Lower Extremity Review
Early assessment and intervention of acquired adult flatfoot, particularly concerning Posterior Tibial Tendon Dysfunction (PTTD) is essential. I’ll be discussing proactive management, emphasizing the importance of early intervention, comprehensive foot assessment, and the strategic application of orthotic devices to prevent the progression of PTTD and improve long-term patient outcomes.
By Dr. James McGuire DPM, LPT, LPed, FAPWHc
Minimally Invasive Surgery (MIS) in foot and ankle continues to evolve, offering new avenues for patient care. This discussion delves into the nuances of MIS, particularly concerning bunion correction and common challenges. For those venturing into or deepening their expertise in MIS, understanding the learning curve is paramount. While historically mastering bunion correction required 60–70 cases in 2017, to 40 cases in 2022, advancements like third-generation bunion correction with 2 screws, stable fixation, and jigs have significantly reduced this learning. It is important to note that these learning curves are not directly correlated to complication.
By Raquel Sugino, DPM, MS, FACFAS
Gait impairments are among the most common and disabling symptoms of Parkinson’s disease and are especially aggravated in dual-task conditions. Interventions with conventional physical therapy improve gait cadence and speed, cognition, fear of falling, and freezing of gait. However, exergames have attracted interest in the treatment of people with Parkinson’s disease due to the characteristics of the…
The plantar fascia is composed of fibrous connective tissue that forms a band running from the calcaneal tubercle distally to the toes. One of its main roles is to provide passive support to the medial longitudinal arch on the sole of the foot. This support is compared to a tie-rod tension producer during weight bearing. When loaded excessively during vocational or athletic activities, overuse in the form of…
Venous leg ulcers (VLUs) and diabetic foot ulcers (DFUs) are chronic wounds associated with significant morbidity, high recurrence rates, and poor healing outcomes. Conventional treatments often fail to achieve satisfactory results, leading to prolonged pain, infection risks, and reduced quality of life. Oxygen-ozone therapy (OOT) has emerged as a potential adjunct to conventional wound care, with…
Tendon properties influence athletic performance, and Achilles tendon (AT) stiffness correlates with an athlete’s jumping performance across sports. This study examined the relationship between AT stiffness and jumping performance in male athletes. Sixty-six males (24.9 ± 4.7 years; 22 basketball players (22.0 ± 4.1 years), and 44 soccer players (26.3 ± 4.4 years) participated.
Running is a popular competitive and recreational activity with numerous health benefits, including reduced risk of cardiovascular disease and all-cause mortality, and improved mental health. Despite these benefits, running continues to carry a high risk of injury. The primary objective of this study was to compare plantar pressure (peak forefoot and rearfoot pressure, center of pressure displacement and distance) between maximal…
Plantar fasciitis is a very common issue with many treatment options. The purpose of this study was to investigate if patient’s response to previous local steroid injection is predictive of their response to endoscopic plantar fascia release in regard to pain relief, functional recovery, and patient satisfaction. Researchers hypothesized that previous temporary improvement in response to local corticosteroid injection is…
Custom-made footwear designed specifically for indoor use increases footwear adherence in people with diabetes at high ulcer risk. The design and biomechanical requirements of such footwear are important if they are to safely replace regular custom-made footwear for indoor use. Researchers aimed to compare indoor-specific versus regular custom-made footwear for design characteristics and biomechanical function.
Ingrown toenails, a common and often painful condition, frequently require surgical intervention for effective management. This study aimed to compare the clinical outcomes of partial nail avulsion (PNA) with and without adjunctive phenolization, specifically focusing on recurrence and postoperative wound infection rates.
Diabetic foot infections (DFIs) are one of the most important components causes for foot related hospitalization, surgery and lower extremity amputation. In addition to foot specific complications, DFIs are also associated with an increased risk of systemic complications such as acute kidney injury, central line infections, bacteraemia and endocarditis.
Arthrodesis of the first metatarsophalangeal (MTP) joint has been the gold standard for surgical treatment, particularly in cases of advanced joint destruction. This procedure is favored for its effectiveness in alleviating pain and improving function, despite sacrificing joint mobility. This study compares the clinical outcomes of first MTP joint…
Diabetic neuropathy (DN) is a widespread complication of diabetes, affecting nearly 50% of individuals with the condition. It commonly begins with the gradual loss of sensation in the lower extremities, particularly in the feet. If left undetected and untreated, this loss of sensation can lead to serious consequences, such as…
Midfoot pain is common but poorly understood, with radiographs often indicating no anomalies. This study aimed to describe bone, joint and soft tissue changes and to explore associations between MRI-detected abnormalities and clinical symptoms (pain and disability) in a group of adults with midfoot pain, but who were radiographically negative for osteoarthritis.
Hallux valgus is the most common pathology afflicting the hallux. Surgery is generally offered to symptomatic patients who fail conservative treatment. The aim of this study is to evaluate patient-reported reasons for undergoing hallux valgus corrective surgery in a preoperative and postoperative cohort.
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