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Foot Ankle Surg. 2012 Mar;18(1):42-9. doi: 10.1016/j.fas.2011.03.004. Epub 2011 Apr 8.

Pedographic classification and ulcer detection in the diabetic foot.

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Hufeland Klinik, Orthopedic Department, Taunusallee 5, 56130 Bad Ems, Germany.



Plantar pressure is a cause of foot ulceration in diabetes. Attempts to determine a pressure threshold have failed. The aim of this study was to determine a pedographic classification to identify patients at risk for a foot ulcer.


210 diabetics and controls categorized into 4 groups with deformities of the forefoot were analyzed. For the pedographic measurement peak pressure, force and their integrals were analyzed using a percentage and an anatomic mask. A multivariant logistic regression analysis was performed.


Logistic regression analysis using pedographic variables of a percentage mask revealed a combination of 4 variables (pressure time integral forefoot, peak pressure midfoot, pressure time integral heel, and peak pressure heel) identifying the foot ulcer with a sensitivity of 73% and a specificity of 87%. The analysis using an anatomic mask identified 8 variables (pressure time integral mask 4 (metatarsal 2), force mask 9 (2. toe), force time integral mask 8 (great toe), peak pressure mask 6 (metatarsal 4), pressure time integral mask 6 (metatarsal 4), peak pressure mask 8 (great toe), peak pressure mask 7 (metatarsal 5), and force mask 6 (metatarsal 4)) that characterized a pedal ulcer with a sensitivity of 95% and a specificity of 90%.


This screening method identifies diabetics who are at risk for a foot ulcer.

[Indexed for MEDLINE]

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