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
In the introductory article on the dirty truth of biomechanics, we presented a playbook laying out 12 particularly concerning issues as they relate to human weight-bearing and locomotion. In this installment, we will delve into dirty truth number one, problematic anatomy, laying out the “whats” and the “whys”, and how computer-aided gait analysis (CAGA) can make this dirty truth a bit cleaner and more digestible.
By Jay Segel, DPM; Sally Crawford, MS
Unipedal Stance Reliably Measures Neuromuscular Aging
Adequate muscle strength, efficient gait, and good balance, which decline with age, are crucial contributors to independence and well-being. Aging is often associated with disability and multiple health concerns. To address these challenges, effective interventions are essential. This study investigated potential age-related declines in gait, balance, and…
By Asghar Rezaei, Sandesh G. Bhat, Chih-Hsiu Cheng, Robert J. Pignolo, Lichun Lu, and Kenton R. Kaufman
Cell Phone-Related Lower Extremity Injuries While Using Non-Motor Vehicles
A portion of people use or carry cell phones while using bicycles and other non-motor vehicles (eg, scooters, skateboards, skates). This can increase the risk of injury. This study described cell phone-related lower extremity injuries while using non-motor vehicles that were treated at United States (US) hospital emergency departments (EDs).
By Mathias B. Forrester, BS
Introducing the 12 Dirty Truths Playbook: A New LER Series In Biomechanics and CAGA
The medical field continues to experience rapid technological advancements, providing us with critical graphs and quantitative measurements that validate what we see, the qualitative findings. For healthcare professionals charged with understanding and addressing gait, recognizing the correlation of what happens during weightbearing and the challenges/costs to the musculoskeletal system is key.
By Jay Segel, DPM; Sally Crawford, MS
Precision Healing: The Art & Science of Matrix Products in Lower Extremity Wound Care
Wound care is an evolving science, but if there’s one lesson I’ve learned, it’s this: healing isn’t just about using the latest product—it’s about knowing when and how to use it. Early in my career as a family physician, I saw a number of chronic wounds stagnate despite standard treatments. Patients were frustrated. So were we. The limitations of traditional approaches were clear, but what wasn’t clear was…
By Cassandre Voltaire, DO
LER EXPO Conversations: Surgical Considerations for Flexible Adult Stage 2 Flatfoot
Flatfoot, particularly flexible adult Stage 2 flatfoot, presents a complex challenge. This summary reviews proper patient evaluation for the condition and discusses the critical non-surgical and surgical considerations for managing stage 2 flatfoot, offering a deep dive into both soft tissue and osseous procedural options. By understanding the pathology’s nature, evaluating the demographic factors, and…
A summarized talk by Joseph Park, DPM, FACFAS
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ShortTakes From the Literature
Children Sweat Just Like Adults
A recently published study from Australia sought to determine whether children...
Football Line Position Increases Heat Risk Compared to BMI
A study focusing on high school football players in Georgia revealed that...
Preventing Exertional Heat Stroke in Football: New Paradigm Focuses on Line Positions
Among American sports, football has the highest incidence of exertional heat...
Comparison of ESWT and HILT for Calcaneal Spurs
Calcaneal spur (CS), a prevalent cause of localized heel pain, can...
Suture Method Matters in Knee Arthroscopy for Meniscus Repair
The choice of meniscus repair technique has effects on long-term outcomes and...
Primates and Rodents Heal 3 Times Faster Than Humans
Skin wounds, which affect survival and biological functioning, are common in...
Risks Associated with Ankle Sprain in Soccer Players
Soccer is associated with substantial injury risk, with reported between 13 to...
Sarcopenia Common in Older Patients with RLS
Restless legs syndrome (RLS) is a disorder characterized by nocturnally...
A Foot Forward for Optimum Health
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Industry News & Updates
Smart Insole Tracks How You Walk, Run, Stand
A new smart insole system that uses machine learning to learn and classify 8...
Data-Driven Designs to Improve Prosthetic Legs
Researchers have developed a new, data-driven way of fitting prosthetic legs,...
Evaluating FAST Walk System for Neuromodulation-Assisted Gait Recovery in Chronic Stroke
In an effort to address the ongoing challenge of gait impairment after stroke,...
Zimmerman Shoes Acquires Markell Shoe Company
Zimmerman Shoes, Orwigsburg, Pennsylvania, the United States’ oldest...
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When an Ankle Injury Isn’t Just a Sprain
Background: A 13-year-old male athlete with no history of injuries, was playing in a middle school...
Proximal Tibiofibular Synostosis in a Female Soccer Athlete
Background: Osteochondromas are the most prevalent benign bone tumor, occurring mostly in the long...
“Robotic pill” safely delivers injectable osteoporosis drug
A proven and effective medication for osteoporosis, which is currently only available as an...
BMI alone may not be a sufficient indicator of metabolic health
Evidence shows that a high proportion of U.S. adults with normal body mass index (BMI) still have...
Full recovery may be possible among men who use steroids for muscle growth
Full recovery of testosterone production may be possible for men who wish to stop using...
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
Cold and Heat Foot Therapy Wrap
Tuli’s Foot Therapy Wrap is a versatile solution for relieving plantar fasciitis, heel pain, and foot fatigue using both cold and heat therapy. Designed for targeted relief, it reduces inflammation, soothes stiffness, and enhances comfort. Benefits include the...
Ankle Plating System
The Arsenal Ankle Plating System™ consists of 37 anatomically designed plates throughout 9 plate families, offering a plating solution for any ankle fracture. The plates are stout where it matters and sleek where needed, which makes a difference when treating complex...
3-in-1 Massager for Knee Pain
Kneeflow is an at-home, personalized massaging device that can help with the recovery process, prevention, and relief. The device uses 3 methods to provide deeper penetration into joints, cartilage, and tissue for faster and more effective pain relief: Soft airbags...
IB Lab FROG: AI for Radiological/Orthopedic Assessments
IB Lab FROG is an artificial intelligence (AI) module that offers a comprehensive suite of automated measurements on X-rays, designed for radiological and orthopedic foot assessments. IB Lab FROG covers key foot pathologies and delivers clinicians accurate,...
Relaxation Compression Boots
SoleFlux Relax Compression Boots are designed to effectively relieve leg pain and discomfort. The boots utilize intermittent pneumatic compression (IPC) technology, which simulates manual massages to enhance blood circulation and alleviate various symptoms: These air...
AFO with Adaptable, Modular Design
The patented and PDAC-approved Prime Brace offers unmatched adaptability and patient compliance. Its modular design allows users to customize the level of stabilization based on their activities and footwear needs, making it a game-changer in ankle foot orthotic (AFO)...
Topical Oxygen Therapy with NATROX O₂
NATROX O2 is a compact, wearable device that generates and delivers a continuous flow of oxygen directly to the wound bed to promote accelerated healing and foster a healthy wound environment, even in wounds that have persisted for years, such as diabetic foot ulcers,...
Portable Digital 3D Force Plate
Kistler has introduced a portable digital 3D force plate with piezoelectric sensors for balance and gait analyses. Thanks to digital technology, the portable force plate allows simpler measurement setups, accommodates up to 16 force plates connected in series, and...
GenuTrain S Pro Knee Brace
The GenuTrain S Pro knee brace, which is designed for active lifestyle and athletic use, adds mechanical stability to the joint by stabilizing the knee with 2 adjustable hinges that are integrated medially and laterally. Depending on the indication, the hinge can be...
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