LER Cover Story:
lerEXPO Highlights: Fibular Nails–Fad or New Standard?
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.
By Brian Burgess, DPM with Brad Abicht, DPM, FACFAS and Jeff Dikis, DPM
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Feature Articles
Can Biofeedback Improve Biomechanical Factors Associated with CAI?
Restoring correct ankle biomechanics is essential for maintaining long-term joint health of the ankle in patients with chronic ankle instability. Lateral ankle sprain (LAS) is 1 of the most common musculoskeletal injuries in athletes and the general public. Incomplete recovery and inadequate restoring of function due to lack of appropriate rehabilitation can lead to chronic ankle instability (CAI). Loss of passive ligamentous stability and deficits in neuromuscular control and…
By Seyed Hamed Mousavi, Fateme Khorramroo, Hooman Minoonejad, and Johannes Zwerver
Varicose Veins of the Lower Extremities: A Primer Part II
Varicose veins affect nearly one third of the adult population and are considered early warnings of the more serious chronic venous insufficiency. Early recognition and prevention are key to suppressing potential life-threatening damage and maintaining patient quality of life. Varicose veins (VVs)—those bulging, twisted blood vessels typically seen on the legs—are more than an esthetic issue. They can be painful and affect patients’ quality of life; left untreated, they can lead to life-threatening chronic venous insufficiency and venous ulcers and warrant a clinician’s attention.
By Angela Kelley, PA-C, MSM
Shopping Cart-Related Lower Extremity Injuries Treated at United States Hospital Emergency Departments
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
Varicose Veins of the Lower Extremities: A Primer Part I
Varicose veins (VVs)—those bulging, twisted blood vessels typically seen on the legs—are more than an esthetic issue. They can be painful and affect patients’ quality of life; left untreated, they can lead to life-threatening chronic venous insufficiency and venous ulcers. And when seen or mentioned, will always warrant a clinician’s attention.
By Angela Kelley, PA-C, MSM
Comparing Aquatic-based and Land-based Exercises for Balance
Aquatic-based exercises are used as an alternative to land-based exercises for older adults who have lower levels of physical activity or neuromuscular disorders that impact their balance function. Balance plays a crucial role in the daily activities of older adults. Aquatic-based exercises (AE) are widely conducted as an alternative to…
By Ying Deng, Zheng Tang, Zhengting Yang, Qi Chai, Wenting Lu, Yunshi Cai, Yiting Luo, and Yongzhao Zhou
A Case Report: Hypertonia of the Big Toe Revealing Parkinson’s Disease
Despite being less commonly discussed than other motor symptoms, such as tremors and bradykinesia, hypertonia of the hallux holds diagnostic and prognostic significance in Parkinson’s disease (PD). This motor anomaly is dissected within the context of the broader clinical spectrum of PD symptoms…
By Houssam Mahla, Abdelilah Rhoul, Mohammed Gartit, Souhail Yachaoui, Ahmed Amine EL Oumri
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ShortTakes From the Literature
Males/Females Experience Pain Through Different Mechanisms
Pain—and how well pain treatments work—differs between the sexes. Females are...
Study Shows Older Sprinters Lose Force Generating Capacity
Both longitudinal and cross-sectional studies have demonstrated that muscle...
A Rare Case of Bilateral Xanthomatosis of the Achilles Tendon
Xanthomatosis is an atypical pseudotumor of connective tissue characterized by...
Does Kinesio Tape Negatively Affect Treatment of Plantar Fasciitis
Radial extracorporeal shock wave therapy (r-ESWT) is accepted as one of the...
HIIT Appears to Temper Metabolic Syndrome in 8-year Study
Metabolic syndrome (MetS) is a set of 5 cardiometabolic risk factors including...
Association of Vit D with Sarcopenic Obesity Risk
Sarcopenic obesity (SO), a relatively new category of obesity and a high-risk...
Low-Intensity Focused Ultrasound for Pain Relief in DPN?
In an interesting, but small, study out of China, researchers evaluated the...
Associations Between Female Sex Hormones and Skeletal Muscle Aging
This study highlights the significant role of circulating sex hormones in the...
A Foot Forward for Optimum Health
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Industry News & Updates
Microneedle Technologies May Accelerate Diabetic Wound Healing
Researchers from the National University of Singapore (NUS) have developed 2...
Customizable Hydrogel Shows Promise for Treating Meniscus Injuries
Through creating a treatment adaptable to the different needs of...
AI Tool Better Assess Parkinson’s Disease, Other Movement Disorders
Diego Guarin, PhD, an assistant professor of applied physiology and...
University Students Develop Prosthetic Foot
When Colorado State University (CSU) engineering student Garrison Hayes was 6...
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IMPACT OF FRAILTY ON WOUND HEALING
Few studies suggested that frailty may increase inflammation, which in turn may negatively impact...
DPN FOUND IN 4/5 PATIENTS IN SAUDI STUDY
This study aims to evaluate the prevalence of such a common and morbid neuropathy complication in...
PREDICTING HEALING OF DFUS WITH MULTISPECTRAL IMAGING
Guidelines recommend adjunctive therapies for diabetic foot ulcers (DFUs) without >50% wound...
E-STIM FOR PREVENTION OF ICU-ACQUIRED WEAKNESS IN COVID-19 PATIENTS
Prolonged immobilization may inevitably lead to complications such as muscle dysfunction and...
lerEXPO Conversations Patient Engagement Vital to Diabetes Prevention
By Keith Loria The American Diabetes Association estimates that 34.2 million people—10.5% percent...
A Message From the Publisher
Welcome to Lower Extremity Review or LER as we call it. This long awaited magazine fills the lower extremity information gap for practitioners in the fields of Podiatry, Physical Therapy, O&P Pedorthics, and Orthopedics. With over 20 years experience in multi-disciplinary editorial development and publishing, the collaboration of this incredible team has made this publication possible
Rich Dubin
Publisher and Chief Executive Officer
Featured Products
Lower Extremity Review
Muscle Retention Cream
Skin healthcare company EX Healthcare recently announced the launch of dermaFIT, a muscle retention cream. This revolutionary body cream combats muscle loss by harnessing the power of the body’s own microRNAs. This cutting-edge product utilizes the power of exosomes...
New Publication Addresses Knee Pain
6-Minute Knee Pain Cure: The Simple Science of Relieving Knee Pain and Restoring Comfort in Walking, Running, Squatting, and Beyond, was written by Jonathan Su, DPT, C-IAYT, CSCS, a physical therapist, yoga therapist, and fitness coach, who drew from his own...
Compression Massage Boots
The Recovery Pro Full Leg Compression Massage Boots (FT-091A&FT-109A) offer powerful and upgraded features to cater to a wide range of needs. Whether it’s for a pre-workout warmup or a post-workout quick recovery, these boots deliver precise and comfortable...
Rapid Crack Repair Cream
SkinIntegra’s Rapid Crack Repair Cream has received the Seal of Approval from the American Podiatric Medical Association (APMA), which recognizes worthy products that can contribute to foot health. Originally developed for people with diabetes suffering from...
TENS Unit
The AUVON PT1 Pro TENS Unit Muscle Stimulator offers a safe, non-invasive, and cost-effective method of body pain relief via 8 customizable modes and 40 levels of intensity and a precise control knob. This cutting-edge device allows users to gradually adjust...
Application for Wound Care
Perceptive Solutions’ WoundZoom PRO is an advanced application that gives healthcare providers a more intelligent and efficient way to manage wound care across a variety of care settings with its non-contact 3D wound measurement technology and intuitive workflow...
Semi-custom Orthotic Insoles
Podiatrists, physical therapists, and other foot and ankle specialists are increasingly recommending Tread Labs’ semi-custom orthotic insoles to their patients, citing impressive outcomes comparable to custom orthotics at a significantly lower cost to the patients....
Total Ankle Replacement System
Enovis™ recently unveiled its Scandinavian Total Ankle Replacement (STAR® Ankle). Recent U.S. Food and Drug Administration approval makes this product the first and only mobile bearing ankle system in the United States produced with e+™ Polyethylene in the United...
Thermal Nail Fungus Treatment
Patented ToeMate® Kits include a microwaveable soaking bowl, pretreatment and thermal chemistry, footrest, and instructions. Infected nails are pretreated with salicylic acid followed by soaking in warm bis (hydrogenated tallow alkyl) dimethyl quaternary chlorides...
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