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Journal of the American Podiatric Medical Association is published by MDPI from Volume 116 Issue 1 (2026). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with American Podiatric Medical Association.

J. Am. Podiatr. Med. Assoc., Volume 112, Issue 5 (09 2022) – 17 articles

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Article
Poor Antifungal Coverage for Onychomycosis in a Cross-Sectional Analysis of Medicaid Formularies
by Julianne M. Falotico and Shari R. Lipner
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 21221; https://doi.org/10.7547/21-221 - 1 Sep 2022
Cited by 6 | Viewed by 98
Abstract
Background: Onychomycosis is the most common nail disease seen in clinical practice. Medication safety, severity of disease, comorbidities, concomitant medications, patient age, and cost are all important considerations when treating onychomycosis. Because cost may affect treatment decisions, we sought to analyze Medicaid formulary [...] Read more.
Background: Onychomycosis is the most common nail disease seen in clinical practice. Medication safety, severity of disease, comorbidities, concomitant medications, patient age, and cost are all important considerations when treating onychomycosis. Because cost may affect treatment decisions, we sought to analyze Medicaid formulary coverage of onychomycosis antifungals. Methods: Public state Medicaid formularies were searched for coverage of US Food and Drug Administration–approved onychomycosis medications and off-label oral fluconazole. Total drug cost for a single great toenail was calculated using the National Average Drug Acquisition Cost. Pearson correlation coefficients were calculated to compare coverage and cost, mycologic cure rate, and complete cure rate. Results: Oral terbinafine and off-label fluconazole were widely covered for onychomycosis treatment. There was poor coverage of oral itraconazole and topical ciclopirox, and there was no coverage of topical efinaconazole and tavaborole without step-edits or prior authorization. There was a significant negative correlation between medication coverage and cost (r = 20.758; P = .040). There was no correlation between medication coverage and mycologic (r = 0.548; P = .339) and complete (r = 0.768; P = .130) cure rates. Conclusions: There is poor Medicaid coverage of antifungals for the treatment of onychomycosis, with step-edits and prior authorization based on cost rather than treatment safety and efficacy. We recommend involving podiatrists and dermatologists in developing criteria for insurance approval of onychomycosis treatments. Full article
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Article
Transmetatarsal Amputations: Outcomes of Primary Healing versus Secondary Healing
by Clare Cormier, Zachary Janes, Yelena Boumendjel and John F. Grady
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 21173; https://doi.org/10.7547/21-173 - 1 Sep 2022
Cited by 3 | Viewed by 127
Abstract
Background: Transmetatarsal amputations are limb salvage surgical procedures that preserve limb length and functional ankle joints. Indications for transmetatarsal amputations include forefoot trauma, infection, and ischemia. Prior research demonstrates patients who undergo transmetatarsal amputations have a lower 2-year mortality rate compared to those [...] Read more.
Background: Transmetatarsal amputations are limb salvage surgical procedures that preserve limb length and functional ankle joints. Indications for transmetatarsal amputations include forefoot trauma, infection, and ischemia. Prior research demonstrates patients who undergo transmetatarsal amputations have a lower 2-year mortality rate compared to those who undergo more proximal amputations. The aim of this study was to determine whether primary closure of a transmetatarsal amputation is a superior treatment compared to secondary healing of a transmetatarsal amputation for forefoot abnormality of infection, gangrene, or chronic ulceration. Methods: A retrospective chart review was performed on patients aged 18 years or older requiring a transmetatarsal amputation because of forefoot abnormality between September of 2011 and December of 2019. Foot and ankle surgeons performed transmetatarsal amputations. Outcome variables measured included healing time of transmetatarsal amputation site, recurrent infection, recurrent gangrene, and the need for revision surgery or higher level amputations. Results: Of the original 112 patients, 76 met the inclusion criteria; 47 of these had primary closure of transmetatarsal amputation and 29 of these had an open transmetatarsal amputation performed. Primarily closed transmetatarsal amputations resulted in a significantly greater overall healing rate of 78.8% (37 of 47) compared to open transmetatarsal amputations, with a healing rate of 37.9% (11 of 29) (P < .01). Closed transmetatarsal amputations were statistically significantly less likely than open transmetatarsal amputations to have recurrent gangrene, require revision pedal operations, or progress to higher level amputations. Conclusions: Our research demonstrated that primary closure of transmetatarsal amputations is a superior treatment compared with secondary healing of transmetatarsal amputations in specific cases of infection, dry gangrene, or chronically nonhealing ulcerations. Full article
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Article
“I’m More Comfortable with a Wide-Fit Shoe” The Footwear Needs and Preferences of Older Adults in Racket Sports
by Joanna E. Reeves, Anita E. Williams and Sharon Jane Dixon
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 21170; https://doi.org/10.7547/21-170 - 1 Sep 2022
Cited by 4 | Viewed by 67
Abstract
Background: Physical activity is important throughout the lifespan. Racket sports are popular with older adults and offer important social benefits. It is unknown how the physiologic changes attributable to aging affect lower limb loading during multidirectional sports and how this may influence footwear [...] Read more.
Background: Physical activity is important throughout the lifespan. Racket sports are popular with older adults and offer important social benefits. It is unknown how the physiologic changes attributable to aging affect lower limb loading during multidirectional sports and how this may influence footwear requirements. The purpose of this work was to explore the footwear needs and preferences of older adults in racket sports to inform footwear design and development. Methods: Semistructured interviews were conducted online with 16 participants (56–92 years of age) who typically play racket sports at least once per week. Thematic analysis was used to group basic themes into organizing themes. Results: The organizing themes were comfort (general comfort, pain-free, and cushioning), functionality (relating to the structure of the shoe and performance), and choice (mostly around the appearance of the shoe). Comfort was a key priority for the majority of participants, although it was often stressed that the footwear must also be supportive. Support was frequently defined in relation to preventing ankle sprains; however, when asked directly about managing injury risk, avoiding certain shots and appropriate grip were mentioned over support. More than half of participants reported needing a wide-fitting sport shoe, which limited the footwear selection available to them. Conclusions: This study provides novel insight into the footwear requirements of active older adults, which can inform the development of footwear to facilitate safe and pain-free participation in sport for all. Full article
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Article
Delayed Treatment of a Medial Swivel Talonavicular Dislocation
by Kyle E. Wamelink and Robb Mothershed
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 21130; https://doi.org/10.7547/21-130 - 1 Sep 2022
Viewed by 59
Abstract
This case describes delayed treatment of a medial talonavicular dislocation with a shear fracture of the talar head, a comminuted posterior talar process fracture, and an intra-articular cuboid fracture with subtle medial displacement of the calcaneocuboid joint and the associated treatment. The injury [...] Read more.
This case describes delayed treatment of a medial talonavicular dislocation with a shear fracture of the talar head, a comminuted posterior talar process fracture, and an intra-articular cuboid fracture with subtle medial displacement of the calcaneocuboid joint and the associated treatment. The injury was sustained in a 35-year-old man following a high-energy motor vehicle accident. Three weeks following the injury, delayed treatment was achieved following an attempted closed reduction under general anesthesia followed by open reduction and percutaneous Kirschner wire fixation. After a 12-month follow-up, the patient was able to return to work and regular activities pain-free without complications. Several associated injuries have been described with isolated talonavicular dislocations. This case reviews the technique and care surrounding this injury pattern and its delayed treatment. Full article
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Article
The Association of Olfactory Impairment with Charcot Neuroarthropathy and Possible Links to Causation
by Andrew J. Rader and Aaron Ruter
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 21100; https://doi.org/10.7547/21-100 - 1 Sep 2022
Cited by 2 | Viewed by 60
Abstract
Background: Charcot neuroarthropathy (CN) is a devastating complication of some diseases affecting the peripheral nervous system. Initial subjective and objective presentation of the disease can be variable. Common among all presentations seems to be uncontrolled inflammation yielding dislocations and/or fractures. The exact cause [...] Read more.
Background: Charcot neuroarthropathy (CN) is a devastating complication of some diseases affecting the peripheral nervous system. Initial subjective and objective presentation of the disease can be variable. Common among all presentations seems to be uncontrolled inflammation yielding dislocations and/or fractures. The exact cause remains the subject of much debate. Methods: Our study retrospectively looks at the function of olfactory function in consecutive patients with CN and compares the findings with a nonaffected population. The University of Pennsylvania Smell Identification Test was used to assess olfaction and document microsomia. Results: Twenty consecutive patients presenting with CN demonstrated significant (P < .0001) microsomia when compared to an unaffected population with diabetes. Conclusions: Microsomia is strongly associated with CN. This finding may be correlated to voltage-gated sodium 1.7 channel impairment and appears to be a candidate precursor for the development of CN. Full article
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Article
The Risks of Using Trimethoprim/Sulfamethoxazole in Patients with Renal and Cardiac Compromise
by Arlene F. Hoffman and Tzu Lu Lin
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 21080; https://doi.org/10.7547/21-080 - 1 Sep 2022
Cited by 4 | Viewed by 240
Abstract
The purpose of this article is to familiarize physicians with the risks of prescribing trimethoprim/sulfamethoxazole (TMP/SMX) for patients who have kidney or cardiac pathology, have hyperkalemia, or take other interacting medications. Although TMP/SMX is a drug that is frequently used to treat skin [...] Read more.
The purpose of this article is to familiarize physicians with the risks of prescribing trimethoprim/sulfamethoxazole (TMP/SMX) for patients who have kidney or cardiac pathology, have hyperkalemia, or take other interacting medications. Although TMP/SMX is a drug that is frequently used to treat skin and soft-tissue infections of the leg and foot, particularly if methicillin-resistant Staphylococcus aureus is identified, it is not an innocuous antibiotic. Literature documenting the many adverse effects of TMP/SMX is reviewed. A case history is presented illustrating the association of TMP/SMX with the development of a life-threatening situation. Ways of avoiding these adverse events are discussed, and the use of safer antibiotics is recommended. Full article
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Article
Longitudinal Epiphyseal Bracket of the First Metatarsal: A Case Series on Treatment of Deformities Associated
by Marco Marcarelli, Carmelo Errichiello, Margherita Germano, Salvatore Risitano, Davide Deledda and Manfred Thomas
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 21076; https://doi.org/10.7547/21-076 - 1 Sep 2022
Viewed by 60
Abstract
Longitudinal epiphyseal bracket of the first metatarsal, also known as first enclosed metatarsal, is a rare congenital disorder characterized by an abnormal development in the length of the first metatarsal ray because of the asymmetric presence of a longitudinal epiphyseal bracket. This causes [...] Read more.
Longitudinal epiphyseal bracket of the first metatarsal, also known as first enclosed metatarsal, is a rare congenital disorder characterized by an abnormal development in the length of the first metatarsal ray because of the asymmetric presence of a longitudinal epiphyseal bracket. This causes interruption in the lengthways development of the affected bone, which becomes squat and short, with a trapezoidal or triangular shape, leading to a hallux varus deformity. First enclosed metatarsal occurs in 2% to 14% of all congenital defects in the hands and feet; with bilateralism in 75% of cases and a greater incidence in male patients. The deformity is classified as a differentiation defect; it is frequently associated with abnormalities such as syndactyly or polydactyly. There are different surgical treatments reported in the literature. Most of them are aimed at the excision of the epiphyseal bracket before complete skeletal maturity and frequently in the first year of life to promote a normal lengthways growth of the bone. In this study, the authors present three cases of bilateral first enclosed metatarsal in which the surgical treatment, aimed at lengthening the first metatarsal ray by using the Penning Minifixator, was instead carried out at the end of growth. This different surgical approach allowed the planning of a surgical operation involving both the skeletal structures and the surrounding soft tissue. (J Am Podiatr Med Assoc 112(5), 2022) Full article
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Article
Multifocal Osteonecrosis in the Foot and Ankle After Extracorporeal Membrane Oxygenation: A Case Report
by Nhat Tien Tran and Kwang-Bok Lee
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 21060; https://doi.org/10.7547/21-060 - 1 Sep 2022
Cited by 1 | Viewed by 66
Abstract
Osteonecrosis is acknowledged as a relatively uncommon disorder caused by various factors, including autoimmune diseases, drug-induced diseases, inherited metabolic disorders, coagulation disorders, and underlying malignancies. To our knowledge, no previous research has investigated osteonecrosis stemming from extracorporeal membrane oxygenation. Herein, we report a [...] Read more.
Osteonecrosis is acknowledged as a relatively uncommon disorder caused by various factors, including autoimmune diseases, drug-induced diseases, inherited metabolic disorders, coagulation disorders, and underlying malignancies. To our knowledge, no previous research has investigated osteonecrosis stemming from extracorporeal membrane oxygenation. Herein, we report a rare case of postperipheral venoarterial extracorporeal membrane oxygenation–induced multifocal osteonecrosis in the foot and ankle that demonstrated a low serpiginous peripheral signal on T1-weighted images and a double-line sign on fat-suppressed or T2-weighted magnetic resonance images. Conservative treatment was applied, and the patient was mostly recuperated after 6 months. (J Am Podiatr Med Assoc 112(5), 2022) Full article
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Article
A 30-Year-Old Man with an Unusually Large Untreated Plantar Fibrolipoma That Disrupted Ambulation and Required Operative Excision
by Rock Cjay Positano, Michael J. Trepal, Michael Ciaramella and Rock G. Positano
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 21019; https://doi.org/10.7547/21-019 - 1 Sep 2022
Viewed by 64
Abstract
A 30-year-old man working as a waiter presented with a progressively enlarging and symptomatic soft-tissue mass on the plantar medial aspect of his left foot. The mass was painful and disrupting ambulation, despite footwear modifications. He ultimately underwent excision of what was a [...] Read more.
A 30-year-old man working as a waiter presented with a progressively enlarging and symptomatic soft-tissue mass on the plantar medial aspect of his left foot. The mass was painful and disrupting ambulation, despite footwear modifications. He ultimately underwent excision of what was a determined to be a fibrolipoma, returning to his regular shoes and all activities. Plantar neoplasms, even when benign, can grow to sizes that can result in significant disability. If left untreated, particularly in individuals engaged in occupations requiring frequent standing or walking, excision of the mass will often require a more aggressive operative approach. (J Am Podiatr Med Assoc 112(5), 2022) Full article
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Article
Letter to the Editor
by Hakan Zeybek
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 20286; https://doi.org/10.7547/20-286 - 1 Sep 2022
Viewed by 77
Abstract
To the Editor: I have read with great interest Gauresh Vargaonkar’s paper titled ‘‘Giant Cell Tumor of the Tendon Sheath Around the Foot and Ankle’’ [...] Full article
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Article
Barometric and Spatiotemporal Gait Differences Between Leading and Nonleading Feet of Handball Players
by Mariam A. Ameer, Mohamed I. Kamel and Shaimaa A. Ali
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 20271; https://doi.org/10.7547/20-271 - 1 Sep 2022
Cited by 4 | Viewed by 58
Abstract
Background: Side-to-side stress imbalance has been suggested as a risk factor for injury in unilateral sports. The leading leg is suggested to be essential in sports rehabilitation for the return of athletes to the playground. The main aim of this study was to [...] Read more.
Background: Side-to-side stress imbalance has been suggested as a risk factor for injury in unilateral sports. The leading leg is suggested to be essential in sports rehabilitation for the return of athletes to the playground. The main aim of this study was to evaluate the dynamic pedobarometric and spatiotemporal gait differences between the leading and nonleading feet of male handball players. Methods: Thirty healthy elite male handball players (mean ± SD: age, 31.7 ± 2.99 years; height, 177.5 ± 6.0 cm; weight, 78.9 ± 6.3 kg; body mass index, 25.0 ± 0.7) participated in this study; all of the participants were backcourt and pivot handball players. The assessments were performed using the Tekscan Walkway pressure sensor to detect and compare the variables of interest between the leading and nonleading feet during normal walking at a self-selected speed. Results: Maximum force, peak pressure (total and forefoot pressure), foot width, single-limb support time, and step velocity were significantly increased in the leading foot compared with the nonleading foot. In addition, maximum force, foot width, and total peak pressure showed moderate positive significant correlations with body mass index. Conclusions: The differences in the pedobarometric and spatiotemporal gait parameters may result from the physiologic and mechanical demands that are put on the leading foot of handball players, which need more rehabilitation attention and protection to avoid expected injuries. (J Am Podiatr Med Assoc 112(5), 2022) Full article
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Article
Assessment of a Novel Augmented Closure Technique for Surgical Wounds Associated with Transmetatarsal Amputation: A Preliminary Study
by Jeffery Alexander, Vishal Desai, Sharif Denden and Nicholas Alianello
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 20256; https://doi.org/10.7547/20-256 - 1 Sep 2022
Cited by 7 | Viewed by 70
Abstract
Background: Transmetatarsal amputation (TMA) is a viable option to avoid major amputation and limb loss in patients with forefoot sepsis, infection, or tissue loss. However, TMAs are associated with a significant incidence of dehiscence, readmission, and reoperation rates ranging from 26% to 63%. [...] Read more.
Background: Transmetatarsal amputation (TMA) is a viable option to avoid major amputation and limb loss in patients with forefoot sepsis, infection, or tissue loss. However, TMAs are associated with a significant incidence of dehiscence, readmission, and reoperation rates ranging from 26% to 63%. To encourage tissue healing, neovascularization, and durable closure, a nonwoven, resorbable, synthetic hybrid-scale fiber matrix whose architecture is similar to native human extracellular matrix was used in an augmented closure technique. We comparatively evaluated clinical outcomes and complication rates in TMA procedures with and without augmented closure. Methods: A retrospective analysis of ten patients who underwent TMA with augmented closure using the synthetic matrix and ten patients who underwent TMA with standard primary closure was conducted. Results: After TMA, 80% of the patients who underwent augmented closure demonstrated complete wound healing compared with 60% of the control group. Patients undergoing augmented closure demonstrated five instances of wound dehiscence and 20% limb loss compared with eight instances of wound dehiscence and 40% limb loss in the control group. After TMA and augmented closure, patients required eight interventional procedures before complete healing compared with patients undergoing standard closure, who required 13 interventional procedures before complete healing. Conclusions: Augmented closure of surgical wounds after TMA using a synthetic hybrid-scale fiber matrix provided a unique means of reducing time to healing (18%), wound dehiscence (29%), number of procedures performed (39%), and rate of limb loss (20%). Augmented closure, therefore, offers a means of improving quality of life and reducing risk for patients undergoing TMA, and potentially reducing total cost of care. (J Am Podiatr Med Assoc 112(5), 2022) Full article
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Article
Incidence of Complications and Risk Factors for Nonunion After Ankle Fracture in Diabetes Mellitus
by Lawrence A. Lavery, David C. Lavery, Tyson Green, Nathan Hunt, Matthew Malone and Dane Wukich
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 20246; https://doi.org/10.7547/20-246 - 1 Sep 2022
Cited by 4 | Viewed by 140
Abstract
Background: To evaluate complications and risk factors for nonunion in patients with diabetes after ankle fracture. Methods: We conducted a retrospective study of 139 patients with diabetes and ankle fractures followed for 1 year. We evaluated the incidence of wounds, infections, nonunions, Charcot’s [...] Read more.
Background: To evaluate complications and risk factors for nonunion in patients with diabetes after ankle fracture. Methods: We conducted a retrospective study of 139 patients with diabetes and ankle fractures followed for 1 year. We evaluated the incidence of wounds, infections, nonunions, Charcot’s arthropathy, and amputations. We determined Fracture severity (unimalleolar, bimalleolar, trimalleolar), nonunion, and Charcot’s arthropathy from radiographs. Nonunion was defined as a fracture that did not heal within 6 months of fracture. Analysis of variance was used to compare continuous variables, and χ2 tests to compare dichotomous variables, with α = 0.05. Logistic regression was performed with a binary variable representing nonunions as the dependent variable. Results: Complications were common: nonunion (24.5%), Charcot’s arthropathy (7.9%), wounds (5.2%), wound site infection (17.3%), and leg amputation (2.2%). Patients with nonunions were more likely to be male (55.9% versus 29.5%; P = .005), have sensory neuropathy (76.5% versus 32.4%; P , .001), have end-stage renal disease (17.6% versus 2.9%; P < .001), and use insulin (73.5% versus 40.1%; P < .001), b-blockers (58.8% versus 39.0%; P = .049), and corticosteroids (26.5% versus 9.5%; P = .02). Among patients with nonunion, there was an increased risk of wounds (odds ratio [OR], 3.3; 95% confidence interval [CI], 1.46–7.73), infection (OR, 2.04; 95% CI, 0.72–5.61), amputation (OR, 7.74; 95% CI, 1.01–100.23), and long-term bracing (OR, 9.51; 95% CI, 3.8–23.8). In the logistic regression analysis, four factors were associated with fracture nonunion: dialysis (OR, 7.7; 95% CI, 1.7–35.2), insulin use (OR, 3.3; 95% CI, 1.5–7.4), corticosteroid use (OR, 4.9; 95% CI, 1.4–18.0), and ankle fracture severity (bimalleolar or trimalleolar fracture) (OR, 2.5; 95% CI, 1.1–5.4). Conclusions: These results demonstrate risk factors for nonunions: dialysis, insulin use, and fracture severity after ankle fracture in patients with diabetes. (J Am Podiatr Med Assoc 112(5), 2022) Full article
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Article
Relationship Between Type of Accessory Navicular Bone and Radiographic Parameters of the Foot
by Serkan Bayram and Mustafa Kara
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 20231; https://doi.org/10.7547/20-231 - 1 Sep 2022
Cited by 2 | Viewed by 76
Abstract
Background: We evaluated the relationship between the type of accessory navicular bone (ANB) and radiographic parameters of the foot in patients with bilateral ANBs of different types. Methods: Patients with bilateral ANBs of different types participated in this study between May 2019 and [...] Read more.
Background: We evaluated the relationship between the type of accessory navicular bone (ANB) and radiographic parameters of the foot in patients with bilateral ANBs of different types. Methods: Patients with bilateral ANBs of different types participated in this study between May 2019 and April 2020. Patient data, including age, sex, body mass index (BMI), and presence of symptoms, were obtained. We aimed to compare the radiographic parameters of both feet to evaluate the differences from one another in patients with bilateral ANBs of different types (one side type 1 and one side type 2) because the foot angles may differ in each person. Seven radiographic parameters evaluating hindfoot, midfoot, and forefoot alignment were measured: calcaneal pitch angle, talocalcaneal angle, tibiocalcaneal angle, naviculocuboid overlap, talonavicular coverage angle, and anteroposterior and lateral talo– first metatarsal angles. Results: Twenty patients (13 women and seven men) with a mean 6 SD age of 38.5 ± 12.3 years were included in the study. The patients had a mean 6 SD height of 168.1 ± 7.1 cm, weight of 77.2 ± 10.5 kg, and BMI of 27.4 ± 4.3. There were no significant differences between type 1 and type 2 ANBs in any radiographic parameters and no significant correlations between radiographic parameters and age, BMI, or the presence of symptoms. Conclusions: We found that the type of ANB had no effect on the radiographic measurements of the foot in patients with bilateral ANBs of different types. Age, BMI, and the presence of symptoms also demonstrated no correlations with the radiographic parameters. (J Am Podiatr Med Assoc 112(5), 2022) Full article
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Article
Toenail Dust as a Potential Occupational Hazard in Podiatric Medicine
by Komal Saini, Tiffany Tran, Melody Khosravi, Jannani Krishnan, Dyane E. Tower and Chia-Ding Shih
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 20197; https://doi.org/10.7547/20-197 - 1 Sep 2022
Cited by 1 | Viewed by 138
Abstract
Background: Debridement of toenails is a common procedure that leads to the production of nail dust aerosols in the work environment. Previous studies indicate that inhaled nail dust can cause respiratory distress and eye irritation. This comprehensive review aimed to assess the available [...] Read more.
Background: Debridement of toenails is a common procedure that leads to the production of nail dust aerosols in the work environment. Previous studies indicate that inhaled nail dust can cause respiratory distress and eye irritation. This comprehensive review aimed to assess the available literature on the effect of nail dust exposure and to evaluate nail dust as a potential occupational hazard for podiatric physicians. Methods: A comprehensive literature search was conducted via PubMed, Google Scholar, CINAHL, Cochrane Library, and ClinicalTrials.gov. Risks of bias of the collected studies were evaluated using various assessment tools to match the type of study design. A qualitative analysis of the included studies was performed, from which primary and secondary outcome measures were extracted: prevalence of symptoms and specific microorganisms in nail dust. Results: Of 403 articles screened, eight met the inclusion criteria. The primary outcome measure resulted in a pooled prevalence of eye-related symptoms being the most consistent symptom reported (41%–48%). The secondary outcome measure resulted in a pooled prevalence of Trichophyton rubrum (9.52%–38%) and Aspergillus (11.11%–35.48%) as the most common microorganisms present in nail dust. Conclusions: From the included eight articles, we found that nail dust is a potential occupational hazard, especially for those exposed more often. Aspergillus and T rubrum are most commonly associated with nail dust leading to development of respiratory illness. It is important to take preventive measures in podiatric medical clinics by using improved and efficient personal protective equipment for workers exposed to nail dust. Detailed health safety guidelines can be developed to decrease respiratory symptoms and diseases from nail dust exposure. (J Am Podiatr Med Assoc 112(5), 2022) Full article
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Article
Unusual Phlegmon in the Plantar Foot of a Healthy Patient
by Patrick A. Deheer, Timothy P. Barry and Bethany J. Badell
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 20160; https://doi.org/10.7547/20-160 - 1 Sep 2022
Viewed by 121
Abstract
Phlegmons are unencapsulated collections of inflammation that track along soft tissues in various parts of the human body. These soft-tissue lesions are uncommon in the lower extremities and can be difficult to identify and treat. This article presents a case of a plantar [...] Read more.
Phlegmons are unencapsulated collections of inflammation that track along soft tissues in various parts of the human body. These soft-tissue lesions are uncommon in the lower extremities and can be difficult to identify and treat. This article presents a case of a plantar foot phlegmon in a nondiabetic patient that was recalcitrant to debridement and antibiotics. The patient’s aseptic phlegmon completely resolved with surgical debridement and iodoform packing. This case report demonstrates the role of advanced imaging in the diagnosis of lower-extremity phlegmons and the importance of thorough surgical debridement and packing for successful resolution. (J Am Podiatr Med Assoc 112(5), 2022) Full article
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Article
Desmoplastic Fibroblastoma: A Case of a Rapidly Growing Mass in the Foot
by Trusha Jariwala, Michael I. Gazes and Martin M. Pressman
J. Am. Podiatr. Med. Assoc. 2022, 112(5), 20097; https://doi.org/10.7547/20-097 - 1 Sep 2022
Viewed by 83
Abstract
Desmoplastic fibroblastomas are benign and uncommon soft-tissue tumors. They are typically slow-growing, painless masses found in adult men. Rapidly growing masses have been previously reported, but are more rare. A 56-year-old man presented with a rapidly growing mass in his left foot, which [...] Read more.
Desmoplastic fibroblastomas are benign and uncommon soft-tissue tumors. They are typically slow-growing, painless masses found in adult men. Rapidly growing masses have been previously reported, but are more rare. A 56-year-old man presented with a rapidly growing mass in his left foot, which was diagnosed as a desmoplastic fibroblastoma after pathologic evaluation. Although many case reports have been published in the dermatology literature, it is important to be aware of this benign neoplasm to avoid confusion with other rapidly growing malignant soft-tissue masses reported in the podiatry literature. (J Am Podiatr Med Assoc 112(5), 2022) Full article
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