%0 Journal Article
%A García Madrid, Marta
%A García Álvarez, Yolanda
%A Sanz Corbalán, Irene
%A Álvaro Afonso, Francisco Javier
%A López Moral, Mateo
%A Lázaro Martínez, José Luis
%T Predictive value of forefoot plantar pressure to predict reulceration in patients at high risk
%D 2022
%@ 0168-8227
%U https://hdl.handle.net/20.500.14352/71876
%X Aims: To analyze a plantar pressure cut-off point for diabetic foot reulceration beneath the metatarsal heads in patients with previous forefoot amputation.Methods: A one-year prospective study was conducted in a total of 105 patients at high risk for foot ulceration. Peak plantar pressure (PPP) and pressure-time integral (PTI) in the entire foot, the forefoot region, and each metatarsal head separately were registered. ROC curves were used to select the optimal diagnostic pressure cut-off points. Patients were follow-up monthly or until the development of an ulcer event.Results: A total of 52 (49.5%) patients developed a reulceration. Using ROC analyses for PPP in the full-foot and in the forefoot, did not predict reulceration beneath the metatarsal heads. Analyzing separately each metatarsal head all patients with values greater than or equal to 20.8 N/cm2 at the 1st, 18.62 N/cm2 for the 2nd, 18.85 at the 3rd, 17.88 at the 4th, and 12.2 at the 5th metatarsal heads will suffer a reulceration despite the use of orthopedic treatment with optimum values of sensitivity (from 100 to 87.5) and specificity (from 83.2 to 62.8).Conclusion: Barefoot pressures beneath the metatarsal heads should be analyzed separately to predict the region at risk of reulceration.
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