Limited joint mobility and plantar fascia function in Charcot's neuroarthropathy

Aim: The aim of this study was to investigate the prevalence of limited joint mobility at the first metatarsophalangeal joint (MPJ) and dysfunction of the plantar fascia in people with diabetes mellitus and Charcot's neuroarthropathy and a control group. Methods: Fifteen subjects with a history of mid-foot Charcot's neuroarthropathy and 26 controls with sensory neuropathy but no Charcot's neuroarthropathy were recruited. Ranges of ankle and first MPJ dorsiflexion were measured for each participant. Plantar fascia function was assessed using Jack's test. Results: The range of dorsiflexion at the first MPJ was significantly reduced in the subject group compared with the control group (51.2 vs. 64.8; P < 0.001). Jack's test demonstrated the plantar fascia to be ruptured or dysfunctional in all feet in the subject group and to be functioning in all feet in the control group. Conclusions: It is not possible to determine from this study if the limited joint mobility at the first MPJ and dysfunction of the plantar fascia preceded or followed the development of Charcot's neuroarthropathy; however, these results are a previously unreported finding in Charcot's neuroarthropathy.