Journal of Foot and Ankle Research最新文献

{"title":"Prevalence of plantar ulcer and its risk factors in leprosy: a systematic review and meta-analysis.","authors":"Karthikeyan Govindasamy, Joydeepa Darlong, Samuel I Watson, Paramjit Gill","doi":"10.1186/s13047-023-00674-4","DOIUrl":"10.1186/s13047-023-00674-4","url":null,"abstract":"<p><strong>Background: </strong>Plantar ulcers are a leading complication of leprosy that requires frequent visits to hospital and is associated with stigma. The extent of burden of ulcers in leprosy and its risk factors are scant impeding the development of targeted interventions to prevent and promote healing of ulcers. The aim of this review is to generate evidence on the prevalence of plantar ulcer and its risk factors in leprosy.</p><p><strong>Methods: </strong>Databases (Medline, Embase, Web of Science, CINAHL, BVS), conference abstracts and reference lists were searched for eligible studies. Studies were included that reported a point prevalence of plantar ulcer and/or its \"risk factors\" associated with development of ulcers (either causatively or predictively), including individual level, disease related and bio-mechanical factors. We followed PRISMA guidelines for this review. Random-effects meta-analysis was undertaken to estimate the pooled point prevalence of ulcers. Reported risk factors in included studies were narratively synthesised. This review is registered in PROSPERO: CRD42022316726.</p><p><strong>Results: </strong>Overall, 15 studies (8 for prevalence of ulcer and 7 for risk factors) met the inclusion criteria. The pooled point prevalence of ulcer was 34% (95% CIs: 21%, 46%) and 7% (95% CIs: 4%, 11%) among those with foot anaesthesia and among all people affected by leprosy, respectively. Risk factors for developing ulcers included: unable to feel 10 g of monofilament on sensory testing, pronated/hyper-pronated foot, foot with peak plantar pressure, foot with severe deformities, and those with lower education and the unemployed.</p><p><strong>Conclusions: </strong>The prevalence of plantar ulceration in leprosy is as high as 34% among those with loss of sensation in the feet. However, the incidence and recurrence rates of ulceration are least reported. The inability to feel 10 g of monofilament appears to be a strong predictor of those at risk of developing ulcers. However, there is a paucity of evidence on identifying those at risk of developing plantar ulcers in leprosy. Prospective studies are needed to estimate the incidence of ulcers. Identifying individuals at risk of ulcers will help design targeted interventions to minimize risk factors, prevent ulcers and promote ulcer healing.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"77"},"PeriodicalIF":2.5,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10641946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89720139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I know what I'm supposed to do, but I don't do it\": patient-perceived risk factors that lead to their lower extremity amputations.","authors":"Marcelle Ben Chmo, Lisa Matricciani, Saravana Kumar, Kristin Graham","doi":"10.1186/s13047-023-00675-3","DOIUrl":"10.1186/s13047-023-00675-3","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to extend on our previous research by exploring patient-perceived factors that lead to their Lower Extremity Amputations (LEA). LEA are a serious complication of Type 2 Diabetes Mellitus (T2DM), LEA are thought to be preventable with early detection and management of risk factors. Our previous study identified that these factors extend beyond the typical biological and modifiable risk factors and may also extend to patient awareness and competing priorities. Therefore, this research explored these issues in further detail, identifying patient-perceived factors that lead to their LEA.</p><p><strong>Methods: </strong>A qualitative descriptive methodology involving non-probability purposive sampling was used to recruit inpatients at a tertiary metropolitan hospital in South Australia. Semi-structured interviews were conducted, and data were transcribed verbatim. Data from the interviews were analysed using thematic analysis and the constant comparison approach.</p><p><strong>Results: </strong>A total of 15 participants shared their perspectives of risk factors for LEA. Two main themes emerged: intrinsic and extrinsic factors. Intrinsic factors identified in this study included identity, ambivalence, denial, inevitability, and helplessness. Extrinsic factors related to resources, rapport with healthcare professionals, and management of care.</p><p><strong>Conclusions: </strong>Through identifying that a combination of perceived personal attributes (intrinsic) and system-level (extrinsic) factors likely contribute to LEA, this study highlights the complexity of factors that contribute to patients' perceptions of what led to their diabetes related LEA. These findings support the importance of a nuanced approach in managing patients with diabetes who are at risk of LEA as it's likely patients' personal circumstances, day-to-day life's requirements and responsibilities, their interaction with healthcare professionals all seemingly contribute to how risks are viewed and managed. Tackling this challenge will require reimagining diabetes care, acknowledgement of risk factors beyond the obvious and addressing persistent access and workforce issues.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"79"},"PeriodicalIF":2.9,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10642033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92157159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testosterone replacement therapy is associated with increased odds of Achilles tendon injury and subsequent surgery: a matched retrospective analysis.","authors":"J Alex Albright, Mary Lou, Elliott Rebello, Jonathan Ge, Edward J Testa, Alan H Daniels, Michel Arcand","doi":"10.1186/s13047-023-00678-0","DOIUrl":"10.1186/s13047-023-00678-0","url":null,"abstract":"<p><strong>Background: </strong>Prescription of testosterone replacement therapy (TRT) has increased in the United States in recent years, and though anabolic steroids have been associated with tendon rupture, there is a paucity of literature evaluating the risk of Achilles tendon injury with TRT. This study aims to evaluate the associative relationship between consistent TRT, Achilles tendon injury, and subsequent surgery.</p><p><strong>Methods: </strong>This is a one-to-one matched retrospective cohort study utilizing the PearlDiver database. Records were queried for patients aged 35-75 who were prescribed at least 3 consecutive months of TRT between January 1, 2010 and December 31, 2019. Achilles tendon injuries and subsequent surgeries were identified using ICD-9, ICD-10, and CPT billing codes. Multivariable logistic regression was used to compare odds of Achilles tendon injury, Achilles tendon surgery, and revision surgery, with a p-value < 0.05 representing statistical significance.</p><p><strong>Results: </strong>A sample of 423,278 patients who filled a TRT prescription for a minimum of 3 consecutive months was analyzed. The 2-year incidence of Achilles tendon injury was 377.8 (95% CI, 364.8-391.0) per 100,000 person-years in the TRT cohort, compared to 245.8 (95% CI, 235.4-256.6) in the control (p < 0.001). The adjusted analysis demonstrated TRT to be associated with a significantly increased likelihood of being diagnosed with Achilles tendon injury (aOR = 1.24, 95% CI, 1.15-1.33, p < 0.001). Of those diagnosed with Achilles tendon injury, 287/3,198 (9.0%) of the TRT cohort subsequently underwent surgery for their injury, compared to 134/2,081 (6.4%) in the control cohort (aOR = 1.54, 95% CI, 1.19-1.99, p < 0.001).</p><p><strong>Conclusions: </strong>There is a significant association between Achilles tendon injury and prescription TRT, with a concomitantly increased rate of undergoing surgical management. These results provide insight into the risk profile of TRT and further research into the science of tendon pathology in the setting of TRT is an area of continued interest.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"76"},"PeriodicalIF":2.9,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A classification of the plantar intrinsic foot muscles based on the physiological cross-sectional area and muscle fiber length in healthy young adult males.","authors":"Yuki Kusagawa, Toshiyuki Kurihara, Sumiaki Maeo, Takashi Sugiyama, Hiroaki Kanehisa, Tadao Isaka","doi":"10.1186/s13047-023-00676-2","DOIUrl":"10.1186/s13047-023-00676-2","url":null,"abstract":"<p><strong>Background: </strong>Plantar intrinsic foot muscles (PIFMs) are composed of 10 muscles and play an essential role in achieving functional diversity in the foot. Previous studies have identified that the morphological profiles of PIFMs vary between individuals. The morphological profiles of a muscle theoretically reflect its output potentials: the physiological cross-sectional area (PCSA) of a muscle is proportional to its maximum force generation, and the muscle fiber length (FL) is its shortening velocity. This implies that the PCSA and FL may be useful variables for characterizing the functional diversity of the individual PIFM. The purpose of this study was to examine how individual PIFMs can be classified based on their PCSA and FL.</p><p><strong>Methods: </strong>In 26 healthy young adult males, the muscle volume and muscle length of seven PIFMs (abductor hallucis, ABDH; abductor digiti minimi, ABDM; adductor hallucis oblique head, ADDH-OH; ADDH transverse head, ADDH-TH; flexor digitorum brevis, FDB; flexor hallucis brevis, FHB; quadratus plantae, QP) were measured using magnetic resonance imaging. The PCSA and FL of each of the seven PIFMs were then estimated by combining the data measured from the participants and those of muscle architectural parameters documented from cadavers in previous studies. A total of 182 data samples (26 participants × 7 muscles) were classified into clusters using k-means cluster analysis. The optimal number of clusters was evaluated using the elbow method.</p><p><strong>Results: </strong>The data samples of PIFMs were assigned to four clusters with different morphological profiles: ADDH-OH and FHB, characterised by large PCSA and short FL (high force generation and slow shortening velocity potentials); ABDM and FDB, moderate PCSA and moderate FL (moderate force generation and moderate shortening velocity potentials); QP, moderate PCSA and long FL (moderate force generation and rapid shortening velocity potentials); ADDH-TH, small PCSA and moderate FL (low force generation and moderate shortening velocity potentials). ABDH components were assigned equivalently to the first and second clusters.</p><p><strong>Conclusions: </strong>The approach adopted in this study may provide a novel perspective for interpreting the PIFMs' function based on their maximal force generation and shortening velocity potentials.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"75"},"PeriodicalIF":2.9,"publicationDate":"2023-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72211536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intersectionality, vulnerability and foot health inequity.","authors":"Joana Almeida,&nbsp;Jonathan Brocklehurst,&nbsp;Adrienne Sharples","doi":"10.1186/s13047-023-00647-7","DOIUrl":"10.1186/s13047-023-00647-7","url":null,"abstract":"<p><p>Foot health and wellbeing in the UK are often overlooked in healthcare. Foot health outcomes are strongly interlinked to the social determinants of health, in that the way these determinants intersect can impact an individual's vulnerability to foot pain and disorders. In this commentary we explore some social determinants that hinder individuals from improving their foot health behaviour and ultimately reducing foot pain and foot disorder vulnerability. We focus on socioeconomic status, gender, disability, age, culture and ethnicity, and footwear quality; we also highlight the potential impact of the Covid-19 pandemic and the cost-of-living crisis on foot health inequities; rises in inflation have resulted in footcare becoming less affordable among vulnerable groups, like those with intellectual disabilities and chronic illness, older people, those living in rural and inner-city communities, and the ethnically and linguistically diverse population living in the UK. There is an urgent need to raise awareness of the social determinants of foot health, their intersectionality, and their impact on foot pain and disorder vulnerability. Despite the Black Report and both Marmot Reviews, little progress has been made in raising this awareness. It is recommended to widen the range of foot health interventions, by including it in GP consultations, developing cultural sensitivity within foot health services, creating more comprehensive educational foot health programmes, and developing a more sustainable footwear industry.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"73"},"PeriodicalIF":2.9,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinically-accessible and laboratory-derived predictors of biomechanical response to standalone and supported lateral wedge insoles in people with knee osteoarthritis.","authors":"Michael A Hunt,&nbsp;Calvin T F Tse,&nbsp;Michael B Ryan,&nbsp;Alexander Scott,&nbsp;Eric C Sayre","doi":"10.1186/s13047-023-00671-7","DOIUrl":"10.1186/s13047-023-00671-7","url":null,"abstract":"<p><strong>Background: </strong>Lateral wedge insoles (both standalone and those incorporating individualized arch support) have been frequently studied for the effects on knee joint loading and pain in people with knee osteoarthritis. It has been shown that many people who use these insoles do not obtain the intended biomechanical effect, and thus may not experience a clinical benefit. The ability to identify biomechanical responders to lateral wedge insoles before research or clinical intervention is an important objective for efficient resource use and optimizing patient outcomes. The purpose of our exploratory, hypothesis-generating study was to provide an initial assessment of variables that are associated with the biomechanical response to lateral wedge insoles in people with knee osteoarthritis.</p><p><strong>Methods: </strong>We collected a number of demographic (age, sex, body mass index, foot posture), clinical (knee pain, foot pain, radiographic disease severity), and walking-related (speed, knee alignment, frontal plane subtalar movement, and foot rotation) outcomes from 53 individuals with painful, radiographically-confirmed knee osteoarthritis. The walking-related outcomes were obtained using equipment both from the research laboratory and the clinical setting. We used logistic regression to generate predictive models to determine candidate variables associated with a reduction in the knee adduction moment during walking - a surrogate for tibiofemoral load distribution, and a known biomechanical risk factor for osteoarthritis progression - with the use of standalone and arch-supported lateral wedge insoles. Three different response thresholds (2%, 6%, and 10% reductions in the knee adduction moment) were used.</p><p><strong>Results: </strong>In general, biomechanical responders were those who walked faster, were female, had less varus alignment, and had less severe radiographic severity. Findings were similar between the standalone and arch-supported lateral wedge insoles, as well as between models using the laboratory-derived or clinically-available measures of walking performance.</p><p><strong>Conclusions: </strong>Our hypothesis-generating study provides valuable information that will inform future research into the efficient and effective use of lateral wedge insoles in the conservative management of knee osteoarthritis.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"74"},"PeriodicalIF":2.9,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10601168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for a randomised feasibility trial comparing a combined program of education and exercise versus general advice for ankle osteoarthritis.","authors":"Michelle D Smith, Viana Vuvan, Natalie J Collins, David J Hunter, Nathalia Costa, Melinda M Franettovich Smith, Bill Vicenzino","doi":"10.1186/s13047-023-00669-1","DOIUrl":"10.1186/s13047-023-00669-1","url":null,"abstract":"<p><strong>Background: </strong>Ankle osteoarthritis (OA) is a serious problem with high associated pain and disability. While education and exercise are recommended for the initial management of OA, this has not been investigated in ankle OA. The primary aim of this study is to establish the feasibility of running a full-scale randomised controlled trial (RCT) investigating a combined education and exercise program compared to a general advice program for people with ankle OA. The secondary aims are to collect preliminary data which will inform sample size calculations, and understand the perspectives of people with ankle OA on their participation in the trial.</p><p><strong>Methods: </strong>Thirty individuals aged 35 years or older with symptomatic radiographic ankle OA will be recruited from the community and randomised to receive either a combined education and exercise program or a general advice program, both of which will be delivered by a physiotherapist in a group setting. Primary outcomes of feasibility include responses to study advertisements, number of eligible participants, recruitment rate, adherence with the intervention, fidelity of the intervention, adverse events, drop-out rate, and credibility and expectancy of the intervention. Secondary participant-reported outcomes will include global rating of change, patient acceptable symptom state, severity of ankle pain and stiffness, self-reported function, quality of life, satisfaction with treatment, and use of co-interventions. Follow up will be at 8 weeks and 3 months. Physical measures of 40 m walking speed, timed stairs descent, heel raise endurance and ankle dorsiflexion range of motion will be collected at baseline and 8 weeks. Primary feasibility outcomes will be reported descriptively, and estimates of the variability of secondary participant-reported and physical outcomes will be calculated. Semi-structured interviews will be conducted with participants to understand perspectives about the intervention and participation in the trial, with data analyzed thematically.</p><p><strong>Discussion: </strong>Study findings will establish the feasibility of running a full-scale RCT to investigate a combined education and exercise program compared to a general advice program for people with ankle OA. This study is a necessary first step to advance the international research agenda of evaluating the efficacy of exercise in the management of ankle OA.</p><p><strong>Trial registration: </strong>ACTRN12623000017628. Registered 10 January 2023, https://www.anzctr.org.au/ACTRN12623000017628.aspx .</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"72"},"PeriodicalIF":2.9,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multi-professional survey of UK practice in the use of intra-articular corticosteroid injection for symptomatic first metatarsophalangeal joint osteoarthritis.","authors":"Michael R Backhouse, Jill Halstead, Edward Roddy, Vivek Dhukaram, Anna Chapman, Susanne Arnold, Julie Bruce","doi":"10.1186/s13047-023-00672-6","DOIUrl":"10.1186/s13047-023-00672-6","url":null,"abstract":"<p><strong>Background: </strong>The first metatarsophalangeal joint is the most common site of osteoarthritis (OA) in the foot and ankle. Intra-articular corticosteroid injections are widely used for this condition, but little is known about their use in practice. This study explored current practice within the UK National Health Service (NHS) relating to the administration of intra-articular corticosteroids for people with painful first metatarsophalangeal joint (MTPJ) OA.</p><p><strong>Methods: </strong>A cross-sectional survey using Qualtrics online survey platform (Qualtrics, Provo, UT, USA), distributed through professional bodies, special interest groups, and social media.</p><p><strong>Results: </strong>One hundred forty-four healthcare professionals responded, including podiatrists (53/144; 39%), orthopaedic surgeons (28/144; 19%), podiatric surgeons (26/144; 17%) and physiotherapists (24/144; 16%). Half of respondents administered up to 25 corticosteroid injections per year (67/136; 49%) but some administered more than fifty (21/136; 15%). Injections were administered across the healthcare system but were most common in hospital settings (64/136; 44%) followed by community (38/136; 26%), with less delivered in primary care (11/136; 8%). Half of respondents routinely used image-guidance, either ultrasound or x-ray/fluoroscopy (65/136; 48%) although over one third used none (52/136; 38%). Imaging guidance was more common amongst medical professionals (21/31; 68%) compared to non-medical health professionals (45/105; 43%). Overall, methylprednisolone acetate was the most common corticosteroid used. Medical professionals mostly injected methylprednisolone acetate (n = 15/27; 56%) or triamcinolone acetonide (n = 11/27; 41%), whereas premixed methylprednisolone acetate with lidocaine hydrochloride was the most common preparation used by non-medical health professionals (41/85; 48%). When injecting non premixed steroid, lidocaine hydrochloride (15/35; 43%) was the most common choice of local anaesthetic for non-medical health professionals but medical professionals showed more variation between lidocaine hydrochloride (8/23; 35%) levobupivacaine hydrochloride (9/23; 39%) and bupivacaine hydrochloride (5/23; 22%).</p><p><strong>Conclusions: </strong>Multiple professional groups regularly administer intra-articular corticosteroids for symptomatic first MTPJ OA across a range of NHS healthcare settings. Overall, methylprednisolone acetate was the most commonly administered steroid and lidocaine hydrochloride the most common local anaesthetic. There was large variation in the use of imaging guidance, type and dose of steroid, local anaesthetic, and clinical pathways used in the intra-articular injection of corticosteroids for people with first MTPJ OA.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"71"},"PeriodicalIF":2.9,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10580568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validity and reliability of hallux valgus angle measurement on smartphone digital photographs.","authors":"Albert Cakar, Ozkan Kose, Firat Dogruoz, Huseyin Selcuk, Tolga Kirtis, Omer Faruk Egerci","doi":"10.1186/s13047-023-00670-8","DOIUrl":"10.1186/s13047-023-00670-8","url":null,"abstract":"<p><strong>Background: </strong>This prospective study aimed to test the reliability and validity of hallux valgus angle (HVA) measurement on smartphone digital photographs compared with the standard radiographic evaluation.</p><p><strong>Methods: </strong>Twenty Seven female patients (45 feet) with forefoot deformity were evaluated with weight-bearing anteroposterior foot radiographs and smartphone photographs. Radiographic hallux valgus angle (rHVA) was measured on digital radiographs. Two different photographic HVA measurement methods were used. In the first, the longitudinal axes of the first metatarsal and proximal phalanx were determined, and the angle between these axes was measured (pHVA), similar to the radiographic method. In the other method, the angle of the margo medialis pedis was measured on the photograph (pMMP). Two independent observers performed all measurements twice on two different occasions. Reliability analysis was performed using the interclass correlation coefficient. Agreement between the measurements was tested using Bland-Altman analysis.</p><p><strong>Results: </strong>The repeated rHVA, pHVA and pMMP measurements showed excellent intra and inter-observer reliability, with ICC values above 0.900. The mean rHVA, pHVA, and pMMP were statistically similar (p:0.929, 27.03°±8.7°, 27.11°±8.8° and 26.5°±9.0° respectively). The mean difference between the rHVA and pHVA was - 0.07°±5.1° (range, --9.67 to 9.56°), and the mean difference between the rHVA and pMMP was 0.53°±4.4° (range, -9.76° to 8.22°). There was a strong positive correlation between both photographic methods and radiographic measurements (rho = 0.809, p = 0.001 and rho = 0.872, p = 0.001). In the Bland Altman plot, the upper and lower LOAs (95%CI) ranged from - 10.11° to 9.93° for rHVA and pHVA, and from - 8.26° to 9.33° for rHVA and pMMP. Linear regression analysis showed a proportional bias for pHVA but not for the pMMP (p:0.010 versus p:0.633, respectively). The range of the mean difference (prediction interval) between the pMMP and rHVA was 17.59° and 20° for pHVA and rHVA. Simple linear regression showed that the rHVA was predicted by the following equation: rHVA = 4.73 + 0.84 × pMMP (r2 = 0.761, p < 0.001).</p><p><strong>Conclusions: </strong>Although measuring HVA through smartphone photographs is reliable, it is not a valid prediction method.</p><p><strong>Level of evidence: </strong>Level II, diagnostic assessment.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"70"},"PeriodicalIF":2.5,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10577965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between triglyceride glucose index and severity of diabetic foot ulcers in type 2 diabetes mellitus.","authors":"Weihao Chen, Xuedong Wang, Qilin Jiang, Jiyan Wu, Wanyan Shi, Xiaoxiao Wang, Yihu Yin, Jiayin Zheng, Xiang Hu, Cai Lin, Xingxing Zhang","doi":"10.1186/s13047-023-00663-7","DOIUrl":"10.1186/s13047-023-00663-7","url":null,"abstract":"<p><strong>Background: </strong>Triglyceride glucose (TyG) index is a good surrogate biomarker to evaluate insulin resistance (IR). The study aimed to investigate whether the TyG index is related to the severity of diabetic foot ulcers (DFUs) in patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A total of 1059 T2DM patients were enrolled in this observational, retrospective, single-center study. TyG index was calculated as ln[fasting triglycerides (mg/dl) × fasting glucose (mg/ dl)/2]. The severity of DFUs was classified into mild-to-moderate DFUs (Wagner grade score < 3) and severe DFUs (Wagner grade score ≥ 3) based on Wagner classification. Patients were stratified according to the tertiles of TyG index. Logistic regression models were implemented to explore the association between TyG index and the severity of DFUs. Subgroup analyses were used to verify the reliability of results.</p><p><strong>Results: </strong>Compared with the reference lowest TyG tertile (T1), the highest tertile (T3) was associated with 0.377-fold increased risk of prevalence of severe DFUs (odds ratio [OR] 1.377, 95% confidence interval [CI] 1.017-1.865) (P = 0.039). After adjusting for potential confounders, the multivariable-adjusted OR and 95% CI were 1.506 (1.079-2.103) (P = 0.016) in patients with highest tertile. Moreover, subgroup analyses indicated that the association was stronger among men, patients with age ≥ 65 years, duration of diabetes more than 10 years, or without PAD.</p><p><strong>Conclusions: </strong>Elevated TyG index is independently associated with severity of DFUs even after adjusting conventional confounders.</p>","PeriodicalId":49164,"journal":{"name":"Journal of Foot and Ankle Research","volume":"16 1","pages":"68"},"PeriodicalIF":2.9,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10552301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41148703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}