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A hyperextension MTPJ movement pattern associated with limited ankle dorsiflexion has been characterized in people with diabetic neuropathy. Increased MTPJ extension during movement and functional tasks was correlated with severity of resting MTPJ alignment. Repetition of this movement pattern could be an important factor in the etiology of MTPJ deformity and future risk of ulceration.
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Cheuy et al. (2016) studied this question.
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