Journal of the American Podiatric Medical Association

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In Appreciation

by Warren S. Joseph

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 454-455; https://doi.org/10.7547/8750-7315-106.6.454 - 1 Nov 2016

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Medical literature is dependent on peer review [...] Full article

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Open AccessArticle

Celebrating Our Potential

by R. Daniel Davis

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 453; https://doi.org/10.7547/8750-7315-106.6.453 - 1 Nov 2016

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One of the things I love most about our profession is its tremendous potential [...] Full article

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Partial Rupture of the Tibialis Posterior Tendon Associated with a Closed Medial Malleolar Fracture. A Case Report

by Jin Park

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 449-452; https://doi.org/10.7547/15-078 - 1 Nov 2016

Cited by 3 | Viewed by 38

Abstract

Rupture of the tibialis posterior tendon associated with ankle fracture is rare and difficult to diagnose. This rupture can be easily overlooked because the clinical examination is limited owing to acute pain related to a closed ankle fracture. Complete rupture of the tibialis [...] Read more.

Rupture of the tibialis posterior tendon associated with ankle fracture is rare and difficult to diagnose. This rupture can be easily overlooked because the clinical examination is limited owing to acute pain related to a closed ankle fracture. Complete rupture of the tibialis posterior tendon can be identified by a loss of tension during ankle fracture fixation, but partial rupture is more difficult to detect because the tibialis posterior tendon can maintain its tension. A few cases of complete rupture of the tibialis posterior tendon combined with ankle fracture have been reported. It is well-known that failure to diagnose a rupture of the tibialis posterior tendon can lead to long-term disability and a planovalgus foot. However, to our knowledge, this is the first report of partial rupture of the tibialis posterior tendon in the English literature. Herein, we describe a patient with a neglected partial rupture of the tibialis posterior tendon combined with a medial malleolar fracture. Full article

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Open AccessCase Report

Staged Reconstruction for Acute Charcot’s Subtalar Joint Dislocation. A Case Report

by Spencer Monaco, Patrick Burns and Alissa Toth

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 445-448; https://doi.org/10.7547/15-088 - 1 Nov 2016

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Abstract

Charcot's neuroarthropathy can have devastating consequences if left untreated or misdiagnosed. With progression of the disease from the acute to the chronic phase, substantial deformity and instability may result, leading to ulceration and a nonfunctional limb. The purpose of this case report is [...] Read more.

Charcot's neuroarthropathy can have devastating consequences if left untreated or misdiagnosed. With progression of the disease from the acute to the chronic phase, substantial deformity and instability may result, leading to ulceration and a nonfunctional limb. The purpose of this case report is to present a staged reconstruction for active Charcot's neuroarthropathy involving the subtalar joint with complete dislocation that resulted in limb salvage and maintenance of limb function at 1-year follow-up. Although for many patients the mainstay of treatment for early Charcot's neuroarthropathy is conservative care with off-loading, early surgical correction that includes external fixation followed by definitive arthrodesis for select patients may be warranted. Full article

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Delayed Surgical Reconstruction of a Peroneal Tendon Rupture in an Accessory Os Peroneum. A Rare Differential Diagnosis in Chronic Ankle Pain

by Julia Evers, Dirk Wähnert, Niklas Grüneweller, Michael J. Raschke and Sabine Ochman

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 439-444; https://doi.org/10.7547/15-092 - 1 Nov 2016

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A fracture of the os peroneum is a rare cause of ankle and foot pain and is often overlooked and not assumed. Only a few case reports have discussed the different etiologies, options for diagnosis, and therapeutic interventions for acute cases. We present [...] Read more.

A fracture of the os peroneum is a rare cause of ankle and foot pain and is often overlooked and not assumed. Only a few case reports have discussed the different etiologies, options for diagnosis, and therapeutic interventions for acute cases. We present a case of delayed diagnosis of an os peroneum fracture due to a distortion of the ankle that occurred during air sports. Initial diagnostic testing with magnetic resonance imaging demonstrated a rupture of the peroneus longus tendon with no pathologic abnormalities at the peroneus brevis tendon. During surgery, a combination of an os peroneum fracture and a peroneus brevis tendon split was found and was successfully treated with bone and tendon repair using a lasso stich technique. Full article

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Multiple Eccrine Syringofibroadenoma of Mascaro of the Lower Extremity

by Danae L. Lowell, Nichol L. Salvo, William J. Weily, Michael Swiatek and Hannah Sahli

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 433-438; https://doi.org/10.7547/15-066 - 1 Nov 2016

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Eccrine syringofibroadenoma (ESFA) is a rare benign lesion of ductal and secretory differentiation exhibiting multiple cutaneous polymorphic presentations with an unknown etiology. We present a case of ESFA that uniquely exhibited large, thick, verrucous-like hyperplastic growths as well as superficial shiny mosaic plaques [...] Read more.

Eccrine syringofibroadenoma (ESFA) is a rare benign lesion of ductal and secretory differentiation exhibiting multiple cutaneous polymorphic presentations with an unknown etiology. We present a case of ESFA that uniquely exhibited large, thick, verrucous-like hyperplastic growths as well as superficial shiny mosaic plaques and deep ulcerations in three different anatomical locations in the same patient. The diagnosis of ESFA was confirmed histologically after biopsies were performed on all of the affected areas. In addition to a case report and literature review, we also present classification, clinical, and histologic aspects of ESFA. Full article

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Silver Nitrate Interpreted as Osseous Pathology on Radiographs. Two Case Reports

by Jared Clifford

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 430-432; https://doi.org/10.7547/15-063 - 1 Nov 2016

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Silver nitrate is often used topically for hemostasis. When radiography is performed after the application of silver nitrate, an artifact appears on the radiograph that may be mistaken for an abnormal calcification or a foreign body. The patients in the following two cases [...] Read more.

Silver nitrate is often used topically for hemostasis. When radiography is performed after the application of silver nitrate, an artifact appears on the radiograph that may be mistaken for an abnormal calcification or a foreign body. The patients in the following two cases were treated with topical silver nitrate. In each case, radiographs taken after treatment seemed to demonstrate abnormal soft-tissue calcifications in the area of silver nitrate application. Subsequent clinical examination revealed no calcifications, and it was determined that the abnormal radiographic findings were silver nitrate artifacts. Although this phenomenon has been described in the medical literature, misdiagnosis still occurs and could potentially lead to additional imaging or unnecessary procedures. Full article

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An Unusual Presentation of Verrucous Carcinoma of the Foot with Bone Invasion

by Ho Min Lee, Young Sung Kim, Jong Pil Kim, Jong Im Lee and Kyeong Soo Uhm

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 427-429; https://doi.org/10.7547/15-046 - 1 Nov 2016

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Verrucous carcinoma of the foot is a rare malignancy, and proper diagnosis can be delayed [...] Full article

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Erratum In The Design, Development, and Reliability Testing of a New Innovative Device to Measure Ankle Joint Dorsiflexion

by

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 426; https://doi.org/10.7547/8750-7315-106.6.426 - 1 Nov 2016

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In ‘‘The Design, Development, and Reliability Testing of a New Innovative Device to Measure Ankle Joint Dorsiflexion,’’ by James Charles MHSc(Pod), which appeared in the September/October 2016 issue, Volume 106, Number 5, the author omitted conflict of interest and financial disclosures [...] Full article

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The Effect of Walking Speed on Foot Kinematics is Modified When Increased Pronation is Induced

by Joana F. Hornestam, Thales R. Souza, Paula Arantes, Juliana Ocarino and Paula L. Silva

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 419-426; https://doi.org/10.7547/15-120 - 1 Nov 2016

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Background: The relation between walking speed and foot kinematics during gait is not well established, and neither is it clear whether this relation is modified in the presence of factors expected to increase pronation (eg, abnormal foot alignment). Understanding how foot kinematics is [...] Read more.

Background: The relation between walking speed and foot kinematics during gait is not well established, and neither is it clear whether this relation is modified in the presence of factors expected to increase pronation (eg, abnormal foot alignment). Understanding how foot kinematics is affected by walking speed under varying conditions could contribute to our understanding of stresses to the musculoskeletal system during walking. We evaluated the effect of walking speed on foot kinematics in the frontal plane during gait and determined whether this effect is modified by using medially inclined insoles that force the foot into increased pronation. Methods: Twenty-six healthy young adults were assessed while walking on a treadmill wearing flat insoles and wearing medially inclined insoles. Foot kinematics in the frontal plane was measured with a three-dimensional motion analysis system. Data were analyzed during the stance phase of gait. Results: There was no main effect of speed on average calcaneal position. However, there was a significant insole type 3 walking speed interaction effect. In the flat insole condition, increased walking speed was associated with a less inverted average calcaneal position (or greater magnitudes of eversion), whereas in the inclined insole condition, higher speeds were associated with a less everted average calcaneal position (or increased magnitudes of inversion). Conclusions: The magnitude of foot eversion increases at faster gait speeds under typical conditions. In the presence of factors that induce excessive pronation, however, this effect is reversed. Results suggest that individuals use greater active control of foot motion at faster speeds in the presence of excessive pronation to improve push-off efficiency. Potential clinical consequences of this functional strategy are discussed. (J Am Podiatr Med Assoc 106(6): 419-426, 2016) Full article

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Effects of Lateral and Medial Wedged Insoles on Knee and Ankle Internal Joint Moments During Walking in Healthy Men

by Claudiane A. Fukuchi, Ryan T. Lewinson, Jay T. Worobets and Darren J. Stefanyshyn

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 411-418; https://doi.org/10.7547/15-077 - 1 Nov 2016

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Abstract

Background: Wedged insoles have been used to treat knee pathologies and to prevent injuries. Although they have received much attention for the study of knee injury, the effects of wedges on ankle joint biomechanics are not well understood. This study sought to evaluate [...] Read more.

Background: Wedged insoles have been used to treat knee pathologies and to prevent injuries. Although they have received much attention for the study of knee injury, the effects of wedges on ankle joint biomechanics are not well understood. This study sought to evaluate the immediate effects of lateral and medial wedges on knee and ankle internal joint loading and center of pressure (CoP) in men during walking. Methods: Twenty-one healthy men walked at 1.4 m/sec in five footwear conditions: neutral, 68 (LW6) and 98 (LW9) lateral wedges, and 68 (MW6) and 98 (MW9) medial wedges. Peak internal knee abduction moments and angular impulses, internal ankle inversion moments and angular impulses, and mediolateral CoP were analyzed. Analysis of variance with post hoc analysis and Pearson correlations were performed to detect differences between conditions. Results: No differences in internal knee joint loading were found between neutral and any of the wedge conditions. However, as the wedge angle increased from medial to lateral, the internal ankle inversion moment (LW6: P ¼ .020; LW9: P , .001; MW6: P ¼ .046; MW9: P , .001) and angular impulse (LW9: P ¼ .012) increased, and the CoP shifted laterally (LW9: P , .001) and medially (MW9: P , .001) compared with the neutral condition. Conclusions: Neither lateral nor medial wedges were effective in altering internal knee joint loading during walking. However, the greater internal ankle inversion moment and angular impulse observed with lateral wedges could lead to a higher risk of ankle injury. Thus, caution should be taken when lateral wedges need to be prescribed. (J Am Podiatr Med Assoc 106(6): 411-418, 2016) Full article

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Caliper Method Versus Digital Photogrammetry for Assessing Arch Height Index in Pregnant Women

by Kathryn D. Harrison and Jean L. McCrory

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 406-410; https://doi.org/10.7547/14-077 - 1 Nov 2016

Cited by 4 | Viewed by 52

Abstract

Background: Foot anthropometry may be altered during pregnancy. Pregnant women often report lower-extremity pain that may be related to these alterations. The Arch Height Index Measurement System is a common method of foot arch assessment; however, the required calipers are costly and are [...] Read more.

Background: Foot anthropometry may be altered during pregnancy. Pregnant women often report lower-extremity pain that may be related to these alterations. The Arch Height Index Measurement System is a common method of foot arch assessment; however, the required calipers are costly and are not widely available. Thus, we compared the reliability of a digital photogrammetry method of arch height index (AHI) assessment with that of the Arch Height Index Measurement System. Methods: Ten pregnant women (mean 6 SD: age, 29 6 4 years; height, 166.9 6 6.8 cm; weight, 63.3 6 8.8 kg) in their second trimester were recruited to participate, along with a control group of 10 nulliparous weight-matched women (mean 6 SD: age, 22 6 2 years; height, 164.6 6 4.8 cm; weight, 61.5 6 8.1 kg). During the second and third trimesters, and once postpartum, AHI was assessed using calipers and using digital photogrammetry. Mixed model absolute agreement type intraclass correlation coefficient (ICC) was used to determine correlation between the two methods for sitting and standing AHI. Results: The ICC results for sitting AHI only (0.819–0.968) were reasonable for clinical measures; ICC values for standing AHI (0.674–0.789) did not reach values deemed reasonable for clinical use. Conclusions: Caliper and digital photogrammetry methods of AHI assessment are correlated in pregnant women; however, for standing AHI, the correlation is not sufficient for clinical use. Photogrammetry may still be appropriate for clinical use, as long as values from this method are not substituted directly for results obtained from calipers. (J Am Podiatr Med Assoc 106(6): 406-410, 2016) Full article

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Plantar Pressure During Gait in Pregnant Women

by Jeanne Bertuit, Clara Leyh, Marcel Rooze and Véronique Feipel

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 398-405; https://doi.org/10.7547/15-064 - 1 Nov 2016

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Abstract

Background: During pregnancy, physical and hormonal modifications occur. Morphologic alterations of the feet are found. These observations can induce alterations in plantar pressure. This study sought to investigate plantar pressures during gait in the last 4 months of pregnancy and in the postpartum [...] Read more.

Background: During pregnancy, physical and hormonal modifications occur. Morphologic alterations of the feet are found. These observations can induce alterations in plantar pressure. This study sought to investigate plantar pressures during gait in the last 4 months of pregnancy and in the postpartum period. A comparison with nulliparous women was conducted to investigate plantar pressure modifications during pregnancy. Methods: Fifty-eight women in the last 4 months of pregnancy, nine postpartum women, and 23 healthy nonpregnant women (control group) performed gait trials on an electronic walkway at preferred speeds. The results for the three groups were compared using analysis of variance. Results: During pregnancy, peak pressure and contact area decreased for the forefoot and rearfoot. These parameters increased significantly for the midfoot. The gait strategy seemed to be lateralization of gait with an increased contact area of the lateral midfoot and both reduced pressure and a later peak time on the medial forefoot. In the postpartum group, footprint parameters were modified compared with the pregnant group, indicating a trend toward partial return to control values, although differences persisted between the postpartum and control groups. Conclusions: Pregnant women had altered plantar pressures during gait. These findings could define a specific pattern of gait footprints in late pregnancy because plantar pressures had characteristics that could maintain a stable and safe gait. (J Am Podiatr Med Assoc 106(6): 398-405, 2016) Full article

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Top 100 Cited Foot and Ankle–Related Articles

by Patrick A. DeHeer, William Adams, Faye-Rose Grebenyuk, Eric Meshulam, Kory Miskin, Tiffany Truong Koch and Corey Groh

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 387-397; https://doi.org/10.7547/15-091 - 1 Nov 2016

Cited by 14 | Viewed by 49

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Background: Article citations are a well-accepted method of evaluating the influence or impact of a particular article. Other medical specialties have published the top cited articles in their specialty. To date, an analysis of the foot and ankle podiatric medicine– related article citation [...] Read more.

Background: Article citations are a well-accepted method of evaluating the influence or impact of a particular article. Other medical specialties have published the top cited articles in their specialty. To date, an analysis of the foot and ankle podiatric medicine– related article citation method has not been published. Methods: Three citation indices were used on October 10, 2014, February 20, 2015, and May 1, 2015, to determine the top 100 cited foot and ankle–related articles. Results: Most of the top 100 cited foot and ankle podiatric medicine–related articles were published in The Journal of Bone and Joint Surgery by medical doctors in the United States in the past two decades, with most of the article topics being the diabetic foot or trauma. The predominant level of evidence for the articles is evenly distributed among levels III, IV, and V. Conclusions: Podiatric medical research and publication has made great strides during the past two decades, particularly in the diabetic foot, but continued research and peerreviewed journal publication in additional areas regarding the foot and ankle must become a priority in the podiatric medical community. (J Am Podiatr Med Assoc 106(6): 387-397, 2016) Full article

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Calcaneal Bone Mass Modification in Recreational Runners

by Elena Escamilla-Martínez, Alfonso Martínez-Nova, Beatriz Gómez-Martín, Raquel Sánchez-Rodríguez, Lourdes María Fernández-Seguín and Juan Diego Pedrera-Zamorano

J. Am. Podiatr. Med. Assoc. 2016, 106(6), 381-386; https://doi.org/10.7547/15-122 - 1 Nov 2016

Cited by 1 | Viewed by 38

Abstract

Background: The calcaneus is the bone of the foot that first receives the impact of running, generating vibrations that might have a positive effect in modifying the trabecular bone mass. The objective of this study was to determine the variation in calcaneal bone [...] Read more.

Background: The calcaneus is the bone of the foot that first receives the impact of running, generating vibrations that might have a positive effect in modifying the trabecular bone mass. The objective of this study was to determine the variation in calcaneal bone density in runners during a 6-month training season, comparing it with a control sample. Methods: Bone density of the heel was measured in 33 male recreational runners by means of a contact ultrasonic bone analyzer. Measurements were made on three occasions during a training season: at the beginning, at 350 km, and at 700 km. All of the runners wore the same model of running shoes during this period. Measurements of bone density were also made in a control sample of 62 men who did not engage in physical exercise. Results: There was a significant decrease in mean calcaneal bone density over the course of the training season (from 86.1 dB/MHz to 83.2 dB/MHz; P = .006), but no significant differences with the control sample value (from 80.7 dB/MHz to 81.1 dB/MHz; P = .314). The runners’ body composition changed during the study period, with lean mass increasing and fat mass decreasing. Conclusions: Distance running seems to have a negative effect on calcaneal bone mass density during the course of a 700-km training season. (J Am Podiatr Med Assoc 106(6): 381-386, 2016). Full article

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J. Am. Podiatr. Med. Assoc., Volume 106, Issue 6 (11 2016) – 15 articles , Pages 381-455

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