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Lower Extremity Review

Civilian Lower Extremity Injuries Resulting from Fires in the United States

Civilian Lower Extremity Injuries Resulting from Fires in the United States

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Background: In 2023, an estimated 13,350 civilian fire injuries were reported in the United States (US). The objective of this study was to characterize civilian lower extremity injuries resulting from fires in the US. Methods: Data were obtained from the National Fire Incident Reporting System (NFIRS), which collects information on incidents to which fire departments respond in the US. Cases were civilian lower extremity injuries resulting from fires reported to NFIRS during 2014-2023. The distribution of cases was determined for patient characteristics, type of injury, and circumstances of injury.

By Mathias B. Forrester, BS

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Machine Learning Combined with Explainable Artificial Intelligence Facilitate Accurate Balance Ability Classification

Machine Learning Combined with Explainable Artificial Intelligence Facilitate Accurate Balance Ability Classification

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Using computerized posturographic parameters provides a highly quantitative and objective measure without ceiling or floor effect as a classifier or predictor of falls. The balance control problem is one of the major contributing factors to falls and may change with aging, medication, or acute illness. Computerized posturography obtained in standing conditions has been applied to classify fall risk for older adults or disease groups.

By Huey-Wen Liang, Rasoul Ameri, Shahab Band, Hsin-Shui Chen, Sung-Yu Ho, Bilal Zaidan, Kai-Chieh Chang, and Arthur Chang

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CAGA 101: The 12 Dirty Truths Playbook Dirty Truth #2: Realities of Center of Pressure in Dynamic World

CAGA 101: The 12 Dirty Truths Playbook Dirty Truth #2: Realities of Center of Pressure in Dynamic World

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It’s a physics problem – We live dynamic lives, in turn, we suffer dynamic consequences! In the last installment, we focused on our problematic anatomy. We continue this discussion by looking at what happens when we add the interaction between 2 dissimilar bodies, the foot and the floor, and the introduction of force.

By Jay Segel, DPM; Sally Crawford, MS

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Targeted Hip Muscle Strengthening Improves Lower Extremity Kinematics in Runners

Targeted Hip Muscle Strengthening Improves Lower Extremity Kinematics in Runners

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Dynamic knee valgus, a highly reliable measure of this alignment assessed in the frontal plane, is a valuable tool for identifying this pathomechanical dysfunction. The purpose of this study was to investigate the effectiveness of functional hip abductor strength training on reducing contralateral pelvic drop angle…

By Shreen Ahmed Lashien, Ahmed Omar Abdelnaeem, and Ebtessam Fawzy Gomaa

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CAGA 101: The 12 Dirty Truths Of Foot Mechanics

CAGA 101: The 12 Dirty Truths Of Foot Mechanics

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In the introductory article on the dirty truth of biomechanics, we presented a playbook laying out 12 particularly concerning issues as they relate to human weight-bearing and locomotion. In this installment, we will delve into dirty truth number one, problematic anatomy, laying out the “whats” and the “whys”, and how computer-aided gait analysis (CAGA) can make this dirty truth a bit cleaner and more digestible.

By Jay Segel, DPM; Sally Crawford, MS

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Unipedal Stance Reliably Measures Neuromuscular Aging

Unipedal Stance Reliably Measures Neuromuscular Aging

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Adequate muscle strength, efficient gait, and good balance, which decline with age, are crucial contributors to independence and well-being. Aging is often associated with disability and multiple health concerns. To address these challenges, effective interventions are essential. This study investigated potential age-related declines in gait, balance, and…

By Asghar Rezaei, Sandesh G. Bhat, Chih-Hsiu Cheng, Robert J. Pignolo, Lichun Lu, and Kenton R. Kaufman

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Introducing the 12 Dirty Truths Playbook: A New LER Series In Biomechanics and CAGA

Introducing the 12 Dirty Truths Playbook: A New LER Series In Biomechanics and CAGA

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The medical field continues to experience rapid technological advancements, providing us with critical graphs and quantitative measurements that validate what we see, the qualitative findings. For healthcare professionals charged with understanding and addressing gait, recognizing the correlation of what happens during weightbearing and the challenges/costs to the musculoskeletal system is key.

By Jay Segel, DPM; Sally Crawford, MS

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Precision Healing: The Art & Science of Matrix Products in Lower Extremity Wound Care

Precision Healing: The Art & Science of Matrix Products in Lower Extremity Wound Care

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Wound care is an evolving science, but if there’s one lesson I’ve learned, it’s this: healing isn’t just about using the latest product—it’s about knowing when and how to use it. Early in my career as a family physician, I saw a number of chronic wounds stagnate despite standard treatments. Patients were frustrated. So were we. The limitations of traditional approaches were clear, but what wasn’t clear was…

By Cassandre Voltaire, DO

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LER EXPO Conversations: Surgical Considerations for Flexible Adult Stage 2 Flatfoot

LER EXPO Conversations: Surgical Considerations for Flexible Adult Stage 2 Flatfoot

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Flatfoot, particularly flexible adult Stage 2 flatfoot, presents a complex challenge. This summary reviews proper patient evaluation for the condition and discusses the critical non-surgical and surgical considerations for managing stage 2 flatfoot, offering a deep dive into both soft tissue and osseous procedural options. By understanding the pathology’s nature, evaluating the demographic factors, and…

A summarized talk by Joseph Park, DPM, FACFAS

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Movements Count: 5 Minutes of Exercise Per Day Could Lower Blood Pressure

Movements Count: 5 Minutes of Exercise Per Day Could Lower Blood Pressure

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In free-living environments, more time spent in exercise-like activities has the strongest association with blood pressure (BP), and even small changes to daily movement patterns can elicit clinically meaningful improvements. Multinational researchers from the ProPASS Consortium (Prospective Physical Activity, Sitting and Sleep) used data from thigh-worn accelerometers and BP measurements of…

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Minimally Invasive Bunion Surgery for Hallux Valgus: A Surgical Technique

Minimally Invasive Bunion Surgery for Hallux Valgus: A Surgical Technique

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Hallux valgus (HV) is a common forefoot problem with a reported prevalence of 23% in adults age 18–65 years and 35.7% in adults aged over 65 years. More than a hundred procedures were described to treat HV deformity. Traditionally, surgical treatment of HV included open osteotomies and soft tissue procedures. In recent years, minimally invasive surgery…

By Erdi Özdemir, MD, and Michael Aynardi, MD

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Computer-Aided Gait Analysis Can “See” Blind Gait

Computer-Aided Gait Analysis Can “See” Blind Gait

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Imagine for a moment, you were cast into a world of uncertainty by the loss of sight. Your relationship with all you know is forever changed. We have “tells” to these challenges and learn ways of adapting to our new circumstances. We do things slower, with less confidence, and rely on our other senses. We listen for auditory cues, but perhaps the sense we lean on…

By Jay Segel, DPM; Sally Crawford, MS; Ronald Sherman, DPM, MBA

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