{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T14:09:37Z","timestamp":1789826977114,"version":"4.0.1"},"reference-count":22,"publisher":"American Diabetes Association","issue":"10","content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2004,10,1]]},"abstract":"<jats:p>OBJECTIVE\u2014The aim of this study was to quantify the association between claw\/hammer toe deformity and changes in submetatarsal head (sub-MTH) fat-pad geometry in diabetic neuropathic feet.<\/jats:p>\n               <jats:p>RESEARCH DESIGN AND METHODS\u2014Thirteen neuropathic diabetic subjects (mean age 56.2 years) with toe deformity, 13 age- and sex-matched neuropathic diabetic control subjects without deformity, and 13 age- and sex-matched healthy control subjects without deformity were examined. From high-resolution sagittal plane magnetic resonance images of the second and third ray of the foot, toe angle (a measure of deformity), sub-MTH fat-pad thickness, and subphalangeal fat-pad thickness were measured. The ratio of these thicknesses was used to indicate fat-pad displacement.<\/jats:p>\n               <jats:p>RESULTS\u2014Sub-MTH fat pads were significantly thinner (2.5 \u00b1 1.3 vs. 6.0 \u00b1 1.4 mm, P &amp;lt; 0.001) and subphalangeal fat pads significantly thicker (9.1 \u00b1 1.9 vs. 7.6 \u00b1 1.2 mm, P &amp;lt; 0.005) in the neuropathic group with deformity compared with neuropathic control subjects. As a result, thickness ratio was substantially smaller in the deformity group: 0.28 \u00b1 0.14 vs. 0.79 \u00b1 0.14 in neuropathic control subjects (P &amp;lt; 0.001). A significant correlation of 0.85 was present between toe angle and thickness ratio (P &amp;lt; 0.001). No significant differences were found between neuropathic and healthy control subjects.<\/jats:p>\n               <jats:p>CONCLUSIONS\u2014This study shows a distal displacement and subsequent thinning of the sub-MTH fat pads in neuropathic diabetic patients with toe deformity and suggests that, as a result, the capacity of the tissue in this region to reduce focal plantar pressure is severely compromised. This condition is likely to increase the risk of plantar ulceration in these patients.<\/jats:p>","DOI":"10.2337\/diacare.27.10.2376","type":"journal-article","created":{"date-parts":[[2007,3,5]],"date-time":"2007-03-05T22:51:27Z","timestamp":1173135087000},"page":"2376-2381","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":101,"title":["Plantar Fat-Pad Displacement in Neuropathic Diabetic Patients With Toe Deformity"],"prefix":"10.2337","volume":"27","author":[{"given":"Sicco A.","family":"Bus","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Maas","sequence":"additional","affiliation":[{"name":"Department of Radiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"Cavanagh","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P. J.","family":"Michels","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Levi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","reference":[{"key":"2022031216003168800_R1","doi-asserted-by":"crossref","unstructured":"Bojsen-Moller F: Anatomy of the forefoot, normal and pathologic. Clin Orthop Rel Res\u2008142: 10\u201318, 1979","DOI":"10.1097\/00003086-197907000-00003"},{"key":"2022031216003168800_R2","unstructured":"Bojsen-Moller F, Flagstad KE: Plantar aponeurosis and internal architecture of the ball of the foot. 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