Biomechanical factors in diabetic foot disease

Methods Although the risk of vascular disease is markedly increased in diabetes [1], it is the combination of altered vascular status and nerve damage that often leads to ulceration and amputation [2]. Important early studies by Brand and colleagues [3] focused on elevated stress in a deformed, neuropathic limb as a causative factor in tissue breakdown and this has been a constant theme of experimental and analytical studies to the present day.