Hyperpression plantaire et pied diabétique : Place de l'évaluation podoscopique et de l'appareillage préventif

The aim of our study was the detection of different strains and biomechanical abnormalities of diabetic foot through a podoscopic assessment and the implementation of preventive measures in the presence of foot at risk. We conducted a prospective study from June 2013 to June 2014. Demographic characteristics, type of diabetes and age were collected; all patients underwent examination of bare feet, then followed by an assessment with a tangential lighting podoscope and an electronic podometer revealing plantar hyperpressure. We randomly recruited 50 patients (34 women), mean age 52 years, patients were type 2 diabetes for 60%, duration of diabetes 12.3±8.3 years. Neuropathic involvement was found in 46% of cases. Static electronic pedometer showed hyperpressure in the heel in 18 feet, on the 2ndmetatarsal head (n=22), on the 2ndand 3rdmetatarsal heads (n=11), and the midfoot (n=2). Dynamic found a hyperpressure on the 2ndmetatarsal head for 30 diabetic foot, on the 2ndand 3rdmetatarsal heads (n=16), the midfoot (n=2), and heel (n=26). Foot orthotics were prescribed in 22% of cases. DN associated with plantar hyperpressure is the cause of most ulcers. Static analysis and dynamic plantar pressure can detect areas with hyper support process and permit preventive measures, including devices for reducing conflict and protect at risk areas.