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

Autor:	Askø Andersen J; Orthopedic Department, Nordsjaellands Hospital, Hillerød, Denmark jonas.hedegaard.andersen@regionh.dk.; Steno Diabetes Center Copenhagen, Herlev, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Rasmussen A; Steno Diabetes Center Copenhagen, Herlev, Denmark., Engberg S; Steno Diabetes Center Copenhagen, Herlev, Denmark.; Novo Nordisk A/S, Bagsvaerd, Denmark., Bencke J; Department of Orthopedic Surgery, Copenhagen University Hospital at Amager-Hvidovre, Copenhagen, Denmark., Frimodt-Møller M; Steno Diabetes Center Copenhagen, Herlev, Denmark., Kirketerp-Møller K; Steno Diabetes Center Copenhagen, Herlev, Denmark.; Copenhagen Wound Healing Center Bispebjerg Hospital, Copenhagen, Denmark., Rossing P; Steno Diabetes Center Copenhagen, Herlev, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Jazyk:	angličtina
Zdroj:	BMJ open diabetes research & care [BMJ Open Diabetes Res Care] 2024 Dec 03; Vol. 12 (6). Date of Electronic Publication: 2024 Dec 03.
DOI:	10.1136/bmjdrc-2024-004398
Abstrakt:	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. Competing Interests: Competing interests: None of the authors have any competing interests related to this work. Outside of this work: PR has received consultancy and/or speaking fees (to SDCC) from AbbVie, Astellas, AstraZeneca, Bayer, Boehringer Ingelheim, Gilead, Eli Lilly, MSD, Novo Nordisk and Sanofi Aventis, and research grants from Novo Nordisk and AstraZeneca. MF-M has received speaking fees from Boehringer Ingelheim, Novartis, Baxter and Sanofi. KK-M has received consultancy and/or speaking fees from Coloplast, Mölnlycke, SoftOx A/S and Bayer Pharmaceuticals AG. SE is employed in Novo Nordisk A/S. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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