Lower Extremity Review
Charcot neuroarthropathy is a complex condition that often leads to considerable challenges due to its complex nature. One primary concern is the management of soft tissue complications, including chronic wounds and surgical dehiscence, which are prevalent among Charcot patients. These complications can significantly impact limb functionality and…
By Kelsey Millonig, DPM, MPH, FACFAS, DABPM, DABFAS
Falls are a major public health concern, causing millions of injuries in the United States (US) each year. A portion of injuries caused by falls are likely to involve the lower extremity. The objective of this study was to describe lower extremity injuries caused by falls treated at US hospital emergency departments (EDs).
By Mathias B. Forrester, BS
We all know we will not live forever, but perhaps a good goal would be to not outlive your health. We also know that there are elements of our health we can control and those we can’t. Aging is a simple fact, though we often don’t consider it at the functional microscopic level. We can’t do much about the ending, but we have much to say and…
By Jay Segel, DPM; Sally Crawford, MS
Over the last few decades, clinicians have debated the merits of traditional plaster casting versus modern 3D scanning in orthotic capture. Amid continuing discourse, 1 principle holds: the clinician’s grasp of anatomical data and its impact on device design is critical to success. Equally as vital is the orthotic lab’s role in translating clinical intent into design.
By Dr. Dean Hartley (Podiatrist & Adjunct Engineering Fellow–University of Queensland)
Orthokine® is the proprietary name for a German-developed autologous conditioned serum (ACS) therapy now advanced in musculoskeletal medicine for joint pain. In scientific literature and clinical contexts, Orthokine is used interchangeably with the generic designation autologous conditioned serum (ACS), with…
By Dr. Hooman Mir, DPM, MSci, FAPWCA
UTRGV, School of Podiatric Medicine
Department of Podiatric Medicine, Surgery & Biomechanics
Each one of these so-called “Dirty Truths” has its specific reason, or reasons, for making the list. This one gets most of its “dirtiness” educationally and clinically. Many patients are familiar with the term “pronation,” though their understanding may vary. A clear explanation of body planes and planes of motion is important for an accurate understanding of this concept.
By Jay Segel, DPM; Sally Crawford, MS
Ankle-Foot Orthoses (AFOs) play an essential role in the management of various lower extremity conditions. Coding and compliance accuracy and proper documentation can pose a challenge. Providers must accurately explain why the specific AFO is needed. This is not just a box-ticking exercise but a fundamental element to avoid audit failures.
I am regularly asked, “Why 3D printed?” There are obvious environmental and manufacturing benefits, although speaking from my clinical perspective–it is the design freedom that is most important. The ability to have an unrestricted design envelope, being able to design and manufacture devices lighter, thinner, fully-custom and quicker are just a few of the benefits.
By Dean Hartley (Podiatrist & Adjunct Engineering Fellow–University of Queensland)
Orthobiologics is the science of harnessing and concentrating substances (substrates) that occur naturally in the body. It is theorized that in higher concentrations, biologics may help to enhance (or) improve the healing process. Orthobiologics and bone substitutes represent groundbreaking advancements in regenerative medicine.
By Asim Raja, DPM, FACFAS
Millions of families in the United States (US) own dogs, and with these dogs comes an assortment of dog items (gates, beds, toys, etc.). Tens of thousands of falls associated with dogs are treated at US hospital emergency departments (EDs) each year, a portion of which involve dog items. The objective of this study is to describe dog-item-related…
By Mathias B. Forrester, BS
Assessing the clinical efficacy of different therapeutic options for KOA will aid clinicians in treating patients. While clinicians recognize the positive role of physical therapy in improving symptoms and functionality in knee osteoarthritis (KOA) patients, these methods may differ in mechanisms of action, applicability, and efficacy variances.
By Xiao Chen, Yuanhe Fan, Hongliang Tu, and Yuan Luo
I used to think documentation was the easy part. Write what you saw, describe what you did, keep it clear and detailed. I was trained well. I took pride in good notes—organized, clinical, complete. The kind you’d feel confident handing off to a colleague.
By Cassandre Voltaire, DO, ABWMS
The biomechanics of the diabetic foot are an intricate interplay of physiological and mechanical challenges that necessitate specialized care strategies. Diabetes often triggers changes in foot structure and function as a result of complications including peripheral neuropathy, vascular issues, and obesity.
By James McGuire, DPM, LPT, LPed, FAPWHc
This study highlights the importance of a user-centered design in enhancing adherence to and satisfaction with AFOs. Ankle-foot orthoses (AFOs) are essential in pediatric rehabilitation particularly for children with conditions such as cerebral palsy, drop foot, or neuromuscular impairments.
By Peter Dabnichki and Toh Yen Pang
Dirty Truth #4: Shock Absorption is Energy Loss–Understanding Loading in Gait Analysis
Perhaps the most surprising and unintuitive of all the dirty truths is number four, “Shock absorption via cushion is energy loss.” At first blush, cushion seems like a no-brainer benefit. When we delve into this idea a bit deeper, applying our structure, the forces acting on the lower limbs, and applying the physics that we talked about in the last three dirty truths, the truth of number four becomes clear.
By Jay Segel, DPM; Sally Crawford, MS
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