Neuropathy, Claw Toes, Intrinsic Muscle Volume, and Plantar Aponeurosis Thickness in Diabetic Feet

Background: The objective of this study was to explore the relationship between claw toe deformity, peripheral neuropathy, intrinsic muscle volume, and plantar aponeurosis thickness using computed tomography (CT) images of diabetic feet. Methods: Forty randomly-selected subjects with type 2 diabetes were selected for each of the following four groups (n = 10 per group): 1) peripheral neuropathy with claw toes, 2) peripheral neuropathy without claw toes, 3) non-neuropathic with claw toes, and 4) non-neuropathic without claw toes. The intrinsic muscles of the foot were segmented from processed CT images. Plantar aponeurosis thickness was measured in the reformatted sagittal plane at 20% of the distance from the most inferior point of calcaneus to the most inferior point of the second metatarsal. Five measurement sites in the medial-lateral direction were utilized to fully characterize the plantar aponeurosis thickness. A linear mixed effects analysis on the effect of peripheral neuropathy and claw toe deformity on plantar aponeurosis thickness and intrinsic muscle volume was performed. Results: Presence of claw toe deformity ( p = 0.008) and presence of neuropathy ( p = 0.039) were both associated with decreased intrinsic muscle volume. Subjects with both neuropathy and claw toe deformity had significantly thicker plantar aponeurosis tissue compared with the other three permutation subgroups ( p < 0.001). A negative correlation was observed between plantar aponeurosis thickness and intrinsic muscle volume ( R 2 = -0.3233, p < 0.001). Conclusions: In subjects with claw toe deformity, there were strong relationships between smaller intrinsic foot muscle volumes and thicker plantar aponeurosis tissue. Intrinsic muscle atrophy and plantar aponeurosis thickening may be related to the development of claw toes.

Bionic Design for Mars Sampling Scoop Inspired by Himalayan Marmot Claw

Cave animals are often adapted to digging and life underground, with claw toes similar in structure and function to a sampling scoop. In this paper, the clawed toes of the Himalayan marmot were selected as a biological prototype for bionic research. Based on geometric parameter optimization of the clawed toes, a bionic sampling scoop for use on Mars was designed. Using a 3D laser scanner, the point cloud data of the second front claw toe was acquired. Parametric equations and contour curves for the claw were then built with cubic polynomial fitting. We obtained 18 characteristic curve equations for the internal and external contours of the claw. A bionic sampling scoop was designed according to the structural parameters of Curiosity’s sampling shovel and the contours of the Himalayan marmot’s claw. Verifying test results showed that when the penetration angle was 45° and the sampling speed was 0.33 r/min, the bionic sampling scoops’ resistance torque was 49.6% less than that of the prototype sampling scoop. When the penetration angle was 60° and the sampling speed was 0.22 r/min, the resistance torque of the bionic sampling scoop was 28.8% lower than that of the prototype sampling scoop.

Metatarsal Shaft Fracture with Associated Metatarsophalangeal Joint Dislocation

Metatarsophalangeal joint dislocations of lesser toes are often seen in the setting of severe claw toes. Traumatic irreducible dislocations have been reported in rare cases following both low-energy and high-energy injuries to the forefoot. In this case report, I present a previously unreported association of a metatarsal shaft fracture with metatarsophalangeal joint dislocation of a lesser toe.

Podiatric Medical Abnormalities in a Random Population Sample 40 Years or Older in Spain

Background Podiatric medical abnormalities are highly prevalent, yet few random population studies exist that determine the presence of pathologic abnormalities in the feet, despite their importance. The aim of this study was to determine the prevalence of podiatric medical abnormalities in a random sample population 40 years or older. Methods An observational study was conducted of a random sample population (n = 1,002) located in A Coruña, Spain. Anthropometric variables, comorbidity (Charlson score), quality of life (36-item Short-Form Health Survey), and podiatric medical examination findings were studied. A descriptive analysis and multivariate logistic regression were performed. Results The most common diseases were claw toes (69.7%), hallux valgus (38%), and hallux extensus (15.8%), which increased with age and female sex. The most frequent metatarsal formula was index minus (40.9%), followed by index plus minus (35.0%). The most frequent digital formula was Egyptian foot (57.1%), followed by Greek foot (31.4%). In this study, although the presence of podiatric medical abnormalities reduced the probability of enjoying a better quality of life, it did not do so significantly. After taking into account age, sex, comorbidity, body mass index (BMI), and the presence of podiatric medical abnormalities, the variables with an independent effect that modified the physical component of quality of life were sex (female), comorbidity, and BMI. Conclusions There was a high prevalence of podiatric medical abnormalities, which increased with age and female sex. Comorbidity, BMI, and sex modified quality of life independently of podiatric medical abnormalities.