Cover Story | Lower Extremity Review Magazine

Cover Story

Lower Extremity Review

When Long COVID Walks into the Office: Recognizing Foot and Ankle Manifestations

2026, Cover Story, October

A Patient walks into the office with generalized foot pain. Taking a history, you learn the patient has fatigue, or myalgias in other muscles, or feels weak all the time. What are the usual diagnoses? Long COVID has changed how I approach foot and ankle pain in these patients. I no longer believe we can safely evaluate lower-extremity symptoms without at least considering its potential role. When patients tell me their feet “haven’t been right” since having COVID, I don’t dismiss the comment. I treat it as a meaningful clinical clue. This does require some outside-the-box thinking, and we all need to start taking a deeper dive.

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

Minimally Invasive Surgery (MIS) for Bunion Correction: Techniques, Evidence, and Case Analysis

2026, Cover Story, September

The surgical landscape for hallux valgus (bunion) correction has undergone a significant transformation since 2019, driven by FDA clearance of percutaneous burrs and specialized instrumentation. This article examines the shift from open bunionectomies to minimally invasive surgery (MIS), specifically focusing on fourth-generation techniques. Key findings indicate that MIS offers superior cosmetic outcomes, preserved joint range of motion, and immediate weight-bearing capabilities. While the procedure presents a steep learning curve, its versatility allows for the correction of mild to severe deformities through three-dimensional metatarsal realignment. Evidence suggests that while two-screw fixation is biomechanically superior, single-screw techniques offer reduced operative time and lower hardware removal rates. The preservation of soft tissues and blood supply in MIS facilitates a unique healing process where the resulting “pyramid-shaped” void undergoes calcification and ossification, supported by Wolf’s Law.

By Brad Abicht, DPM, FACFAS

lerEXPO Highlights: Promoting Diabetic Foot Health Through a Patient Activation Program

2026, August, Cover Story

In the quiet of a clinical exam room, the most telling diagnostic tool often isn’t a scalpel or a high-tech scanner–it is a gallon-sized freezer bag. Inside, the plastic crinkles as a patient pulls out a dozen amber pill bottles. They stare at the labels, a look of profound confusion on their faces, often unable to explain what half of the medications are even for. This “bag of pills” is the visceral reality for many of the 38 million Americans living with diabetes.

By Dr. Windy Cole, DPM, CWSP, FACCWS, FFPM RCPS (Glasg)

Diabetic Foot: The Scope of the Problem

2026, Cover Story, July

The human foot is often treated as a medical afterthought–a neglected masterpiece at the very end of the body. In the hierarchy of anatomy, we prioritize the head and the heart, yet we frequently ignore the foundation that allows us to navigate our lives until the moment it begins “killing us.” Practicing at this anatomic peninsula requires a unique perspective.

By Dr. David Armstrong, DPM, PHD

lerEXPO Highlights: 5 Surprising Lessons from the Frontlines of Limb Preservation

2026, Cover Story, June

In the relentless landscape of diabetic limb preservation, the clock is the surgeon’s most formidable adversary. Every 20 seconds, a lower limb is lost to amputation somewhere on the globe. For those of us operating out of high-volume centers like the University of Maryland, these aren’t just figures in a journal–they are the visceral realities of a Tuesday-to-Thursday phenomenon.

Imagine a patient walking into your clinic on a Tuesday, seemingly stable. By Thursday, they are in the emergency department (ED) with a white cell count of 35,000–a systemic alarm bell signaling a limb in total crisis. In Baltimore, even the sterile pad gloves discarded on the street seem to tell us we’re doing too much, urging us to take a day off. But in limb salvage, a day off is a luxury the pathology doesn’t allow. To get close to great in these outcomes, we must move beyond the standard debridement and embrace a more aggressive, nuanced surgical philosophy.

By Jake Wynes, DPM, MS, FACFAS

Wound Talk with Dr. Windy Cole: Giving Lymphedema the Squeeze: All Things Compression

2026, Cover Story, May

In traditional medicine, we often treat the vascular, integumentary, and lymphatic systems as separate silos. However, the “Veil Theory,” championed by Dr. Heather Hettrick, reveals that these systems are inextricably linked. At the center of this connection is the endothelial glycocalyx, a microscopic, sieve-like layer within our blood vessels that regulates the movement of fluid and proteins.

By Dr. Windy Cole, DPM, CWSP, FACCWS, FFPM RCPS (Glasg) with Dr. Loan Lam DPM,
FAWPHc, FAPWCA, CWSP, CHWS, CLWT and guest Cam Ayala

Snake Bites to the Lower Extremity Reported to U.S. Emergency Departments

2026, April, Cover Story

Background: Thousands of snake bites occur in the U.S. each year. Venomous snake bites can produce serious adverse effects, and even bites from nonvenomous snakes may cause adverse effects. Snake bites are often treated at hospital emergency departments (EDs). The objective of this study was to describe snake bites to the lower extremity treated at US hospital EDs.

Methods: The data source for this study was the National Electronic Injury Surveillance System (NEISS), a database of consumer product- and activity-related injuries collected from a representative sample of approximately 100 U.S. hospital EDs. National estimates are calculated from database records according to the sample weight assigned to each case based on the inverse probability of the hospital being selected for the NEISS sample. Cases were snake bites to the lower extremity treated during 2000–2024. The distribution of snake bites to the lower extremity was determined for selected variables.

By Mathias B. Forrester, BS

lerEXPO Highlights: Fibular Nails–Fad or New Standard?

2026, Cover Story, March

This article synthesizes the key findings, surgical techniques, and clinical insights from a lerEXPO’s 2025 Gait Keepers Journal Club regarding the use of intramedullary fibular nails for distal fibula fractures. The primary focus is on a retrospective multi-center study published in the Journal of Foot & Ankle Surgery (JFAS) in 2023, which represents the largest cohort of its kind to date.

The transition from traditional Open Reduction Internal Fixation (ORIF) with plates and screws toward intramedullary fibular nailing represents a significant paradigm shift in ankle fracture management. While historically reserved for “train wreck” patients–those with compromised soft tissue, diabetes, or advanced age–current clinical evidence suggests that fibular nails are highly effective for simpler fracture patterns, such as stress-positive Weber B fractures.

By Brian Burgess, DPM with Brad Abicht, DPM, FACFAS and Jeff Dikis, DPM

Closing the Loop on “Frequent Flyers”

2026, Cover Story, February

I used to think that my job ended when the wound closed. Document the healing, schedule a routine follow-up, and move on to the next case. But after over 2 decades managing diabetic foot wounds at high volume, I’ve learned that the months immediately following epithelialization are (counterintuitively) when my patients need me most.

The “frequent flyers” in my practice are diabetic patients who cycle in and out: ulcer, healing, discharge, recurrence, ulcer again. Some have already lost part of a foot to amputation. Others carry multiple comorbidities–vascular disease, renal insufficiency, and poor glycemic control. These are the patients who have the deck stacked against them. Their decline follows a predictable path. Without a rigorous, closed-loop post-healing protocol, these patients almost always reulcerate. Studies show that reulceration rates hover around 40% at 1 year and up to 65% at 5 years 1. Hospitalization for cellulitis or abscess becomes routine. Amputation often feels inevitable.

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

Zipline-Related Lower Extremity Injuries Treated at Hospital Emergency Departments

2026, Cover Story, January

A zipline is a horizontal rope, wire, or beam with a mechanical system that allows a person to slide along the rope, wire, or beam by hanging beneath it. Ziplines can range from something as simple as a piece of wire and a clothesline pulley to complex assemblies containing cables, attachments, trollies, computer control systems, hydraulics, motors, and sophisticated braking systems. Using ziplines has gained popularity as a form of outdoor recreation. As of 2020, there were over 400 commercial ziplines in the U.S. that provided more than 70 million rides annually.

By Mathias B. Forrester, BS

Controlled Ankle Motion Walkers: Similar, but Not the Same

2025, Cover Story, December

Controlled Ankle Motion walkers (CAMs) are prefabricated ankle-foot interventions commonly used to address a broad range of orthopedic and vascular diagnoses. Variants of these intervention types appear to have differing kinematic features despite being described by the same billing codes and regarded as belonging to the same intervention strategy.

By Michael S. Ginzburg PsyD, CO; Rachel White CPO

Failed Forefoot MIS Surgery: What Can You Do to Prevent This from Happening

2025, Cover Story, November

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

lerEXPO Conversation: Congestive Lower Extremity Failure (CLEF)

2025, Cover Story, October

Healthcare professionals are continually striving to improve patient outcomes through enhanced understanding and precise diagnosis. Yet, a significant pathological continuum, chronic venous insufficiency (CVI) and chronic venous disease (CVD), remains grossly underrecognized and misunderstood by many across the healthcare spectrum. This gap in knowledge often leads to delayed or incorrect diagnoses, suboptimal patient care, and unnecessary suffering for millions worldwide.

By John Chuback, MD

lerEXPO Highlights: The “Cheater Akin” Osteotomy | Who is it Really Cheating?

2025, Cover Story, September

Over the past century, the Akin osteotomy has earned the nickname “cheater Akin,” a term that reflects both its simplicity and the skepticism surrounding its standalone value. However, a deeper look into the history and evolving practices of podiatric and orthopedic surgeons reveals a more nuanced role for this procedure.

By Bradley P. Abicht, DPM, FACFAS

Expert Guidance: Beating the Heat–Back to School Takes Preparation

2025, August, Cover Story

Approximately 9,000 high school athletes are treated for heat-related illnesses every year in the United States. Back-to-school means back-to-sports for many students around the country. With the return of sports, health and safety guidelines must be in place. The National Athletic Trainers’ Association recommends 6 strategies for Exertional Heat Stroke (EHS) preparedness including: 1) hydration access; 2) emergency response plan enacted for school athletics; 3) policy with instructions for initiating emergency medical reservices response; 4) trained athletic training staff for recognition and treatment of EHS; 5) immersion tub filled with ice water before start of practice; 6) monitor wet-bulb globe temperature.

By Ciara L. Taylor, EdD, LAT, ATC

« Older Entries

Join

Subscribe For Updates

Stay in the loop with the latest news and updates! Subscribe now to receive exclusive content, special offers, and important announcements straight to your inbox. Don’t miss out – join our community today for all the latest updates delivered directly to you.



collaborative care builds better outcomes