title: Foot deformities within the diabetic foot and their influence on biomechanics: A review of the literature.
abstract: BACKGROUND
  Diabetes mellitus causes a multitude of complications. Foot ulceration is one complication with serious consequences, amputation. Foot deformities contribute to ulcer development. It would be advantageous to ascertain whether foot deformities are preventable as their presence increases amputation risk.
  
  
  OBJECTIVE
  The objectives were to understand the development of foot deformities in diabetes and explore their biomechanical effects.
  
  
  METHODS
  Literature review.
  
  
  METHODS
  In February 2014 CINAHL, Embase, Ovid and Medline were searched. Studies in English of adults with Diabetes that reported neuropathy, foot deformities or associated gait abnormalities were included for review. All study designs were considered. The articles' quality was considered high overall, assessed using SIGN and CARS.
  
  
  RESULTS
  In total, 17 studies were reviewed. The main themes identified in relation to foot deformities were nerve function, intrinsic foot muscles, muscle weakness and limited joint mobility. Nerve function and intrinsic foot muscle atrophy did not display definitive associations with foot deformities. However, muscle weakness and limited joint mobility were associated with foot deformities, although the relationship is still unclear.
  
  
  CONCLUSIONS
  The development of common foot deformities in diabetes is not well understood. The literature did not support the common belief that motor neuropathy, atrophy and muscle imbalance cause foot deformities.
  
  
  CONCLUSIONS
  An understanding of the aetiology of foot deformities in diabetes mellitus may allow for pro-active management of the foot in anticipation of the development of foot deformities and ulceration. If the aetiology of deformity was established preventative treatment may reduce the incidence of foot deformities and resultant ulcerations and amputations.
authors.affiliation: National Centre for Prosthetics and Orthotics, University of Strathclyde, Glasgow, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Allan
authors.affiliation: Anatomical Concepts (UK) Ltd and Munro Bolton Orthotics Ltd, Clydebank, UK.
authors.forename: William
authors.initials: W
authors.lastname: Munro
authors.affiliation: National Centre for Prosthetics and Orthotics, University of Strathclyde, Glasgow, UK e.figgins@strath.ac.uk.
authors.forename: Elaine
authors.initials: E
authors.lastname: Figgins
mesh_terms: D017719:Diabetic Foot / Q000150:complications* / Q000503:physiopathology*; D005530:Foot Deformities / Q000150:complications* / Q000503:physiopathology*; D006801:Humans; D018908:Muscle Weakness / Q000503:physiopathology; D016059:Range of Motion, Articular / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology
keywords: Diabetes Mellitus; biomechanics; deformities; foot