Predisposing Risk Factors for Osteomyelitis
Diabetic neuropathy is the major contributor to ulcer formation and subsequent
osteomyelitis.
 | Sensory neuropathy:
 | Repetitive damage and trauma without protective reflexes. |
|
| Motor neuropathy:
| Strong plantar flexors overcome weaker dorsiflexors leading to pes cavus and equinus
deformities. |
| Weak intrinsic muscles lead to claw and hammer toe deformities. |
| These imbalances lead to altered weight distribution and foot pressures, causing
abnormal pressure points, shoe wear, and skin breakdown. |
|
| Autonomic neuropathy:
| Deficient sweat production causes thick, dry skin and callus formation in areas of
pressure. Fissures develop and allow entry of microorganisms. Ulcer and sinus tract
formation begins. |
|
Neuropathy and peripheral vascular disease combine to place diabetic patients at a
markedly increased risk to develop osteomyelitis.
|
