Journal of the American Podiatric Medical Association

113 KB

Open AccessArticle

Acceptance Address APMA House of Delegates Washington, DC

by Matthew G. Garoufalis

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 256-259; https://doi.org/10.7547/1030256 - 1 May 2013

Viewed by 57

I stand here today, humbled by the work before us, but grateful for the trust you have laid upon my shoulders and thankful for the pioneering work of the many leaders who have come before me [...] Full article

► Show Figures

Figure 1

37 KB

Open AccessArticle

Navicular Stress Reactions in Runners

by Marie St. Louis

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 255; https://doi.org/10.7547/1030254 - 1 May 2013

Viewed by 66

Abstract

To the Editor: The article titled ‘‘Navicular Stress Reactions in Runners: A Review of Evaluation and Management of a Competitive Athlete,’’ by Robert Yoho, DPM, MS, and Shevonne Wells, DPM, MHA, which appeared in the September/October 2011 issue of JAPMA, is interesting because [...] Read more.

To the Editor: The article titled ‘‘Navicular Stress Reactions in Runners: A Review of Evaluation and Management of a Competitive Athlete,’’ by Robert Yoho, DPM, MS, and Shevonne Wells, DPM, MHA, which appeared in the September/October 2011 issue of JAPMA, is interesting because it brings attention to serious injuries that can occur in competitive athletes [...] Full article

307 KB

Open AccessArticle

Marjolin’s Ulcer of the Hallux

by Sasha Pavlovic, Daniel Surowiec and Marylee Braniecki

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 250-253; https://doi.org/10.7547/1030250 - 1 May 2013

Cited by 3 | Viewed by 59

Abstract

We report the case of a 51-year-old woman with malignant degeneration of a right hallux nail bed ulcer of 20 years’ duration. Histologic examination confirmed the diagnostic features of Marjolin’s ulcer, a well-defined but uncommon malignant ulcer that occurs in chronic wounds and [...] Read more.

We report the case of a 51-year-old woman with malignant degeneration of a right hallux nail bed ulcer of 20 years’ duration. Histologic examination confirmed the diagnostic features of Marjolin’s ulcer, a well-defined but uncommon malignant ulcer that occurs in chronic wounds and cutaneous scars. In this report, we describe the clinical and histopathologic features and the differential diagnosis of this unusual lesion. (J Am Podiatr Med Assoc 103(3): 250–253, 2013) Full article

► Show Figures

Figure 1

170 KB

Open AccessArticle

Open Reduction-Internal Fixation of a Navicular Body Fracture with Dorsal Displacement of the First and Second Cuneiforms. A Case Report

by Robert C. Andersen, Katherine Neiderer, Billy Martin and James Dancho

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 246-249; https://doi.org/10.7547/1030246 - 1 May 2013

Cited by 2 | Viewed by 66

Abstract

Body fractures of the tarsal navicular are relatively uncommon. To date, there is little literature discussing a navicular body fracture with dorsal subluxation of the first and second cuneiforms over the navicular. This case study presents a 30-year-old patient with this injury. He [...] Read more.

Body fractures of the tarsal navicular are relatively uncommon. To date, there is little literature discussing a navicular body fracture with dorsal subluxation of the first and second cuneiforms over the navicular. This case study presents a 30-year-old patient with this injury. He underwent open reduction internal fixation of the navicular body fracture successfully but failed adequate reduction of the navicular cuneiform joint after ligamentous reconstruction. After revisional surgery, he also failed 6 weeks of percutanous pinning with Kirschner-wire fixation. When comparing the literature of a similar injury, the Lisfranc fracture disclocation, the same principles may apply. One should consider rigid open reduction internal fixation or even primary fusion to treat disclocation of the naviculocuneiform joint following a navicular body fracture. (J Am Podiatr Med Assoc 103(3): 246–249, 2013) Full article

► Show Figures

Figure 1

176 KB

Open AccessArticle

Diabetes, Damp Casts, and Hair Dryers are Not a Good Combination

by Bernardine C. Henderson, Derek Lawson and G. Reid Conley

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 243-245; https://doi.org/10.7547/1030243 - 1 May 2013

Cited by 2 | Viewed by 85

Abstract

Second- and third-degree burns of the toes resulted when a 69-year-old man with Charcot foot and a recent fractured ankle followed the advice of his local podiatrist. The man got his fiberglass cast wet while showering and was told to dry his cast [...] Read more.

Second- and third-degree burns of the toes resulted when a 69-year-old man with Charcot foot and a recent fractured ankle followed the advice of his local podiatrist. The man got his fiberglass cast wet while showering and was told to dry his cast using the low setting on a blow dryer. The following presents a literature review of cast drying, hair dryers, and this unfortunate man’s case. (J Am Podiatr Med Assoc 103(3): 243–245, 2013) Full article

► Show Figures

232 KB

Open AccessArticle

Angiokeratoma Presenting as a Melanoma. A Case Report

by Nelida Dumitrache, Katherine Neiderer, Billy Martin and James Dancho

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 241-242; https://doi.org/10.7547/1030241 - 1 May 2013

Cited by 1 | Viewed by 89

Abstract

Angiokeratomas are benign skin lesions that can resemble melanomas or verrucae. Although morbidity from these lesions is rare, treatment for angiokeratomas typically consists of simple surgical excision. We aim to describe a case of a painful angiokeratoma that presented with the appearance of [...] Read more.

Angiokeratomas are benign skin lesions that can resemble melanomas or verrucae. Although morbidity from these lesions is rare, treatment for angiokeratomas typically consists of simple surgical excision. We aim to describe a case of a painful angiokeratoma that presented with the appearance of melanoma. (J Am Podiatr Med Assoc 103(3): 241–242, 2013) Full article

► Show Figures

265 KB

Open AccessArticle

Irreducible Metatarsophalangeal Joint Dislocation of the Lesser Toes. A Case Report

by Honlok Lo, Ping-Cheng Liu, Po-Chih Shen, Shen-Kai Chen, Yuh-Min Cheng and Cheng-Chang Lu

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 236-240; https://doi.org/10.7547/1030236 - 1 May 2013

Cited by 2 | Viewed by 61

Abstract

Irreducible metatarsophalangeal joint dislocation of the lesser toes is a rare injury. We present a 37-year-old man who was injured in a motorcycle accident and dislocated the first to third metatarsophalangeal joints and fractured the fourth metatarsal head. The left first metatarsophalangeal joint [...] Read more.

Irreducible metatarsophalangeal joint dislocation of the lesser toes is a rare injury. We present a 37-year-old man who was injured in a motorcycle accident and dislocated the first to third metatarsophalangeal joints and fractured the fourth metatarsal head. The left first metatarsophalangeal joint was reduced successfully through the closed method, but multiple attempts at closed reduction under local anesthesia failed to reduce the dislocated second and third metatarsophalangeal joints. We performed a dorsal incision between the second and third metatarsals, and the metatarsal heads were found to be entrapped under the plantar plate. Dislocation reduction was performed without damage to the plantar plate, and one Kirschner wire was used to fix the fourth metatarsal head fracture. The pin was removed 8 weeks after surgery, and the patient regained normal gait and returned to work and his previous physical activity level without recurrent dislocation. (J Am Podiatr Med Assoc 103(3): 236–240, 2013) Full article

► Show Figures

106 KB

Open AccessArticle

Nonunion of an Isolated Cuboid Fracture. A Case Report

by Ed Britton and Muhammad Ali Fazal

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 233-235; https://doi.org/10.7547/1030233 - 1 May 2013

Cited by 3 | Viewed by 65

Abstract

Nonunion of an isolated undisplaced cuboid fracture is unusual. We report a case of symptomatic nonunion of an isolated cuboid fracture after nonoperative treatment. Fracture union was achieved with surgery, and the patient returned to full activities. (J Am Podiatr Med Assoc 103(3): [...] Read more.

Nonunion of an isolated undisplaced cuboid fracture is unusual. We report a case of symptomatic nonunion of an isolated cuboid fracture after nonoperative treatment. Fracture union was achieved with surgery, and the patient returned to full activities. (J Am Podiatr Med Assoc 103(3): 233–235, 2013) Full article

► Show Figures

334 KB

Open AccessArticle

Impact of Diabetes and Comorbidities on Split-Thickness Skin Grafts for Foot Wounds

by Crystal L. Ramanujam, David Han, Sharon Fowler, Krista Kilpadi and Thomas Zgonis

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 223-232; https://doi.org/10.7547/1030223 - 1 May 2013

Cited by 32 | Viewed by 83

Abstract

Split-thickness skin grafts can be used for foot wound closure in diabetic and nondiabetic patients. It is unknown whether this procedure is reliable for all diabetic patients, with or without comorbidities of diabetes, including cardiovascular disease, neuropathy, retinopathy, and nephropathy. We retrospectively reviewed [...] Read more.

Split-thickness skin grafts can be used for foot wound closure in diabetic and nondiabetic patients. It is unknown whether this procedure is reliable for all diabetic patients, with or without comorbidities of diabetes, including cardiovascular disease, neuropathy, retinopathy, and nephropathy. We retrospectively reviewed 203 patients who underwent this procedure to determine significant differences in healing time, postoperative infection, and need for revisional surgery and to create a predictive model to identify diabetic patients who are likely to have a successful outcome. Overall, compared with nondiabetic patients, diabetic patients experienced a significantly higher risk of delayed healing time and postoperative complication/infection and, hence, are more likely to require revisional surgery after undergoing the initial split-thickness skin graft procedure. These differences seemed to be related more to the presence of comorbidities than to diabetic status itself. Diabetic patients with preexisting comorbidities experienced a significantly increased risk of delayed healing time and postoperative infection and a higher need for revisional surgery compared with nondiabetic patients or diabetic patients without comorbidities. However, there were no significant differences in outcome between diabetic patients without comorbidities and nondiabetic patients. For individuals with diabetes but without exclusionary comorbidities, split-thickness skin grafting may be considered an effective surgical alternative to other prolonged treatment options currently used in this patient population. (J Am Podiatr Med Assoc 103(3): 223–232, 2013) Full article

► Show Figures

306 KB

Open AccessArticle

Histologic Evaluation of Intermetatarsal Morton’s Neuroma

by Matrona Giakoumis, Jay D. Ryan and Jigna Jani

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 218-222; https://doi.org/10.7547/1030218 - 1 May 2013

Cited by 12 | Viewed by 80

Abstract

The present study was conducted in an attempt to obtain consistent similarities among histologic findings of surgically excised neuromas. Secondly, we looked for a correlation between the presence of a neuroma with certain comorbidities. A total of 22 specimens with a preoperative diagnosis [...] Read more.

The present study was conducted in an attempt to obtain consistent similarities among histologic findings of surgically excised neuromas. Secondly, we looked for a correlation between the presence of a neuroma with certain comorbidities. A total of 22 specimens with a preoperative diagnosis of Morton’s neuroma were sent to the pathology laboratory, and evaluation was performed by a single pathologist. Degenerative changes were seen in 59% of the specimens. Patient age showed trends toward affecting nerve fibrosis, nerve diameter, vessel obstruction, and degenerative changes. The most frequent comorbidity was hypertension, seen in 44% of the participants. Significant histologic similarities among results were not seen; however, certain trends were discovered. Degenerative changes were appreciated in most specimens. Definite histologic findings of neuroma recur, but difficulty in consistent reproducibility may be related to factors such as age, sex, and comorbidities. (J Am Podiatr Med Assoc 103(3): 218–222, 2013) Full article

► Show Figures

178 KB

Open AccessArticle

Arch Height Index Normative Values of College-Aged Women Using the Arch Height Index Measurement System

by Wendi H. Weimar and Justin F. Shroyer

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 213-217; https://doi.org/10.7547/1030213 - 1 May 2013

Cited by 25 | Viewed by 67

Abstract

The arch height index measurement system (AHIMS) device has been found to be a reliable and valid instrument for measuring the arch height index (AHI) of the feet of individuals; however, normative data for the AHI are lacking for various populations. Therefore, the [...] Read more.

The arch height index measurement system (AHIMS) device has been found to be a reliable and valid instrument for measuring the arch height index (AHI) of the feet of individuals; however, normative data for the AHI are lacking for various populations. Therefore, the purposes of this study were to establish population normative AHI values for college-aged females and to compare the observed AHI data across right and left feet. Seventy-nine college-aged females served as study participants, and both feet were measured using the AHIMS in the seated and standing positions. The AHI was calculated as the ratio of the dorsum height of the foot at half the total foot length to the length of the foot from the heel to the base of the first metatarsophalangeal joint. The mean ± SD AHI values for the left and right feet in the seated position were 0.355 ± 0.031 and 0.369 ± 0.034, respectively. The mean ± SD AHI values for the left and right feet in the standing position were 0.338 ± 0.031 and 0.343 ± 0.033, respectively. There were significant differences observed between the left and right feet for the seated (P < .001) and standing (P = .003) positions. Normative values were established for college-aged females for the AHI using the AHIMS. Differences were noted between the right and left feet of the participants sampled. Although normative values were obtained, we caution against using these values to classify foot arch types based solely on a sample of the population studied. (J Am Podiatr Med Assoc 103(3): 213–217, 2013) Full article

► Show Figures

215 KB

Open AccessArticle

Prevalence of Accessory Ossicles and Sesamoid Bones in Hallux Valgus

by Umile Giuseppe Longo, Andrea Marinozzi, Stefano Petrillo, Filippo Spiezia, Nicola Maffulli and Vincenzo Denaro

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 208-212; https://doi.org/10.7547/1030208 - 1 May 2013

Cited by 11 | Viewed by 82

Abstract

Sesamoid bones and accessory ossicles of the foot and ankle, although mostly asymptomatic, can be sources of pain or degenerative changes in response to overuse and trauma. We investigated the prevalence of accessory ossicles and sesamoid bones in a population of Italian women [...] Read more.

Sesamoid bones and accessory ossicles of the foot and ankle, although mostly asymptomatic, can be sources of pain or degenerative changes in response to overuse and trauma. We investigated the prevalence of accessory ossicles and sesamoid bones in a population of Italian women with hallux valgus. A single-center study was performed to determine the prevalence of accessory ossicles and sesamoid bones in the ankle and foot. A total of 505 women with hallux valgus aged 26 to 80 years at the time of hallux valgus correction were examined. Anteroposterior, oblique, lateral foot radiographs and a Muller view were examined regarding the presence, prevalence, coexistence, and distribution of accessory ossicles and sesamoid bones in both feet. The radiographs were analyzed independently by three experienced specialists in foot and ankle surgery. Disagreements were discussed in a consensus meeting, where the radiographs were reevaluated and a final decision was made. There was no statistically significant difference between data of the accessory ossicles and sesamoid bones according to the χ² test. Sesamoid bones were detected in 404 of the 505 patients. The fifth metatarsal sesamoid bone was found in 97 patients. All of the patients presented hallucal sesamoid bones. This is the first detailed report of the prevalence of accessory ossicles and sesamoid bones of the feet in Italian women with hallux valgus. These findings could help clinicians in the diagnosis and management of disorders of accessory ossicles and sesamoid bones, which are often undiagnosed, painful foot syndromes. (J Am Podiatr Med Assoc 103(3): 208–212, 2013) Full article

► Show Figures

181 KB

Open AccessArticle

Do the Presence of Pathologic Changes and the Level of Operator Experience Alter the Rate of Intra-Articular Injection of the First Metatarsophalangeal Joint? A Cadaver Study

by Nima Heidari, Tanja Kraus, Stefan Fischerauer, Norbert Tesch and Annelie Weinberg

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 204-207; https://doi.org/10.7547/1030204 - 1 May 2013

Cited by 4 | Viewed by 56

Abstract

Injections, punctures, and aspirations of the first metatarsophalangeal joint are common interventions. Accurate intra-articular placement of the needle is a prerequisite for the achievement of desirable results and the avoidance of complications. We evaluated the rate of successful intra-articular injections and the influence [...] Read more.

Injections, punctures, and aspirations of the first metatarsophalangeal joint are common interventions. Accurate intra-articular placement of the needle is a prerequisite for the achievement of desirable results and the avoidance of complications. We evaluated the rate of successful intra-articular injections and the influence of the degree of operator experience in achieving this success. A total of 106 cadaveric metatarsophalangeal joints were injected with a methylene blue–containing solution and subsequently dissected to distinguish intra-articular from periarticular injections. To evaluate the importance of experience, 38 injections were performed by a student, 38 by a trained resident, and 30 by an experienced surgeon. In the second part of the study, we examined the relation of pathologic findings of the metatarsophalangeal joint and the accuracy of intra-articular injection. The overall rate of unintentional periarticular injections remained low (9.4%; 10 of 106 joints). The student achieved a successful intra-articular injection in 86.8% of joints (33 of 38), the resident in 92.1% (35 of 38), and the specialist in 93.3% (28 of 30). The number of extra-articular injections increased significantly with the presence of deformity (hallux valgus) and arthritis of the first metatarsophalangeal joint. The presence of pathologic changes reduces the rate of successful intra-articular joint puncture. However, the overall frequency of successful intra-articular injections can be improved through experience and the use of imaging. (J Am Podiatr Med Assoc 103(3): 204–207, 2013) Full article

► Show Figures

Figure 1

139 KB

Open AccessArticle

Reliability and Repeatability of the Portable EPS-Platform Digital Pressure-Plate System

by Ricardo Becerro de Bengoa Vallejo, Marta Elena Losa Iglesias, Joseph Zeni and Stephen Thomas

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 197-203; https://doi.org/10.7547/1030197 - 1 May 2013

Cited by 31 | Viewed by 59

Abstract

Abnormal plantar pressures are the hallmark characteristic of several conditions and pathologic abnormalities. Pressure platforms allow for quick and accurate screening of patients and help guide clinical treatment. However, it is essential to evaluate the reliability and repeatability of these devices before making [...] Read more.

Abnormal plantar pressures are the hallmark characteristic of several conditions and pathologic abnormalities. Pressure platforms allow for quick and accurate screening of patients and help guide clinical treatment. However, it is essential to evaluate the reliability and repeatability of these devices before making clinical decisions. The purpose of this study was to determine the reliability of the EPS-Platform during static and dynamic activities. Fifty-six healthy individuals stood and walked onto the pressure platform. Five trials were performed during two separate testing sessions to determine intrasession and intersession reliability. Pressure data were obtained and several variables of interest were calculated for intrasession and intersession reliability using intraclass correlation coefficients (ICCs), SEM, percent error, and coefficient of variation. Static and dynamic intrasession and intersession reliability produced moderate-to-excellent ICCs, low SEMs, low percent errors, and low coefficients of variation. Static trials had higher ICCs, lower percent errors, and lower coefficients of variation compared with dynamic trials. Intersession reliability also had higher ICCs, lower percent errors, and lower coefficients of variation compared with intrasession reliability. This study demonstrates that the EPS-Platform is a reliable device for collecting gait plantar pressures. Static trials produce better reliability, most likely owing to the large inherent variability during dynamic gait. Intersession reliability was higher than intrasession reliability owing to the intersession measures being calculated with an average of five trials. By averaging the trials, the variability of gait is decreased, and this improves the accuracy of the results. These results can be used as the basis for future studies and to determine a priori sample sizes for investigations that use the EPS-Platform. (J Am Podiatr Med Assoc 103(3): 197–203, 2013) Full article

199 KB

Open AccessArticle

Effectiveness of Neuromuscular Stretching with Symmetrical Biphasic Electric Currents in the Cavus Foot

by Lourdes María Fernández-Seguín, Pedro V. Munuera, Carolina Peña-Algaba, Javier Ramos Ortega, Juan Antonio Díaz-Morales and Elena Escamilla-Martínez

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 191-196; https://doi.org/10.7547/1030191 - 1 May 2013

Cited by 2 | Viewed by 69

Abstract

Pes cavus is a structural deformity in which the increased plantar arch can lead to greater metatarsal verticality with the consequent excess of pressure under the forefoot zone (especially the metatarsal zone), causing pain and significant loss of functional capacity. We sought to [...] Read more.

Pes cavus is a structural deformity in which the increased plantar arch can lead to greater metatarsal verticality with the consequent excess of pressure under the forefoot zone (especially the metatarsal zone), causing pain and significant loss of functional capacity. We sought to determine whether neuromuscular stretching with symmetrical rectangular biphasic currents can reduce the pressure supported by this zone. This prospective, nonrandomized, longitudinal, analytical, and experimental controlled trial included 34 patients with pes cavus. Pedobarometric measurements were made using the footscan USB Gait Clinical System platform considering the toes and metatarsal heads, forefoot, midfoot, and hindfoot before and after performing stretching using a Med Tens 931 electrotherapy device. The measurements were repeated 7 days after the application. With the Student t test for paired samples, we showed that there was a significant decline in metatarsal pressure (P < .001) in the zones of the first (P = .045) and third (P = .01) metatarsals and that this reduction was maintained 1 week after the plantar stretching. Plantar stretching with symmetrical rectangular biphasic currents is effective for the prevention and treatment of pes cavus metatarsalgia caused by excessive pressure. (J Am Podiatr Med Assoc 103(3): 191–196, 2013) Full article

► Show Figures

Figure 1

542 KB

Open AccessArticle

Joint Debridement and Metatarsal Remodeling in Freiberg’s Infraction

by Mehmet Erdil, Yunus Imren, Kerem Bilsel, Ayhan Erzincanli, Murat Bülbül and Ibrahim Tuncay

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 185-190; https://doi.org/10.7547/1030185 - 1 May 2013

Cited by 14 | Viewed by 50

Abstract

Freiberg’s infraction is an osteochondrosis that is characterized by osteonecrosis of the metatarsal head, with pain and tenderness around the metatarsophalangeal joint. We sought to evaluate the outcome of joint debridement and metatarsal remodeling for the treatment of advanced-stage Freiberg’s infraction. Between March [...] Read more.

Freiberg’s infraction is an osteochondrosis that is characterized by osteonecrosis of the metatarsal head, with pain and tenderness around the metatarsophalangeal joint. We sought to evaluate the outcome of joint debridement and metatarsal remodeling for the treatment of advanced-stage Freiberg’s infraction. Between March 1, 2006, and April 30, 2011, 14 patients (eight females and six males) with symptomatic unilateral Freiberg’s disease refractory to conservative treatment (Smillie stages IV and V) underwent joint debridement with metatarsal head remodeling by two surgeons. To evaluate functional outcome, American Orthopaedic Foot and Ankle Society and 36-Item Short Form Health Survey forms were completed by the patients preoperatively and postoperatively at months 3, 6, and 12. Active-assisted range-of-motion exercise was allowed after 4 weeks of short-leg walking cast wear, and weightbearing on the forefoot was allowed as tolerated. Mean patient age was 27.0 years (range, 16–53 years), and mean follow-up was 40.2 months (range, 14–54 months). Mean ± SD American Orthopaedic Foot and Ankle Society and 36-Item Short Form Health Survey scores were 46.8 ± 8.95 and 28.9 ± 4.3 preoperatively and 76.2 ± 9.5 and 45.6 ± 7.7 1 year after surgery, respectively. There was a significant increase in both scores (P ≤ .001). In advanced-stage Freiberg’s infraction of the second metatarsal, joint debridement and metatarsal head remodeling is a safe and simple therapeutic option, and it provides better quality of life for patients. (J Am Podiatr Med Assoc 103(3): 185–190, 2013) Full article

► Show Figures

Figure 1

224 KB

Open AccessArticle

Variations of the Origin of the Arcuate Artery

by BiBi N. Singh, William Burmeister, Katherine Machado, Luis Rodriguez and Annabelle Santos-Dookie

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 181-184; https://doi.org/10.7547/1030181 - 1 May 2013

Cited by 4 | Viewed by 60

Abstract

The purpose of this study was to investigate the origin of the arcuate artery. This cadaveric study was performed on 20 feet from ten cadavers of both sexes (age range, 61–94 years). The results indicate that the arcuate artery originated from the dorsalis [...] Read more.

The purpose of this study was to investigate the origin of the arcuate artery. This cadaveric study was performed on 20 feet from ten cadavers of both sexes (age range, 61–94 years). The results indicate that the arcuate artery originated from the dorsalis pedis artery in 13 of 20 specimens (65%) and from the lateral tarsal artery in 6 of 20 (30%), and a variation in origination was noted in 1 of 20 specimens (5%). This cadaveric study demonstrates that the arcuate artery can originate from the dorsalis pedis artery, the lateral tarsal artery, and one other variant. The dorsal arterial network of the lower extremity is important to consider during the overall clinical and surgical assessment of a patient. (J Am Podiatr Med Assoc 103(3): 181–184, 2013) Full article

► Show Figures

Figure 1

504 KB

Open AccessArticle

Three-Dimensional Finite Element Analysis Used to Compare Six Different Methods of Syndesmosis Fixation with 3.5- or 4.5-mm Titanium Screws. A Biomechanical Study

by Mehmet Serhan Er, Ozgur Verim, Levent Altinel and Suleyman Tasgetiren

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 174-180; https://doi.org/10.7547/1030174 - 1 May 2013

Cited by 14 | Viewed by 54

Abstract

Use of thicker and longer (four cortices) screws or of multiple screws seems to be more stable and efficient for syndesmosis fixation. A three-dimensional finite element model of an ankle was constructed from serial axial sections from an existing two-dimensional computed tomographic image. [...] Read more.

Use of thicker and longer (four cortices) screws or of multiple screws seems to be more stable and efficient for syndesmosis fixation. A three-dimensional finite element model of an ankle was constructed from serial axial sections from an existing two-dimensional computed tomographic image. Constructions of syndesmosis fixation with 3.5-mm single tricortical, 3.5-mm single quadricortical, 3.5-mm double tricortical, 3.5-mm double quadricortical, 4.5-mm single tricortical, and 4.5-mm single quadricortical screws were performed on this model. Physiologic loads approximating those during stance phase normal walking were applied to this ankle system. Stress values on the screws using the six fixation methods were compared. The highest maximum stress was determined over 3.5-mm cortical screws applied as single quadricortical, and the lowest maximum stress was determined over the 4.5-mm cortical screw applied as single quadricortical. Stress on the 3.5-mm single screw with quadricortical application was found to be higher than that with tricortical application and also compared with the 4.5-mm quadricortical screw application. Differences between the 4.5-mm single tricortical and quadricortical screws and between the 3.5-mm single tricortical and 3.5-mm double tricortical screw applications were not significant. Quadricortical application of 3.5-mm single screws and tricortical application of 3.5-mm double cortical screws are not good choices for syndesmosis fixation. If the plan is tricortical application, a 3.5-mm single cortical screw is adequate. If quadricortical application of syndesmosis fixation is planned, a 4.5-mm cortical screw should be used. (J Am Podiatr Med Assoc 103(3): 174–180, 2013) Full article

► Show Figures

Figure 1

375 KB

Open AccessArticle

The Impact of Footwear and Walking Distance on Gait Stability in Diabetic Patients with Peripheral Neuropathy

by Bijan Najafi, Tahir Khan, Adam Fleischer and James Wrobel

J. Am. Podiatr. Med. Assoc. 2013, 103(3), 165-173; https://doi.org/10.7547/1030165 - 1 May 2013

Cited by 35 | Viewed by 60

Abstract

We explored gait differences in patients with diabetes and peripheral neuropathy (DPN) and aged-matched controls over short and long walking distances. The potential benefit of footwear for improving gait in patients with DPN was also explored. Twelve patients with DPN and eight controls [...] Read more.

We explored gait differences in patients with diabetes and peripheral neuropathy (DPN) and aged-matched controls over short and long walking distances. The potential benefit of footwear for improving gait in patients with DPN was also explored. Twelve patients with DPN and eight controls walked at their habitual speed over short (7 m) and long (20 m) distances under two conditions: barefoot and regular shoes. A validated system of body-worn sensors was used to extract spatiotemporal gait parameters. Neuropathy severity was quantified using vibratory perception threshold measured at the great toe. Gait deterioration in the DPN group was observed during all of the walking trials. However, the difference between patients with DPN and participants in the control group achieved statistical significance only during long walking distance trials. Shod and barefoot double support times were longer in the DPN group during long walking distances (>20%, P = .03). Gait unsteadiness, defined as coefficient of variation of gait velocity, was also significantly higher in the DPN group when barefoot walking over long distances (83%, P = .008). Furthermore, there was a high correlation between neuropathy severity and gait unsteadiness best demonstrated during the barefoot walking/long walking distance condition (r = 0.77, P < .001). The addition of footwear improved gait steadiness in the DPN group by 46% (P = .02). All differences were independent of age, sex, and body mass index (P > .05). This study suggests that gait alteration in patients with DPN is most pronounced while walking barefoot over longer distances and that footwear may improve gait steadiness in patients with DPN. (J Am Podiatr Med Assoc 103(3): 165–173, 2013) Full article

► Show Figures

Figure 1

Journal Menu

Journal Browser

J. Am. Podiatr. Med. Assoc., Volume 103, Issue 3 (05 2013) – 19 articles , Pages 165-259

Further Information

Guidelines

MDPI Initiatives

Follow MDPI