Journal of the American Podiatric Medical Association最新文献

{"title":"Is Pain Inevitable after Tibia Pilon Fractures?: A 3-Year Prospective Analysis.","authors":"Batuhan Gencer, Özgür Doğan","doi":"10.7547/23-231","DOIUrl":"https://doi.org/10.7547/23-231","url":null,"abstract":"<p><strong>Background: </strong>Tibia pilon fractures are associated with a low rate of pain-free return to normal life. Our objective was to ascertain the prevalence of chronic pain in the extensive postoperative follow-up of pilon fractures. Additionally, the factors affecting the existence and intensity of pain were investigated.</p><p><strong>Methods: </strong>This prospective cohort study analyzed 85 patients, with a mean follow-up of 32.98 months (range, 24-65), treated with single-staged surgery between 2015 and 2019. The analyzed parameters were as follows: demographic data, injury mechanisms, fracture type, operation type, preferred main incision and implant, whether posterolateral incision and implant are used, whether the patient can be operated on within the first 48 hours after admission, follow-up period, and complications. Patients' pain occurrence and intensity were questioned using the Stanmore Functional Scale.</p><p><strong>Results: </strong>During the final follow-up, only 18 (21.2%) patients reported that they returned to pain-free normal life. The choice of implant and incision was found to be significantly related to both the occurrence and the severity of pain (P < .05). Furthermore, the severity of pain was also found to be significantly related to fracture type and posterolateral incision (P < .05).</p><p><strong>Conclusions: </strong>When treating pilon fractures, postoperative pain should be considered as a parameter. Dual-plating has been linked to long-term pain after pilon fractures and this should be kept in mind when creating a treatment plan.</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":"143700828","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 Use of Multilayer Felt Padding in the Treatment of Neuropathic Plantar Foot Ulcerations.","authors":"Khanh Phuong Tong, Kayla N Obradovic, Alyse L Acciani, Norman Wortzman, Stuart Kigner","doi":"10.7547/22-088","DOIUrl":"https://doi.org/10.7547/22-088","url":null,"abstract":"<p><strong>Background: </strong>Neuropathic plantar foot ulcers are difficult to treat due to their location and the repetitive pressures applied during ambulation. Total-contact casts and removable off-loading devices are effective in off-loading pressures; however, patient intolerance and adherence are barriers to use. Felt padding can provide off-loading with greater tolerance. We present novel felt padding techniques that provide off-loading with greater adherence and may ultimately lead to greater rates of wound closure.</p><p><strong>Methods: </strong>This retrospective study included patients with neuropathic plantar foot ulcers seen at a single center between August 1, 2016 and July 15, 2020. Felt padding was applied to the plantar foot during clinic visits. Ulcer characteristics, medical history, and treatment options were extracted and evaluated. Statistical analyses were performed with descriptive statistics, two-sample t tests, and Fisher exact tests. Kaplan-Meier method was used to estimate time to reach 50% ulcer surface area reduction.</p><p><strong>Results: </strong>Of 59 included patients with neuropathy and a plantar foot ulcer treated with felt padding, 46 (78.0%) had diabetes mellitus. Mean ± SD surface area was 1.0 ± 1.8 cm2. Mean ± SD and median (interquartile range) healing times were 67.4 ± 76.3 days and 45 (40) days, respectively. The percentage healed by 12 weeks was 78.0%. There was no significant difference in healing times between diabetic and nondiabetic patients (P = .57).</p><p><strong>Conclusions: </strong>Multilayer felt padding is an important adjunctive tool for off-loading and healing of neuropathic plantar foot ulcers. Use of multilayer felt off-loading padding should be considered for patients with suspected low adherence to wearing a removable knee-high or ankle-high off-loading device.</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":"143700573","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":"Quality Assessment of YouTube Videos as a Source of Information on Ingrown Toenails.","authors":"Erdi Imre","doi":"10.7547/22-054","DOIUrl":"https://doi.org/10.7547/22-054","url":null,"abstract":"<p><strong>Background: </strong>YouTube is one of the most widely used Internet sources, and many patients watch YouTube videos for gathering more information, especially about health problems. This study aimed to investigate the informative capabilities of YouTube videos about ingrown toenails. We hypothesize that most of the shared information is of low quality independent of source and that the attraction effect of videos is unrelated to quality.</p><p><strong>Methods: </strong>The first 50 videos in the English language using the keyword query ingrown toenail in YouTube search were analyzed. Journal of the American Medical Association (JAMA) benchmark criteria were used to assess video reliability, and Global Quality Score (GQS) and toenail specific score (TSS) were used to assess the quality of educational content.</p><p><strong>Results: </strong>The first 50 videos had 71,842,230 views (median, 333,585). Forty-one videos (82%) were from health-care professionals, seven (14%) were educational videos, and two (4%) were personal videos. The median JAMA score was 2, with the highest scores coming from academic sources. When grouped by view count (>300,000 versus ≤300,000) and like count (>10,000 versus ≤10,000), there was no significant difference in JAMA and GQS scores. The median GQS and toenail specific score were 3.0 and 5.5, respectively. Video duration was a significant predictor of GQS as a result of regression analysis (P = .002; β = 0.425).</p><p><strong>Conclusions: </strong>Illustrated by the high number of views, ingrown toenail is a popular health topic on YouTube. Although popular and with content mostly uploaded by health-care professionals, content quality was found to be poor and videos to be unreliable and insufficient for informing patients because most videos seem to be geared toward entertainment rather than direct patient education. Health-care professionals should be aware of the generally low-quality data available.</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":"143700593","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":"Outcomes and Comparisons of Minimally Invasive Distal Metatarsal and Phalangeal Osteotomies With Traditional Open Osteotomies for Hallux Valgus Deformity.","authors":"Adam R Johnson","doi":"10.7547/23-013","DOIUrl":"https://doi.org/10.7547/23-013","url":null,"abstract":"<p><strong>Background: </strong>Ongoing efforts and innovations to improve current bunionectomy procedures have led to a resurgence of minimally invasive surgery.</p><p><strong>Methods: </strong>A retrospective review of 23 patients who underwent a minimally invasive distal metatarsal and phalangeal osteotomy bunionectomy procedure was undertaken. The procedure was accomplished using stab incisions (less than 5 mm in length) for the introduction of cutting routers and fixation devices to avoid disruption of the soft tissues in and around the first metatarsophalangeal joint, including avoidance of first metatarsophalangeal joint lateral soft tissue release.</p><p><strong>Results: </strong>The results revealed that the procedure led to an average reduction in first intermetatarsal angle of 63% (14.5° preoperatively versus 5.3° postoperatively) and a reduction in hallux abductus angle of 54% (33.8° preoperatively versus 15.5° postoperatively). Tibial sesamoid position was also recorded and reduced by 63% (an average position of 5 preoperatively versus an average position of 2 postoperatively).</p><p><strong>Conclusions: </strong>A review of recent literature demonstrated that these results were comparable to open midshaft and base osteotomies.</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":"143699564","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":"Outcome of Minimally Invasive Chevron and Akin Procedure With an Osteotomized Metatarsal Head Translation of More Than Fifty Percent for the Correction of Hallux Valgus.","authors":"Michael Michlin, David Segal, Meron Talmor, Ran Atzmon, Dan Perl, Ezequiel Palmanovich, Nissim Ohana","doi":"10.7547/l23-232","DOIUrl":"https://doi.org/10.7547/l23-232","url":null,"abstract":"<p><strong>Background: </strong>Surgical protocols for hallux valgus (HV) surgery rely on the severity of the deformity, utilizing various techniques for different severity grades. The purpose of this study was to evaluate the association between the extent of the distal fragment translation and patient-reported outcome measures (PROMs) in patients with HV of varying severity grades who had undergone the same surgery, a minimally invasive chevron and Akin (MICA) procedure, with a fragment translation of at least 50%.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients who had undergone a MICA procedure for HV between January 1, 2017, and August 1, 2022, and had had at least 1-year follow-up. We collected medical and demographic information and conducted radiographic measurements. PROMs (European Foot and Ankle Society questionnaire and satisfaction anchor questions) were the primary outcome measure and were collected via a telephone survey.</p><p><strong>Results: </strong>Of the 140 cases reviewed, 105 (75% [97 patients]) were included: six (5.7%) were defined as mild HV, 66 (62.9%) as moderate HV, and 33 (31.4%) as severe HV. The mean preoperative and postoperative first intermetatarsal angles were 13.67 ± 2.94° and 3.1 ± 2.34°, respectively. The mean preoperative and postoperative HV angles were 31.41 ± 8.56° and 8.21 ± 5.02°, respectively. The mean translation was 77.49 ± 13.18%. The extent of translation did not correlate with intermetatarsal angle or HV angle (P = .45 and .62, respectively). The PROM questionnaires were answered by 73 patients (80 feet [76.19% of total cases]). The mean postoperative European Foot and Ankle Society score was 18.59 ± 6.63, and 67 patients (83.8%) declared that they were satisfied with the surgery. PROMs were not associated with preoperative HV severity or translation extent (P > .1).</p><p><strong>Conclusions: </strong>With MICA distal osteotomy and translation of the first metatarsal head by more than 50% (up to 100%), we were able to correct even severe HV deformities that would previously have required proximal osteotomies and obtain significant angle correction with good clinical results.</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":"143710273","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 Bicortical versus Unicortical Medial Malleolus Fixation.","authors":"Ryan Lerch, Jeffrey Manway, Gele Moloney","doi":"10.7547/22-098","DOIUrl":"https://doi.org/10.7547/22-098","url":null,"abstract":"<p><strong>Background: </strong>Ankle fractures continue to increase in incidence and severity in an older, more challenging geriatric population. Medial malleolus fixation with partially threaded cancellous 4.0-mm screws, a common fixation method, has been shown to fail due to pullout strength. Subsequent cadaveric models have shown increased pullout strength with the use of bicortical screws. The literature has also demonstrated fairly good clinical results with the use of bicortical screw fixation in a general population as well as in a complicated patient cohort.</p><p><strong>Methods: </strong>We sought to compare bicortical fully threaded 3.5-mm screw fixation with unicortical partially threaded 4.0-mm fixation in medial malleolus fractures. The aim was to compare postoperative complications such as screw failure/loosening, nonunion, delayed union, painful hardware, time to union, and time to full weightbearing.</p><p><strong>Results: </strong>Of 292 patients retrospectively reviewed, 126 were included following the inclusion and exclusion criteria. The data included 48 patients in the bicortical group and 78 in the unicortical group, with a mean ± SD combined age of 56.0 ± 18.0 years. Complications occurred in three patients (6%) in the bicortical screw fixation group and in six (8%) in the unicortical group, which did not reach statistical significance.</p><p><strong>Conclusions: </strong>These results show that medial malleolus fixation has an overall low complication rate of 7% total combined, which is comparable with the current literature. We demonstrated no significant differences in complications, weeks to ambulation, or time to union between bicortical and unicortical fixation.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 6","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052875","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 2021 Podiatric Residency Candidate and Program Virtual Interview Experience During COVID-19 with Multispecialty Reflections and Recommendations for a Successful Virtual Match: A 2024 Update.","authors":"Andrew J Meyr, Danae L Lowell, Susan K Claffey, Moraith G North, Charles Lombardi","doi":"10.7547/24-095","DOIUrl":"https://doi.org/10.7547/24-095","url":null,"abstract":"<p><p>This objective of this communication is to provide an update from the Council of Teaching Hospitals (COTH) and the American Association of Colleges of Podiatric Medicine (AACPM) with respect to the profession's residency interview process, otherwise known as the Centralized Residency Interview Process (CRIP). During the 2022-2023 academic year, CRIP returned to an in-person format following a period of virtual interviews during the COVID-19 pandemic. Survey data since this change indicate that a large majority of residency program directors and student applicants prefer an in-person format to the residency interview process. This communication serves as an organizational update with respect to the residency interview process aimed at the profession, residency programs directors, and student applicants.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 6","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059522","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":"Supernumerary Muscles in the Leg and Foot: A Review of Their Types, Frequency, and Clinical Implications.","authors":"Anushka S Ramnani, Jessica T Landeros, Mathew Wedel, Rebecca Moellmer, Stephen Wan, David W Shofler","doi":"10.7547/23-042","DOIUrl":"https://doi.org/10.7547/23-042","url":null,"abstract":"<p><p>Variations of the ankle anatomy are infrequent and exist as supernumerary muscles and tendons. Often understudied and overlooked, their presence can cause many complications of the lower extremity. These muscles, although often asymptomatic, can cause great pain and complications such as tenosynovitis, tarsal tunnel syndrome, lateral ankle instability, and ankle pain when they impinge on the normal anatomy of the patient. The goals of this study were to examine the prevalence of common variants such as the peroneus quartus, peroneus digiti quinti, accessory soleus, flexor accessorius digitorum longus, peroneocalcaneus internus, and tibiocalcaneus internus and to understand the morphological and clinical significance of these accessory muscles and their interactions with surrounding muscles. A literature review of anatomically and clinically based articles was conducted to evaluate the supernumerary muscles. Phrases such as accessory muscles were used to refine the search. Supernumerary muscles have an incidence of 3% to 62%, depending on the muscular compartment and the specific muscle. Although conservative treatments such as orthoses and nonsteroidal anti-inflammatory drugs may help alleviate some pain, surgical treatment yields higher success rates. Identification of supernumerary muscles is mainly by magnetic resonance imaging, but they can be detected by other methods, such as ultrasound. Due to the wide implications of these supernumerary muscles, this study attempted to create a reference guide for physicians to use in aiding their diagnoses and therapeutic plans. Although supernumerary muscles are typically asymptomatic, knowledge of these muscles is beneficial for clinicians in aiding their treatment plans.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 6","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052891","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":"Electrophysiologic Evidence of Concomitant Focal Nerve Entrapments in Persons With Rheumatoid Arthritis: A Cross-Sectional Study.","authors":"Michael S Nirenberg, Roberto P Segura, Alex M Segura, Lauren L Schnack, Craig W Forsthoefel, Carey Dachman","doi":"10.7547/22-186","DOIUrl":"https://doi.org/10.7547/22-186","url":null,"abstract":"<p><strong>Background: </strong>Although an association between peripheral nerve entrapment issues and rheumatoid arthritis (RA) has been found, research has generally focused solely on nerve entrapment in the upper or lower extremity individually rather than on the consideration of nerve entrapment simultaneously in the upper and lower extremities. In addition, most of these studies have used small sample sizes. The aim of this study was to evaluate the incidence of carpal tunnel syndrome (CTS) and tarsal tunnel syndrome (TTS) concurrently in patients with RA using a relatively large sample size.</p><p><strong>Methods: </strong>A cross-sectional study using a nonprobability sampling method retrospectively surveyed the incidence of CTS and TTS in 338 patients with RA who had clinical signs of nerve entrapment and electrodiagnostic test evidence of CTS or TTS. The study comprised a sample of 269 women and 69 men.</p><p><strong>Results: </strong>Electrodiagnostic testing found CTS in 256 patients (75.7%) and TTS in 82 patients (24.3%); CTS was found in 56 men and 200 women, and TTS was seen in 13 men and 69 women. Concurrent CTS and TTS occurred in 50 patients (14.8%; nine men and 41 women).</p><p><strong>Conclusions: </strong>Peripheral nerve entrapment in the form of CTS and TTS was found to have a high incidence in persons with RA. The incidence of CTS and TTS occurring simultaneously in persons with RA was also found to be significant.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 6","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059442","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":"Arthroscopically Assisted Reduction and Fixation of Acute Tillaux, Pilon, Bosworth, Talar, and Calcaneal Fractures: A Systematic Review.","authors":"Konstantinos Giatroudakis, Efthymios Iliopoulos, Georgios Drosos, Konstantinos Tilkeridis, Athanasios Ververidis","doi":"10.7547/23-200","DOIUrl":"https://doi.org/10.7547/23-200","url":null,"abstract":"<p><p>Increased use of arthroscopically assisted techniques for the treatment of ankle fractures has been reported. Despite their rapid development, there is only one systematic review regarding arthroscopically assisted treatment of ankle fractures, in which, however, only malleolar fracture studies are included. Various other types of ankle fractures have also been treated with arthroscopically assisted procedures. The purpose of this review was to identify and evaluate the existing literature about arthroscopically assisted surgical management of other types of foot and ankle fractures, such as Tillaux, pilon, Bosworth, talar, and calcaneal fractures. A systematic review was conducted until December 2022 using the Arksey and O'Malley framework and reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Three databases-PubMed, Elsevier Scopus, and Cochrane Library-were searched for relevant studies. The chosen studies were divided into groups according to the fracture type. Of the 424 initially identified studies, 36 were finally included in the review: 22 case reports or case series and 14 original retrospective cohort studies. Participant demographic characteristics; methods of arthroscopically assisted reduction and fixation; and clinical, radiologic, and patient-reported outcomes were extracted. Arthroscopically assisted techniques for the treatment of Tillaux, pilon, Bosworth, talar, and calcaneal fractures are effective procedures and have already shown satisfactory and promising clinical and radiologic outcomes. There are some limitations in their use though, especially in some specific fracture patterns. Long-term effects and possible superiority of arthroscopically assisted techniques over classic reduction and fixation must be further studied.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 6","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059458","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}