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Neuropathy (+/-) ischaemia + abnormal foot structure + poor footwear
Callus
Increased pressure
Necrosis of tissue
Break in epidermis/dermis
figure 2.2   Pathway to foot ulceration in the diabetic foot
Author Note
Foot deformity plus neuropathy lead to increased repetitive pressure
and altered time loading over vulnerable areas of the foot which in turn
cause callus and ulceration. The commonest site for ulceration in the
neuropathic foot is under the first metatarso-phalangeal joint.
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