Journal of the American Podiatric Medical Association最新文献

{"title":"The Health-Related Quality of Life in Patients with Diabetic Foot Ulcers in Türkiye: Challenges in Diagnosis and Treatment.","authors":"Mustafa Salış, Boran Yalçın, Bülent Çağlar Bilgin, Ezgi Salış, Alaettin Ünsal, Didem Arslantaş","doi":"10.3390/japma116040045","DOIUrl":"https://doi.org/10.3390/japma116040045","url":null,"abstract":"<p><p><b>Background</b>: Diabetes mellitus (DM) is a metabolic disease with an increasing global prevalence. It is characterized by chronic and systemic complications. Due to these complications, DM significantly impacts patients' health-related quality of life (HRQoL). One of the most critical complications of DM is diabetic foot ulcers (DFUs), which have serious consequences for patients and healthcare systems. <b>Objective</b>: This study aimed to investigate variables potentially associated with HRQoL in patients with DFUs presenting to our wound care unit. <b>Methods</b>: This prospective cross-sectional study was conducted from February to May of 2023 at the Wound Care Unit of the General Surgery Department at Eskişehir City Hospital. A total of 209 patients who agreed to participate were included in the study. Data were collected via a structured questionnaire developed based on the literature, which included the Diabetic Foot Ulcer Scale-Short Form (DFS-SF). We used the Kolmogorov-Smirnov test, univariate analyses (Mann-Whitney U and Kruskal-Wallis tests), and multiple linear regression. <b>Results</b>: In the multivariate analysis, receipt of foot care education (<i>p</i> < 0.001), frequency of hospital applications due to DFU (<i>p</i> = 0.008), and Wagner classification (<i>p</i> = 0.012) were found to be predictors of HRQoL for DFUs (Adjusted R² = 0.206, F = 4.365, <i>p</i> < 0.001). <b>Conclusions</b>: To maintain a high HRQoL among DFU patients, they should immediately apply to specialized Wound Care Units, receive education, especially regarding early diagnosis and treatment, and receive multidisciplinary management for DFU.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579316","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":"Association Between Plantar Pressure Distribution and Postural Stability in Patients with Diabetic Foot: A Cross-Sectional Study.","authors":"Yağmur Uysal, Yavuz Aslan, Esra Atılgan","doi":"10.3390/japma116040044","DOIUrl":"https://doi.org/10.3390/japma116040044","url":null,"abstract":"<p><p>Plantar load distribution and postural stability are key functional domains in diabetic foot assessment, yet their association in early-stage disease remains poorly characterized. This study aimed to investigate the association between static plantar load distribution and postural stability parameters in 31 patients with early-stage diabetic foot (Meggitt-Wagner grade 0-1). A cross-sectional study was conducted with 31 participants (mean age 58.48 ± 9.53 years; 51.6% with loss of protective sensation). Static plantar load distribution was assessed using the Tekscan Pressure Measurement System (Presto-Scan DB software) and postural stability was assessed using the Nintendo Wii Balance Board^® under bipedal eyes-open, bipedal eyes-closed, and single-leg stance conditions. Spearman correlation analyses with Benjamini-Hochberg false discovery rate (FDR) correction were performed. A rearfoot-dominant loading pattern was observed bilaterally (right: 61.5 ± 8.2%; left: 61.8 ± 7.9%). Mean CoP sway velocity was 4.78 ± 1.98 mm/s (eyes open) and 5.76 ± 1.88 mm/s (eyes closed) in bipedal stance. No statistically significant associations between plantar load distribution and CoP parameters were found after FDR correction (all q > 0.05). Adults with early-stage diabetic foot exhibit a rearfoot-dominant loading pattern and sensory-dependent postural control behavior. The absence of significant cross-domain associations suggests that static plantar load distribution and postural stability represent complementary assessment targets. Future controlled studies with matched healthy comparators are needed to determine clinical significance.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579180","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":"Association Between Minimally Invasive Osteotomy Techniques and Bunion Correction Outcomes.","authors":"Daniel Lowe, Jade Henckel, Leon Rosefigura, Chin-I Cheng, Vanessa Adelman, Ronald Adelman","doi":"10.3390/japma116040043","DOIUrl":"https://doi.org/10.3390/japma116040043","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery (MIS) for hallux valgus (HAV) correction may benefit from using the medial eminence to enhance lateral capital fragment translation. This study investigates whether osteotomy placement through the medial eminence correlates with improved HAV and forefoot width (FW) correction. A retrospective analysis of 20 patients who underwent MIS bunion correction was performed. Pre- and postoperative radiographs were reviewed to assess hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position, osteotomy location, osteotomy angle, capital fragment shift, and forefoot width. Pearson correlation and multivariable linear regression were used to identify associations. Chart review was performed at the one-year mark for complications (recurrence, infection, non-union, hardware failure). Significant correlations were found between DMAA and HVA (r = 0.883, <i>p</i> < 0.001), DMAA and IMA (r = 0.573, <i>p</i> = 0.008), and HVA and capital fragment shift (r = 0.541, <i>p</i> = 0.014). Osteotomy location and angle were not significantly associated with correction. Multivariable analysis showed DMAA was independently associated with HVA correction (β = 0.679, <i>p</i> < 0.001), and both capital fragment shift and metatarsal head angulation were associated with FW narrowing. Additionally, no patients in this cohort experienced complications. Use of the medial eminence in MIS osteotomy was not associated with improved HAV or FW correction. Angular deformity parameters and lateral fragment shift were more predictive of radiographic outcomes.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579222","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":"Avoidance of Major Amputation After Deep Vein Arterialization and Advanced Wound Management in a Patient with Diabetes and No Direct Revascularization Options: A Case Report.","authors":"Mohammad Hossain, Timothy Cheung, Anahita Dua, Sara Rose-Sauld","doi":"10.3390/japma116040042","DOIUrl":"https://doi.org/10.3390/japma116040042","url":null,"abstract":"<p><p>Chronic limb-threatening ischemia (CLTI) in patients with no conventional targets for revascularization presents a formidable challenge in limb salvage. Deep venous arterialization (DVA) is an emerging endovascular approach that redirects arterial blood flow into the venous system to perfuse the ischemic foot. Despite early promising results, appropriate wound management of the ischemic foot following a DVA procedure has been described in the literature, albeit infrequently and with limited standardization. Here, we present a case of an 85-year-old male with multiple comorbidities, including peripheral artery disease and a prior right above-knee amputation (AKA), who underwent a successful left-sided DVA following an open transmetatarsal amputation (TMA) for infection. A staged wound care approach with guillotine amputation, delayed revision and skin grafting ultimately preserved his only remaining limb and allowed for ambulation. This case underscores the potential of DVA as a limb-saving option in complex \"no-option\" patients when paired with multidisciplinary care and tailored wound management.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 4","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579231","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 Insoles on Plantar Fascia Tension During Running in Individuals with Flatfoot.","authors":"Misa Morioka, Tomoya Takabayashi, Honoka Nishiguchi, Takanori Kikumoto, Masayoshi Kubo","doi":"10.3390/japma116030040","DOIUrl":"https://doi.org/10.3390/japma116030040","url":null,"abstract":"<p><p><b>Background</b>: Plantar fasciitis is a common condition likely caused by abnormal foot alignment, such as flatfoot. Insoles are commonly used to treat flatfoot, and systematic reviews have shown that insoles improve pain; however, the underlying mechanism is unclear. This study aimed to investigate the effects of insoles on plantar fascial tension during running in individuals with flatfoot. <b>Methods</b>: The participants were 14 individuals with flatfoot. The task involved running under two conditions: with and without insoles. Insoles that absorbed the shock and supported the medial longitudinal arch were used. The foot marker trajectories and ground reaction forces were measured during running sessions. The plantar fascia tension was estimated based on the ground reaction force, moment arm of the ground reaction force, and that of plantar fascia. Statistical parametric mapping was used to compare the plantar fascia tension during the stance phase between the two conditions. <b>Results</b>: When running with and without insoles, the peak plantar fascial tension was observed at midstance. Planar fascial tension was significantly lower with insoles over a wider range during the stance phase than that without insoles (<i>p</i> < 0.05). <b>Conclusions</b>: This study provided evidence that insoles can reduce plantar pain while running. This result may be useful for reducing pain in individuals with flatfoot and preventing the onset of plantar fasciitis.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317809","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":"Offloading Adherence for Appearance's Sake?","authors":"Ryan T Crews, Nahir Negron-Fernandez, Sai V Yalla, Adam E Fleischer, Andrew J M Boulton, Neil D Reeves, Loretta Vileikyte, Noah J Rosenblatt","doi":"10.3390/japma116030041","DOIUrl":"10.3390/japma116030041","url":null,"abstract":"<p><p><b>Introduction</b>: Offloading adherence (OA) is critical for diabetic foot ulcer (DFU) healing. This report investigated whether DFU patients with low overall OA (<20%) limit offloading device usage to days they come to the clinic. <b>Methods</b>: Activity monitors measured OA 24 h/day. Daily walking and standing OA were calculated for up to four weeks, and participants self-reported their cumulative adherence. Each day was classified as to whether a DFU-related clinic visit occurred. <b>Results</b>: Four participants from an ongoing RCT were identified with <20% overall adherence, despite self-reporting 65-80% adherence. Most days they did not wear their devices at all, while the majority of wear-days coincided with footcare visits. <b>Conclusions</b>: This report describes a cohort that had low daily OA yet consistently wore their devices to the clinic and self-reported inflated OA. To improve OA and DFU healing, more research is needed to understand this phenomenon and help clinicians ascertain adherence during patient encounters.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317826","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":"Reconsidering Nerve Decompression Surgery in Diabetes Foot Complications.","authors":"D Scott Nickerson","doi":"10.3390/japma116030037","DOIUrl":"10.3390/japma116030037","url":null,"abstract":"<p><p>In 1988, plastic surgeon Lee Dellon in Annals of Plastic Surgery hypothesized that there was \"A Cause for Optimism in Diabetic Neuropathy\". He noted that entrapment neuropathy is common in diabetic peripheral neuropathy (DPN) and explained that multiple sites of local nerve entrapment can also produce the classically described clinical picture of progressive and irreversible 'length dependent axonopathy'. This observation has justified for him the use of nerve decompression (ND) surgery for beneficial treatment of DPN pain, diabetic foot ulcer (DFU), ulcer recurrences and their subsequent complications. Subsequent observational and controlled reports have consistently demonstrated post-operative benefit for these problems, but ND has not yet been widely adopted. The lack of an etiologic explanation of the physiology changes which would allow surgery to modify the metabolic disturbances of diabetes has likely been involved in such hesitance. Recent explanations that glycolysis is altered in diabetes through intensified polyol metabolism which produces swollen nerves, local peripheral entrapments and compression neuropathy now provide plausible associations of hyperglycemia with epidermal hypoxia and nutrition deficit. Recognition that nerve enlargements can create secondary fibro-osseous compressions explains the well-known association of diabetes and compression syndromes. Peripheral nerve entrapments damage small c-fibers and produce sympathetic autonomic as well as sensorimotor dysfunction. This explains the diminished skin microcirculation, epidermal hypoxia and nutrition deficit seen in diabetes, DPN, DFU and Charcot neuroarthropathy. Laboratory and clinical evidence has demonstrated that ND in diabetes rejuvenates at least two sympathetically commanded skin microcirculation processes and explains how surgery is producing beneficial results. This article recapitulates the literature which clarifies the processes by which ND surgery can modify painful DPN, DFU occurrence, ulcer healing, DFU recurrence risk, amputations after DFU healing, and bilateral pain relief after unilateral surgery.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317829","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":"Reducing Lower Extremity Amputations via Peer Support Interventions: A Scoping Review.","authors":"Sophia A Sorrentino, Brittany M Cook, Sanam N Jhaveri, Mohammad S Javed, Tze-Woei Tan, David G Armstrong, Ryan T Crews","doi":"10.3390/japma116030039","DOIUrl":"10.3390/japma116030039","url":null,"abstract":"<p><p>Patients with diabetes and/or peripheral artery disease (PAD) are at risk for lower limb amputation and a subsequently higher mortality risk. Peer support interventions have been shown to increase diabetes self-management and glycemic control. This scoping review aims to synthesize the current literature on peer support interventions in reducing lower limb amputations. A PubMed search was conducted in June of 2023, excluding publications prior to 2000, focusing on two themes: (1) peer support and (2) the patient population of interest (i.e., individuals with diabetic foot disease and/or PAD). Studies were included if they addressed the population of interest, involved a peer support intervention to improve lower extremity health, and had outcomes pertaining to the health of the lower extremities or programmatic metrics such as participant satisfaction or program adherence. Out of 1730 publications initially identified, six met the inclusion criteria. These six studies were categorized as group foot care education studies (n = 4) or group cognitive behavioral studies (n = 2). The group foot care education studies showed mixed results, which varied from no effect to significant improvements in foot care, self-management, and complications. There was a trend of improvement in self-management behaviors and physical activity in cognitive behavioral interventions. Despite showing promise in other settings, there have been limited investigations of peer support interventions to improve lower extremity outcomes and avert amputations in persons with diabetes and/or PAD. Further studies are required to conclusively determine the efficacy of peer support interventions to reduce lower extremity amputation rates.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317780","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":"Quantitative Assessment of the Correlation Between 'COVID Toes' Search Volume and COVID-19 Case Incidence and Mortality Dynamics: A Longitudinal Data-Driven Approach.","authors":"Anna E Kotula, Rahul A Pithadia, Ashley Wysong, Mark R Wakefield, Yujiang Fang","doi":"10.3390/japma116030038","DOIUrl":"https://doi.org/10.3390/japma116030038","url":null,"abstract":"<p><p>COVID-19, caused by the SARS-CoV-2 virus, has become a global public health crisis with diverse clinical manifestations affecting multiple organ systems, including the integumentary system. One notable cutaneous manifestation, referred to as \"COVID toes,\" involves the development of pernio-like chilblains, characterized by red-to-violet macules, plaques, or nodules, primarily on toes and fingers. This characteristic clinical feature gained significant attention due to its apparent association with COVID-19, especially during the early stages of the pandemic when individuals with mild or asymptomatic cases exhibited these symptoms. Concurrently, digital platforms such as Google Trends have emerged as tools for tracking public interest in health-related topics, offering insights into real-time patterns of disease awareness. Previous research has demonstrated that Google Trends data may correlate with the incidence of infectious diseases, suggesting that search interest can be a proxy for disease outbreaks. In this study, we sought to explore the potential relationship between public interest in COVID toes, as reflected in Google Trends, and the incidence and mortality rates of COVID-19. Specifically, we examined whether peaks in search interest for \"COVID toes\" corresponded with surges in COVID-19 cases and deaths. By analyzing trends in search data, we aimed to assess the utility of digital platforms as an epidemiological tool for monitoring disease progression and public awareness. Our findings provide insights into the potential role of digital search data in forecasting outbreaks and highlight the interplay between public perception and the clinical burden of COVID-19, emphasizing the importance of real-time data in public health surveillance and response.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317772","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":"Quantification of the Mechanical Response of the Plantar Fascia to Changes in Rearfoot Position.","authors":"Mark Price, Thomas Mychost, Roozbeh Naemi, Nachiappan Chockalingam","doi":"10.3390/japma116030036","DOIUrl":"10.3390/japma116030036","url":null,"abstract":"<p><p><b>Background</b>: Changes in the rearfoot calcaneal position affect the foot \"arch structure\" during the stance phase of gait and hence influence reactions in the plantar fascia thickness and stiffness during weight bearing. However, previous research has focused on the non-weight-bearing assessment of plantar fascia thickness (PFT) and stiffness (PFS) and has not linked these measurements to rearfoot position. <b>Methods</b>: This study aims to investigate if a change in the weight-bearing rearfoot position influences the PFT and PFS. A linear actuator-driven 3D-printed platform was utilised to reliably move the rearfoot through a range of frontal (F (4,12) = 19,585.8, <i>p</i> = 0.00) and sagittal plane angles (F (2,6) = 11,751.32, <i>p</i> = 0.00) whilst weight bearing. An ultrasound probe capable of shear wave elastography was incorporated into the platform for the closed-chain weight-bearing assessment of the PF. The PFT and PFS were collected for 13 (26 feet) participants (11 male, two female; age 35.62 ± 15.04; BMI: 30.31± 6.22 Kg/m²) from a convenience sample who met the inclusion criteria. <b>Results</b>: The data were subject to appropriate statistical, collective and cluster analysis. Individual participant data analysis showed a strong nonlinear correlation between PFT and PFS in the relaxed calcaneal position. The rearfoot sagittal plane cluster demonstrated an auxetic property in 54.3% of the group, where both the PFT and PFS increased. The frontal plane cluster demonstrated an auxetic property in 76% of the group, where the PFT increased as the PFS increased. <b>Conclusions</b>: The results suggest that the PF does have a specific response to changes in the rearfoot position for individuals, which, in some, can show an auxetic property.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"116 3","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317818","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}