The clinical use of the 10 g monofilament and its limitations: A review

BackgroundDiabetes mellitus is one of the most prevalent chronic diseases worldwide including Singapore. The 10 g monofilament is commonly used by clinicians to examine diabetic patients for neuropathy due to its low cost and convenience. The aim of this literature review is to evaluate the use of the monofilament and the factors that affect its diagnostic value.MethodsA systematic search of AMED, Medline, EMBASE and Cinahl databases was conducted to identify English language articles from 1990 to 2009 which investigated the use of the monofilament.ResultsA total of 34 studies were identified, consisting of 24 observational studies, 8 prospective studies, 1 review article and 1 randomised controlled trial. 6 recurrent themes emerged from these 34 studies.ConclusionsThe 10 g monofilament remains a useful clinical tool for detecting severe neuropathy and hence identifying patients at increased risk of ulceration and amputation. However, a consensus on the protocol in the use of the monofilament needs to be reached. Further research regarding the effects of environmental conditions on the accuracy of the monofilament is also essential.