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Lower Extremity Review

First MPJ Arthrodesis – Techniques, Non-Union Management & Key Considerations

First MPJ Arthrodesis – Techniques, Non-Union Management & Key Considerations

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First metatarsophalangeal joint (MPJ) arthrodesis has been studied extensively since its inception in 1852. The procedure primarily aims to relieve pain, restore length, and stabilize the medial column of the foot. This in turn helps re-establish the foot’s weight-bearing pattern, contributing to a balanced foot tripod. Despite its long history and effectiveness, MPJ arthrodesis is not without complications, the most notable of which is non-union.

By Patrick DeHeer, DPM FACFAS, FFPM RCPS (Glasg)

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3D Printing Enables Dose-Response Approach to Foot Orthotic Therapy

3D Printing Enables Dose-Response Approach to Foot Orthotic Therapy

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No matter which biomechanical principles we utilize to prescribe and produce custom foot orthoses for our patients, we all must admit that prescribing footwear interventions is not like prescribing medication – no one knows the right dose. How stiff should the shell be? How high should the arch be? How much rearfoot or forefoot posting is optimal for that specific patient? An experienced practitioner can make reasonable inferences and often produce a beneficial…

By Paul Langer, DPM

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How Biomechanics Helped Me Run My 1st Half Marathon at Age 60

How Biomechanics Helped Me Run My 1st Half Marathon at Age 60

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With a focus on muscle activation, range of motion, and neuromotor training, this 60-year-old went from not being a runner to a half marathon in just a few months. I have never been a runner. The furthest I had ever run was the 7.5-mile Bay to Breakers race across San Francisco, 40 years ago while in college. A few years ago, I started running 1 mile per week to maintain my health for my family, my fitness, and for myself.

By Christopher K. Wong, PT, PhD

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Firefighter Footwear

Firefighter Footwear

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Firefighter footwear is subject to a host of regulations, primarily set by the National Fire Protection Association (NFPA) – but selected by the local authority for fire jurisdiction. This footwear is designed to provide adequate protection against multiple hazards encountered during firefighting as well as…

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Firefighter Lower Extremity Injuries in the United States

Firefighter Lower Extremity Injuries in the United States

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Background: In 2020, there were over 1 million career and volunteer firefighters in the United States (US). Thousands of injuries involving firefighters occur annually. The body part involved in the highest proportion of injuries is the lower extremity. The objective of this study was to characterize firefighter lower extremity injuries in the US.

By Mathias B. Forrester, BS

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Cat-Related Falls and Hits Affecting the Lower Extremity Treated at United States Hospital Emergency Departments

Cat-Related Falls and Hits Affecting the Lower Extremity Treated at United States Hospital Emergency Departments

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Background: An estimated 46.5 million United States (US) households owned a cat in 2023-2024. Interactions with cats may result in injury. The objective of this study is to describe cat-related falls and hits affecting the lower extremity. Methods: Cat-related falls (falls, trips, slips, jumped down) and hits (hit or other contact with an object) affecting the lower extremity during 2000-2023 were…

By Mathias B. Forrester, BS

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Celebrating 15 Years of Healthcare Innovations

Celebrating 15 Years of Healthcare Innovations

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11 Readers offer their thoughts on the greatest innovations of the last 15 years. The dictionary defines innovation as the introduction or use of new ideas or ways of doing things. But it’s really much more than that: In What Customers Want, innovation expert Anthony Ulwick wrote, “Innovation is not the result of thinking differently. It is the result of thinking deliberately (in specific ways) about existing problems and unmet needs.” Others have added that innovation is a corporate mindset of continuous quality improvement that encourages improving processes or revising products in response to customer needs.

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Assessment of Physical Activity in Older Adults Across Care Levels

Assessment of Physical Activity in Older Adults Across Care Levels

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Physical activity is a modifiable lifestyle factor that is well established as an important determinant for maintaining function and independence in daily life, and thus is imperative for healthy aging. The 2020 recommendations from the World Health Organization (WHO) highlight that every minute…

By Astrid Ustad, Karen Sverdrup, Gro Gujord Tangen, Øystein Døhl, Beatrix Vereijken, Pernille Thingstad, and Nina Skjæret-Maroni

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Shopping Cart-Related Lower Extremity Injuries Treated at United States Hospital Emergency Departments

Shopping Cart-Related Lower Extremity Injuries Treated at United States Hospital Emergency Departments

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Tens of thousands of shopping cart-related injuries are treated at United States (US) hospital emergency departments (EDs) each year. This study described shopping cart-related lower extremity injuries treated at US hospital EDs. Methods: An analysis was performed of shopping cart-related lower extremity injuries reported to the National Electronic Injury Surveillance System during 2000-2023. 

By Mathias B. Forrester, BS

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lerEXPO Conversations: Facts, Fictions, Fallacies of the Lapidus Bunionectomy

lerEXPO Conversations: Facts, Fictions, Fallacies of the Lapidus Bunionectomy

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The Lapidus bunionectomy, named after American orthopedic surgeon Paul Lapidus, has emerged as a highly popular surgical approach to correcting severe cases of hallux valgus, the deformity commonly known as a bunion. This procedure involves fusing the first tarsometatarsal joint to realign and stabilize the metatarsal bone, aiming to correct the deformity at its root and ideally prevent recurrence.

By Patrick DeHeer, DPM FACFAS, FFPM RCPS (Glasg)

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Retro Walking Shown to Decrease Inflammatory and Obesity Markers

Retro Walking Shown to Decrease Inflammatory and Obesity Markers

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Backward walking offers many benefits relative to forward walking, not least of which is a decrease in C-reactive protein, body mass index, and blood pressure levels. It is a widely accepted fact that obesity is not much amenable to medical treatment. Diet and exercise, systematically undertaken, is the only way to treat obesity, manifested as…

By Ajith Soman, Sunil Chandy, Khalid Alkhathami, Baranitharan Ramamoorthy, and Bijad Alqahtani

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Dog-Related Falls Affecting the Lower Extremity Treated at United States Hospital Emergency Departments

Dog-Related Falls Affecting the Lower Extremity Treated at United States Hospital Emergency Departments

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Background: Falls are a leading cause of non-fatal injuries in the United States (US). There are a variety of fall risk factors, among which are pets. Tens of thousands of fall injuries associated with dogs are treated at US hospital emergency departments (EDs) each year. The objective of this study is to describe dog-related falls affecting the lower extremity treated at US hospital EDs.

By Mathias B. Forrester, BS

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