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Relationship between metatarsal length difference and diagnosis diabetic foot in adult patients from the “Hospital Regional Docente de Trujillo”, Peru.
Universidad Nacional de Trujillo
Orthopaedics and Rehabilitation
Department of Surgery, Division of Traumatology and orthopedics, Hospital Regional Docente de Trujillo Mansiche Avenue 795, Trujillo 13011
Sandro Rodriguez Vasquez MD
Sandro Rodriguez Vasquez MD
Required: English, Accepted: Spanish
Type of Research Project
- Clinical Project without Laboratory work
What is the background of the project?
The importance of knowing and preventing the diabetic foot lies on the risk of death that it presents. The appearance of this complication is associated with different risk factors, such as age, sex, disease time presenting, concluding that they are variables strongly associated with diabetic foot. Modifiable risk factors, such as plantar foot pressures or at the time of walking, lead to changes in the biodynamics of the foot, which if handled correctly can reduce the occurrence of this complication and even prevent it. It has been found that in patients with diabetes mellitus and peripheral neuropathy the movements of individually and unified metatarsals are reduced, concluding that this may be related to tissue deterioration and the location of deformities in the diabetic foot. Variations in metatarsal lengths are associated with forefoot pain with multiple causes and consequences. For the study of these lengths there are 3 main forms of radiological measurement. It has not been possible to determine which is the best method of measurement.
What is the aim of the project?
To determine the relationship between the difference in metatarsal length and diabetic foot in adult patients from the “Hospital Regional Docente de Trujillo”, Peru.
What techniques and methods are used?
1. Participants selection: Selection criteria for the sample will be considered, such as age (adult), date of hospital care, diagnosis of diabetic foot, among others. 2. The information will be collected from the clinical records and the foot full projection x-ray. 2.1. In the clinical record, information about the characteristics that describe the sample and information on the diabetic foot variable will be considered. 2.2. Subsequently, in the foot full projection x-ray, only the length of the 1st and 2nd metatarsals will be measured and their difference will be obtained. 3. Analysis: 3.1. For descriptive analysis of data, the Hardy-Clapham method will be used, which consists in evaluating the difference between the length of the arcs circumference radius centered at the intersection of the long axis of the second metatarsal and a mediotarsal transverse line drawn between the medial portion of the joint of the navicular thallus and the most lateral portion of the calcaneal-cuboid joint. 3.2. For statistical analysis, the data will be processed and analyzed using the statistical package IBM SPSS Statistics 26. To determine the association between metatarsals length difference and diagnosis of diabetic foot, Pearson's Chi square test will be used with a significance level of 5%. (p<0,05)
What is the role of the student?
- The student will mainly observe
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks of the student will be performed on his/her own
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
- Collecting basic information from clinical records of previously examined patients with diabetic foot such as age, date of hospital care, anamnesis, and data about the physical exam. - Confirming the diagnosis of diabetic foot using the operational definition of the variable given by the tutor. - Obtaining the full foot projection radiography of the diabetic foot provided by the patient or doctor in charge. - Examination of the foot projection radiography focusing on the variable “difference in metatarsal length”, therefore, the length of the 1st and 2nd metatarsal will be measured in order to obtain their difference. Finally, the student will fill in the data in the database made by the main researcher.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Optional preliminary readings will be given by the tutor and other researchers from the Investigation department, almost every day.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a scientific report
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Bibliographic search and knowledge about radiographies interpretation. Also the student should know how to perform teamwork and leadership. They must be disciplined, able to work under pressure and to have empathy and respect for the hospital workers. Subjects passed: Anatomy
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students
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- 2. Waaijman R; De Haart M; Arts ML; et al. Risk factors for plantar foot ulcer recurrence in neuropathic diabetic patients. Diabetes Care. 2014 [Consulted January 5th; 2020]; 37:1697-705. Available on: https://care.diabetesjournals.org/content/37/6/1697.long
- 3. DiLiberto F; Tome J; Baumhauer J; Houck J; Nawoczenski D. Individual metatarsal and forefoot kinematics during walking in people with diabetes mellitus and peripheral neuropathy. Gait & Posture. 2015 [Consulted January 5th; 2020]; 42(4): 435–441. Available on: https://www.sciencedirect.com/science/ article/abs/pii/S0966636215007407?via%3Dihub
- 4. Telfer S; Kindig M; Sangeorzan B; Ledoux W. Metatarsal Shape and Foot Type: A Geometric Morphometric Analysis. Journal of Biomechanical Engineering. 2017 [Consulted January 5th; 2020]; 139(3):31-8. Available on: https://www.ncbi.nlm.nih.gov/pubmed/27802481
- 5. Chauhan D; Bhutta M; Barrie J. Does it matter how we measure metatarsal length? Foot and Ankle Surgery. 2011 [Consulted January 5th; 2020]; 17(3):124–127. Available on: https://www.ncbi.nlm.nih.gov/pubmed/21783070
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