Journal of the American Podiatric Medical Association最新文献

{"title":"Beliefs About and Use of Forefoot Lateral Wedging in Podiatric Medical Practice: A Survey of Podiatric Physicians in New Zealand.","authors":"Aaron Jackson, Kelly Sheerin, Duncan Reid, Matthew R Carroll","doi":"10.7547/22-022","DOIUrl":"https://doi.org/10.7547/22-022","url":null,"abstract":"<p><strong>Background: </strong>Evidence is limited exploring the beliefs and application of forefoot lateral wedges (FLWs) in clinical practice by podiatric physicians. We aimed to understand rationale and beliefs that guide the use of FLWs among podiatrists.</p><p><strong>Methods: </strong>A cross-sectional study of New Zealand (NZ) podiatrists was conducted between May 31 and July 26, 2021. Data were collected anonymously using a Web-based survey platform. The 30-item survey included questions to elicit participant characteristics, why and when podiatrists used orthosis modifications, what biomechanical assumptions influenced clinical decision-making, and how podiatrists fabricated and placed FLWs.</p><p><strong>Results: </strong>Of 65 survey completers, most were trained in NZ (90.8%), had more than 10 years' experience (70.8%), and worked with a mixed case load (60.0%); 77.3% prescribed zero to ten foot orthoses per week, with FLWs used in 44% of prescriptions. Peroneal tendon injuries and chronic ankle instability were most likely to be treated with FLWs. The most common belief was that FLWs increase first metatarsophalangeal joint range of motion (86.2%). The FLWs were regularly manufactured from 3-mm (73.8%), medium-density ethyl vinyl acetate (92.9%) and positioned from the calcaneocuboid joint (54.8%) to the sulcus (78.6%).</p><p><strong>Conclusions: </strong>Podiatrists in NZ frequently use FLWs. These were generally manufactured from 3-mm, medium-density ethyl vinyl acetate and positioned from the calcaneocuboid joint to the sulcus. The most common rationales for use were to increase first metatarsophalangeal joint range of motion, shift the center of pressure medially, and balance the foot. A discordance was found between the theories of foot function on which clinicians placed the greatest importance and the biomechanical outcomes they thought were being achieved. Survey data also highlighted inconsistency in the nomenclature used to describe FLW thickness and inclination.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700796","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":"Does a Relationship Exist Between Plantar Heel Pain and Stress, Anxiety, and Depression: A Systematic Review of the Literature.","authors":"Joshua Nadimi, Wahid Abdul, Rhys Whelan, Anne-Marie Hutchison","doi":"10.7547/23-174","DOIUrl":"https://doi.org/10.7547/23-174","url":null,"abstract":"<p><strong>Background: </strong>Plantar heel pain (PHP) is a debilitating physical condition and may be acute or chronic. The aim of this systematic review of the literature was to examine whether there is an association between patients with PHP and stress, anxiety, and depression.</p><p><strong>Methods: </strong>A literature search of MEDLINE, Embase, Web of Science Core Collection, PsycInfo, CINAHL, Cochrane Central Register of Controlled Trials, and PEDro was conducted in May 2021. Articles were independently assessed by two reviewers and vetted for eligibility according to set inclusion/exclusion criteria and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Methodological quality assessment of eligible articles was undertaken using a Critical Appraisal Skills Programme-based tool. Extracted data included study design, population characteristics, method of diagnosis, and quality of life measures. A descriptive analysis was performed because of the heterogeneous nature of the data.</p><p><strong>Results: </strong>In total, 666 citations were identified from the literature search and eight studies were found to be eligible for the review. A total of 5,883 patients with PHP were identified. Four studies were found to be of medium quality and four studies were found to be of low quality according to the Critical Appraisal Skills Programme scoring tool. An association between PHP and quality of life was demonstrated across a variety of outcome measures and study designs.</p><p><strong>Conclusions: </strong>This study suggests an association between PHP and stress, anxiety, and depression. However, current research in this area is low in both quality and quantity and further robust studies are required to guide management.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700815","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":"Reoperation and Reamputation Rates After Isolated Sesamoidectomy for Foot Ulcers.","authors":"Bryanna D Vesely, Devon Niewohner, Cody Blazek","doi":"10.7547/23-001","DOIUrl":"https://doi.org/10.7547/23-001","url":null,"abstract":"<p><strong>Background: </strong>Foot wounds are a serious medical condition that can progress rapidly. For patients who have failed conservative treatment, surgery to remove infected bone or surgically offload the wound may be necessary.</p><p><strong>Methods: </strong>In our study, we looked at all patients at a single institution over a 7.5-year time period who underwent isolated sesamoidectomy for osteomyelitis or recurrent wounds. A total of 21 patients with 22 operative extremities and an average 430-day follow-up (21-1,346 days) were included in the study.</p><p><strong>Results: </strong>We found a 36.3% reoperation rate due to persistent wound resistant to conservative treatment or infection, with the most common procedure being a partial first-ray amputation (27.3% of patients). We found that the average time to reoperation after the initial surgery was 152.9 days.</p><p><strong>Conclusions: </strong>To our knowledge, this is the first study to look at reoperation rates after sesamoidectomy surgery for wounds. We conclude that isolated sesamoidectomy is an appropriate procedure for isolated osteomyelitis to the sesamoids or resistant wounds that have failed conservative treatment, with overall low reoperation rates compared with distal foot amputations.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700606","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 Fifth Metatarsophalangeal Joint Subluxation: A Case Report.","authors":"Susanna Basciani, Simone Santini, Gianluca Marineo, Piergianni Di Santo, Andrea Marinozzi","doi":"10.7547/22-151","DOIUrl":"10.7547/22-151","url":null,"abstract":"<p><p>Dislocations or subluxations of the metatarsophalangeal joints are rare, and open reduction is necessary in exceptional cases. In this case report, we present the case of a 30-year-old man who had chronic dislocation of the fifth metatarsophalangeal joint after a motorcycle accident. Stiffening of the joint capsule prevented closed reduction; therefore, the patient underwent surgery. After performing a Gauthier-type osteotomy, the joint was stabilized by Kirschner wire. The patient had an excellent recovery with no new dislocation episodes.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9878692","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":"High Tibial Nerve Entrapment: A Common Component of Tarsal Tunnel Syndrome.","authors":"Roberto P Segura, Michael S Nirenberg","doi":"10.7547/22-227","DOIUrl":"https://doi.org/10.7547/22-227","url":null,"abstract":"<p><strong>Background: </strong>Tarsal tunnel syndrome (TTS) is the result of compression of the tibial nerve in the area of the medial foot, ankle, or both. Individuals suffering from TTS may experience pain, burning, cramping, or numbness on the sole of the foot and toes. Tarsal tunnel syndrome is divided into a distal component and a proximal component. The latter is referred to as high TTS (HTTS) in which the tibial nerve is compressed above the location of the laciniate ligament. Research on HTTS is scant, and this study is among the first to evaluate the prevalence of HTTS in individuals with clinical signs and symptoms of TTS.</p><p><strong>Methods: </strong>The prevalence of HTTS was studied retrospectively in 175 patients who presented with clinical signs and symptoms of TTS and underwent electrodiagnostic testing. The electrodiagnostic testing involved conventional evaluation and a technique known as \"inching\" or short segment stimulation.</p><p><strong>Results: </strong>Of the 175 patients studied, 93 (53.1%) were found to have a focal entrapment in the area proximal to the laciniate ligament.</p><p><strong>Conclusions: </strong>Electrodiagnostic evidence of a focal nerve entrapment in the area proximal to the laciniate ligament, known as HTTS, occurred in a significant number of patients who presented with clinical signs and symptoms of TTS.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700822","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":"Predictors of Peripheral Neuropathy Among Persons with Diabetes Mellitus: A Multicenter Cross-Sectional Study.","authors":"Yakubu Lawal, Rifkatu Mshelia-Reng, Special Odiase Omonua, Kenechukwu Odumodu, Ramatu Shuaibu, Ukamaka Dorothy Itanyi, Amina Ibrahim Abubakar, Hadijat Oluseyi Kolade-Yunusa, Zumnan Songden David, Babajide Ogunlana, Andrew Clarke, Olufemi Adediran, Caleb O Ehusani, Zulfiqarali Abbas, Felicia Ehusani Anumah","doi":"10.7547/l22-053","DOIUrl":"https://doi.org/10.7547/l22-053","url":null,"abstract":"<p><strong>Background: </strong>Diabetic peripheral neuropathy (DPN) is a microvascular complication of diabetes mellitus (DM) that causes substantial morbidities, including pain, foot ulcers, lower-limb amputations, and depression. It is said to affect approximately 50% of adults with DM. Understanding the predictors of DPN will help refocus on early preventive strategies to reduce its numerous morbidities.</p><p><strong>Methods: </strong>A total of 1,040 persons with DM were consecutively enrolled. Relevant medical history, clinical examinations, and laboratory investigations were performed. Multiple logistic regression was used to determine predictors of DPN. Significance was set at P ≤ .05.</p><p><strong>Results: </strong>Significant predictors of DPN included age (odds ratio [OR], 1.99; P = .003); female sex (OR, 1.94; P = .023); DM duration (OR, 2.01; P = .032); history of systemic hypertension (OR, 1.68; P = .037); height (OR, 2.02; P = .001); generalized obesity (OR, 2.02; P = .002); central obesity (OR, 1.12; P = .047); poor control of systolic blood pressure (OR, 1.78; P = .001), diastolic blood pressure (OR, 1.45; P = .006), fasting plasma glucose (OR, 2.43; P = .004), 2-hour postprandial glucose (2HrPP) (OR, 2.83; P = .001), and glycated hemoglobin (OR, 2.31; P = .004); and peripheral artery disease (OR, 1.89; P = .002). The negative predictors of DPN include antidiabetics (OR, 2.39; P = .008), antihypertensives (OR, 2.45; P = .009), statins (OR, 2.21; P = .004), and antiplatelets (OR, 2.46; P = .030).</p><p><strong>Conclusions: </strong>Significant predictors of DPN include age, DM duration, female sex, height, history of systemic hypertension, and obesity. Others include poor control of systolic and diastolic blood pressure, fasting plasma glucose, 2HrPP, and glycated hemoglobin levels. Negative predictors include antidiabetics, antihypertensives, statins, and antiplatelets.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700588","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 Bone and Marrow Harvesting Approach Through Posterior Subtalar Screw Tunnel for Revision Talonavicular Joint Arthrodesis.","authors":"Andrew S Au, Peter A Blume","doi":"10.7547/22-175","DOIUrl":"https://doi.org/10.7547/22-175","url":null,"abstract":"<p><p>We present a case report of revision talonavicular joint arthrodesis following painful nonunion. Following the removal of the previously united subtalar joint arthrodesis hardware, the posterior screw tunnel was used to access the internal aspect of the calcaneus for bone and marrow harvesting avoiding a second graft site incision. A suction curettage system was then used to acquire adequate autologous cancellous bone graft and nondiluted bone marrow. The talonavicular joint was then prepared for revision arthrodesis, followed by augmentation with the autologous cancellous bone graft and rigid internal fixation placed across the joint for compression. There were no complications noted at the donor site or the arthrodesis site immediately following surgery or during follow-up. Radiographs obtained 4 months postoperatively demonstrate osseous union at the talonavicular joint and near complete consolidation at the calcaneal donor site. The patient is currently walking pain-free in a walking boot and will be continually followed to allow for long-term outcome measures.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700748","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":"Comparison of Lipid and Glucose Levels in Individuals with and Without Plantar Fasciitis: A Cross-Sectional Observational Study.","authors":"Sayyed-Hadi Sayyed-Hosseinian, Farshid Bagheri, Fatemeh Sistanian, Alireza Mousavian, Mohammad Hosein Ebrahimzadeh, Amir Reza Kachooei, Mahla Daliri","doi":"10.7547/22-084","DOIUrl":"https://doi.org/10.7547/22-084","url":null,"abstract":"<p><strong>Background: </strong>Tendon problems and biomechanical alterations are linked to hyperlipidemia. We sought to determine the relationship of plantar fasciitis (PF) with lipid profile parameters and fasting blood sugar (FBS) levels.</p><p><strong>Methods: </strong>In a case-control study, we enrolled 68 patients with a clinical diagnosis of PF in the case group and 136 individuals without PF in the control group. Patients' height, weight, body mass index (BMI), FBS level, and lipid profile, including low-density lipoprotein (LDL-C), high-density lipoprotein, and total cholesterol levels and triglyceride levels, were compared between the groups. The mean difference of each variable between the patient and control groups was tested using an independent t test. We calculated the odds ratio to quantify the strength of association between PF and elevated lipid profile. Correlation coefficient analyses were used to calculate the correlation of patients' BMI with lipid profile and FBS levels to evaluate the BMI variable as a confounder.</p><p><strong>Results: </strong>Patients with PF had higher levels of total cholesterol (P = .001), LDL-C (P = .004), and triglycerides (P = .02). Odds ratio calculation showed that patients with serum LDL-C levels greater than 130 mg/dL were 3.3 times more likely to develop PF. We found no association between lipid profile parameters and BMI (as a confounder) in either group.</p><p><strong>Conclusions: </strong>These findings show higher serum LDL-C parameters in patients with PF and may be sufficient to support a further clinical trial using statin treatment for persistent PF with increased LDL-C levels.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700807","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":"Early Staged Surgical Reconstruction for Active Midfoot and Ankle Charcot's Neuroarthropathy.","authors":"Michael J Hurst, Hannah J Hughes, Patrick R Burns","doi":"10.7547/22-036","DOIUrl":"https://doi.org/10.7547/22-036","url":null,"abstract":"<p><strong>Background: </strong>Charcot's neuroarthropathy (CN) is a destructive inflammatory process that affects patients with peripheral neuropathy, most commonly those with uncontrolled diabetes mellitus. The disease progresses through an active hyperemic phase that eventually becomes inactive, and the affected bone consolidates. The period in which the disease progresses from active to inactive is when instability, deformity, dislocation, and ulceration may occur depending on what deforming forces are stressing the affected pathologic area. There is a paucity of literature to support early primary surgical intervention, either single or staged, for active CN.</p><p><strong>Methods: </strong>The purpose of this case series was to retrospectively review 30 reconstructions in 30 patients who underwent primary surgical intervention for active midfoot and ankle CN. All of the 30 patients underwent staged deformity correction with temporary circular ring external fixation followed by definitive internal fixation.</p><p><strong>Results: </strong>Twenty-seven of the staged reconstructions (90%) at final follow-up resulted in limb salvage with no minor amputations after reconstruction. Mean final follow-up was 24.4 months. Nine of the 30 patients (30%) did not remain ulcer-free; however, 50% of the patients had a preexiting ulceration before surgical intervention, and the cohort exhibited a 40% healing rate of ulcers.</p><p><strong>Conclusions: </strong>We achieved a 90% limb salvage rate in patients with active midfoot and ankle CN with a staged surgical intervention protocol. Surgical intervention in the active stage of CN may be beneficial for patients who have gross instability with ulceration, significant midfoot collapse, and frank dislocation.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700818","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":"Static and Dynamic Foot Pressure Analysis in Asymptomatic Adults: A Cross-Sectional Analysis.","authors":"Osama Neyaz, Binayak Patra, Raj Kumar Yadav, Shabeeba Sherin","doi":"10.7547/23-024","DOIUrl":"https://doi.org/10.7547/23-024","url":null,"abstract":"<p><strong>Background: </strong>Normative data on plantar pressure distribution are essential for comparing the plantar pressures of healthy people with those of symptomatic individuals. The present study analyzed the foot pressure distribution variations among healthy males and females in static and dynamic conditions.</p><p><strong>Methods: </strong>A prospective cross-sectional study was conducted in the Department of Physical Medicine and Rehabilitation on individuals aged 18 to 65 years with no known foot pathologies or deformities. Both static and dynamic pedobarographic variables were measured using the BTS P-WALK system.</p><p><strong>Results: </strong>Among 160 participants, the static analysis showed that average hindfoot pressure (right, 59.8 ± 21.4; left, 72.1 ± 55.4) was significantly higher than average forefoot pressure (right, 29.2 ± 13.9; left, 23.4 ± 12.7) (P < .001). The average forefoot pressure was significantly higher in males (right, 30.1 ± 23.8; left, 23.8 ± 21.7) than in females (right, 21.8 ± 20.6; left, 16.6 ± 15.3) (P = .043 and .016, respectively), whereas the average hindfoot pressure was higher in females (right, 63.5 ± 25.9; left, 75.3 ± 23.9) than in males (right, 56.1 ± 19.6; left, 68.8 ± 24.2) (P = .043 and .089, respectively).</p><p><strong>Conclusions: </strong>The hindfoot bore more load than the forefoot when standing. Males carried a greater proportion of load over the forefoot than females. When walking, overall, the weightbearing pattern over the hindfoot and forefoot was similar.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700611","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}