Predictors of Diabetic Foot Reulceration beneath the Hallux

Abstract EN

Aims.

To evaluate the factors that predict reulceration beneath the hallux in people with a history of diabetic foot ulceration.

Methods.

A prospective study conducted between January 2012 and December 2014 was performed in a diabetic foot unit to assess the risk factors associated with hallux reulceration.

Sixty patients with diabetic neuropathy and a history of previous ulcer were consecutively included.

Sociodemographic factors and comorbidities plus the biomechanical and radiographic factors were obtained.

Follow-up on participants was conducted every month, and they wore offloading therapeutic footwear and custom-made insoles.

Hallux reulceration during the follow-up period was assessed as the main outcome measure in the study.

Results.

Patients were followed up during 29 (14.2-64.4) months.

Twenty-nine patients (52%) developed a new ulceration: 9 patients (31%) in the hallux and 20 (69%) in other locations.

Functional hallux limitus (p=0.005, 95% CI (2.097–73.128), HR 12.384) and increased body mass index (p=0.044, 95% CI (1.003-1.272), HR 1.129) were associated with the hallux ulceration-free survival time in the multivariate Cox model.

Conclusions.

Obesity and the presence of functional hallux limitus increase the probability of developing hallux reulceration in patients with diabetic neuropathy and a history of ulcers.