{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T07:29:57Z","timestamp":1784618997627,"version":"3.55.0"},"reference-count":47,"publisher":"MDPI AG","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>People at risk for diabetic foot ulcer (DFU) often misunderstand why foot ulcers develop and what self-care strategies may help prevent them. The etiology of DFU is complex and difficult to communicate to patients, which may hinder effective self-care. Thus, we propose a simplified model of DFU etiology and prevention to aid communication with patients. The Fragile Feet &amp; Trivial Trauma model focuses on two broad sets of risk factors: predisposing and precipitating. Predisposing risk factors (eg, neuropathy, angiopathy, and foot deformity) are usually lifelong and result in \u201cfragile feet.\u201d Precipitating risk factors are usually different forms of everyday trauma (eg, mechanical, thermal, and chemical) and can be summarized as \u201ctrivial trauma.\u201d We suggest that the clinician consider discussing this model with their patient in three steps: 1) explain how a patient\u2019s specific predisposing risk factors result in fragile feet for the rest of life, 2) explain how specific risk factors in a patient\u2019s environment can be the trivial trauma that triggers development of a DFU, and 3) discuss and agree on with the patient measures to reduce the fragility of the feet (eg, vascular surgery) and prevent trivial trauma (eg, wear therapeutic footwear). By this, the model supports the communication of two essential messages: that patients may have a lifelong risk of ulceration but that there are health-care interventions and self-care practices that can reduce these risks. The Fragile Feet &amp; Trivial Trauma model is a promising tool for aiding communication of foot ulcer etiology to patients. Future studies should investigate whether using the model results in improved patient understanding and self-care and, in turn, contributes to lower ulceration rates.<\/jats:p>","DOI":"10.7547\/21-027","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T19:48:41Z","timestamp":1678391321000},"source":"Crossref","is-referenced-by-count":6,"title":["Fragile Feet and Trivial Trauma: Communicating the Etiology of Diabetic Foot Ulcers to Patients"],"prefix":"10.3390","volume":"113","author":[{"given":"Gustav","family":"Jarl","sequence":"first","affiliation":[{"name":"Department of Prosthetics and Orthotics, Faculty of Medicine and Health, \u00d6rebro University, \u00d6rebro, Sweden."},{"name":"University Health Care Research Center, Faculty of Medicine and Health, \u00d6rebro University, \u00d6rebro, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaap J.","family":"van Netten","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Academic Medical Center, Amsterdam, the Netherlands."},{"name":"School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A.","family":"Lazzarini","sequence":"additional","affiliation":[{"name":"School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia."},{"name":"Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"N Engl J Med","first-page":"2367","article-title":"Diabetic foot ulcers and their recurrence","volume":"376","author":"Armstrong DG","year":"2017","unstructured":"Armstrong DG, Boulton AJM, Bus SA: Diabetic foot ulcers and their recurrence. 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