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
CAGA 101: The 12 Dirty Truths of Foot Mechanics
Dirty Truth #4: Shock Absorption is Energy Loss–Understanding Loading in Gait Analysis
Perhaps the most surprising and unintuitive of all the dirty truths is number four, “Shock absorption via cushion is energy loss.” At first blush, cushion seems like a no-brainer benefit. When we delve into this idea a bit deeper, applying our structure, the forces acting on the lower limbs, and applying the physics that we talked about in the last three dirty truths, the truth of number four becomes clear.
By Jay Segel, DPM; Sally Crawford, MS
Forefoot Adduction Strengthens the Abductor Hallucis in HV
Integrating targeted exercises focused on AH strengthening, both pre- and post-surgery, offers a comprehensive approach to HV management. The abductor hallucis (AH) is the most important muscle in the…
By Giacomo Farì, Laura Dell’Anna, Francesco Paolo Bianchi, Rachele Mancini, Enrica Chiaia Noya, Carlo De Serio, Riccardo Marvulli, Luisa De Palma, Danilo Donati, Roberto Tedeschi, Maurizio Ranieri, Marisa Megna, and Andrea Bernetti
Lower Extremity Injuries Managed by Fire Department Emergency Medical Services
Emergency medical services (EMS) calls accounted for 65.2% of all incidents to which United States (US) fire departments responded in 2023. A portion of fire department EMS calls are likely to involve lower extremity injuries. The objective of this study was to describe the pattern of these lower extremity injuries.
By Mathias B. Forrester, BS
Antimicrobial Resistance in Wound Care
Chronic, hard-to-heal wounds are a major aspect of care in most podiatric offices, which is why antimicrobial resistance (AMR) is an escalating concern for healthcare practitioners. AMR is not only a growing concern for patient health but also poses potential legal and economic ramifications for healthcare providers.
By Windy Cole, DPM, CWSP, FAPWH
Non-Unions of the Hind Foot
Hind foot non-unions are a complex orthopedic challenge that clinicians face, particularly due to the unique anatomy and weight-bearing responsibilities of this part of the foot. Non-unions occur when a fracture fails to heal nine months after injury or shows no radiographic improvement over a consecutive 3-month period. This condition is not only painful but can also severely impact mobility and quality of life.
By Zeeshan Husain, DPM, FACFAS, FASPS
CAGA 101: The 12 Dirty Truths of Foot Mechanics
Dirty Truth #3: What We Can’t See Is Key. In the last 2 installments, we talked about our problematic foot anatomy and what happens to the structure during weight bearing and activity. Much like how a mousetrap precisely captures its target, analyzed computer-aided gait analysis (CAGA) reports accurately “mousetrap” and track the unseeable, providing valuable insights and objective data.
By Jay Segel, DPM; Sally Crawford, MS
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ShortTakes From the Literature
Exercise, Kinesiology Tape or Orthosis Best for Pain in Women with HV
One of the most common foot health problems in adults is hallux valgus. The...
Outcomes after Arthroscopic Broström-Gould Procedure for CLAI
Chronic lateral ankle sprains are common injuries that are largely sequelae of...
Freeze-Dried Platelet-Derived Concentrate for Achilles Tendon Rupture in Athletes
Achilles tendon ruptures (ATRs) often occur in competitive athletes. Various...
Posture Adaptations to Varying Visual Conditions in Dancers & Non-Dancers with CAI
Even though dancers have good postural control ability, ankle sprain is the...
Factors Impacting Lower Limb Injury in Female Runners
Running is a popular form of physical activity with significant health...
Risk Factors of Ankle Sprain in Soccer Players
Soccer is associated with substantial injury risk, with reported between 13 to...
Positive Outcomes of Medial Arch-Hindfoot Reconstruction in Children
Although surgical alignment of the rear-foot might be sufficient to achieve...
Sports- and Recreation-Related Toe Fractures
Fractures of the toes are among the most frequently diagnosed lower extremity...
A Foot Forward for Optimum Health
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Industry News & Updates
Gait Retraining Eases Pain, Slows Cartilage Damage
Researchers from the University of Utah (U of U), Salt Lake City; New York...
Pin-Free Robotic Surgery–New Orthopedic Technology
Scientists at Saarland University’s Homburg Campus, Germany, have developed a...
Smart Textiles Use Acoustic Waves to Precisely Measure Touch, Pressure, Movement
Smart textiles developed by researchers at ETH Zurich, Switzerland, use...
Stimulating the Vagus Nerve Through the Ear to Alleviate Knee Pain
A rehabilitation scientist and his team at The University of Texas at El Paso...
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Syndesmosis Ankle Sprain in a 21-Year-Old Division 1 Collegiate Football Player
Background: Syndesmotic injuries make up 12% of all ankle sprains, but 25% of ankle sprains in...
Syndesmosis Sprain in a 19-Year-Old Division 1 Collegiate Football Player
Background: Syndesmosis ankle sprains account for 25% of all ankle sprains in National Collegiate...
Neurocognitive Hop Performance and Chronic Ankle Instability
This study aimed to compare the relationship between self-reported ankle disability and...
Injury & Treatment Characteristics in Middle School Athletes
These researchers analyzed injury and treatment patterns among middle school-aged athletes...
Contributing Factors to Persistent Pain After LAS
This study investigated factors that may contribute to the development of persistent pain 6 months...
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
Thermal Imaging Module for MolecuLightDX
MolecuLight recently announced the availability of its new Thermal Imaging Module for the MolecuLightDX™ fluorescence imaging platform. This innovative clip-on module allows clinicians using the DX device to capture informative thermal images simultaneously with the...
Carbon Fiber Insoles
Overpowered Insoles, made from carbon fiber, feature unparalleled strength, an ultra-lightweight design, and cutting-edge technology, all to empower athletes of all levels to achieve new heights of speed, agility, and performance. Overpowered Insoles elevate the...
Guide to Help Patients with Recovery After Knee Replacement
Katy Vincent, who underwent a total knee replacement at age 54, reveals how she took control of her recovery and return to mental and physical fitness in A Joint Decision ... Total Knee Replacement: Your Handbook for Success (published by Balboa Press AU). This...
CBD Topical Pain Relief
Haylex Laboratories has announced the global release of Ortho Freeze Plus, an over-the-counter topical pain reliever combining the power of lidocaine, diclofenac, and a potent 6,000mg dose of CBD extract isolate (NO THC). Recommended by sports medicine doctors,...
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...
Adjustable Toe Separators
Tuli’s Soft Moves Adjustable Toe Separators provide customizable comfort and gentle alignment with a patent-pending design made from soft, medical-grade silicone gel. They help relieve pain from bunions, plantar fasciitis, hammertoes, and more while promoting...
Fusion Collection from Waco
Waco Shoe Company’s Fusion Collection is an orthotic-grade footwear line that combines casual designs for those who value support and sporty style. The Fusion Collection for women includes Zest, a strappy sandal; Vitality, a practical clog; Energy, a versatile...
UV Shoe Sanitizers
The SteriShoe® shoe sanitizer is designed specifically for footwear. This patented product features dual, non-ozone producing 5-watt UVC germicidal bulbs safely housed in steel frames that slip into your shoes. Once activated, they emit light at a wavelength that...
Walking Assistance Wearable Robot
WIM (We Innovate Mobility) is a walking assistance wearable robot designed for the active young generation, seniors seeking improved mobility, and patients recovering from lower extremity injuries. Weighing just 1.6 kilograms, it can be donned or doffed in under 30...
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