Journal of the American Podiatric Medical Association

13 pages, 489 KB

Open AccessArticle

Podiatric Care Associated with Reduced Mortality and Enhanced Amputation-Free Survival

by Wen Zhe Leo, Lixia Ge, Chelsea Law, Tiffany Chew, Jo Ann Lim, Elaine Tan, Huiling Liew, Jeremy Hoe, Jaime Lin and Zhiwen Joseph Lo

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 11; https://doi.org/10.3390/japma116010011 - 23 Feb 2026

Viewed by 1434

Abstract

Background: Diabetic foot ulcers (DFUs) and lower-extremity amputations (LEAs) complicating diabetes mellitus are significant contributors to morbidity, mortality, and disease burden. There is insufficient evidence, however, linking podiatric care to mortality and healthcare resource use. There is, concurrently, inadequate access to podiatric [...] Read more.

Background: Diabetic foot ulcers (DFUs) and lower-extremity amputations (LEAs) complicating diabetes mellitus are significant contributors to morbidity, mortality, and disease burden. There is insufficient evidence, however, linking podiatric care to mortality and healthcare resource use. There is, concurrently, inadequate access to podiatric care, particularly in Asia. This study evaluated the clinical and healthcare use outcomes of patients with DFUs who received podiatric care. Methods: A longitudinal study involving patients in Diabetic Foot in Primary and Tertiary (DEFINITE) Care followed over a period of 2 years reviewed the effectiveness of podiatric care with regard to 1-year outcomes using multiple logistic and zero-inflated negative binomial regressions, adjusting for covariates. Clinical outcomes were minor and major LEA, mortality, and LEA-free survival rates; healthcare use outcomes were the number of admissions, number of visits to clinics and emergency departments, and length of stay. Results: Eligible patients (n = 2798 [65.5%]) completed at least 12 months of follow-up. Comparisons were made with patients without access to podiatric care. The overall mean ± SD patient age was 65.7 ± 12.7 years. Most patients receiving podiatric follow-up were of Malay or Indian ethnicities and had poor diabetic control and chronic kidney disease. There were more admissions (p < 0.01) and visits to the emergency department (p < 0.01) and hospital outpatient clinics (p < 0.01), but a shorter length of stay (incidence rate ratio, 0.833; p < 0.01), without any reported differences regarding visits to public primary care clinics (p = 0.68). There were more minor LEAs (p < 0.01) but fewer deaths (p < 0.01) and greater LEA-free survival (odds ratio, 1.26; p = 0.02). Conclusions: Podiatric care improved clinical outcomes for patients with DFU, particularly in terms of LEA-free survival, with a positive impact on healthcare utilization. This is a crucial contribution to the limited evidence on podiatric care in diabetic limb salvage in Asian populations. Full article

► Show Figures

Figure 1

12 pages, 252 KB

Open AccessArticle

The Effects of Protective Sensation on Functional Capacity, Peripheral Muscle Strength, and Balance in Patients with Type 2 Diabetes Mellitus

by Melis Usul, Semiramis Ozyilmaz, Muhammed Tunc and Ozlem Toluk

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 10; https://doi.org/10.3390/japma116010010 - 23 Feb 2026

Viewed by 779

Abstract

Background: Diabetes-related foot complications are among the most common complications in individuals with type 2 diabetes mellitus. The prevention of foot problems that are at risk of developing because of type 2 diabetes mellitus should be addressed within the framework of preventive approaches [...] Read more.

Background: Diabetes-related foot complications are among the most common complications in individuals with type 2 diabetes mellitus. The prevention of foot problems that are at risk of developing because of type 2 diabetes mellitus should be addressed within the framework of preventive approaches prior to treatment. The aim of this study was to evaluate protective sensation in people with type 2 diabetes mellitus who have not been diagnosed with early diabetes-related foot complications and to investigate the effects of protective sensation on peripheral muscle strength, balance, and functional capacity. Methods: This study included 42 volunteer patients (56.71 ± 7.59 years) who were followed up with a diagnosis of type 2 diabetes mellitus and met the inclusion criteria. Individuals were evaluated prospectively and via face-to-face interviews. Light-touch, vibration, and discrimination sense was evaluated to determine protective sensation. Peripheral muscle strength (quadriceps femoris, biceps brachii, and hand grip) was measured and a 6 min walking test for functional capacity and balance evaluation were performed. Spearman correlation analysis was conducted using SPSS Statistics 21.0 for data analysis. Results: At least one of the components of protective sensation was moderately correlated with peripheral muscle strength, functional capacity, and balance scores. Reduced protective sensation was also observed in individuals with type 2 diabetes mellitus without neuropathy. Conclusions: In type 2 diabetes mellitus patients, decreases in light-touch, vibration, and discrimination sense are moderately associated with parameters of peripheral muscle strength, functional capacity, and balance. In patients with type 2 diabetes mellitus, early foot sole sensory examination may prevent the development of neuropathy and support clinicians in early diagnosis. Full article

12 pages, 912 KB

Open AccessArticle

Prevalence of Common Foot Conditions in Children—A Cross-Sectional Study in Danish Children Aged 6 to 16 Years

by Camilla Hedegaard Larsen, Soeren Boedtker, Lisa Bomark, Ales Jurca, Mostafa Benyahia, Michael Mørk Petersen, Andreas Balslev-Clausen, Steen Harsted and Christian Nai En Tierp-Wong

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 9; https://doi.org/10.3390/japma116010009 - 21 Feb 2026

Viewed by 1173

Abstract

Background: Caregivers often seek medical assistance when their child experiences podiatric medical ailments. Podiatric medical diseases such as ingrown toenails, callosities, warts, metatarsus varus, and hallux valgus frequently occur in children and adolescents. However, treatment, prevention, and rehabilitation are often based on empirical [...] Read more.

Background: Caregivers often seek medical assistance when their child experiences podiatric medical ailments. Podiatric medical diseases such as ingrown toenails, callosities, warts, metatarsus varus, and hallux valgus frequently occur in children and adolescents. However, treatment, prevention, and rehabilitation are often based on empirical experiences; thus, as a first endeavor, clinical and epidemiologic mapping of podiatric medical diseases in children is warranted. We describe the prevalence of common foot conditions—callosities, ingrown toenails, hallux valgus, metatarsus varus, and warts—among Danish schoolchildren aged 6 to 16 years. Methods: In this cross-sectional study, we evaluated foot conditions in children in first (aged 6–8 years), fifth (aged 10–12 years), and ninth (aged 14–16 years) grades. The clinical status of the feet was examined by teams of two podiatric physicians each. Specifically, we evaluated deformities of the foot, foot pathologies, and their anatomical localization. Results: Of 501 children (1002 extremities) evaluated, 417 had one or more of the investigated foot deformities or pathologies. We found 266 various foot pathologies among Danish schoolchildren. Metatarsus varus (53%) and callosities (46%) were the most frequently occurring foot conditions. The prevalence of foot pathologies of ingrown toenails and warts was 14% and 12%, respectively. The prevalence of ingrown toenails, metatarsus varus, and hallux valgus increased with age. Conclusions: This study found that foot pathologies such as warts and ingrown toenails and conditions such as metatarsus varus and callosities are common in Danish primary school students. These findings of high prevalences of foot pathologies and conditions motivate future research projects to clarify how this affects general health and subsequently the relation to pain, health challenges, socioeconomics, and quality of life. Full article

► Show Figures

Figure 1

13 pages, 551 KB

Open AccessReview

Effects of Strengthening the Intrinsic Muscles of the Foot in Adults with Flatfoot: A Scoping Review

by Marta María Moreno-Fresco, Pedro V. Munuera-Martínez, Laura Regife-Fernández, Jose M. Cuevas-Sánchez and Priscila Távara-Vidalón

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 8; https://doi.org/10.3390/japma116010008 - 20 Feb 2026

Cited by 1 | Viewed by 2622

Abstract

Background: Flatfoot is an alteration of the normal structure of the foot, characterized by a partial or total reduction of the medial longitudinal plantar arch, valgus deformity of the heel, and abduction of the forefoot. While treatments often include strengthening of the intrinsic [...] Read more.

Background: Flatfoot is an alteration of the normal structure of the foot, characterized by a partial or total reduction of the medial longitudinal plantar arch, valgus deformity of the heel, and abduction of the forefoot. While treatments often include strengthening of the intrinsic foot muscles, evidence of its efficacy in adults with flatfoot remains limited. Objectives: The main objective of this review was to evaluate the effects of strengthening the plantar intrinsic muscles in adults with flatfoot. Methods: Searches were conducted in PubMed, Embase, Cochrane, PEDro, and Web of Science databases up to October 2023. The review protocol was developed and followed according to the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies included were those published on intrinsic muscle strengthening in adult populations. A qualitative synthesis of all included articles was performed, along with a quantitative sub-analysis of randomized controlled trials and a critical methodological assessment. Results: Eleven studies involving a total of 374 participants were selected. Most studies identified the “short foot exercise” as the optimal exercise for isolating and training the plantar intrinsic foot muscles. The most commonly analyzed variables were the Foot Posture Index and the Navicular Drop Test. Conclusions: Strengthening the plantar intrinsic muscles enhances the height of the medial longitudinal arch, improves hindfoot posture and balance, and increases hallux abductor muscle activity. This strengthening, whether achieved through short foot exercises alone or in combination with other techniques, is effective in treating adult flatfoot. Current literature suggests that a duration of 4–6 weeks may be sufficient to achieve beneficial outcomes. Full article

► Show Figures

Figure 1

8 pages, 1559 KB

Open AccessCase Report

Surgical Technique of Endoscopic-Assisted Flexor Hallucis Longus Tendon Transfer in Foot Drop

by Ali Yüce, Nazım Erkurt and Mustafa Yerli

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 7; https://doi.org/10.3390/japma116010007 - 20 Feb 2026

Viewed by 752

Abstract

The term “foot drop” is defined as the loss of active dorsiflexion at the tibiotalar joint. Surgical procedures such as tendon transfer may be considered in patients who have had foot drop for more than a year. The most commonly reported tendon transfer [...] Read more.

The term “foot drop” is defined as the loss of active dorsiflexion at the tibiotalar joint. Surgical procedures such as tendon transfer may be considered in patients who have had foot drop for more than a year. The most commonly reported tendon transfer in the treatment of drop foot is the tibialis posterior tendon. In cases where the tibialis posterior tendon is non-functional, transfer of one of the non-standard tendons such as FHL tendon to the dorsum of the foot is performed. In the presented case, the surgical technique of endoscopic transfer of the FHL tendon was illustrated. The patient’s AOFAS score was 50 points preoperatively and 78 points at the sixth postoperative month. The active dorsiflexion angle of the foot was increased to 0 degree from −30 degree. Full article

► Show Figures

Figure 1

8 pages, 194 KB

Open AccessArticle

Evaluating Foot Care Knowledge, Attitudes and Practices Among Diabetics in Dubai’s Primary Health Care Sector

by Anne Matter, Derek Santos, Ayesha Al Olama, Mai Haidar AwadAllah and Abir Fahmy Mohamed

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 6; https://doi.org/10.3390/japma116010006 - 20 Feb 2026

Viewed by 783

Abstract

Background/Objectives: This cross-sectional study examined factors associated with diabetic foot complications and identified areas for targeted interventions. Methods: Participants were selected from Dubai Health Authority (DHA) primary health care centers (PHCCs) and divided into two groups: those with diabetic foot complications [...] Read more.

Background/Objectives: This cross-sectional study examined factors associated with diabetic foot complications and identified areas for targeted interventions. Methods: Participants were selected from Dubai Health Authority (DHA) primary health care centers (PHCCs) and divided into two groups: those with diabetic foot complications (DFC) and those without (non-DFC). Data were collected through demographic surveys and a structured questionnaire assessing knowledge, attitudes, and practices (KAP) related to foot care. Results: A significant age disparity was observed within the study population, with 70.6% of individuals in the DFC group being over 60 years. In contrast, only 41.8% of the non-DFC group fell within the same age range, underscoring the potential role of age as a critical risk factor. Analysis of KAP towards diabetic foot care did not reveal any notable differences when stratified by sex, employment status, or overall educational attainment. However, a higher proportion of individuals within the DFC group reported having received no formal education. Furthermore, participation in foot care education programmes was significantly correlated with enhanced knowledge (p < 0.001) and improved practices (p = 0.013). Overall, individuals within the DFC group exhibited significantly poorer self-care practices regarding foot health (p < 0.001). Conclusions: This finding indicates a pressing need for targeted educational interventions aimed at improving outcomes and reducing complications among patients with diabetes. Full article

6 pages, 426 KB

Open AccessArticle

Retrospective Analysis of the Heifetz and Winograd Methods in the Surgical Treatment of Ingrown Toenails

by Ümit Gök and Özgür Selek

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 5; https://doi.org/10.3390/japma116010005 - 20 Feb 2026

Viewed by 716

Abstract

Background: We sought to compare the results of the Heifetz and Winograd methods, used in the surgical treatment of ingrown toenails, and their efficacy in different age groups. Methods: A total of 160 toes of 143 patients surgically treated with the diagnosis of [...] Read more.

Background: We sought to compare the results of the Heifetz and Winograd methods, used in the surgical treatment of ingrown toenails, and their efficacy in different age groups. Methods: A total of 160 toes of 143 patients surgically treated with the diagnosis of toes growing into the skin between 1 June 2012, and 31 July 2019 were evaluated retrospectively. The age, sex, involved foot, involved toe, and relevant Heifetz stages of the patients were assessed. The patients underwent either the Winograd or Heifetz surgical treatment method. The groups were further divided by age (<18 years and ≥18 years) and were re-evaluated in terms of recurrence. Results: No statistically significant difference was detected between the groups in terms of age, sex, side, early infection, and recurrence rates. However, when the groups were divided according to age, a significantly lower recurrence rate was found in patients younger than 18 years who underwent the Heifetz method compared with patients 18 years and older who underwent the Winograd method. Conclusions: Aligned with the literature, these two surgical methods may be regarded as considerably successful, easily applied, and safe, with fewer complications in ingrown toenail cases. Although it is appropriate to select a surgical treatment method depending on the experience of the surgeon, we believe that the Heifetz method should be given priority due to better outcomes in terms of recurrence in patients younger than 18 years. Full article

► Show Figures

Figure 1

7 pages, 1059 KB

Open AccessCase Report

A Novel Minimally Invasive Technique for Hallux Fracture-Dislocation Fixation Using Hypodermic Needles: An Effective Solution for Disaster and Catastrophic Settings

by Muhammed Yusuf Afacan, Ahmet Burak Demirdas, Bedri Karaismailoglu and Goker Utku Deger

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 4; https://doi.org/10.3390/japma116010004 - 19 Feb 2026

Viewed by 607

Abstract

Hallux fractures, particularly those involving the proximal phalanx, can lead to significant functional impairments if not promptly managed. This report introduces a novel, minimally invasive technique for hallux fracture fixation using hypodermic needles. This technique is specifically designed for resource-limited settings such as [...] Read more.

Hallux fractures, particularly those involving the proximal phalanx, can lead to significant functional impairments if not promptly managed. This report introduces a novel, minimally invasive technique for hallux fracture fixation using hypodermic needles. This technique is specifically designed for resource-limited settings such as disasters or emergencies. A 30-year-old female sustained an open proximal phalanx fracture of the left hallux with interphalangeal joint dislocation following a motor vehicle accident. Under local anesthesia in the emergency service settings, fracture reduction and stabilization were achieved using two hypodermic needles. A 21-gauge needle was inserted intramedullary through the medial aspect of the hallux to stabilize the fracture, while an 18-gauge needle was placed distally to secure alignment. Postoperative radiographs confirmed proper alignment, and the needles were removed after four weeks. The patient achieved pain-free ambulation with a full range of motion within six months, with no complications noted. This technique offers a cost-effective, rapid, and practical alternative to traditional methods, eliminating the need for fluoroscopy or specialized surgical tools. It is particularly valuable in emergency and resource-constrained environments, providing favorable clinical and radiological outcomes. This approach demonstrates significant potential for managing hallux fractures in challenging settings and warrants further validation in broader orthopedic practice. Full article

► Show Figures

Figure 1

6 pages, 820 KB

Open AccessCase Report

Effects of Gastrocnemius Stretching Exercise and Insole Combination in a Patient with Heel Pain

by Fatma Erdeo and Serdar Arslan

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 3; https://doi.org/10.3390/japma116010003 - 19 Feb 2026

Viewed by 898

Abstract

Heel pain is a very common foot condition. Mechanical factors are the most common cause of heel pain. The main causes of heel pain include plantar fasciitis, heel spurs, Achilles tendinopathy, heel neuritis, and heel bursitis. This case study aimed to manage pain [...] Read more.

Heel pain is a very common foot condition. Mechanical factors are the most common cause of heel pain. The main causes of heel pain include plantar fasciitis, heel spurs, Achilles tendinopathy, heel neuritis, and heel bursitis. This case study aimed to manage pain in a patient with heel pain accompanied by pronounced pes planus. A 42-year-old woman presented with heel pain and pes planus. The pain was present in the normal standing position and at rest. After examination, a spur, plantar fasciitis, and Morton’s neuroma were diagnosed. The patient, who had not responded to medical and rehabilitative treatments, was evaluated using the visual analog scale and the 36-Item Short Form Survey quality of life questionnaire to assess pain during rest and walking using a newly developed combined exercise method. Significant improvements were observed in the final measurements. This study contributes significantly to our knowledge of the best physiotherapy treatments for patients with heel pain associated with spurs and plantar fasciitis. Full article

► Show Figures

Figure 1

2 pages, 124 KB

Open AccessEditorial

Editor-in-Chief’s Editorial: A New Chapter for the Journal of the American Podiatric Medical Association

by Warren Joseph

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 2; https://doi.org/10.3390/japma116010002 - 13 Feb 2026

Viewed by 761

Abstract

I would like to share an important update about the future of the Journal of the American Podiatric Medical Association (JAPMA) [...] Full article

1 pages, 141 KB

Open AccessEditorial

Publisher’s Note: Welcome to the Journal of the American Podiatric Medical Association

by Carla Aloè

J. Am. Podiatr. Med. Assoc. 2026, 116(1), 1; https://doi.org/10.3390/japma116010001 - 5 Feb 2026

Viewed by 442

Abstract

We are delighted to announce our established partnership with the American Podiatric Medical Association (APMA) to publish the Journal of the American Podiatric Medical Association (JAPMA) on its behalf [...] Full article

Journal Menu

Journal Browser

J. Am. Podiatr. Med. Assoc., Volume 116, Issue 1 (February 2026) – 11 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI