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
Effectiveness of Offloading Interventions for People With Diabetes-related Foot Ulcers
These authors searched PubMed, EMBASE, Cochrane databases, and trials registries for all studies relating to offloading interventions in people with DFU to address 14 clinical question comparisons. Outcomes included ulcers healed, plantar pressure, weight-bearing activity, adherence, new lesions…
By P.A. Lazzarini, D.G. Armstrong, R.T. Crews, C. Gooday, G. Jarl, K. Kirketerp-Moller, V. Viswanathan, and S.A. Bus
Surgical Management of Chronic Achilles Tendon Rupture: Evidence‑based Guidelines
The Achilles tendon is the largest and strongest tendon in the human body, connecting the muscles of the gastrosoleus complex to the calcaneus. The Achilles tendon is important to maintain the standing posture, and during walking, running, and jumping.
By Shi-Ming Feng, Nicola Maffulli, Francesco Oliva, Amol Saxena, Yue-Feng Hao, Ying-Hui Hua, Hai-Lin Xu, Xu Tao, Wei Xu, Filippo Migliorini, and Chao Ma
Point of Care Diagnostic Ultrasound in the Evaluation of Patients with Patellar Tendinopathy
Point of care diagnostic ultrasound can be a useful tool for the evaluation, diagnosis, treatment, and risk identification of patellar tendinopathy. Measurements of the patellar tendon that may be useful include tendon thickness, stiffness, and biomarkers of tendon quality which can provide clinicians with a more …
By Sarah L. Woelfel, MA, LAT, ATC and Adam B. Rosen, PhD, ATC
Professional Bull Riding Is a Growing Sport
Move over pickleball! Professional bull riding is a growing sport across the United States and the world. Viewership of the events—topping 30 million at a time—increases weekly. The Professional Bull Riders (PBR, the leading association of riders) signed a 10-year broadcast deal in 2018 with CBS and another in 2023 with Spanish-language Univision.
Examining Effect of Tai Chi Lower Leg Exercise in Fall Prevention in Older Adults
Tai Chi is an evidence-based fall prevention training for older adults, yet its effective movements remain unclear. Practicing Tai Chi (TC)—exercise that consists of a series of slow movements performed in semi-squat positions with an emphasis on coordination of whole-body movement and mind—is an effective way to prevent falls in older adults.
By Min Mao, PhDc; Vicki S. Mercer, PT, PhD; Fuzhong Li, PhD; Michael T. Gross, PT, PhD, FAPTA; Troy Blackburn, PhD, ATC; and Bing Yu, PhD
Seeking the Optimal AFO Stiffness for Energy Cost Reduction
To maximize the AFO’s effect on walking energy cost reduction, the AFO’s bending stiffness needs to be individually optimized. The stiffness of a dorsal leaf ankle foot orthosis (AFO) that minimizes walking energy cost in people with plantarflexor weakness varies between individuals. Using predictive simulations, the authors of this article studied the…
By NFJ Waterval, MSC; MM van der Krogt, Dr; K Veerkamp, T Geijtenbeek, PhD; J Harlaar, Dr, IR; F Nollet, MD, PhD; and MA Brehm, PhD
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ShortTakes From the Literature
Foot Massage Improved Volume & Composition of Breast Milk
One of the important problems for mothers after the birth of a premature...
Weight-Loss Surgery Has Lasting Benefits in Teens
About 1 in 5 adolescents in the U.S. has obesity. Lifestyle changes, such as...
Study Details 3-Years of Injuries in University Women’s Soccer
Sport Sciences researchers from Waseda University in Japan sought understand...
Youth Sport-Related Knee Joint Injuries & Thigh Muscle Strength
Knee extensor and flexor muscle (ie, thigh) weaknesses are well-established...
Yoga Practice as a Potential Sarcopenia Prevention
Sarcopenia is characterized by the progressive loss of skeletal muscle mass...
MS Relapse Prevention: Baby Let the Sun Shine In
Getting at least 30 minutes of daily summer sun in the first year of life may...
Timing of Resistance Exercise and Cardiometabolic Health
In this secondary analysis, there was no difference between morning (AM) and...
Which Is Better…
1) Balance Training vs Hip Strengthening for CAI Reductions in balance...
A Foot Forward for Optimum Health
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Industry News & Updates
AAOS Announces Strategic Transition of Fracture & Trauma Registry
The American Academy of Orthopaedic Surgeons (AAOS) announced the strategic...
PFA Appoints New Executive Director
The Pedorthic Footcare Association (PFA) announced that its board’s executive...
Robotic Shorts Support Walking
Researchers at the Technical University of Munich (TUM) have developed robotic...
Biomimetic Artificial Muscle Properties Similar to Natural Muscle Tissue
Researchers from China have successfully developed an artificial muscle with...
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Risk of Prolonged Opioid Use in Older Patients After Hip Fracture Surgery
There is a notable risk of prolonged opioid use in older patient populations following...
Opioids Overprescribed to Children, Adolescents for Common Orthopaedic Procedures
While pain control is an important component of orthopaedic surgery postoperative care, the...
Effects of COVID-19 on Youth Athletes Differs by Sport, Age
When single sport youth athletes have their routine disrupted, as occurred during the COVID-19...
Study Reports Injury Rates Across High School and College Sports
In an analysis of more than 26,000 injuries across high school and college sports, the sports with...
MIDDLE SCHOOL CONCUSSION RATES HIGHER THAN HIGH SCHOOL, COLLEGE
New research presented at the National Athletic Trainers’ Associations’ 2021 NATA Virtual Clinical...
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
Enhanced Performance and Recovery Products
KT Ice is a groundbreaking series of products designed to revolutionize the way consumers prepare, perform, and recover from physical activity. The KT Ice series features a comprehensive range of products tailored to support individuals at every stage of their fitness...
Surestep Children’s Sandals
Surestep Sandals have the same attention to detail as the company’s shoes. They are designed with a wider, deeper heel, toe box, and instep, leaving room for braces and a comfortable fit. The unique tread promotes intrinsic movement and flexibility while a “cut-line”...
Noninvasive Magnetic Peripheral Nerve Stimulation for PDN
Neuralace Medical’s Axon Therapy mPNS, for the treatment of chronic painful diabetic neuropathy (PDN), is the first US Food & Drug Administration–cleared non-invasive, magnetic peripheral nerve stimulation (mPNS) treatment for PDN. The device utilizes a pioneering...
Surgical Navigation System for TAA
The ExactechGPS® Ankle is the world’s first surgical navigation system for total ankle arthroplasty (TAA). GPS Ankle is a first-of-its-kind technology, which connects the preoperative plan with real-time intraoperative instrument guidance and confirms that resections...
Red Light Therapy
Lumaflex Essential is a Class II US Food & Drug Administration–cleared red light therapy device designed for speedy 10-minute treatments. This portable, flexible device is not just for competitive athletes or fitness enthusiasts. Rather, it can help a wide range...
Interactive Therapy Solution for Outpatient Clinics, Home Health
LudoFit PRO is an interactive therapy exercise solution designed for clinicians working with patients in clinic and home settings. It can be downloaded onto Windows computers, Mac computers, or iPads, and no special equipment is needed. The app uses the device’s web...
Pediatric Bio-integrative Fixation Devices
OSSIOfiber® bio-integrative fixation technology has been cleared for use in orthopedic surgery for children and adolescents in standard clinical practice. The OSSIOfiber compression screw product family is indicated for maintenance of alignment and fixation of bone...
Golf Stability Insoles
The Golf Stability™ Insole by Spenco is the brand’s first golf-specific insole designed to stabilize feet during the golf swing, creating more consistent and accurate shots. The insoles feature a Cobra heel that maintains proper weight distribution and positioning for...
PRECISION® MIS Bunion System
Paragon 28’s PRECISION® MIS Bunion System was engineered to allow surgeons to complete a distal metatarsal osteotomy using a minimally invasive surgical (MIS) technique. The system features an outrigger designed for controlled triplanar correction including...
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