Feature Article | Lower Extremity Review Magazine

This case study documents the transition from rigid post-operative immobilization to dynamic carbon fiber bracing in a 46-year-old patient following primary open Achilles tendon repair performed in a foot and ankle surgical practice. At 6 weeks post-op, the patient was transitioned out of a tall controlled-ankle-motion boot into the Trulife L-Pace, a posterior lateral strut carbon fiber AFO selected for its intermediate stiffness, energy return characteristics, and compatibility with standard footwear.

CAGA 101: The 12 Dirty Truths of Foot Mechanics

“It’s all Greek to me,” and other versions of this quote are common idioms in modern language to denote communication issues, for example, when patients and practitioners from different specialties use different languages to discuss the same problem. Whatever one thinks of the phrase’s origins, the sentiments of Julius Caesar’s quote from William Shakespeare are clear. We don’t always understand one another.

By Jay Segel, DPM; Sally Crawford, MS

Regenerative Therapies Move to the Front Line in Lower Extremity Care

For decades, the treatment pathway for chronic foot and ankle conditions followed a familiar progression: conservative care, escalating symptoms and ultimately, surgery for patients who failed to improve. Today, that pathway is evolving. A growing number of clinicians are incorporating regenerative therapies earlier in the process, offering patients additional options before surgical intervention becomes necessary.

By Keith Loria

Medicare Without the Maze

If you talk to patients and clinicians actually living and working inside Medicare Advantage (MA), a pattern emerges that doesn’t show up in the glossy ads touting its promise. People are spending an enormous amount of time and energy trying to navigate a system that is supposed to make their lives easier. Clinicians are burning out on the administrative friction that comes with it.

By Mikel D. Daniels, DPM, MBA, President and Chief Medical Officer, WeTreatFeet Podiatry

Lapidus in a Box™: A Novel All-in-One Solution for Modern Lapidus Arthrodesis

The Lapidus procedure remains one of the most powerful techniques for correcting hallux valgus deformity, restoring first-ray stability, and addressing pathologic hypermobility at the first tarsometatarsal (TMT) joint. While surgical indications continue to expand, many surgeons still face challenges involving reduction control, fixation strength, maintenance of correction, fusion-site compression, and operating room efficiency.

By Robby Amiot, DPM, FACFAS

Unilateral Drop Foot in a Patient with Diabetic Neuropathy

This case study documents the functional impact of the Trulife A-Pace Anterior Lateral Strut Carbon Fibre AFO in a 62-year-old female with longstanding type 2 diabetes, established peripheral neuropathy, and a new unilateral left-sided drop foot presentation. The etiology was a common peroneal mononeuropathy, confirmed on electrodiagnostic study, with an indeterminate trigger but presumed multifactorial in the setting of underlying diabetic microvascular disease and mechanical compression from prolonged cross-legged sitting.

lerEXPO Highlights: 5 Insights That Are Changing How We Treat Flatfoot

Flatfoot is frequently marginalized in clinical conversations as a mere structural quirk–a low arch that requires little more than an orthotic. Yet, for patients, it represents a progressive biomechanical failure and a source of chronic, lifestyle-altering pain. For the surgical community, it has long been a battlefield of competing philosophies. How do 15 of the world’s leading orthopedic minds find common ground on a condition so riddled with nuance?

By Jeff Dikis, DPM, Brad Abicht, DPM, FACFAS and Julio Ortiz, DPM, FACFAS

Insurance Prior Authorization Reform: Why It Matters for Podiatrists

There’s a quiet but meaningful shift happening in the way insurance companies handle prior authorizations. For those of us in podiatry, it has the potential to change how we deliver care in very practical ways. Starting (it has been reported) January 1, several of the country’s largest insurers, such as UnitedHealthcare, Humana, and Aetna are planning to adopt a single, standardized approach for pre-treatment reviews.

By Mikel D. Daniels, DPM, MBA, President and Chief Medical Officer, WeTreatFeet Podiatry

Dirty Truth #10: Bottom Up and Top Down

Dirty Truth #10 is grounded in the old saying, “where the rubber meets the road.” When your foot strikes the ground, the ground hits you back. The foot goes from an unloaded state (swing phase) to a weight-bearing, interactive body, getting pushback during every step you take on that road. The equal and opposite force Newton promised us. This bottom-up view changes everything.

By Jay Segel, DPM; Sally Crawford, MS

Biointegrative Implants Reshape Foot and Ankle Surgery

For decades, metal hardware has been the standard in foot and ankle surgery. Screws, plates and pins have provided reliable fixation, enabling surgeons to stabilize bones and joints during healing. While effective, these materials often remain in the body permanently, and in some cases, require secondary procedures for removal due to irritation or complications.

By Keith Loria

Rock Climbing-Related Lower Extremity Injuries Treated at Hospital Emergency Departments

Rock climbing includes different disciplines such as traditional climbing (temporary rope anchoring placed during the climb), top rope or speed climbing (rope anchoring at the top of the wall, indoor only), sport climbing (ropes anchored at multiple fixed points while ascending), and bouldering (short distance climbing without ropes). It can be performed outdoors on natural terrain or outdoors and…

By Mathias B. Forrester, BS

lerEXPO Highlights: AI-Assisted Risk Stratification and Management in Diabetic Limb Salvage

The global prevalence of diabetes is increasing and is projected to affect 642 million people by 2040, highlighting the growing need for effective prevention, management, and supportive care. Diabetes can be associated with a range of health complications that require ongoing medical attention. Among these, diabetic foot conditions–particularly ulcerations and infections–are leading contributors to non-traumatic lower-limb amputations.

By Dr. Laura Shin

Rethinking the Role of the Plantar Fascia’s Windlass Mechanism

Ever since Sahelanthropus tchadensis stood upright 7 million years ago, the feet of our common ancestors have undergone a series of important structural changes necessary to accommodate the functional requirements of bipedal locomotion. While the feet of arboreal primates were well-adapted for grasping branches during movement through tree canopies, their hypermobile midfoot and adducted great toe led to instability and buckling during the push-off phase of gait…

By Tom Michaud, DC, and Nicolas Haelewijn, Ph. D.

The Halo Effect of Technology in Podiatric Practice

When patients enter a podiatry office, their impressions begin forming immediately. Before any history is taken or exam performed, they are already processing what they see. Eyes are drawn to the physical space, the efficiency of the front desk, the demeanor of the staff. They enter the treatment room and notice the equipment in the room while waiting for the physician. These early signals shape expectations in ways that are both subtle and powerful.

By Mikel D. Daniels, DPM, MBA, President and Chief Medical Officer, WeTreatFeet Podiatry

CAGA 101: The 12 Dirty Truths of Foot Mechanics