Journal of the American Podiatric Medical Association最新文献

{"title":"Bidirectional Limb Salvage and Its Impact on Residual Limb Survivorship: Is a Partial Calcanectomy in Ambulatory Midfoot Amputees Worthwhile?","authors":"Craig J Verdin, Nicole K Cates, Holly D Shan, Karen K Evans, Christopher E Attinger, John S Steinberg, Jayson N Atves","doi":"10.3390/japma116040056","DOIUrl":"10.3390/japma116040056","url":null,"abstract":"<p><p>Partial calcanectomies and midfoot amputation are commonly used functional limb salvaging interventions; however, it is well documented that they independently result in global biomechanical disruption of diabetic foot, further placing the residual limb at risk for limb loss. We retrospectively identified and reviewed 9 ambulatory midfoot amputees (10 feet) who developed heel osteomyelitis, whom were treated with an ipsilateral partial calcanectomy to determine whether the combined anterior and posterior interventions result in additive dysfunction that impacts function or places the residual pedal construct at risk for limb loss.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Lower Extremity Injuries in Rodeo Athletes: A Systematic Review with Meta-Analysis.","authors":"Bethany Robinson, Evelyn Heigh-Rosen, Charlotte Bolch","doi":"10.3390/japma116040054","DOIUrl":"10.3390/japma116040054","url":null,"abstract":"<p><p>Rodeo, a non-traditional sport, may pose a higher risk of injury compared to other sports due to the intense forces exerted by livestock. The purpose of this study is to investigate the prevalence of lower extremity injuries and discuss potential strategies for injury reduction among rodeo athletes. A systematic review with meta-analysis, following PRISMA guidelines, was performed. A comprehensive search of three electronic databases was conducted, searching for studies assessing the epidemiological trends of lower extremity injuries in rodeo athletes. Studies were included if they were published in English, reported injury frequencies by body part, involved collegiate or professional rodeo athletes, and covered more than one rodeo event type. Among the seven identified studies on rodeo injury prevalence, six focused on Canadian and American professional rodeo athletes, while one studied collegiate athletes. The order of injury prevalence of the lower extremity was found to be thigh/knee (TK) > ankle (A) > lower leg (LL) > foot/toes (FT) across all rodeo athletes. Timed event athletes exhibited a nine-percent higher prevalence of thigh/knee and ankle injuries compared to rough stock athletes. Lower extremity injuries accounted for approximately twenty-eight percent of injuries among collegiate and professional rodeo athletes.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexisting Onychomycosis and Subungual Malignant Melanoma: A Case Series Illustrating Diagnostic Complexity in Podiatric Practice.","authors":"Fedan Avrumova, Erica B Friedman, Inna Verzub","doi":"10.3390/japma116040055","DOIUrl":"10.3390/japma116040055","url":null,"abstract":"<p><strong>Background: </strong>Subungual malignant melanoma (SMM) is an uncommon but potentially life-threatening neoplasm that frequently mimics benign nail disorders, particularly onychomycosis. Although misdiagnosis of SMM as fungal infection is well documented, laboratory-confirmed coexistence of onychomycosis and melanoma within the same nail unit is exceedingly rare and remains insufficiently characterized in the literature.</p><p><strong>Methods: </strong>A two-patient case series is presented in which both individuals underwent comprehensive clinical evaluation, nail unit biopsy, histopathologic examination with special staining, and molecular and/or mycologic testing. Longitudinal follow-up was obtained to evaluate clinical course and outcomes.</p><p><strong>Results: </strong>Both patients presented with chronic hallux nail dystrophy and laboratory-confirmed onychomycosis. In each case, fungal infection was confirmed, however, persistent symptoms prompted subsequent biopsies, that revealed malignant melanoma. In Case 1, a 71-year-old man with <i>Candida parapsilosis</i> onychomycosis underwent an initial nail unit biopsy demonstrating at least melanoma in situ with ulceration. Repeat biopsy confirmed invasive melanoma with an approximate Breslow thickness of 1.0 mm, while final pathology following partial hallux amputation revealed residual ulcerated melanoma with a Breslow thickness of 2.1 mm, negative margins, and negative sentinel lymph nodes, consistent with Stage IIB disease. In Case 2, an 88-year-old woman with dermatophytic onychomycosis consistent with <i>Trichophyton</i> species had an initial fragmented biopsy demonstrating invasive subungual melanoma with an estimated Breslow thickness of 0.6 mm. Final pathology following distal hallux amputation confirmed residual acral melanoma with a Breslow thickness of 0.6 mm, no ulceration, a mitotic rate of less than 1/mm², and negative margins, consistent with pT1a disease. Factors contributing to delayed melanoma recognition differed between cases: prior trauma, delayed intervention, and chronic ulceration complicated Case 1, whereas treatment for presumed onychomycosis without improvement delayed suspicion in Case 2.</p><p><strong>Conclusions: </strong>These findings demonstrate that positive mycologic results do not exclude concurrent melanoma and underscore the potential for diagnostic anchoring bias, supporting early biopsy consideration in refractory or atypical nail dystrophy.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To Evaluate Efficacy of Intralesional Platelet-Rich Plasma in Patients with Plantar Fasciitis.","authors":"Sanjiv Kumar, Chethan Channaveera, Satyaranjan Sethi, Ranjan Kumar Wadhwa, Vijender Anand","doi":"10.7547/24-161","DOIUrl":"https://doi.org/10.7547/24-161","url":null,"abstract":"<p><strong>Background: </strong>Plantar fasciitis (PF)is one of the most common causes of heel pain that affecting 10 of the general population. Platelet rich plasma(PRP)has been demonstrated to be helpful in managing PF and reducing plantar facia thickness (PFT). This study objective was to know the effect and efficacy of ultrasound (USG) guided intralesional PRP in PF in relation to pain, PFT and foot function index (FFI).</p><p><strong>Methods: </strong>A prospective interventional study was conducted in a tertiary care hospital on eighty-five diagnosed cases of unilateral PF. All patients had undergone pain intensity assessment by visual analogue scale (VAS), FFl, and USG examination of PFT after USG guided intralesional PRP injection was assessed at baseline (0 weeks), 2 weeks and 6 weeks.</p><p><strong>Results: </strong>Following USG guided intralesional PRP injection,a statistically significant decrease was noted in plantar fascia thickness (PFT) from baseline 0 (week) 6. 592mm ± 0. 51mm to 5. 169mm ± 0. 39mm and reduced to 4. 07mm ± 0. 39mm at 2nd week and 6th week, respectively (P value 0. 001).A statistically significant reduction of VAS score was noted which reduced from 8. 647 ± 0. 55 to 5. 588 ± 1. 13 (2nd week) and further reduced to 1. 21 ± 1. 06 at the end of 6 weeks (p value 0. 001). Mean FFI in our study at baseline was 85. 494 ± 6. 55, at 2 weeks mean FFI was 49. 341 ± 7. 277 and the end of 6 week it reduced to 24. 235 ± 1. 608 (P value 0. 001) statistically significant decrease was noted.</p><p><strong>Conclusions: </strong>PRP injection helps in the reduction of heel pain (VAS), reduction in PFT, and improvement in all domains of FFI, leading to enhancement of quality of life.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation Analysis Between Hip Internal Rotation Range and Plantar Pressure During Standing And Walking.","authors":"Ziyang Yang, Chen Yan, Xiaocong Yan, Chanchan Ge, Desheng Jiang, Niyuan Hu, Zhenghao Xue, Ying Qin","doi":"10.7547/24-144","DOIUrl":"https://doi.org/10.7547/24-144","url":null,"abstract":"<p><strong>Context: </strong>Different studies on football players with fifth metatarsal stress fractures have found that hip internal rotation (HIR)range of motion is significantly reduced, while lateral forefoot pressure is significantly increased; therefore, the purpose of this study was to determine whether HIR range of motion is related to lateral plantar pressure.</p><p><strong>Methods: </strong>The study included 120 college students (60 males and 60 females). HIR was measured using a smartphone inclinometer app in the prone position and a compass app in the supine position. Plantar pressure was assessed using the Gaitview AFA-50 system during standing and walking. Correlation analysis was performed using SPSS 27.0.</p><p><strong>Results: </strong>Among all subjects, HIR activity in the prone position was significantly negatively correlated with standing second through fourth metatarsophalangeal joints(MTPJ2-4), fifth metatarsophalangeal joint (MTPJ5), and midfoot (FM)pressures and significantly positively correlated with standing first toe (T1)pressure. During walking, there is a significant negative correlation between HIR in the prone position and MTPJ2-4, MTPJ5, FM, and lateral heel (LH). Similarly, in the supine position, HIR is significantly negatively correlated with MTPJ2-4, MTPJ5, FM, medial heel (MH), and LH.</p><p><strong>Conclusion: </strong>There is a significant negative correlation between HIR and lateral plantar pressure, indicating that reduced HIR is associated with increased lateral plantar pressure. Improving HIR through targeted rehabilitation may reduce lateral plantar pressure, offering new approaches for non-surgical treatment of little toe capsulitis and reducing the risk of fifth metatarsal stress fractures.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Ankle Fracture Outcomes with Short-Term Postoperative Immobilization.","authors":"Zaigang Dong, Wenze Liu, Kai Lei, Xiaole Xue, Biao Ning, Xuebin Zhang","doi":"10.7547/24-128","DOIUrl":"https://doi.org/10.7547/24-128","url":null,"abstract":"<p><strong>Background: </strong>This paper aims to investigate the effect of short-term cast immobilization on the prognosis of ankle fractures.</p><p><strong>Methods: </strong>A total of 60 patients who underwent ankle fracture surgery in our hospital from September 2021 to September 2022 were included and divided into a cast immobilization group (<i>n</i> = 30) and a control group (<i>n</i> = 30). Both groups were given open reduction and internal fixation. After the operation, the immobilization group used a plaster cast bandage to fix the ankle joint of the affected side in the functional position for 2 weeks; the control group did not receive cast immobilization and was only bandaged with routine wound dressings. The visual analog scale (VAS) score, ankle joint range of motion (ROM), lower extremity deep venous thrombosis rate, and ankle joint function score were followed up in the two groups.</p><p><strong>Results: </strong>All patients were followed up for 6 months. The VAS scores of the cast immobilization group were lower than the control group at 1, 3 and 7 days post-operation (<i>p</i> < 0.05). At 1, 2 and 3 months post-operation, the dorsiflexion ROM of the ankle joint in the cast immobilization group was larger than control group (<i>p</i> < 0.05). The ankle plantarflexion ROM at postoperative 1 and 2 months were larger than the control group (<i>p</i> < 0.05). The AOFAS of cast immobilization group was larger than the control group at 3 months post-operation (<i>p</i> = 0.002). The postoperative deep venous thrombosis rate was 1/30 (3.3%) in the cast immobilization group and 3/30 (10%) in the control group (<i>p</i> = 0.605).</p><p><strong>Conclusions: </strong>Short-term cast immobilization after ankle fracture surgery can significantly reduce postoperative pain in the early stage, without increasing the recovery and the incidence of deep venous thrombosis.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"N95 Usage During the COVID-19 Pandemic.","authors":"Nicole M DeLauro, Nader Ghobrial, Dong Yu","doi":"10.7547/20-101","DOIUrl":"https://doi.org/10.7547/20-101","url":null,"abstract":"","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Approach to Plantar Fasciitis Treatment: Pulsed Electromagnetic Field Therapy.","authors":"Christopher Bromley, Caitlyn McManus, Daniel McManus","doi":"10.7547/24-136","DOIUrl":"https://doi.org/10.7547/24-136","url":null,"abstract":"<p><strong>Background: </strong>Pulsed electromagnetic field (PEMF) therapy is a conservative, noninvasive, nonpharmacologic option for the treatment of plantar fasciitis that accelerates the body's anti-inflammatory and healing responses.</p><p><strong>Methods: </strong>In this case series, adult patients presenting with more than 2 weeks of heel pain due to plantar fasciitis were treated with the OrthoCor Active System PEMF device for 12 weeks. Efficacy was measured at 0 (baseline), 4, 8, and 12 weeks of treatment. Ultrasound was used to measure maximum plantar fascia thickness and hypoechoic region width. Function was evaluated using the Foot and Ankle Disability Index (FADI) and Patient-Specific Functional Scale (PSFS) survey scores.</p><p><strong>Results: </strong>Repeated measures analysis of variance showed a statistically significant improvement in all assessments with PEMF therapy. The mean plantar fascia thickness decreased by 34%, the mean hypoechoic region width decreased by 79%, the mean FADI score improved by 46%, and the mean PSFS score improved by 166%. Compared with data from other studies, PEMF and stretching therapy reduced plantar fascia thickness by 34% compared with 16% for dexamethasone injection and 6% for placebo saline injection; the FADI improved by 46% after 12 weeks of PEMF therapy compared with 43% after 1 year of treatment with indomethacin, heat and shoe pads, plantar fascia stretching, or calf stretching; and PSFS improved by 166% after PEMF therapy compared with 96% after primal reflex release treatment.</p><p><strong>Conclusions: </strong>Pulsed electromagnetic field therapy was effective for stimulating healing and improving function in patients with plantar fasciitis, as demonstrated by significant improvements in ultrasound measures and functional scores. This study suggests that PEMF therapy is an effective conservative, nonpharmacologic treatment option for plantar fasciitis.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Angioleiomyoma of the Hindfoot: A Rare Cause of Chronic Heel Pain.","authors":"Alec Wroblewski, Hayden Bush, Devon Niewohner, Jung Wha Kim-Shapiro, John Bonvillian","doi":"10.3390/japma116040053","DOIUrl":"https://doi.org/10.3390/japma116040053","url":null,"abstract":"<p><p>Angioleiomyoma is a benign soft tissue tumor originating from the smooth muscle of vascular structures. Though relatively uncommon, it frequently occurs in the lower extremities and is often misdiagnosed due to its nonspecific clinical presentation. We report the case of a 54-year-old female with chronic posterolateral heel pain initially attributed to insertional Achilles tendinopathy and Haglund's deformity. After failure of conservative management, MRI revealed a well-circumscribed subcutaneous lesion with signal characteristics concerning for a soft tissue neoplasm. Surgical excision was performed, and histopathologic analysis confirmed a venous-type angioleiomyoma, characterized by thick-walled vascular channels and smooth muscle proliferation without atypia. Immunohistochemistry was positive for SMA, weakly positive for desmin, and ERG-positive in the vascular endothelium. The patient experienced complete symptom resolution postoperatively. Although not exceedingly rare, angioleiomyomas remain underrecognized in clinical practice, particularly in the foot and ankle, resulting in diagnostic delays averaging over five years. MRI demonstrated characteristic features described in recent literature, validating its utility in preoperative assessment. This case reinforces the importance of maintaining a broad differential when evaluating chronic, focal heel pain and supports the use of advanced imaging and histopathologic confirmation in atypical cases. Greater awareness of angioleiomyomas can help reduce diagnostic delays and improve outcomes in patients with chronic, unexplained soft tissue pain in the foot and ankle.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobility of the First Ray in Feet with and Without Hallux Valgus.","authors":"Patricia Granados-Gómez, María Reina-Bueno, Mercedes Gómez-Castro, Pedro V Munuera-Martínez","doi":"10.3390/japma116040052","DOIUrl":"https://doi.org/10.3390/japma116040052","url":null,"abstract":"<p><p><b>Background:</b> This study aimed to describe the dorsiflexion and plantarflexion motion of the first ray in feet with and without hallux valgus. <b>Methods:</b> Eight hundred feet were examined and classified into normal feet without hallux valgus (<i>n</i> = 227) and feet with hallux valgus (<i>n</i> = 387). Dorsiflexion and plantarflexion of the first ray were quantified with a handheld ruler. Univariate comparisons of the first ray mobility were made between feet with and without hallux valgus. A two-stage cluster analysis was performed to define the range of dorsiflexion and plantarflexion values in both groups. Odds Ratios were obtained to determine whether dorsiflexion or plantarflexion showed more influence on hallux valgus. Multinomial logistic regression was used to predict the probability of having or not having hallux valgus, given dorsiflexion and plantarflexion of the first ray as independent variables. <b>Results:</b> Dorsiflexion showed statistically significant differences between groups (<i>p</i> = 0.011) but with a small effect size (Rosenthal's r = 0.10). Plantarflexion showed statistically significant differences between groups (<i>p</i> < 0.001) with a larger effect size (r = 0.71). Range of dorsiflexion was between 6 and 7 mm in both normal and hallux valgus feet. Range of plantarflexion in normal feet was 6-7 mm, and in hallux valgus feet 4-5 mm. Logistic regression showed that plantarflexion of the first ray had higher influence on HV than dorsiflexion. <b>Conclusions:</b> In hallux valgus feet, plantarflexion of the first ray was significantly lower than in normal feet, suggesting that a decreased range of plantarflexion is strongly related to hallux valgus.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}