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
Civilian Lower Extremity Injuries Resulting from Fires in the United States
Background: In 2023, an estimated 13,350 civilian fire injuries were reported in the United States (US). The objective of this study was to characterize civilian lower extremity injuries resulting from fires in the US. Methods: Data were obtained from the National Fire Incident Reporting System (NFIRS), which collects information on incidents to which fire departments respond in the US. Cases were civilian lower extremity injuries resulting from fires reported to NFIRS during 2014-2023. The distribution of cases was determined for patient characteristics, type of injury, and circumstances of injury.
By Mathias B. Forrester, BS
Machine Learning Combined with Explainable Artificial Intelligence Facilitate Accurate Balance Ability Classification
Using computerized posturographic parameters provides a highly quantitative and objective measure without ceiling or floor effect as a classifier or predictor of falls. The balance control problem is one of the major contributing factors to falls and may change with aging, medication, or acute illness. Computerized posturography obtained in standing conditions has been applied to classify fall risk for older adults or disease groups.
By Huey-Wen Liang, Rasoul Ameri, Shahab Band, Hsin-Shui Chen, Sung-Yu Ho, Bilal Zaidan, Kai-Chieh Chang, and Arthur Chang
LER EXPO Conversations: FAQ – Diagnostic Miscues in Podiatric Dermatology
Performing a biopsy is crucial for achieving diagnostic accuracy. Podiatric physicians may biopsy less frequently than their dermatology counterparts, but an earlier biopsy can significantly improve patient care. Many skin conditions can mimic common podiatric issues, and a biopsy allows for histopathological examination, which can…
By Leland Jaffe, DPM, FACFAS.CWSP
CAGA 101: The 12 Dirty Truths Playbook Dirty Truth #2: Realities of Center of Pressure in Dynamic World
It’s a physics problem – We live dynamic lives, in turn, we suffer dynamic consequences! In the last installment, we focused on our problematic anatomy. We continue this discussion by looking at what happens when we add the interaction between 2 dissimilar bodies, the foot and the floor, and the introduction of force.
By Jay Segel, DPM; Sally Crawford, MS
Targeted Hip Muscle Strengthening Improves Lower Extremity Kinematics in Runners
Dynamic knee valgus, a highly reliable measure of this alignment assessed in the frontal plane, is a valuable tool for identifying this pathomechanical dysfunction. The purpose of this study was to investigate the effectiveness of functional hip abductor strength training on reducing contralateral pelvic drop angle…
By Shreen Ahmed Lashien, Ahmed Omar Abdelnaeem, and Ebtessam Fawzy Gomaa
A New Innovative and Transformational Approach to Treatment of Toenail Onychomycosis
Toenail onychomycosis has long been difficult to treat because many factors affect the treatment outcome: aging patients, long-standing infection, slow growth of thickened nails, co-morbidities, limitations of the treatment (eg, treatment length, side effects, toxicity, physical limitations of the patient).
By Tracey C. Vlahovic, DPM, and Lewis H. Freed, DPM
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ShortTakes From the Literature
Arthroscopic Broström-Gould Effective for Chronic Ankle Instability
Chronic lateral ankle sprains are common injuries that are largely sequelae of...
The Link Between Proprioception and function in neurological conditions: Systematic-Review
Source: Robertson LS, Fisher G, Diong J, Butler AA, Gandevia SC, Héroux ME....
Peak Knee Flexion Angle Can Identify Persons Post-Stroke with Stiff-Knee Gait
Stiff-knee gait (SKG) affects 25–75% of individuals with post-stroke gait...
Muscle Strengthening Exercise for Foot & Ankle Best Practices
Foot and ankle muscle strengthening exercises are common interventions for...
Positive Outcomes of Medial Arch and Hindfoot Reconstruction in Children
Although surgical alignment of the rear-foot might be sufficient to achieve...
Firefighters’ exposure footwear impacts lower limb walking biomechanics
This study, by researchers from Shanghai, China, investigates the...
3D Mapping of Fracture Line Morphology of Pilon Fractures
In this study, the morphological characteristics of Pilon fractures were...
Biomarker Candidates to Predict DVT and Healing After Achilles Rupture
Deep venous thrombosis (DVT) and poor long-term patient outcomes frequently...
A Foot Forward for Optimum Health
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Industry News & Updates
Accurate, Rapid Arthritis Diagnosis Using Synovial Fluid
A research team from the Advanced Bio and Healthcare Materials Research...
Eldercare Robot Helps People Sit, Stand and Prevents Falls
To help address the eldercare challenge, a team of engineers from the...
Bio(printed) Skin for Wound Healing
Researchers from the anatomy and pharmacology departments at the University of...
Smart Patch Soothes Arthritic Pain with Heat
Researchers from Dalian University of Technology, China, have developed a...
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Post-LAS Walking Boot Use Reduces CAI
*Early Career Winner* This study investigated the effectiveness of care strategies and...
Muscle Contributions Altered During Drop Vertical Jumps in CAI
This study examined the joint loads and muscle forces during landing in individuals with chronic...
The Impact of Supervised Rehabilitation and Re-Injury of LAS
There is an increased risk for re-injury throughout the first 12 months after an acute lateral...
LAS Healthcare Utilization by D-I Collegiate Athletes
Lateral ankle sprain (LAS) is a common injury with a high recurrence rate. Potential inequities in...
A Case of Posterior Ankle Impingement In a Collegiate Level Soccer Player
Background: Posterolateral ankle impingement typically presents as pain on the posterolateral...
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
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Lower Extremity Review
Minimally Invasive ACL Repair Implant
The proprietary bio-engineered Bridge-Enhanced® ACL Repair (BEAR®) Implant is used to facilitate healing of the torn anterior cruciate ligament (ACL) by acting as a bridge between the 2 ends of the torn ligament. The surgeon injects a small amount of the patient’s own...
Minimally Invasive ACL Repair Implant
The proprietary bio-engineered Bridge-Enhanced® ACL Repair (BEAR®) Implant is used to facilitate healing of the torn anterior cruciate ligament (ACL) by acting as a bridge between the 2 ends of the torn ligament. The surgeon injects a small amount of the patient’s own...
Vibration Stimulation for Tendinopathy
Tend-Deep is an easy-to-use, at-home wellness device that uses pinpointed direct vibrational stimulation with multiple patterns and settings to provide convenient at-home treatment for pain points and tendons. The device’s direct vibration stimulation specifically...
Bunion Screw Technology
Voom™ Medical Devices’s Revcon™ bunion screw technology is indicated for use in minimally invasive bunion surgery (MIBS). The patented dual-zone screw technology features alternating non-compressive thread pitches targeted to the cortical and cancellous regions of the...
Elevating Walker-Chair
The Zeen® is a groundbreaking “Elevating Walker-Chair” that supports mobility and autonomy for those whose lives are restricted due to a variety of physical limitations. Compared to traditional walkers and wheelchairs, the device continually supports users while...
Compression Calf Sleeves
The R2 3.0 compression calf sleeve by COMPRESSPORT® is designed to increase stability and reduce shocks. The seamless, multi-gradual compression, quick-drying fabric, and specially designed K-Protect band reduce impact. The new 3D weave activates the proprioceptors:...
Shoes for Healthcare Professionals
Clove Nursing Shoes are engineered to keep up with the rigorous demands of medical professionals, providing all-day comfort and stability. A 10mm heel drop and blister-preventing heel cup ensure maximum comfort during long shifts. ASTM-certified slip-resistant...
Semi-Flexible Ligament Orthosis
As the newest addition to Bauerfeind’s knee portfolio, the innovative SecuTec Genu Flex knee orthosis stabilizes the knee joint and relieves the ligaments. The device features a Flex-Link System that enables a precise and secure fit throughout each state of recovery...
Revitalign Maia Sneaker for Women
The Revitalign® Maia is a new women’s athletic walking shoe offering comfort and style for daily use. The Maia sneaker is made with PURE WALKING technology offering advanced cushioning, articulated flex zones, and 360-degree orthotic support. The design includes an...
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