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
No-Nonsense Recap: Orthobiologics and Bone Substitutes: A Primer
Orthobiologics is the science of harnessing and concentrating substances (substrates) that occur naturally in the body. It is theorized that in higher concentrations, biologics may help to enhance (or) improve the healing process. Orthobiologics and bone substitutes represent groundbreaking advancements in regenerative medicine.
By Asim Raja, DPM, FACFAS
Dog-Item-Related Falls Affecting the Lower Extremity Treated at United States Hospital Emergency Departments
Millions of families in the United States (US) own dogs, and with these dogs comes an assortment of dog items (gates, beds, toys, etc.). Tens of thousands of falls associated with dogs are treated at US hospital emergency departments (EDs) each year, a portion of which involve dog items. The objective of this study is to describe dog-item-related…
By Mathias B. Forrester, BS
Top 3 Recommended Therapies for KOA: Knee Orthoses, Hydrotherapy, Exercise
Assessing the clinical efficacy of different therapeutic options for KOA will aid clinicians in treating patients. While clinicians recognize the positive role of physical therapy in improving symptoms and functionality in knee osteoarthritis (KOA) patients, these methods may differ in mechanisms of action, applicability, and efficacy variances.
By Xiao Chen, Yuanhe Fan, Hongliang Tu, and Yuan Luo
Wound Care Update: I Thought I Was Doing Everything Right…Until the Denials Came In
I used to think documentation was the easy part. Write what you saw, describe what you did, keep it clear and detailed. I was trained well. I took pride in good notes—organized, clinical, complete. The kind you’d feel confident handing off to a colleague.
By Cassandre Voltaire, DO, ABWMS
Unique Biomechanical Challenges of the Diabetic Foot
The biomechanics of the diabetic foot are an intricate interplay of physiological and mechanical challenges that necessitate specialized care strategies. Diabetes often triggers changes in foot structure and function as a result of complications including peripheral neuropathy, vascular issues, and obesity.
By James McGuire, DPM, LPT, LPed, FAPWHc
Prototype AFO Focuses on Aesthetics, Comfort, Function
This study highlights the importance of a user-centered design in enhancing adherence to and satisfaction with AFOs. Ankle-foot orthoses (AFOs) are essential in pediatric rehabilitation particularly for children with conditions such as cerebral palsy, drop foot, or neuromuscular impairments.
By Peter Dabnichki and Toh Yen Pang
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ShortTakes From the Literature
Diabetic Foot Infection in Relation to Bacteraemia and Endocarditis
Diabetic foot infections (DFIs) are one of the most important components...
First MTP Joint-Preserving Surgery for Forefoot Deformity in Patients with RA
Arthrodesis of the first metatarsophalangeal (MTP) joint has been the gold...
Diagnostic Advancements in Early Detection of Diabetic Neuropathy
Diabetic neuropathy (DN) is a widespread complication of diabetes, affecting...
Study Compares Clinical and MRI Findings for Midfoot Pain
Midfoot pain is common but poorly understood, with radiographs often...
Why I Want Bunion Surgery—The Patient’s Perspective
Hallux valgus is the most common pathology afflicting the hallux. Surgery is...
Anatomy of Plantaris Tendon and Management of Midportion Achilles Tendinopath
Midportion Achilles tendinopathy (Mid-AT) is a complex condition that may be...
A Novel Reconstructive Approach for Plantar Charcot Midfoot Ulcer
Chronic plantar ulcers in Charcot neuropathic osteoarthropathy (CNO) present a...
Transtibial Amputee: Adaptation Time with Robotic Prosthesis and Gait Symmetry
Below-knee amputations significantly affect quality of life by eliminating the...
A Foot Forward for Optimum Health
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Industry News & Updates
Pediatric Soft Exoskeleton Made of Smart Materials
A next-generation lightweight, soft exoskeleton for children with cerebral...
AOPA Announces 2026 Board of Directors
The American Orthotic and Prosthetic Association (AOPA) has announced its 2026...
Researchers Engineer Treatment Design Software for Movement Impairments
Researchers led by Benjamin J. Fregly, PhD, a professor of mechanical...
Insulin + Metformin May Be a New DFU Treatment
Researchers from Michigan State University (MSU), East Lansing, and South...
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Venous Leg Ulcers and Concomitant Lymphedema
By M. Mark Melin, Caroline Fife, Marlin Shul, Monika Gloviczki, Adelaide Herbert, Heather Barnhart...
Natural Zinc Ion Based Technology for Next Generation Compression and Wound Care Devices
By Cristina Acevedo, PhD; Ian Crane; Rohit Kankaliya; Rajib Mondal, PhD; Albert Ortega; Kevin...
Chronic Lipodermatosclerosis in a Patient with Functional Venous Disease
By Preshy Varghese, MBBS, MMed, FRCS, FRACGP Case Report 70-year-old man with a BMI of 57.1...
Innovative Compression Technology May Reduce Hospital Visits and Improves Self-Care in Venous Leg Ulcer Patients
By Andreas Nilsson and Josefin Damm The cost of treatment, such as nursing time required for...
Return-to-Sport Following Deltoid Ligament and Syndesmosis Repair in a Division 1 Football Defensive Back
Background: A 22-year-old, Division I male football defensive back, with no previous history of...
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
Virtual Reality Gait-Training Platform
GaitBetter is a state-of-the-art motor-cognitive virtual reality (VR) intervention for gait rehabilitation and fall prevention. It uses gamification and semi-immersive VR to simulate motor-cognitive challenges that patients experience in everyday life. Clinically...
Lightweight, High-Rebound Insoles
OrthoLite® has expanded its range of insoles with the introduction of OrthoLite® Float. This product combines exceptional lightness with high-rebound support, adding comfort and high energy underfoot across all categories of footwear. With a resilience of >38%,...
Circular Frame Hinges for Knee, Ankle Applications
Orthofix Medical’s TrueLok™ Phantom and Tornado Hinges, from the company’s Orthopedics TrueLok circular frame portfolio, are designed for use with TrueLok circular frame offerings, including the TrueLok EVO Ring Fixation System. The TrueLok EVO System is a circular...
Smart Boots for DFU Treatment
The Foot Defender+ powered by Sensoria is designed to help heal diabetic foot ulcers (DFUs) and reduce the risk of amputations for extended quality of life. The solution combines the Foot Defender Smart Boot with Sensoria Core microelectronics and the Sensoria Patient...
Orthosis for Treatment of Shin Splints
Invented by former elite athletes turned medical doctor, biomedical engineer, and product designer, the Solushin® orthosis is designed to treat medial tibial stress syndrome (shin splints). Designed to be worn before or after running, for 30 minutes to 2 hours, it...
Minimally Invasive Bunion Fixation System
Stryker’s PROstep MIS Lapidus fixation system is designed to treat bunions using a minimally invasive surgical reduction, while providing faster recovery. It uses the hallux valgus deformity and subsequent fusion of the first metatarsal cuneiform joint. The technology...
Hyaluronic Acid and Alginate Device for Tendon Repairs
VersaWrap® is a U.S. Food and Drug Administration–cleared medical device implant (not tissue), comprising hyaluronic acid (HA) and alginate, that provides a gelatinous encasement for peripheral nerves, tendons, and surrounding tissues such as ligaments and skeletal...
Knee and Ankle Compression Sleeves
FUTURO™ Brand’s reengineered premium compression sleeves for muscle and joint support have a new sleek look, smooth low-profile construction, and ultra-soft fabric with 4-way stretch that delivers an unrestricted comfortable fit, flexibility, and range of motion. A...
Nitinol Implant System for MTP Fusions, Lapidus Procedures
REFLEX® HYBRID combines the compression of a nitinol staple with the stability of a locking plate, offering indication-specific implants designed for metatarsophalangeal (MTP) fusions and Lapidus procedures. When paired with a cannulated screw with a Dynamic Disc, or...
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