Original Article: Complications Plantar pressures in diabetic patients with foot ulcers which have remained healed

Aims Therecurrenceoffootulcersisasignificantprobleminpeoplewithdiabeticneuropathy.Thepurposeofthisstudywasto measure in-shoe plantar pressures and other characteristics in a group of neuropathic patients with diabetes who had prior foot ulcers which had remained healed. Methods ThiswasanepidemiologicalcohortstudyofpatientsfromdiabetesclinicsoftwoSwedishhospitals.Fromadatabase of 2625 eligible patients, 190 surviving patients with prior plantar ulcers of the forefoot (hallux or metatarsal heads) caused by repetitive stress were identified and 49 patients agreed to participate. Barefoot and in-shoe plantar pressures were measured during walking. Data on foot deformity, activity profiles and self-reported behaviour were also collected. Results Mean barefoot plantar peak pressure at the prior ulcer site (556 kPa) was lower than in other published series, although the range was large (107‐1192 kPa). Mean in-shoe peak pressure at this location averaged 207 kPa when measured withaninsolesensor.Barefootpeakpressureonlypredicted35%ofthevarianceofin-shoepeakpressure,indicatingvariation in the efficacy of the individual footwear prescriptions (primarily extra-depth shoes with custom insoles).