Effect of flexor tendon tenotomy of the diabetic hammertoe on plantar pressure: a randomized controlled trial

Introduction The aim of this study was to evaluate the effects of flexor tendon tenotomy treatment of the diabetic hammertoe deformity on plantar pressure.Research design and methods The study was a substudy including participants from a randomized study on tenotomy treatment of diabetic hammertoes....

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Main Authors: Peter Rossing, Jesper Bencke, Klaus Kirketerp-Møller, Marie Frimodt-Moller, Jonas Askø Andersen, Anne Rasmussen, Susanne Engberg
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/12/6/e004398.full
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author Peter Rossing
Jesper Bencke
Klaus Kirketerp-Møller
Marie Frimodt-Moller
Jonas Askø Andersen
Anne Rasmussen
Susanne Engberg
author_facet Peter Rossing
Jesper Bencke
Klaus Kirketerp-Møller
Marie Frimodt-Moller
Jonas Askø Andersen
Anne Rasmussen
Susanne Engberg
author_sort Peter Rossing
collection DOAJ
description Introduction The aim of this study was to evaluate the effects of flexor tendon tenotomy treatment of the diabetic hammertoe deformity on plantar pressure.Research design and methods 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 or 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.Results 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)).Conclusion 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.
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spelling doaj-art-deb8931d19a14d049396a4a3db6ea4a12024-12-16T12:40:09ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972024-12-0112610.1136/bmjdrc-2024-004398Effect of flexor tendon tenotomy of the diabetic hammertoe on plantar pressure: a randomized controlled trialPeter Rossing0Jesper Bencke1Klaus Kirketerp-Møller2Marie Frimodt-Moller3Jonas Askø Andersen4Anne Rasmussen5Susanne Engberg6Steno Diabetes Center Copenhagen, Herlev, DenmarkDepartment of Orthopedic Surgery, Copenhagen University Hospital at Amager-Hvidovre, Copenhagen, DenmarkSteno Diabetes Center Copenhagen, Herlev, DenmarkSteno Diabetes Center Copenhagen, Herlev, DenmarkOrthopedic Department, Nordsjaellands Hospital, Hillerød, DenmarkSteno Diabetes Center Copenhagen, Herlev, DenmarkSteno Diabetes Center Copenhagen, Herlev, DenmarkIntroduction The aim of this study was to evaluate the effects of flexor tendon tenotomy treatment of the diabetic hammertoe deformity on plantar pressure.Research design and methods 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 or 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.Results 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)).Conclusion 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.https://drc.bmj.com/content/12/6/e004398.full
spellingShingle Peter Rossing
Jesper Bencke
Klaus Kirketerp-Møller
Marie Frimodt-Moller
Jonas Askø Andersen
Anne Rasmussen
Susanne Engberg
Effect of flexor tendon tenotomy of the diabetic hammertoe on plantar pressure: a randomized controlled trial
BMJ Open Diabetes Research & Care
title Effect of flexor tendon tenotomy of the diabetic hammertoe on plantar pressure: a randomized controlled trial
title_full Effect of flexor tendon tenotomy of the diabetic hammertoe on plantar pressure: a randomized controlled trial
title_fullStr Effect of flexor tendon tenotomy of the diabetic hammertoe on plantar pressure: a randomized controlled trial
title_full_unstemmed Effect of flexor tendon tenotomy of the diabetic hammertoe on plantar pressure: a randomized controlled trial
title_short Effect of flexor tendon tenotomy of the diabetic hammertoe on plantar pressure: a randomized controlled trial
title_sort effect of flexor tendon tenotomy of the diabetic hammertoe on plantar pressure a randomized controlled trial
url https://drc.bmj.com/content/12/6/e004398.full
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