Lower Extremity Review
Achilles tendon ruptures are among the most devastating lower extremity injuries an athlete can face. Historically, the medical community has been divided between traditional open surgery and non-operative management. While open surgery effectively lowers the risk of re-rupture, the posterior ankle’s poor blood supply can sometimes lead to severe wound complications that can end careers. High-profile cases, such as NFL player Robert Mathis and…
By Kirk McCullough, MD
The current model for managing diabetic foot syndrome is characterized as reactive and fragmented, contributing to a global crisis where a limb is lost to amputation every 20 seconds. Dr. Bijan Najafi, a bioengineer and research director at UCLA Center for Advanced Surgical and Interventional Technology (CASIT), says that “we can’t manage what we can’t measure,” advocating for a shift toward decentralized, proactive care facilitated by digital health technologies.
By Bijan Najafi, PHD, MSc
Peripheral musculoskeletal structures may undergo changes after stroke, but tendon-specific adaptations with functional recovery are not well defined. This study examined lower extremity tendon thickness in patients with post-stroke hemiplegia before and after an inpatient rehabilitation program and explored associations between tendon thickness and clinical improvement. 45 patients with post-stroke hemiplegia completed a 4-week rehabilitation program.
In recent years, various diabetic socks have been developed and introduced to help prevent diabetes related foot ulcers (DFUs). However, the question of which type of sock is most suitable for individuals with diabetes has not been adequately addressed. This review systematically explores the current evidence regarding the performance and structural properties of diabetic socks, along with a narrative analysis of commercial socks.
The Achilles tendon (AT) plays a crucial role in force transmission and movement efficiency, and greater tendon stiffness may enhance elastic energy storage and improve performance in explosive movements. Shear-wave elastography (SWE) enables reliable, non-invasive assessment of tendon stiffness, yet its associations with other ultrasound (US)-derived properties and functional outcomes remain insufficiently defined in athletes.
Diabetic peripheral neuropathy (DPN) is a common and debilitating complication of diabetes that leads to chronic pain, sensory loss, and functional decline. While spinal cord stimulation (SCS) is FDA-approved for painful diabetic neuropathy, its potential to modify disease pathology rather than merely suppress symptoms remains poorly understood. This narrative review bridges this knowledge gap by elucidating the role of SCS in mitigating structural and…
Achilles tendon (AT) wounds are defined as partial or complete disruptions of the tendon that create direct communication with the external environment (Lamah L Diallo M Tekpa JBD). The incidence of bilateral AT lacerations in children remains unknown. These researchers report a case of simultaneous bilateral AT laceration in a 14-year-old adolescent following a domestic accident.
Chronic ankle instability (CAI) is a common functional disorder in older adults, affecting their balance and quality of life. Effective ways to enhance ankle stability and function remains a key for healthy aging. This study aims to explore the effects of the Otago Exercise Program (OEP) combined with Neuromuscular Electrical Stimulation (NMES) on ankle stability, the pain index, and balance ability in older adults aged 60 and above with CAI.
A novel folinic acid (FA) wound treatment (FAWT) significantly (P < 0.05) improved healing of chronic diabetic foot ulcers (DFUs). In a double-blind randomized controlled trial, 10 subjects with chronic DFUs were treated daily with either control therapy (n = 5; PluroGel) or FAWT (n = 5; PluroGel containing 2.5% FA). After 12 weeks, the FAWT group demonstrated significantly greater DFU area reduction compared with controls (88% [SD 16] vs 40% [SD 39], respectively).
Metallic biomaterials enable successful reconstruction of skeletal tissues by supporting repair, load-bearing function, and anatomical alignment in foot and ankle surgery. The unique anatomic and biomechanics in this region, and challenging pathologies such as flatfoot and Charcot neuroarthropathy, present challenges. Intervention requires targeted biomaterial solutions.
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
A study from Korea has demonstrated that foot intrinsic muscle dynamic stretching training improved dynamic balance, velocity, step lengths, stride length, and dynamic gait index (DGI) in patients with chronic stroke.
Lateral ankle sprains are one of the most common musculoskeletal injuries. Up to 70% of individuals who sustain lateral ankle sprains develop chronic ankle instability (CAI). Exercise therapy is considered an effective treatment for patients with CAI.
“…In one analysis of sedentary behavior, participants were found to spend 14 hours sitting each day. In the NHANES nationally representative survey, the self-reported number of hours spent sedentary in 2007-2008 was 5.7, and this increased to 6.4 hours per day for 2015 – 2016 (Du et al 2019). Using accelerometry-derived data, U.S.
This study forms the basis of a digital twin system of the knee joint, using advanced quantitative MRI (qMRI) and machine learning to advance precision health in osteoarthritis (OA) management and knee replacement (KR) prediction. The study authors combined deep learning–based segmentation of knee joint structures with…
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