Journal of the American Podiatric Medical Association最新文献_第8页

Transarticular versus Transosseous Amputations in Diabetic Foot Osteomyelitis: A Retrospective Comparative Study. 糖尿病足骨髓炎的经关节截肢与经骨截肢：回顾性比较研究

IF 0.5 4区医学

Journal of the American Podiatric Medical Association Pub Date : 2024-09-01 DOI: 10.7547/21-205

Felix W A Waibel, Madlaina Schöni, Thomas V Häller, Daniel Langthaler, Martin C Berli, Benjamin A Lipsky, Ilker Uçkay, Lukas Jud

{"title":"Transarticular versus Transosseous Amputations in Diabetic Foot Osteomyelitis: A Retrospective Comparative Study.","authors":"Felix W A Waibel, Madlaina Schöni, Thomas V Häller, Daniel Langthaler, Martin C Berli, Benjamin A Lipsky, Ilker Uçkay, Lukas Jud","doi":"10.7547/21-205","DOIUrl":"10.7547/21-205","url":null,"abstract":"Background: Reamputations are frequent after minor amputations performed for diabetic foot osteomyelitis (DFO). Whether the type of amputation is associated with a particular outcome is unknown. The aim of this study was to evaluate whether amputations of the transarticular compared with the transosseous type have different rates of clinical and microbiological failure.Methods: We actively followed 284 patients with DFO (543 episodes of minor foot amputations: 203 transarticular and 340 transosseous) for 1 year. We assessed the long-term effect of transarticular compared with transosseous amputations on the rates of clinical and microbiological failure using comparative statistics, log-rank survival analyses, Kaplan-Meier curves, and multivariate Cox regressions.Results: In 122 episodes (22.5%) there was clinical failure that led to reamputation. The difference in the risk of clinical failure of transarticular versus transosseous amputations was nonsignificant (44 [21.7%] versus 78 [22.9%]; Pearson χ2 test: P = .73). Similarly, the difference in microbiological failure (32 episodes, 5.9% overall) between groups was nonsignificant (11 [5.4%] and 21 [6.2%], respectively; P = .72). The mean time between the index surgery and clinical failure was 2.2 months for transarticular and 3.2 months for transosseous amputations (Mann-Whitney U test; P = .39). Survival analyses showed similar evolutions for each group (log-rank test; P = .85). In the multivariate Cox regression analysis, the type of amputation did not significantly influence clinical or microbiological failures.Conclusions: In DFO, there is no significant difference between transarticular and transosseous amputations within 1 year in the incidence of clinical or microbiological failures.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 5","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639155","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}

引用次数: 0

Metatarsal Osteotomy versus Metatarsal Head Resection for Distal Diabetic Foot Ulcers. 跖骨截骨术与跖骨头切除术治疗糖尿病足远端溃疡的比较

IF 0.5 4区医学

Journal of the American Podiatric Medical Association Pub Date : 2024-09-01 DOI: 10.7547/20-090

Wei Tseng, Maria Bolla, Amy Wong, Ewald R Mendeszoon, Hau T Pham

{"title":"Metatarsal Osteotomy versus Metatarsal Head Resection for Distal Diabetic Foot Ulcers.","authors":"Wei Tseng, Maria Bolla, Amy Wong, Ewald R Mendeszoon, Hau T Pham","doi":"10.7547/20-090","DOIUrl":"10.7547/20-090","url":null,"abstract":"Background: We compared the effectiveness of metatarsal osteotomy, specifically using the osteoclasis (OC) technique, with that of metatarsal head resection (MHR) in healing distal metatarsal plantar ulcers.Methods: This retrospective study reviewed patients who underwent OC or MHR for the treatment of submetatarsal ulcers between January 1, 2014, and December 31, 2017. Patients with infected ulcers or osteomyelitis were excluded. A 1-year follow-up was used to evaluate the results.Results: Of the 31 study patients (seven women and 24 men; mean ± SD age, 55.3 ± 11.7 years), 17 underwent MHR and 14 underwent OC. All of the patients had diabetic neuropathy and distal submetatarsal ulcer. Four of 17 patients in the MHR group and three of 14 patients in the OC group had moderate peripheral vascular disease. All of the patients in the MHR group healed their ulcers in a mean ± SD of 5.8 ± 2.3 weeks. During 12-month follow-up of the MHR group, one patient needed revision, one developed a transfer ulcer, and two developed toe ulcers. In the OC group, all of the patients healed after surgery in a mean ± SD of 4.2 ± 1.8 weeks. During the 12-month follow-up of the OC group, one patient developed Charcot's neuropathy and two developed transfer ulcers.Conclusions: For metatarsal head neuropathic ulcers, both OC and MHR achieved healing in a relatively short time, with few complications. A prospective study with a larger patient population is needed to better compare the two procedures.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 5","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639138","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}

引用次数: 0

Effects of Hypogonadism and Testosterone Therapy on Diabetic Foot Complications. 性腺功能减退症和睾酮疗法对糖尿病足并发症的影响。

IF 0.5 4区医学

Journal of the American Podiatric Medical Association Pub Date : 2024-09-01 DOI: 10.7547/22-112

Daniel C Jupiter, Kelli L Faaitiiti, Robert A Rodriguez, Efstathia Polychronopoulou, David S Lopez

{"title":"Effects of Hypogonadism and Testosterone Therapy on Diabetic Foot Complications.","authors":"Daniel C Jupiter, Kelli L Faaitiiti, Robert A Rodriguez, Efstathia Polychronopoulou, David S Lopez","doi":"10.7547/22-112","DOIUrl":"https://doi.org/10.7547/22-112","url":null,"abstract":"Background: Results of recent studies suggest that high levels of endogenous testosterone decrease the risk of diabetes. Testosterone therapy may delay the transition from prediabetes to diabetes and accelerate healing of diabetic foot ulcers in hypogonadal men. We investigated whether testosterone therapy in this population decreases the occurrence of diabetic foot complications within 1 and 5 years of diabetes diagnosis.Methods: Optum's deidentified Clinformatics Data Mart database was searched for male patients with diabetes. Associations between testosterone therapy and the occurrence of ulceration or the use of wound care were explored in the entire population and in those with and without hypogonadism using both bivariate and multivariate analyses.Results: Contrary to the hypotheses, testosterone therapy seems to confer increased risk of diabetic foot complications. In hypogonadal men with at least 1 year of follow-up after diabetes diagnosis, any use of testosterone therapy increased the odds of wound care utilization by a factor of 1.10 (95% confidence interval, 1.03-1.17), and the odds of ulceration by a factor of 1.13 (95% confidence interval, 1.03-1.24). Similar results are seen in all men, both with and without hypogonadism. Further exploration reveals that hypogonadism also increases the risk of wounds among people with diabetes with care utilization in the entire population.Conclusions: Further research is needed to elucidate the mechanisms by which hypogonadism and testosterone therapy impact diabetic foot complications, and whether these mechanisms are mediated by vascular or neurologic factors.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 5","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639104","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}

引用次数: 0

Pedal Vessel Calcification and Risk of Major Adverse Foot Events in the Diabetic Neuropathic, Nephropathic Foot. 糖尿病神经性和肾病性足部的足底血管钙化与足部重大不良事件的风险

IF 0.5 4区医学

Journal of the American Podiatric Medical Association Pub Date : 2024-09-01 DOI: 10.7547/23-233

Michael A Jones, Garrett S Bullock, Meghan M Crowfoot, David R Sinacore

{"title":"Pedal Vessel Calcification and Risk of Major Adverse Foot Events in the Diabetic Neuropathic, Nephropathic Foot.","authors":"Michael A Jones, Garrett S Bullock, Meghan M Crowfoot, David R Sinacore","doi":"10.7547/23-233","DOIUrl":"10.7547/23-233","url":null,"abstract":"Background: We aimed to determine the relative risk of pedal vessel calcification (PVC) on major adverse foot events (MAFEs) and chronic kidney disease (CKD) stage in patients with diabetes mellitus (DM) and peripheral neuropathy (PN).Methods: We retrospectively reviewed electronic medical records of 152 patients with diagnoses of DM, PN, and CKD stages one to five who had at least one foot radiograph obtained. PVC was scored (from 0-4) based on foot anatomic location and radiology reported MAFEs, which includes foot fracture, Charcot neuroarthropathy, foot ulcer, osteomyelitis, or minor amputation. Risk ratios (RR) with 95% confidence intervals (95% CI) and Poisson regressions were performed assessing the risk of sustaining MAFEs with number of PVCs and stage of CKD.Results: The risk of any MAFE increased as PVC score increased (RR = 1.23); the risk of any MAFE increased as CKD stage increased (RR = 1.35); and risk of any PVC increased as CKD stage increased (RR = 1.71).Conclusions: Pedal vessel calcification on a foot radiograph increases the risk of any MAFE and increases with progressive stage of CKD. Pedal vessel calcification may serve as a gateway to prompt investigation, treatment, or referral for at-risk diabetic neuropathic, nephropathic patients.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hoop Stress Elicited at Medial Tibial Crural Fascia Attachment During Passive Dorsiflexion: A Proof-of-Concept Study for Medial Tibial Stress Syndrome Causation. 被动外翻时胫骨内侧硬筋膜附着处产生的环形应力：胫骨内侧应力综合征病因的概念验证研究。

IF 0.5 4区医学

Journal of the American Podiatric Medical Association Pub Date : 2024-09-01 DOI: 10.7547/23-169

Amy H Amabile, Thomas A Hulcher, Mariano Figueroa-Perez, Madeline R Reich

{"title":"Hoop Stress Elicited at Medial Tibial Crural Fascia Attachment During Passive Dorsiflexion: A Proof-of-Concept Study for Medial Tibial Stress Syndrome Causation.","authors":"Amy H Amabile, Thomas A Hulcher, Mariano Figueroa-Perez, Madeline R Reich","doi":"10.7547/23-169","DOIUrl":"10.7547/23-169","url":null,"abstract":"Background: Identification of a specific causal mechanism for medial tibial stress syndrome has been elusive, although there is a consensus that it may be caused by traction on the tibial periosteum elicited by soft tissues. The crural fascia (CF) attaches directly to the tibia throughout the length of the leg, encircling it in a grossly cylindrical fashion, and the leg may thus be viewed as a type of fluid-filled cylinder, subject to both longitudinal and hoop stresses. Prior researchers have not considered the possibility that strain on the medial tibia could be produced by the CF during gait and passive stretching, secondary to fluid pressure increases in the fascial compartments of the leg. The purpose of the present research was to verify the existence of measurable hoop strain in the CF of a cadaver donor at the medial tibial border during a heel cord stretch.Methods: Strain gauges were affixed to the CF of a cadaver donor to measure hoop and longitudinal strain during repeated heel cord stretches applied manually, and with measurements taken from each strain gauge separately.Results: Passive heel cord stretches produced 182.96 × 10-3 mV/V and 138.00 × 10-3 mV/V hoop strain in the CF, in the distal third and middle third of the leg, respectively. A maximum longitudinal strain in the CF of the superficial posterior compartment of 75.00 × 10-3 mV/V was also produced.Conclusions: A heel cord stretch applied to a cadaver donor can elicit a measurable hoop strain within the CF attachment to the medial border of the tibia, in a grossly 2-to-1 manner consistent with the ratio of hoop to longitudinal strain seen with gases and liquids in a closed cylinder. Further research is indicated to replicate these results in multiple subjects, with variation in cadaver fixative and experimental set-up.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 5","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639110","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}

引用次数: 0

Developing a Podiatric Telemedicine Framework for Service Users and Providers in a Primary-Care Setting. 为基层医疗机构的服务使用者和提供者开发足病远程医疗框架。

IF 0.5 4区医学

Journal of the American Podiatric Medical Association Pub Date : 2024-09-01 DOI: 10.7547/24-122

Lisa Ann Stojmanovski Mercieca, Cynthia Formosa, Nachiappan Chockalingam

{"title":"Developing a Podiatric Telemedicine Framework for Service Users and Providers in a Primary-Care Setting.","authors":"Lisa Ann Stojmanovski Mercieca, Cynthia Formosa, Nachiappan Chockalingam","doi":"10.7547/24-122","DOIUrl":"https://doi.org/10.7547/24-122","url":null,"abstract":"Background: The use of telemedicine has garnered significant traction amidst the COVID-19 pandemic. The sudden adoption of certain practices in podiatry was not always supported by empirical evidence, resulting in the development of guidelines and metrics that lacked a foundation in rigorous research.Methods: A modified Delphi composed of three rounds was conducted with 16 stakeholders (service users, foot and ankle health-care providers, and policymakers) from a primary-care setting to develop a podiatric telemedicine framework for a primary-care setting. The first round consisted of focus group discussions, the second round consisted of a questionnaire composed of different statements that emerged from focus group discussions, and the final third round consisted of a questionnaire with statements from the second round that required further reiterations. Statements that achieved an 80% or higher level of agreement were accepted to form part of the podiatric telemedicine framework.Results: Excellent consensus data was obtained to develop the podiatric telemedicine framework. Although podiatric telemedicine for low-risk patients in a primary-care setting is relatively new, stakeholders highlighted the importance of having podiatric telemedicine guidelines and setting service user and provider expectations clear on what podiatric telemedicine has to offer and its pitfalls.Conclusions: The podiatric telemedicine framework developed is recommended to all foot and ankle health-care professionals in a primary-care setting who wish to provide telemedicine consultations. Moreover, it is recommended that a pilot study be carried out to look into the feasibility of this framework being translated and implemented as a guideline related to foot and ankle telemedicine consultations.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 5","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639099","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}

引用次数: 0

How Canines Can Assist Our Patients with Diabetes: Diabetes Alert Dogs: What Are Their Capabilities? 警犬如何帮助我们的糖尿病患者？糖尿病预警犬：它们有哪些能力？

IF 0.5 4区医学

Journal of the American Podiatric Medical Association Pub Date : 2024-09-01 DOI: 10.7547/22-125

David W Jenkins, Kaitlin M Thompson, Nikki Goeddeke

{"title":"How Canines Can Assist Our Patients with Diabetes: Diabetes Alert Dogs: What Are Their Capabilities?","authors":"David W Jenkins, Kaitlin M Thompson, Nikki Goeddeke","doi":"10.7547/22-125","DOIUrl":"https://doi.org/10.7547/22-125","url":null,"abstract":"Background: The canine olfactory system is used for tasks that greatly aid society, such as detecting explosives, finding lost persons, and detecting many diseases and abnormal blood sugar levels early. However, the reliability of detection of glycemic fluctuations is questionable.Methods: We reviewed the literature on the capability of canines in detecting significant variations in blood sugar. Traditional studies and anecdotal reports were assessed. Articles and resources that outline the available training and certification process were included.Results: Publications included studies of canines' ability to detect scents associated with hyperglycemia and hypoglycemia as well as behavioral changes associated with blood sugar abnormalities. Several anecdotal reports denoted excellent canine performance in detection. Perusal of literature and Web-based resources found a range of available training, from formal (with certification) to do-it-yourself home training. Evidence supporting improved mental/physical health in persons using service dogs was robust.Conclusions: Canines have the capability to detect numerous medical conditions, including dangerous fluctuations in blood sugar in persons with diabetes, especially hypoglycemia. Most studies on the reliability and performance of diabetes alert dogs report potential lifesaving benefits but demonstrate notable variability and inconsistencies, which may be due to lack of required formal training or a certification process. Most owners believe their dogs are highly effective and greatly improve their life and safety. Due to the improving technology seen with continuous glucose monitoring devices, many believe diabetes alert dogs will become obsolete. Aside from an early warning system, diabetes alert dogs can play a significant role in overall quality of life, especially in benefiting physical and mental health.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 5","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639114","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}

引用次数: 0

Disease Knowledge and Behavior Regarding the Diabetic Foot in Persons at Different Risks for Foot Ulceration According to the International Working Group on the Diabetic Foot Guidelines. 根据国际工作组指南，不同足部溃疡风险人群对糖尿病足的疾病知识和行为。

IF 0.5 4区医学

Journal of the American Podiatric Medical Association Pub Date : 2024-09-01 DOI: 10.7547/22-087

Marta García-Madrid, Mateo López-Moral, Aroa Tardáguila-García, Raúl J Molines-Barroso, Yolanda García-Álvarez, José Luis Lázaro-Martínez

{"title":"Disease Knowledge and Behavior Regarding the Diabetic Foot in Persons at Different Risks for Foot Ulceration According to the International Working Group on the Diabetic Foot Guidelines.","authors":"Marta García-Madrid, Mateo López-Moral, Aroa Tardáguila-García, Raúl J Molines-Barroso, Yolanda García-Álvarez, José Luis Lázaro-Martínez","doi":"10.7547/22-087","DOIUrl":"10.7547/22-087","url":null,"abstract":"Background: We aimed to analyze levels of knowledge and behavior regarding diabetic foot care and prevention in persons with diabetes according to the International Working Group on the Diabetic Foot (IWGDF) risk stratification system.Methods: This descriptive study included 83 persons with diabetes at different risk levels for diabetic foot ulceration (DFU) (IWGDF risk 0-3). The previously validated Patient Interpretation of Neuropathy questionnaire was used to analyze their levels of understanding of foot complications. Participants responded using a 5-point Likert scale.Results: Patients with IWGDF risk 3 knew that good circulation and absence of polyneuropathy in their feet were related to healthy feet relative to the other groups. In addition, they knew that a DFU is not painful relative to the other groups. High-risk patients knew which physical causes could affect the development of a DFU and that foot self-care and medical control could prevent DFU.Conclusions: Patients with IWGDF risk 3 knew the natural progression of diabetic foot complications and how to prevent them. Clinicians should focus their efforts on educating patients with diabetes who are at lower risk for DFU.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417420","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}

引用次数: 0

Evaluation and Management of Idiopathic Unilateral Footdrop. 特发性单侧足下垂的评估和管理。

IF 0.5 4区医学

Journal of the American Podiatric Medical Association Pub Date : 2024-09-01 DOI: 10.7547/22-080

Mehmet Selçuk Saygılı, Ali Çağrı Tekin, Mehmet Kürşad Bayraktar, Mustafa Çağlar Kır, Mustafa Buğra Ayaz, Selcen Kanyılmaz

{"title":"Evaluation and Management of Idiopathic Unilateral Footdrop.","authors":"Mehmet Selçuk Saygılı, Ali Çağrı Tekin, Mehmet Kürşad Bayraktar, Mustafa Çağlar Kır, Mustafa Buğra Ayaz, Selcen Kanyılmaz","doi":"10.7547/22-080","DOIUrl":"10.7547/22-080","url":null,"abstract":"Background: We evaluated patients who were followed after acutely developing single-sided footdrop and improving with conservative management or spontaneously.Methods: In 2019 and 2020, ten patients were retrospectively evaluated for unilateral weakness of the lower extremity in the form of absent dorsiflexion at the ankle joint and were given a diagnosis of footdrop without etiologic cause. Patients were followed for 18 months. Patients were evaluated for acute footdrop of the affected extremity with electromyography, lumbar spine magnetic resonance imaging (MRI), knee MRI, peripheral MRI neurography, and noncontrast brain MRI. Each patient was evaluated for a history of COVID-19 infection during the past year. Patients with any identified cause were excluded.Results: Initial evaluation of muscle strength revealed 0/5 by the Medical Research Council muscle testing scale. In two patients, muscle strength was 3/5 at month 6 and in eight patients it was 4/5. Muscle strength of all of the patients improved to 5/5 at 1 year. Six patients were dispensed an ankle-foot orthosis, and nine patients performed physical therapy. Electromyography identified significant neuropathy at the level of the common peroneal at the fibular head in all of the patients. Compared with peroneal nerve stimulation below and above the fibular head in the lateral popliteal fossa, a 50% reduction in sensory amplitude and motor conduction slowing greater than 10 m/sec were present. Knee MRI revealed no masses, edema, or anatomical variations at the level of the fibular head.Conclusions: Spontaneous resolution of unilateral acute footdrop without an etiologic cause can occur within 1 year.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10112042","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}

引用次数: 0

Management of Children with Megafoot Secondary to Proteus Syndrome: A Report of Three Cases with Long-Term Follow-Up. 继发于变形虫综合征的巨足症患儿的治疗：三例病例的长期随访报告。

IF 0.5 4区医学

Journal of the American Podiatric Medical Association Pub Date : 2024-09-01 DOI: 10.7547/22-130

Mehmet Demirel, Dağhan Koyuncu, Yavuz Sağlam, Fuat Bilgili, Önder İsmet Kılıçoğlu, Hayati Durmaz

{"title":"Management of Children with Megafoot Secondary to Proteus Syndrome: A Report of Three Cases with Long-Term Follow-Up.","authors":"Mehmet Demirel, Dağhan Koyuncu, Yavuz Sağlam, Fuat Bilgili, Önder İsmet Kılıçoğlu, Hayati Durmaz","doi":"10.7547/22-130","DOIUrl":"10.7547/22-130","url":null,"abstract":"Background: Proteus syndrome is a rare disorder characterized by overgrowth of limbs and organs and neurocutaneous findings.Methods: We examined three Proteus syndrome cases with unilateral foot enlargement, megafoot. The patients had ambulatory and cosmetic difficulties. Debulking surgery was performed.Results: After the surgeries, patient mobility and functional scores were analyzed and found to be improved; only one patient had recurrence after 5 years. In the literature, there is no consensus about the treatment and the timing of treatment of Proteus syndrome. The literature suggests that early surgery for megafoot leads to better functional results. Debulking surgery and amputation are the two options mentioned. In the present cases, soft-tissue debulking was performed.Conclusions: In patients with megafoot caused by Proteus syndrome, the functional results were better for those with early debulking surgery compared with those who did not undergo surgery. Patients were able to fit into shoes and walk without difficulty.","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"114 5","pages":""},"PeriodicalIF":0.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639122","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}

引用次数: 0