Journal of the American Podiatric Medical Association

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by Robert D. 'Doug' Sowell

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 385; https://doi.org/10.7547/87507315-91-7-385 - 1 Jul 2001

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For many years, through its Department of Governmental Affairs, APMA has had a strong legislative agenda. High on our list of priorities has been ensuring that DPMs are defined as physicians in all legislation and promoting an environment that does not permit discrimination [...] Read more.

For many years, through its Department of Governmental Affairs, APMA has had a strong legislative agenda. High on our list of priorities has been ensuring that DPMs are defined as physicians in all legislation and promoting an environment that does not permit discrimination by class of provider [...] Full article

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Bilateral Forefoot Gangrene Secondary to Lemierre’s Disease

by Jeffrey L. Kaufman

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 381; https://doi.org/10.7547/87507315-91-7-381 - 1 Jul 2001

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Abstract

To the Editor: The report by Soave et al in the March 2001 issue of the Journal (“Bilateral Forefoot Gangrene Secondary to Lemierre’s Disease”) demonstrates the problem of symmetric acral gangrene, which is a terribly mutilating complication of systemic sepsis [...] Full article

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Isolated Gouty Tophus of a Tibial Sesamoid of the Foot

by Harvey Lemont and Marc Sabo

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 379-380; https://doi.org/10.7547/87507315-91-7-379 - 1 Jul 2001

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Abstract

A case of tophaceous gout involving a foot sesamoid is described in a middle-aged man with a history of chronic gout. Microscopic findings consisting of tophaceous foci located beneath an intact hyaline articulating surface are correlated with associated radiographs. (J Am Podiatr Med [...] Read more.

A case of tophaceous gout involving a foot sesamoid is described in a middle-aged man with a history of chronic gout. Microscopic findings consisting of tophaceous foci located beneath an intact hyaline articulating surface are correlated with associated radiographs. (J Am Podiatr Med Assoc 91(7): 379-380, 2001) Full article

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Brachymetatarsia of the Third and Fourth Metatarsals

by William P. Goforth and Troy D. Overbeek

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 373-378; https://doi.org/10.7547/87507315-91-7-373 - 1 Jul 2001

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Abstract

A cylindrical autogenous diaphyseal bone graft from the neighboring second and fifth metatarsals to correct brachymetatarsia of the third and fourth metatarsals was last described by Biggs in 1979. The authors present a literature review and case report for the treatment of the [...] Read more.

A cylindrical autogenous diaphyseal bone graft from the neighboring second and fifth metatarsals to correct brachymetatarsia of the third and fourth metatarsals was last described by Biggs in 1979. The authors present a literature review and case report for the treatment of the rare clinical entity of brachymetatarsia. (J Am Podiatr Med Assoc 91(7): 373-378, 2001) Full article

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Partial Calcanectomy in the Treatment of Chronic Heel Ulceration

by Sean Lehmann, R. Dan Murphy and Lawrence Hodor

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 369-372; https://doi.org/10.7547/87507315-91-7-369 - 1 Jul 2001

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Abstract

Chronic decubitus ulceration of the heels is a common condition encountered by podiatric physicians, especially in diabetic patients. Very often these ulcerations can progress to osteomyelitis of the calcaneus. Many times, this in turn leads to a below-the-knee amputation. A partial calcanectomy is [...] Read more.

Chronic decubitus ulceration of the heels is a common condition encountered by podiatric physicians, especially in diabetic patients. Very often these ulcerations can progress to osteomyelitis of the calcaneus. Many times, this in turn leads to a below-the-knee amputation. A partial calcanectomy is a viable alternative to below-the-knee amputation. A more functional limb both mechanically and cosmetically is achieved, and the morbidity and mortality associated with the calcanectomy is less than with a below-the-knee amputation. A brief overview of the history and outcomes associated with this procedure is outlined and a case utilizing a partial calcanectomy is presented. (J Am Podiatr Med Assoc 91(7): 369-372, 2001) Full article

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Acute Charcot Foot Changes versus Osteomyelitis. Does Tc-99m HMPAO Labeled Leukocytes Scan Differentiate?

by Steven F. Boc, Keith Brazzo, Dana Lavian and Thomas Landino

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 365-368; https://doi.org/10.7547/87507315-91-7-365 - 1 Jul 2001

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Abstract

Osteomyelitis often complicates a diabetic neuropathic foot, leading to amputation, decreased function, and quality of life. Therefore, early detection and treatment are paramount. Furthermore, neuroarthropathic (Charcot) changes in the foot often resemble infection and must be differentiated. Currently, the Tc-99m HMPAO Labeled Leukocytes [...] Read more.

Osteomyelitis often complicates a diabetic neuropathic foot, leading to amputation, decreased function, and quality of life. Therefore, early detection and treatment are paramount. Furthermore, neuroarthropathic (Charcot) changes in the foot often resemble infection and must be differentiated. Currently, the Tc-99m HMPAO Labeled Leukocytes Scan is considered to be the most reliable noninvasive imaging modality of choice in determining Charcot foot changes versus osteomyelitis. The purpose of this article is to alert the clinician that although the Tc-99m HMPAO Labeled Leukocytes Scan may be the second most reliable test next to bone biopsy for determining osteomyelitis, false positives do occur. (J Am Podiatr Med Assoc 91(7): 365-368, 2001) Full article

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Syndrome of Painful Legs and Moving Toes. A Case Study

by Joonhyun Yoon, Christopher Crabtree and Georgeanne Botek

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 361-364; https://doi.org/10.7547/87507315-91-7-361 - 1 Jul 2001

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Abstract

Painful legs and moving toes syndrome is characterized by spontaneous causalgic pain in the lower extremities associated with peculiar involuntary movements of the lower extremities, especially the toes and feet. The pain is diffuse, intractable, aching, and deep. The movements consist of persistent [...] Read more.

Painful legs and moving toes syndrome is characterized by spontaneous causalgic pain in the lower extremities associated with peculiar involuntary movements of the lower extremities, especially the toes and feet. The pain is diffuse, intractable, aching, and deep. The movements consist of persistent writhing movements in the digits that cannot be limited voluntarily. The syndrome has been observed after a variety of abnormalities affecting the posterior nerve roots, the spinal ganglia, and the peripheral nerves. This article reviews commonly reported findings and current concepts in the etiology and management of this condition. (J Am Podiatr Med Assoc 91(7): 361-364, 2001) Full article

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Podiatric Medical Applications of Posterior Night Stretch Splinting

by Angela Evans

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 356-360; https://doi.org/10.7547/87507315-91-7-356 - 1 Jul 2001

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Abstract

Podiatric physicians encounter many conditions, especially in sports medicine, that involve pain in the vicinity of the rearfoot or lower leg. These conditions are often associated with ankle equinus and may affect either child or adult sports participants. A review of the literature [...] Read more.

Podiatric physicians encounter many conditions, especially in sports medicine, that involve pain in the vicinity of the rearfoot or lower leg. These conditions are often associated with ankle equinus and may affect either child or adult sports participants. A review of the literature and clinical experience identify posterior night stretch splinting as an effective adjunct in the treatment of persistent symptomatic plantar fasciitis, negating the need for corticosteroid injections, further protracted pain, or surgery. This article reviews clinical cases in which night stretch splinting was used for a variety of diagnoses. Further research is needed into its efficacy for conditions other than plantar fasciitis. (J Am Podiatr Med Assoc 91(7): 356-360, 2001) Full article

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Onychomycosis: An Analysis of 50 Cases and a Comparison of Diagnostic Techniques

by Piotr Borkowski, Marie Williams, Jean Holewinski and Bradley Bakotic

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 351-355; https://doi.org/10.7547/87507315-91-7-351 - 1 Jul 2001

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Abstract

Onychomycosis is an extremely common condition that is increasing in prevalence. Although often innocuous, it may be complicated by discomfort and secondary bacterial infections. Recently introduced oral medications may be highly effective in the eradication of this condition; however, they may carry with [...] Read more.

Onychomycosis is an extremely common condition that is increasing in prevalence. Although often innocuous, it may be complicated by discomfort and secondary bacterial infections. Recently introduced oral medications may be highly effective in the eradication of this condition; however, they may carry with them significant expense and potentially serious side effects. Prior to the initiation of antifungal oral therapy, definitive diagnosis is mandatory. This study compares the sensitivity of potassium hydroxide (KOH) preparations, surgical pathology diagnostic testing (SPDT), and culture techniques for the detection of onychomycosis in 50 cases of clinically suspected onychomycosis. Analysis showed that SPDT was significantly more sensitive when compared to KOH and culture. The results suggest that SPDT may be the true gold standard for the diagnosis of onychomycosis. (J Am Podiatr Med Assoc 91(7): 351-355, 2001) Full article

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A Prospective Study of Predictors for Foot Ulceration in Type 2 Diabetes

by T. Kästenbauer, S. Sauseng, G. Sokol, M. Auinger and K. Irsigler

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 343-350; https://doi.org/10.7547/87507315-91-7-343 - 1 Jul 2001

Cited by 69 | Viewed by 127

Abstract

One hundred eighty-seven type 2 diabetic patients without a history of foot ulceration were followed for a mean period of 3.6 years to investigate the incidence of foot ulceration in a diabetes cohort and to analyze risk factors for foot ulceration by multivariate [...] Read more.

One hundred eighty-seven type 2 diabetic patients without a history of foot ulceration were followed for a mean period of 3.6 years to investigate the incidence of foot ulceration in a diabetes cohort and to analyze risk factors for foot ulceration by multivariate means. During the study, 10 subjects developed 18 forefoot ulcerations. In multivariate logistic regression, significant predictors for foot ulceration were an elevated vibration perception threshold (VPT) (relative risk [RR] = 25.4), an increased plantar pressure (RR = 6.3), and daily alcohol intake (RR = 5.1). This is the first prospective study to demonstrate plantar pressure and daily alcohol intake as predictors of foot ulceration among patients without previous ulceration. Further, VPT could be confirmed as the strongest predictor for foot ulceration, and it was clearly demonstrated that the more pronounced severity of complications occurred among subjects with elevated VPT. (J Am Podiatr Med Assoc 91(7): 343-350, 2001) Full article

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Symmetry of Plantar Pressures and Vertical Forces in Healthy Subjects During Walking

by R. Scott VanZant, Thomas G. McPoil and Mark W. Cornwall

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 337-342; https://doi.org/10.7547/87507315-91-7-337 - 1 Jul 2001

Cited by 41 | Viewed by 154

Abstract

The purpose of this study was to determine the degree of symmetry for in-shoe plantar pressure and vertical force patterns between the left and right feet of healthy subjects during walking. Thirty subjects with a mean age of 29.6 years participated in the [...] Read more.

The purpose of this study was to determine the degree of symmetry for in-shoe plantar pressure and vertical force patterns between the left and right feet of healthy subjects during walking. Thirty subjects with a mean age of 29.6 years participated in the study. Each subject walked a distance of 8 m three times while in-shoe plantar pressure and vertical force data were collected. A total of 12 steps were analyzed for both feet, and maximum vertical force, peak pressure, and pressure-time integrals were calculated for four plantar regions of the foot. No differences in the three variables were noted between male and female subjects. Plantar pressure and vertical force patterns were found to be symmetrical between the left and right feet, except for two of the four plantar regions studied. Only the forefoot and rearfoot regions were found to show significant differences between the left and right feet for plantar pressure and vertical force, respectively. The degree of asymmetry for these two plantar regions in the same foot, however, was minimal. (J Am Podiatr Med Assoc 91(7): 337-342, 2001) Full article

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Lesser Proximal Interphalangeal Joint Arthrodesis. A Retrospective Analysis of the Peg-in-Hole and End-to-End Procedures

by Bradley M. Lamm, Carla E. Ribeiro, Tracey C. Vlahovic, Anthony Fiorilli, Gary R. Bauer and Howard J. Hillstrom

J. Am. Podiatr. Med. Assoc. 2001, 91(7), 331-336; https://doi.org/10.7547/87507315-91-7-331 - 1 Jul 2001

Cited by 27 | Viewed by 141

Abstract

A retrospective study was performed to compare the prevalence of complications in peg-in-hole and end-to-end arthrodesis procedures. The authors reviewed 177 second, third, and fourth proximal interphalangeal joint fusions for the correction of hammer toe deformities in 85 patients from 1988 to 1998 [...] Read more.

A retrospective study was performed to compare the prevalence of complications in peg-in-hole and end-to-end arthrodesis procedures. The authors reviewed 177 second, third, and fourth proximal interphalangeal joint fusions for the correction of hammer toe deformities in 85 patients from 1988 to 1998 at the Temple University School of Podiatric Medicine. The average age of the patients was 49 years. Sixteen percent (14) of the subjects were male and 84% were (71) female. Upon follow-up, the fourth digit was generally associated with a greater number of complications for the end-to-end and peg-in-hole procedures, with the second digit being the most common site of fusion. The prevalence of complications was evaluated using contingency table analysis and expressed as a percent of total complications (27%, the end-to-end group; 17%, the peg-in-hole group). A subset of complications deemed clinically relevant was also computed. Similarly, the prevalence of clinically relevant complications for the end-to-end (10%) and the peg-in-hole (9%) procedures was not statistically significant. Therefore, this study showed no statistically significant differences in the total or clinically relevant complications between end-to-end and the peg-in-hole arthrodesis procedures. (J Am Podiatr Med Assoc 91(7): 331-336, 2001) Full article

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J. Am. Podiatr. Med. Assoc., Volume 91, Issue 7 (07 2001) – 12 articles , Pages 331-385

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