Journal of the American Podiatric Medical Association最新文献

{"title":"Large Osteolipoma of the Posterior Ankle: A Rare Tumor in an Unusual Location.","authors":"Forrest Rackard, Xuefei Huang, Debajyoti Saha, Ali Akalin, George Watts, Mathew Most","doi":"10.7547/23-182","DOIUrl":"10.7547/23-182","url":null,"abstract":"<p><p>Osteolipoma is a rare lipoma variant characterized by mature osseus metaplasia within mature adipose tissue, most commonly found in the head and neck, and seldom reported in the extremities. We present a case of a large osteolipoma of the posterior ankle associated with antecedent trauma. These tumors are typically slow growing and can be associated with pain and stiffness, depending on tumor size and location. Treatment is surgical excision, and recurrence is not reported. Interdisciplinary care involving radiology, pathology, and the surgical service is necessary for proper diagnosis and treatment of this rare benign neoplasm.</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":"143700830","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":"Patient Knowledge and Habits as Predictors of Foot Complications in Diabetes: A Cross-Sectional Study.","authors":"Khalid M Edrees, Alanood I Alqahtani, Mansoor Radwi","doi":"10.7547/23-069","DOIUrl":"10.7547/23-069","url":null,"abstract":"<p><strong>Background: </strong>This cross-sectional study aimed to identify patients' awareness of predictors of diabetic foot complications (DFCs) based on 1) knowledge of hemoglobin A1c (HbA1c), 2) performance of fasting blood glucose (FBG) at home, and 3) type of footwear used and relationship with DFCs.</p><p><strong>Methods: </strong>A total of 4,652 diabetic patients were seen between 2006 and 2021 at Dr. Khalid Edrees Specialized Medical Center. A questionnaire was completed by trained nurses at the patients' initial visit, collecting patients' knowledge of the HbA1c test, monitoring of FBG at home, and type of footwear used at the time of the visit. History of foot ulcers, current foot ulceration (CU), and history of lower limb amputation (LLA) were obtained.</p><p><strong>Results: </strong>The majority of our cohort were male (60%), and the mean age was 60 years (SD, 17.5 years). Ninety-six percent had type 2 diabetes, and 39% were diagnosed with diabetes for at least 11 years. More than half did not know what HbA1c was, 32% were not doing home FBG, and 62% were using inappropriate footwear. Fifty-two percent had a CU, 35% had a history of foot ulcers, and 13% had an LLA. We found a significant association between CU and knowledge of HbA1c and type of footwear (P < .001). Similarly, LLA was significantly associated with all of the aforementioned variables (P < .001). A history of foot ulcers was significantly associated with knowledge of HbA1c and type of footwear (P = .001) but not with home FBG.</p><p><strong>Conclusions: </strong>A high proportion of patients in our cohort had never heard of HbA1c and were using traditional footwear. This highlights the importance of patient education regarding the basics of diabetes and the use of appropriate footwear in preventing DFCs.</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":"143700518","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":"Use of Antibiotic Spacer with Syndesmotic \"Fin\" for Treatment of Septic Ankle Joint: Two-Stage Approach or Definitive Management?","authors":"Samantha L Williams, Elizabeth Connolly, John Levin","doi":"10.7547/22-120","DOIUrl":"10.7547/22-120","url":null,"abstract":"<p><p>Septic ankle joint following orthopedic surgery is a rare but limb-threatening complication that requires emergent multi-modal management. Traditionally, spacers serve as stage one of a two-stage approach involving deep infections seeding to a joint. However, a paucity of literature exists regarding the outcomes and longevity of antibiotic spacers in patients who are poor candidates for a subsequent reoperation. We present a case of an 89-year-old female who sustained an open pilon fracture treated with external fixation, and a subsequent open reduction internal fixation following a fall from a height. The patient developed surgical site dehiscence that progressed to a septic ankle joint, confirmed via single-photon emission computed tomography and a three-phase bone scanning. The patient underwent a debridement with operative wash-out and fashioning of a methylmethacrylate antibiotic spacer containing 1 g of vancomycin and 1.2 g of tobramycin. This was positioned in the ankle joint with an adapted \"fin\" extending anteriorly and proximally in the tibiofibular syndesmosis, to provide stability to the spacer, and potentially increase its longevity interpositionally. With aggressive local wound care and an oral antibiotic course, the patient proceeded to complete reepithelialization of the sinus tract 6 weeks postoperatively. Serial imaging and computed tomographic scan confirmed a well-seated spacer, without evidence of migration or extrusion, 14 months after surgery. Outcome data regarding cement ankle arthroplasties are extremely limited. Retrospective case series have quantified average retention anywhere from 6 to 62 months with varying techniques. However, in the setting of multiple comorbidities, or other factors making a patient a poor candidate for reoperation, an antibiotic spacer may serve as a definitive treatment for such an infection with satisfactory outcomes. We believe the presented method, with use of a proximal fin articulating in the tibiofibular syndesmosis, not only improves implant retention, but also, maintains a functional, plantigrade ankle joint.</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":"143700666","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":"Effects of Home-Based Telerehabilitation on Foot Intrinsic Muscle Activity and Thickness in Individuals With Flat Feet: A Preliminary Study.","authors":"Dong-Chul Moon, Jun-Seok Kim","doi":"10.7547/22-178","DOIUrl":"10.7547/22-178","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the effects of movement control exercise (MCE) and abductor hallucis (AbH) muscle contraction, performed via home-based telerehabilitation, on foot intrinsic and extrinsic muscle activity, AbH muscle thickness, and balance in individuals with flat feet.</p><p><strong>Methods: </strong>In total, 30 individuals with flat feet were enrolled in the study. Participants were randomly assigned to home-based telerehabilitation focusing on MCE only or MCE emphasizing short foot motion (SFMCE) for the lower extremities. Exercises were performed over 4 weeks. Data for foot intrinsic and extrinsic muscle activity, AbH muscle thickness, and the Y-balance test were collected before and after the 4-week intervention.</p><p><strong>Results: </strong>Abductor hallucis muscle activity in the SFMCE group was significantly higher after exercise compared with before, and there was also a significant difference between the groups. Furthermore, AbH muscle thickness was significantly greater in the SFMCE group compared with the MCE-only group. The Y-balance test performance improved significantly in the posterolateral direction in the SFMCE group.</p><p><strong>Conclusions: </strong>Home-based telerehabilitation focused on SFMCE can be used to improve foot intrinsic muscle activity, AbH muscle thickness, and functional balance in individuals with flat feet.</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":"143700820","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":"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":"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":"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":"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":"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":"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":"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}