based on foot stiffness and kinetic parameters during walking","authors":"Daiki Yamagiwa ,&nbsp;Yoshitaka Iwamoto ,&nbsp;Rei Konishi ,&nbsp;Masahiro Kuniki ,&nbsp;Nobuhiro Kito","doi":"10.1016/j.foot.2024.102144","DOIUrl":"10.1016/j.foot.2024.102144","url":null,"abstract":"<div><div>This study aimed to classify subgroups of healthy young adults based on foot stiffness and related kinetic parameters during gait, as well as to analyze intra-foot sagittal kinematics within each subgroup. Data were collected from 25 males and 24 females using a 3D motion capture system, which measured the rearfoot, midfoot, and forefoot segments. Cluster analysis identified three subgroups based on the following variables: the truss coefficient, windlass coefficient, forward component of ground reaction force (F-GRF), and ankle plantar flexion power. Group 1 demonstrated the highest foot stiffness, as indicated by the largest truss coefficient, while Groups 2 and 3 exhibited lower stiffness, characterized by greater dorsiflexion of the midfoot and forefoot relative to the rearfoot during the stance phase. Additionally, the kinematic coordination patterns between the rearfoot-midfoot and midfoot-forefoot of Groups 2 and 3 during the early and late stance phases showed significant variation. Group 3, in particular, exhibited lower F-GRF and ankle plantar flexion power than Groups 1 and 2. These results suggest that midfoot movement during the late stance phase is critical in generating foot stiffness, with a midfoot-dominant kinematic pattern potentially serving as a key contributor. The study underscores the importance of understanding intersegmental coordination for managing foot stiffness, which could have implications for improving gait mechanics and preventing injuries. Further research is needed to explore how these findings can be applied to individuals with various foot conditions or pathologies.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102144"},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible fixation versus open reduction internal fixation and primary arthrodesis for ligamentous Lisfranc injuries: A systematic review and meta-analysis","authors":"Kyle P. O’Connor ,&nbsp;Erica R. Olfson ,&nbsp;John T. Riehl","doi":"10.1016/j.foot.2024.102145","DOIUrl":"10.1016/j.foot.2024.102145","url":null,"abstract":"<div><h3>Introduction</h3><div>Flexible fixation (FF) has allowed treatment of isolated ligamentous Lisfranc injuries while preserving joint motion. We hypothesize that patient-reported outcome measures (PROMs), complications, and return-to-activity rates will be similar between patients undergoing FF versus those undergoing open reduction internal fixation (ORIF) or primary arthrodesis (PA).</div></div><div><h3>Methods</h3><div>Databases included PubMed, OVID Medline, Embase, SCOPUS, Cochrane Central Register of Clinical Trials, and clinicaltrials.gov from their inception to 5/13/2024. Search terms focused on treatment of Lisfranc injuries with FF, ORIF, or PA. Only English studies were included. Studies were included if the Lisfranc injury was purely ligamentous and had PROM scores. Quality, validity, and comparability were assessed using MINORS and GRADE criteria. Meta-analysis was conducted using pooled statistics. Cohen’s d and odds ratios (OR) determined effect sizes.</div></div><div><h3>Results</h3><div>Twenty-five studies were included. There were 184 patients undergoing FF, 236 patients undergoing ORIF, and 80 patients undergoing PA. Postoperatively, American Orthopaedic Foot and Ankle Society (AOFAS) scores were 89.7 ± 10.0, 78.7 ± 44.2, and 87.4 ± 31.8, VAS-pain scores were 1.5 ± 1.5, 1.6 ± 3.8, and 0.3 ± 2.6, and return to activity rates (RTA) were 100 %, 63.3 %, and 78.4 %, respectively. Rates of post-traumatic arthritis were 0 %, 13.0 %, and 0 %, hardware removal were 0 %, 86.0 %, and 22.5 %, and complications were 3.8 %, 17.7 %, and 23.5 %. Meta-analysis demonstrated that FF had superiority over ORIF regarding better AOFAS scores and RTA with lower rates of post-traumatic arthritis, hardware removal, and complications (p &lt; 0.05). Also, FF had superiority over PA with higher RTA and lower rates of hardware removal and complications. PA demonstrated better VAS-pain scores (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>FF had satisfactory outcomes after Lisfranc injury treatment. Low-quality evidence suggested that FF had better outcomes, however, this conclusion was drawn from single-arm studies which have significant limitations. Further prospective, comparative studies should investigate this relationship.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102145"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review: Radiological findings at a minimum of 3 years follow-up for unstable ankle fractures in adults treated with surgery","authors":"Anthony Uzoma Okoye ,&nbsp;Linzy Houchen-Wolloff ,&nbsp;Jitendra Mangwani ,&nbsp;Nimra Akram ,&nbsp;Despina Laparidou ,&nbsp;David Nelson ,&nbsp;Sam Cooke","doi":"10.1016/j.foot.2024.102143","DOIUrl":"10.1016/j.foot.2024.102143","url":null,"abstract":"<div><h3>Background</h3><div>Radiological investigations are critical to diagnosis and treatment of many musculoskeletal diseases including detecting earliest degenerative changes (osteoarthritis (OA)) seen in patients with unstable ankle fractures managed surgically. Despite the high incidence of ankle OA, research into early detection using imaging remains sparse.</div></div><div><h3>Objectives</h3><div>To identify the incidence of OA on postoperative imaging in adults with unstable ankle fractures after a minimum follow-up of 3 years with a correlation to patient reported outcomes.</div></div><div><h3>Key findings</h3><div>767 studies were identified on 5 database searches, and 492 abstract titles were screened, while 53 papers were selected for full review. From these only 8 articles met the inclusion criteria. A total of 905 participants aged 18 years and above (mean 46.4 years, 53.8 % male) presented with a range of ankle fracture classifications. This includes 423 cases of Weber classification, 225 cases of OTA/AO, 204 Lauge-Hansen classification, and 53 medial malleoli. From these, 34.7 % cases of OA were identified (minimum of the 3-year follow-up) on different imaging modalities. Our results revealed that mild to moderate OA is common, and functional outcome is mainly good to excellent.</div></div><div><h3>Conclusion</h3><div>1 in 3 patients treated for unstable ankle fracture with open reduction internal fixation will show signs of radiological OA after 3–7 years of index procedure, though with good functional outcome. We were unable to correlate the grade of radiological OA observed with clinical OA. Despite the low sensitivity of X-ray in early detection of OA, we identified a lack of studies in utilising MRI and/or CT imaging, indicating the need for further research. Clinicians should consider using MRI/CT imaging for early detection of OA for patients following unstable ankle fractures, to improve early detection and consequently improve patient reported outcomes.</div></div><div><h3>Level of Clinical Evidence</h3><div>Systematic review = 1.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102143"},"PeriodicalIF":0.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142723888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of custom hard-shell 3D-printed foot orthoses in a cohort of patients who did not respond to treatment with custom ethylene-vinyl-acetate (EVA) foot orthoses","authors":"Laura Barr ,&nbsp;Nikki Munro ,&nbsp;Kirsty Watters ,&nbsp;Ross McCaig ,&nbsp;Jim Richards ,&nbsp;Graham J. Chapman","doi":"10.1016/j.foot.2024.102142","DOIUrl":"10.1016/j.foot.2024.102142","url":null,"abstract":"<div><h3>Background</h3><div>Patients who do not achieve positive outcomes with custom ethylene-vinyl-acetate (EVA) foot orthoses will often be escalated to other services for treatment, which may include surgery.</div></div><div><h3>Objective</h3><div>This study aimed to explore the effectiveness of custom hard-shell 3D-printed foot orthoses for patients who did not respond to treatment with custom EVA foot orthoses and were being considered for treatment escalation.</div></div><div><h3>Design</h3><div>An eight-week clinical evaluation and a two-year review of relevant medical records.</div></div><div><h3>Method</h3><div>Thirty-six consecutive patients with a range of musculoskeletal lower limb pathology who remained symptomatic after 12-weeks use of custom EVA foot orthoses were fitted with custom hard-shell 3D-printed foot orthoses. The Foot Health Status Questionnaire was used to assess patients at baseline and eight-week follow-up in conjunction with the Client Satisfaction with Device module of the Orthotics and Prosthetics User Survey. Patients were categorised as responders or non-responders based on their change in pain scores. A review of relevant medical records two years after receiving their orthoses determined if patients required further treatment for their initial condition.</div></div><div><h3>Results</h3><div>Across the full cohort there were significant improvements in pain, function and foot health. At follow-up, responders reported significantly improved pain, function and foot health compared with non-responders. Twenty-six patients (12 responders, 14 non-responders) required no further treatment for their original condition after two years.</div></div><div><h3>Conclusions</h3><div>Custom hard-shell 3D-printed foot orthoses have the potential to improve pain, function, foot health, and provide satisfaction in patients with lower limb musculoskeletal conditions which do not improve with custom EVA foot orthoses.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102142"},"PeriodicalIF":0.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional changes in the free Achilles tendon volume in response to repeated submaximal contractions","authors":"Eman Merza ,&nbsp;Stephen Pearson ,&nbsp;Glen Lichtwark ,&nbsp;Peter Malliaras","doi":"10.1016/j.foot.2024.102141","DOIUrl":"10.1016/j.foot.2024.102141","url":null,"abstract":"<div><h3>Introduction</h3><div>The Achilles tendon (AT) may become smaller in volume following acute bouts of heavy and sustained loading likely because of transient fluid exudation to the periphery and this could augment cellular mechanotransduction and tendon adaptation. Given the structure of the AT is distinct across its length, regional changes in the free AT volume may occur in response to loading. This study aimed to investigate whether the change in tendon volume in response to repeated submaximal loading is distinct across the free AT length.</div></div><div><h3>Methods</h3><div>Sixteen ATs of healthy males and females (age 24.4 ± 9.4 years, body mass 70.9 ± 16.1 kg, height 1.7 ± 0.1 m) were scanned at rest using freehand 3D ultrasound. Scanning was done before and immediately after submaximal (75 %) voluntary isometric plantarflexion contractions (8 s) involving four sets of ten repetitions. Regional volumetric changes were assessed across the free AT length by dividing the tendon into distal, mid, and proximal regions.</div></div><div><h3>Results</h3><div>Significant reduction in the free AT volume occurred across all tendon regions in response to the intervention, however, the mid- region exhibited the greatest reduction in volume compared to the proximal region (<em>P</em> = 0.025).</div></div><div><h3>Discussion</h3><div>The fact that volume reduction was greatest in the mid-region compared to the proximal region of the free AT may suggest greater tendon adaptation, via mechanotransduction pathways, in the mid-region and this may be important for tendon health and injury prevention.</div></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102141"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanical drivers of intrinsic foot muscle for maximum toe flexor strength in upright standing across different body size","authors":"Keiji Koyama ,&nbsp;Junichiro Yamauchi","doi":"10.1016/j.foot.2024.102128","DOIUrl":"10.1016/j.foot.2024.102128","url":null,"abstract":"<div><p>This study aimed to evaluate maximum toe flexor strength, foot arch height, intrinsic toe flexor muscle size and foot arch stiffness among individuals with different body sizes, and to compare these variables between sitting and standing positions. Maximum toe flexor strength in sitting and standing, and intrinsic foot muscle thicknesses (flexor hallucis brevis: FHB, flexor digitorum brevis: FDB, abductor hallucis: AH and quadratus plantae: QP), were measured using a toe grip dynamometer and a B-mode ultrasound in healthy young men. FHB was thicker than AH, FDB and QP, AH was thicker than FDB and QP, and no significant difference was found between FDB and QP. Toe flexor strength was correlated with FHB and AH, and foot arch height was correlated with FHB. Toe flexor strength was greater in standing than in sitting. Stepwise multiple regression analysis identified FHB and AH as determinants of toe flexor strength in standing, and the relative muscle strength values per body weight in standing were determined by QP, foot arch index and foot arch stiffness. Overweight individuals had a decreased rate of increase in relative toe flexor strength compared to normal individuals. These results suggest that a large muscle thickness of intrinsic foot muscle a key contributor to toe flexor strength. Moreover, toe flexor muscle in upright standing could have the potential to generate force independently of intrinsic foot muscle size, but obese individuals who chronically put weight on their feet might impair the force amplification mechanism in upright standing.</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102128"},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and reliability of the Ipswich touch test in identifying loss of protective sensation among diabetic patients","authors":"Napassorn Khumchum ,&nbsp;Nantawan Koonalinthip ,&nbsp;Siriporn Janchai","doi":"10.1016/j.foot.2024.102132","DOIUrl":"10.1016/j.foot.2024.102132","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the accuracy of the Ipswich touch test compared to the 10-g monofilament test for identifying of loss of protective sensation in Thai patients with diabetes mellitus.</p></div><div><h3>Methods</h3><p>A cross-sectional observational study was conducted on Thai patients with diabetes mellitus who attended routine annual foot check-ups in an outpatient diabetes clinic. The loss of protective sensation was assessed by the Ipswich touch test and compared with the Semmes-Weinstein 10-g monofilament test. Sensitivity, specificity, predictive values and likelihood ratios were calculated to measure the accuracy of the Ipswich touch test against 10-g monofilament as a reference standard. The interrater reliability of the Ipswich touch test was assessed by two raters.</p></div><div><h3>Results</h3><p>In a study of 283 diabetic patients, 10-g monofilament detected a 25 % prevalence of loss protective sensation. The Ipswich touch test demonstrated a good diagnostic accuracy, with a sensitivity of 70.8 %, specificity of 98.6 %, and an area under the curve of 0.85 when compared to 10-g monofilament. Positive and negative predictive values were 94.4 % and 90.8 % respectively. The positive likelihood ratio was 49.82, and the negative likelihood ratio was 0.30. Interrater reliability, assessed with two raters in a subset of 93 participants, yielded a kappa of 0.88, indicating almost perfect agreement.</p></div><div><h3>Conclusions</h3><p>The Ipswich Touch Test demonstrated good accuracy and interrater reliability compared to the standard 10-g monofilament, thus establishing its effectiveness as a valuable diagnostic tool for identifying loss of protective sensation among diabetic patients. However, its relatively low sensitivity suggests it should be used with caution as a screening tool.</p></div>","PeriodicalId":12349,"journal":{"name":"Foot","volume":"61 ","pages":"Article 102132"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}