Soft tissue biomechanics of diabetic foot ulcers

Diabetic foot ulcers are among the most significant complications in people with diabetes mellitus (DM). The number of diabetics is estimated to double by 2030. It is clear that diabetic foot ulcers are a top public healthcare issue. Although the etiology of diabetic foot ulcers remains much unknown, it is widely accepted that repetitive high plantar pressure during walking may initiate the foot ulcer development. In this chapter, we review the effects of DM on the changes of composition and structure of the soft tissues of the diabetic foot and how these factors cause abnormally high plantar pressure during walking. We also review research methods used to quantify alterations of soft tissue mechanical properties of the diabetic foot. The orthotic devices used in the reduction of peak plantar pressure and healing of diabetic foot ulcers are introduced.