Associations Between Diabetic Foot Deformity and the Intrinsic Foot Muscles: A Systematic Review

Area of Science:

• Podiatry
• Diabetology
• Musculoskeletal Research

Background:

• Diabetic foot deformities, like claw toes, are significant complications.
• The role of intrinsic foot muscles (IFMs) in these deformities is traditionally assumed but underexplored.
• Emerging imaging studies suggest a link between IFM changes and diabetic foot deformity.

Purpose of the Study:

• To systematically review existing literature on associations between diabetic foot deformity and intrinsic foot muscle alterations.
• To evaluate the clinical significance of these observed associations.

Main Methods:

• Comprehensive literature search of major databases (Medline, Embase, Scopus, CINAHL, Web of Science) up to June 2023.
• Inclusion of human studies in English focusing on diabetes, foot deformities, and intrinsic foot muscles.
• Quality assessment using STROBE and Newcastle Ottawa Scale.

Main Results:

• 13 studies met inclusion criteria.
• Six studies reported correlations between intrinsic foot muscles and toe deformities (claw/hammer toes).
• Two studies found significant correlations between medial column deformity and intrinsic foot muscle atrophy.

Conclusions:

• A weak association exists between diabetic foot deformity and intrinsic foot muscle atrophy.
• Intermuscular adipose tissue infiltration is also weakly associated with diabetic foot deformity.