{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T19:39:03Z","timestamp":1786995543572,"version":"build-2736575974"},"reference-count":43,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:00:00Z","timestamp":1733184000000},"content-version":"unspecified","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003035","name":"Aase og Ejnar Danielsen Foundation","doi-asserted-by":"crossref","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100003035","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010809","name":"Jascha Foundation","doi-asserted-by":"crossref","award":["6992"],"award-info":[{"award-number":["6992"]}],"id":[{"id":"10.13039\/100010809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100018562","name":"Steno Diabetes Center Copenhagen","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100018562","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open Diab Res Care"],"accepted":{"date-parts":[[2024,11,6]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The aim of this study was to evaluate the effects of flexor tendon tenotomy treatment of the diabetic hammertoe deformity on plantar pressure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Research design and methods<\/jats:title>\n                  <jats:p>The study was a substudy including participants from a randomized study on tenotomy treatment of diabetic hammertoes. This study was conducted between December 20, 2019 and June 22, 2021. Participants were randomized to tenotomy and standard non-surgical treatment <jats:italic>or<\/jats:italic> standard non-surgical treatment alone. Barefoot plantar pressure measurement was performed pre-intervention and 3\u2009months post-intervention. Primary outcome was change in peak plantar pressure post tenotomy treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 95 participants screened in the original study, 45 (57.8% male) were included and<\/jats:p>\n                  <jats:p>completed this substudy. Of the 45 participants, 22 were randomized to intervention. The average age of participants was 65.6 ((SD\u00b1) 9.5) years and 30 (66.7%) had type 2 diabetes.<\/jats:p>\n                  <jats:p>The average peak plantar pressure (PPP) in toe regions of the participants in the intervention group was significantly (p&lt;0.0001) reduced from 205.6\u2009kPa ((Q1\u2013Q3) 152.0\u2013289.1) pre-intervention to 61.3\u2009kPa (39.1\u2013100.5) post-intervention. The average reduction in PPP of toe regions for participants in the intervention group (\u2212145.3\u2009kPa (\u2212225.9 to \u221256.2)) was significantly (p=0.00017) higher than what was observed for participants in the control group (\u22121.6\u2009kPa (\u221230.2 to 27.9)).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study found that tenotomies of the diabetic hammertoe reduces plantar pressure affecting the treated toes. This likely explains the positive effects of tenotomy treatment on diabetic foot ulcers.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjdrc-2024-004398","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T01:25:23Z","timestamp":1733275523000},"page":"e004398","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Effect of flexor tendon tenotomy of the diabetic hammertoe on plantar pressure: a randomized controlled trial"],"prefix":"10.1136","volume":"12","clinical-trial-number":[{"clinical-trial-number":"nct04154046","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5213-5888","authenticated-orcid":false,"given":"Jonas","family":"Ask\u00f8 Andersen","sequence":"first","affiliation":[{"name":"Orthopedic Department, Nordsjaellands Hospital, Hiller\u00f8d, Denmark"},{"name":"Steno Diabetes Center Copenhagen, Herlev, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Rasmussen","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Herlev, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Engberg","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Herlev, Denmark"},{"name":"Novo Nordisk A\/S, Bagsvaerd, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesper","family":"Bencke","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Copenhagen University Hospital at Amager-Hvidovre, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Frimodt-M\u00f8ller","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Herlev, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Kirketerp-M\u00f8ller","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Herlev, Denmark"},{"name":"Copenhagen Wound Healing Center Bispebjerg Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1531-4294","authenticated-orcid":false,"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center Copenhagen, Herlev, Denmark"},{"name":"Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,3]]},"reference":[{"key":"2025073111484470000_12.6.e004398.1","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.jcot.2021.01.017","article-title":"The current burden of diabetic foot disease","volume":"17","author":"Edmonds","year":"2021","journal-title":"J Clin Orthop Trauma"},{"key":"2025073111484470000_12.6.e004398.2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1080\/14737167.2017.1305891","article-title":"Losing a foot versus losing a dollar; a systematic review of cost studies in diabetic foot complications","volume":"17","author":"Petrakis","year":"2017","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"key":"2025073111484470000_12.6.e004398.3","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ando.2017.11.005","article-title":"Cost of diabetic foot in France, Spain, Italy, Germany and United Kingdom: A systematic review","volume":"79","author":"Tchero","year":"2018","journal-title":"Ann Endocrinol Paris"},{"key":"2025073111484470000_12.6.e004398.4","doi-asserted-by":"crossref","DOI":"10.1186\/s13047-020-00383-2","article-title":"Five year mortality and direct costs of care for people with diabetic foot complications are comparable to cancer","volume":"13","author":"Armstrong","year":"2020","journal-title":"J Foot Ankle Res"},{"key":"2025073111484470000_12.6.e004398.5","unstructured":"Federation ID . 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