{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T03:32:32Z","timestamp":1779334352618,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T00:00:00Z","timestamp":1639612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the effect of flexor tenotomy in patients with diabetes on barefoot plantar pressure, toe joint angles and ulcer recurrence during patient follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with a history of ulceration on the toe apex were included. They underwent minimally invasive needle flexor tenotomy by an experienced musculoskeletal surgeon. Dynamic barefoot plantar pressure measurements and static weight\u2010bearing radiographs were taken before and 2\u20134\u00a0weeks after the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 14 patients underwent flexor tenotomy on 50 toes in 19 feet. There was a mean follow\u2010up time of 11.4\u00a0months. No ulcer recurrence occurred during follow\u2010up. Mean barefoot plantar pressure was assessed on 34 toes and decreased significantly after the procedure by a mean 279\u00a0kPa (95% CI: 204\u2013353;<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001). Metatarsophalangeal, proximal interphalangeal and distal interphalangeal joint angles were assessed on nine toes and all decreased significantly (by 7\u00b0 [95% CI: 4\u20139;<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001], 19\u00b0 [95% CI: 11\u201326;<jats:italic>p\u00a0<\/jats:italic>&lt;\u00a00.001] and 28\u00b0 [95% CI: 13\u201344;<jats:italic>p\u00a0<\/jats:italic>=\u00a00.003], respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>These observations show a beneficial effect of flexor tenotomy on biomechanical and musculoskeletal outcomes in the toes, without ulcer recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dme.14761","type":"journal-article","created":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T06:36:06Z","timestamp":1638945366000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Biomechanical and musculoskeletal changes after flexor tenotomy to reduce the risk of diabetic neuropathic toe ulcer recurrence"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6094-2417","authenticated-orcid":false,"given":"Marieke A.","family":"Mens","sequence":"first","affiliation":[{"name":"Amsterdam UMC Department of Radiology and Nuclear Medicine University of Amsterdam Amsterdam Movement Sciences Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6420-6046","authenticated-orcid":false,"given":"Jaap J.","family":"van Netten","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Department of Rehabilitation Medicine University of Amsterdam Amsterdam Movement Sciences Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tessa E.","family":"Busch\u2010Westbroek","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Department of Rehabilitation Medicine University of Amsterdam Amsterdam Movement Sciences Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8357-9163","authenticated-orcid":false,"given":"Sicco A.","family":"Bus","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Department of Rehabilitation Medicine University of Amsterdam Amsterdam Movement Sciences Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geert J.","family":"Streekstra","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Department of Biomedical Engineering and Physics University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruud H. H.","family":"Wellenberg","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Department of Radiology and Nuclear Medicine University of Amsterdam Amsterdam Movement Sciences Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Maas","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Department of Radiology and Nuclear Medicine University of Amsterdam Amsterdam Movement Sciences Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Max","family":"Nieuwdorp","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Department Internal Medicine University of Amsterdam Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sjoerd A. S.","family":"Stufkens","sequence":"additional","affiliation":[{"name":"Amsterdam UMC Department of Orthopaedic Surgery University of Amsterdam Amsterdam Movement Sciences Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,12,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2004.11.0144"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.06.096"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-018-2082-2"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2738"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2007.04.004"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.7547\/0980194"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0117443"},{"issue":"1","key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"e3269","DOI":"10.1002\/dmrr.3269","article-title":"Guidelines on the prevention of foot ulcers in persons with diabetes (IWGDF 2019 update)","volume":"36","author":"Bus SA","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"issue":"1","key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"e3270","DOI":"10.1002\/dmrr.3270","article-title":"Prevention of foot ulcers in the at\u2010risk patient with diabetes: a systematic review","volume":"36","author":"Netten JJ","year":"2020","journal-title":"Diabetes Metab Res Rev"},{"key":"e_1_2_8_12_1","first-page":"41","article-title":"Outpatient percutaneous flexor tenotomies for management of diabetic claw toe deformities with ulcers: a preliminary report","volume":"51","author":"Tamir E","year":"2008","journal-title":"Can J Surg"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2005.05.004"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0958-2592(03)00047-6"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.20601"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-019-05020-7"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14323"}],"container-title":["Diabetic Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.14761","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dme.14761","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dme.14761","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T20:02:34Z","timestamp":1699905754000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/dme.14761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,16]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1111\/dme.14761"],"URL":"https:\/\/doi.org\/10.1111\/dme.14761","archive":["Portico"],"relation":{},"ISSN":["0742-3071","1464-5491"],"issn-type":[{"value":"0742-3071","type":"print"},{"value":"1464-5491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,16]]},"assertion":[{"value":"2021-09-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14761"}}