February 2019

Cover Story

Type 2 Diabetes in Youth: A 21st Century Disorder

As obesity and overweight affect more adolescents, this disease, once attributed to middle age and older, is striking an aggressive course that all clinicians will need to address. With the increasing prevalence of overweight and obesity and with 18.5% (or 13.7 million) of youth already being obese,1 type 2 diabetes (T2D) in youth is becoming an important part of every healthcare practitioner’s daily practice.

By Neil H. White, MD




Expert Commentary

The Power Forward and the Exploding Shoe

Nowadays, when we see a headline about an “exploding shoe,” we instinctively think of an alarming situation involving the Transportation Security Administration—the TSA. Thankfully, that was not the case at a memorable February 20 Atlantic Coast Conference basketball game between Duke and North Carolina.

By Robert M. Conenello, DPM

Guest Editorial

3 Can Be Better Than 6 When It Comes to Weber B Fractures

In medical school, we were taught that Weber B ankle fractures required the 6-week cast immobilization protocol. But for many of us, that protocol has felt excessive due to concerns of increased ankle stiffness, decreased ankle strength, and the possibility of a thrombotic event. However, the thought of possible suboptimal healing of the fracture with less than 6 weeks of immobilization or use of less rigid forms ...

Feature Articles

Conservative Management of Freiberg’s Disease

Key options include immobilization, weight bearing restrictions, NSAIDS, orthotics, padding, and shoe modifications. The first report of osteochondrosis of the second metatarsal head was in a series of six cases presented by Dr. Alfred H. Freiberg at the Southern Surgical and Gynecological Association in 1913. The data was published the following year.

By Kerry Sweet, DPM, FACFAS; Rebecca Omana-Daniels, DPM; and Valerie Marmolejo, DPM

Gait and Balance Dysfunction in Older Adults: Challenges and Interventions

Falls are a significant—yet preventable—health issue among older adults. Each year, 3 million older Americans over the age of 65 are treated in emergency departments for fall-related injuries which often result in disability, loss of independence, reduced quality of life, and death.1 The number of falls is expected to rise as Americans live longer and the number of older adults continues to grow at an unprecedented rate.

By Aisha Cobbs, PhD

Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults Now Available

The 2019 AGS Beers Criteria® includes 5 lists of nearly 100 medications or medication classes to avoid or use with caution for some or all older adults. The American Geriatrics Society (AGS) recently unveiled its latest update to one of geriatrics’ most frequently cited reference tools: The AGS Beers Criteria® for Potentially Inappropriate…

From the Literature

Anterior Femoral Ligament Thickening Seen 3 Years Post-ACL Surgery

Osteoarthritis (OA) affects nearly 50% of patients who undergo anterior cruciate ligament reconstruction (ACLR) within 2 decades after surgery. The mechanism of OA development has been elusive; many experts theorize that disruption of knee–joint tissue homeostasis is key. Now, researchers, using ultrasonography (US), have found an increase in the thickness of the anterior femoral cartilage and cross-sectional area 3 years postoperatively.

Compression in Lymphedema

In a narrative review of old and innovative concepts concerning pressure and stiffness in lymphedema therapy, the authors of a study just published in Phlebology found that the current literature does not appear to be in sync with the array of options available today.

Diabetes Updates:  Amputations Increasing; Insomnia as Risk Factor

Amputations on the Rise – After decades of decline, diabetes-related lower-extremity amputations appear to be on the rise in the United States, according to new data from the Nationwide Inpatient Sample of the US Healthcare Cost and Utilization Project and the National Health Interview Survey of the National Center for Health Statistics, part of the US Centers for Disease Control and Prevention.

Bringing Medical Cannabis Into Skilled Nursing Facilities

When New York state legalized medical cannabis, geriatrician Zachary Palace, MD, CMD, realized that many of the conditions that qualified for the drug were those that he saw regularly in the elderly—like  chronic or neuropathic pain, Parkinson’s disease, and multiple sclerosis.

By Nicole Wetsman 

The Power of a ‘Sit to Stand’: An Infographic

Infographic by Chris Tuckett, Physiotherapist BSc MCSP. Tuckett is based in The Princess Alexandra Hospital NHS Trust, based in Harlow, Essex, UK. Based on: Harvey JA, Chastin SFM, Skelton DA. Breaking sedentary behaviour has the potential to increase/maintain function in frail older adults. J Frailty Sarcopenia Falls. 2018;3(1):26-34. doi: 10.22540/JFSF-03-026.

FDA Adds Boxed Warning to Uloric

The U.S. Food and Drug Administration (FDA) has concluded there is an increased risk of death with Uloric (febuxostat) compared to another gout medicine, allopurinol. This conclusion is based on its review of results from a safety clinical trial that found an increased risk of heart-related death and death from all causes with Uloric.

Book Review: Pedorthic Footwear: Assessment and Treatment

Pedorthic Footwear: Assessment and Treatment, a 578-page resource with 550 illustrations, is the result of an ambitious and unique collaboration of international authors and is edited by Klaas Postema, Karl-Heinz Schott, Dennis Janisse, and Gerardus M. Rommers. In total, 54 authors (physiatrists, pedorthists, movement scientists, and physiotherapists) from 7 countries contributed.

Industry News & Updates

Featured Products

New Sandal Toe Footshell
Spark Kinetic Knee Sleeve
Sand Color Therafirm Ease Microfiber Tights
Non-Opioid, Wearable Pain-Relief Solution
New Apex A-Wave Orthotics in Three Durometers
New Colors for Sigvaris Graduated Compression Garments
OPTP Soft Movement Ball
Shear Alpine Boots
Experience 40% Less Pressure with Duo Med Surg Shoe