Identification of diabetic neuropathic patients at risk of foot ulceration through finite element models and cluster analysis

Background Diabetic foot is an invalidating complication of diabetes mellitus that can lead to foot ulceration and amputations. While experimental analyses are limited solely to measurements of interfacial variables, three-dimensional (3D) patient specific finite element models (FEMs) of the foot can provide both the interfacial pressures and insight into internal stresses and strains tolerated by the plantar tissue [1]. FEMs allows quantifying the loads developed in the different anatomical structures of the foot and to understand how these affect foot tissue [2]. The aim of this study was to identify the neuropathic subjects at risk of ulceration with a cluster analysis classification of simulated plantar pressures and internal stresses. Simulations were ran with gait analysis data acquired 5 years prior to ulcerations.