Journal of the American Podiatric Medical Association最新文献

{"title":"Management and Outcomes of Hallucal Sesamoid Osteomyelitis.","authors":"Cameron Meyer, Jeremy Philipsen, Jeffrey Manway, Patrick Burns","doi":"10.7547/22-217","DOIUrl":"https://doi.org/10.7547/22-217","url":null,"abstract":"<p><strong>Background: </strong>Osteomyelitis in the foot is routinely managed by wide-scale debridement and surgical resection of infected bone. Appropriate debridement is important for optimizing patient success. The sesamoid apparatus is a complex area of foot anatomy with a mosaic of osseous and soft-tissue attachments adjacent to the first metatarsal head. Despite this, in the setting of an infected sesamoid, most providers resect only an isolated infected sesamoid. The aim of this study was to review outcomes of isolated surgical sesamoidectomy in the setting of osteomyelitis and how many may progress to partial first-ray resection.</p><p><strong>Methods: </strong>We retrospectively reviewed 24 patients who underwent sesamoidectomy for osteomyelitis at a single institution by one primary surgeon during a 14-year period (2007-2021). Diagnosis was made by the surgeon and verified by conventional radiography or magnetic resonance imaging interpretation by an independent radiologist.</p><p><strong>Results: </strong>Of the 24 patients, 22 (92%) were diabetic, 12 (50%) smoked, and all had a history of neuropathy. This study revealed a 63% complication rate (n = 15), which led to revisional surgery and often progression to more proximal amputation. Nine patients (37.5%) progressed to partial first-ray resection.</p><p><strong>Conclusions: </strong>This study exposed a high complication rate correlating with progression to additional surgery (P = .05), strongly suggesting that isolated sesamoidectomy may not definitively provide clear enough margins during operative debridement.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506102","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":"The Unusual Suspect-Tarsal Tunnel Syndrome Due to Flexor Digitorum Brevis Hypertrophy.","authors":"Mark D Schuenke, Craig H Thomajan, Kailey Carota Hanley, Al H Makkouk","doi":"10.7547/23-064","DOIUrl":"10.7547/23-064","url":null,"abstract":"<p><p>A rare case of tarsal tunnel syndrome caused by flexor digitorum brevis hypertrophy. The patient presented with medial plantar pain and paresthesia but denies any injury. Magnetic resonance imaging revealed a marked hypertrophy of the flexor digitorum brevis in close proximity to the medial and lateral plantar nerves, with herniation into the porta pedis. Surgical excision of the herniated muscle was performed, along with a tarsal tunnel release. The combined treatment resulted in symptomatic relief.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506111","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":"Long-Term Clinical and Radiographic Outcomes After Surgical Treatment for Ankle Fracture-Dislocations.","authors":"Tuna Pehlivanoglu, Mehmet Demirel, Daghan Koyuncu, Natiq Valiyev, Turgut Akgül, Onder Ismet Kilicoglu","doi":"10.7547/22-225","DOIUrl":"10.7547/22-225","url":null,"abstract":"<p><strong>Background: </strong>Ankle fractures constitute 10% of all traumatic fractures in clinical practice. Concurrent tibiotalar dislocations form 21% to 36% of all ankle fractures. Although mechanism of injury is similar to nondislocated ankle fractures, fracture-dislocations cause more extensive bone and soft-tissue damage. Treatment is a challenge for orthopedic surgeons due to concomitant pathologies. It is associated with malreduction, chronic pain, and post-traumatic osteoarthritis. We aimed to investigate the relationship between ankle osteoarthritis radiographic stage and clinical outcomes.</p><p><strong>Methods: </strong>Records and data of 27 patients were retrospectively analyzed. Clinical status at final follow-up was evaluated by a single orthopedic surgeon. Range of motion, American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score, and visual analog scale score were the clinical parameters that were assessed. Radiologic assessment was made by standard anteroposterior, lateral, and mortise views. Preoperative osseoligamentous injury pattern, presence of posterior malleolar fracture, syndesmosis injury, and postoperative ankle osteoarthritis were investigated.</p><p><strong>Results: </strong>At final follow-up, mean ± SD Ankle-Hindfoot Score was 98.25 ± 1.06 and visual analog scale score during daily activities was 1.52 ± 0.70. Mean ± SD ankle dorsiflexion and plantarflexion were significantly lower on the affected sides (14.07° ± 7.97° and 36.30° ± 6.59°) than on the unaffected sides (28.15° ± 2.82° and 46.30° ± 2.97°), respectively (P < .001). No significant difference for inversion and eversion was observed. Twenty-four patients demonstrated radiographic signs of ankle osteoarthritis and three did not. No significant difference was found among Takakura stages in any of the variables.</p><p><strong>Conclusions: </strong>Although the post-traumatic osteoarthritis rate was high for ankle fracture-dislocation, surgical treatment achieved excellent functional results. Even if advanced stages of ankle arthritis according to Takakura classification developed, patients had satisfactory clinical and functional results.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972352","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":"Management of Avascular Necrosis of the Talus After a Talar Body Fracture by Core Decompression and Insertion of Demineralized Bone Matrix and Bone Marrow Aspirate Concentrate.","authors":"Mujtaba Qureshi, Ali Saleh, Kenny Luong, John Caponigro, Samuel Adegboyega","doi":"10.7547/23-108","DOIUrl":"https://doi.org/10.7547/23-108","url":null,"abstract":"","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506103","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":"Checkrein Syndrome.","authors":"Kaitlyn J Loesel, Anthony J Brando, Timothy Ford","doi":"10.7547/24-051","DOIUrl":"10.7547/24-051","url":null,"abstract":"<p><p>Checkrein syndrome is a rare condition affecting the flexor hallucis longus (FHL) tendon as a result of either surgery or trauma. Checkrein syndrome is defined as the occurrence of hallux malleus upon dorsiflexion of the ankle, which is reduced upon plantarflexion of the ankle. The literature supports various treatments for this condition; however, lengthening of the FHL tendon remains the mainstay of treatment. In this case series, we describe two cases of checkrein syndrome with different etiologies: pilon fracture and gunshot wound to the leg. Both of these cases were successfully treated with FHL tendon lengthening, with one case requiring a hallux interphalangeal joint arthrodesis.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506093","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":"Modified Zigzag Nail Bed Flap with Three Rotations as a Therapeutic Approach in Congenital Malalignment of the Great Toenail.","authors":"Qiaochu Zhou, Wenting Su, Wenzheng Zhu, Wei Wang","doi":"10.7547/23-022","DOIUrl":"https://doi.org/10.7547/23-022","url":null,"abstract":"<p><p>Congenital malalignment of the great toenail is rare and often causes nail deformity. When these complications of transverse overcurvature and retronychia occur, the degree of improvement with the conventional surgical approach is significantly limited for nail deformities or recurrence. We present a case of a 22-year-old woman with congenital malalignment of the great toenail associated with retronychia and transverse overcurvature. We describe the application of the zigzag nail bed flap with three rotations in congenital malalignment of the great toenail, modifying the original approach according to the patient's multiple nail deformities, while achieving satisfactory results. To our knowledge, there is no report of this in the literature.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506104","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":"Effect of Foot Anthropometric Measurements on Pain and Functional Disability of Pregnant and Nonpregnant Women.","authors":"Rabia Koca, Müşerref Ebru Şen, Mehmet Yılmazer","doi":"10.7547/22-202","DOIUrl":"10.7547/22-202","url":null,"abstract":"<p><strong>Background: </strong>Weight gain during pregnancy, loosening of the foot ligaments with relaxin hormone release, and anthropometric and biomechanical changes can be seen in the foot with the growing fetus. We sought to determine whether these pregnancy-related changes cause painful musculoskeletal problems by altering the proximal structures of the lower extremities and the structure of the spine.</p><p><strong>Methods: </strong>Both feet of 210 women (half in the third trimester of pregnancy) aged 18 to 40 years with similar demographic characteristics were evaluated by measuring navicular drop, hallux valgus angle, foot width, foot length, and tibiocalcaneal angle. Foot Function Index for foot-ankle, Kujala Patellofemoral Score for knee, Western Ontario and McMaster Universities Osteoarthritis Index for hip, Oswestry Disability Index for waist, and Modified Neck Disability Index for neck were used to determine pain and functional limitation.</p><p><strong>Results: </strong>Pain and functional disability in the waist, hip, knee, and foot-ankle joints; navicular drop; hallux valgus angle; and tibiocalcaneal angle were significantly higher in pregnant women versus the control group (P < .001). Pain and dysfunction in all of the joints increased as navicular drop increased in pregnant and nonpregnant women. In addition, the increase in other anthropometric measurements in both groups was determined to caused pain and functional disability in most of the women, especially in foot-ankle joints. However, the cause of joint pain and functional deficiencies was unrelated to pregnancy.</p><p><strong>Conclusions: </strong>Foot deformities and proximal region complaints were significantly higher in pregnant women, and foot deformities caused more foot-ankle pain and disability in both groups. No difference was observed in pregnant women versus the control group.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073648","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":"Pseudoaneurysm after Distal Chevron Osteotomy Bunionectomy.","authors":"Grant Yonemoto, Martin Pressman, Britt H Tonnessen, Steven Vyce, Michael Gazes","doi":"10.7547/23-036","DOIUrl":"https://doi.org/10.7547/23-036","url":null,"abstract":"<p><p>Iatrogenic pseudoaneurysms are a rare complication after foot and ankle surgery. A pseudoaneurysm is described as a defect in an arterial wall contained in the surrounding soft tissue. We present a 72-year-old woman who underwent a distal chevron osteotomy bunionectomy complicated by a postoperative pseudoaneurysm to the plantar lateral hallucis artery. This case represents a rare complication to a common procedure and bunionectomy technique.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506108","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":"A Method for Weightbearing Assessment of Plantar Fascia Thickness and Stiffness.","authors":"Mark Price, Thomas Mychost, Roozbeh Naemi, Nachiappan Chockalingam","doi":"10.7547/24-057","DOIUrl":"https://doi.org/10.7547/24-057","url":null,"abstract":"<p><strong>Background: </strong>The plantar fascia of the foot is complex in both its structure and function. Previous research using ultrasound-based techniques has focused on nonweightbearing assessment of plantar fascia thickness (PFT) and plantar fascia stiffness (PFS). However, weightbearing assessment (closed chain) has not previously been performed in a way to demonstrate the response of the plantar fascia to load. This study aimed to develop a protocol that enables precise and consistent measurement of the PFT and PFS while bearing weight in a fixed calcaneal stance position.</p><p><strong>Methods: </strong>An ultrasound probe capable of shear wave elastography was integrated into a bespoke three-dimensional printed platform incorporating a window to allow positioning of the ultrasound probe. This allowed a closed-chain assessment of the plantar fascia in which a standardized protocol was developed for measurement of the PFT and PFS. The images produced were composed of clips, which were then subdivided into multiple frames.</p><p><strong>Results: </strong>A total of 13 participants (26 feet) had PFT and PFS assessed using the protocol. The results showed a low coefficient of variation (CV) in frame analysis for PFT (CV, 0) and PFS (CV, 0.01). One-clip analysis also demonstrated a low CV for PFT (CV, 0.02) and PFS (CV, 0.01). In addition, a cluster analysis indicated two distinct groups that demonstrated a strong correlation between PFT and PFS (group 1 and group 2 correlation coefficients, 0.83 and 0.98, respectively).</p><p><strong>Conclusions: </strong>The protocol reported in this study was shown to be a valid and reliable method for assessing PFT and PFS in a weightbearing position, which has many clinical and research implications.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506090","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":"A Rare Case of Third Metatarsal Pseudoepiphyses in a Pediatric Patient.","authors":"Lindsay K LeSavage, Bryanna D Vesely, David M Pagnanelli, Cody D Blazek","doi":"10.7547/22-058","DOIUrl":"https://doi.org/10.7547/22-058","url":null,"abstract":"<p><p>We report the case of a 10-year-old boy presenting for evaluation of bilateral arch pain and flatfoot deformity. Foot radiographs revealed a mushroom-shaped cleft traversing the proximal end of the third metatarsals, consistent with a pseudoepiphysis. There is literature suggesting that this is a common finding in the distal first metatarsal as well as pediatric metacarpal bones; however, the incidence in the third metatarsals has not been clearly established. Only one study to date has analyzed accessory proximal growth centers in the second metatarsal, and it reported this anomaly in 6.3% of pediatric radiographs reviewed. To our knowledge, there are no reports in the literature on complete bilateral pseudoepiphyses in the third metatarsals. Recognizing this anomaly is important to prevent misdiagnosing as a malignant or traumatic pathology.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 3","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144506091","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}