Journal of the American Podiatric Medical Association

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Open AccessArticle

The Effectiveness of Organized Podiatric Medicine

by Richard B. Viehe

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 165-166; https://doi.org/10.7547/87507315-93-2-165 - 1 Mar 2003

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In past messages, I have discussed the success of APMA in several areas, including our educational activities, our Internet site for members and the public, surgical procedures, medical and surgical products, and scientific literature [...] Full article

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Open AccessReview

Handbook of Lower Extremity Infections

by Mark Kosinski

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 164; https://doi.org/10.7547/87507315-93-2-164 - 1 Mar 2003

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Abstract

Disorders of the Heel, Rearfoot, and Ankle is a comprehensive textbook that addresses some of the most common foot and ankle conditions treated by podiatric physicians [...] Full article

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Open AccessArticle

American Podiatric Medical Association Best Walking City Competition, 2002

by Allan H. Fisher, George P. Tzamaras, Allison J. Brewer and Julia E. Scherer

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 161-163; https://doi.org/10.7547/87507315-93-2-161 - 1 Mar 2003

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Abstract

In 2002, the American Podiatric Medical Association initiated a “walking city competition.” The objective of the study was to identify the best cities for walking in the United States. Full article

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Open AccessArticle

Revisiting Epinephrine in Foot Surgery

by Philip Radovic, Robert G. Smith and Don Shumway

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 157-160; https://doi.org/10.7547/87507315-93-2-157 - 1 Mar 2003

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Abstract

Anesthetics containing epinephrine have long been thought unsuitable for use in the foot and, particularly, the digits. However, research suggests that epinephrine use is beneficial in the appropriately selected patient. These benefits include a decreased local anesthetic plasma concentration; an increased duration of [...] Read more.

Anesthetics containing epinephrine have long been thought unsuitable for use in the foot and, particularly, the digits. However, research suggests that epinephrine use is beneficial in the appropriately selected patient. These benefits include a decreased local anesthetic plasma concentration; an increased duration of anesthesia, with a decreased need for additional narcotic use after surgery; decreased development of hemorrhage and postoperative hematoma, without occlusion of vessels; and a lack of complications (in millions of patients reported on in the literature). A retrospective review of more than 150 patients receiving local anesthetics containing epinephrine revealed no complications in the foot and ankle. Full article

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Open AccessArticle

Implementation of Computerized Student-Patient Logs in Podiatric Medical Education

by Graham P. Shaw, Joel R. Clark and Stephen J. Morewitz

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 150-156; https://doi.org/10.7547/87507315-93-2-150 - 1 Mar 2003

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Abstract

In recent years, there has been a rapid increase in World Wide Web– based teaching and learning materials; however, present-day systems for recording student-patient interactions have trailed behind other academic areas in the appropriate use of technology. This article reviews the implementation of [...] Read more.

In recent years, there has been a rapid increase in World Wide Web– based teaching and learning materials; however, present-day systems for recording student-patient interactions have trailed behind other academic areas in the appropriate use of technology. This article reviews the implementation of an innovative Web-based computerized studentpatient log. This system represents considerable improvement in terms of efficiency and accuracy over traditional paper-based reporting systems. It facilitates faculty tracking of students’ clinical experiences at geographically disparate locations and allows gaps in student knowledge to be more easily identified. Moreover, the Web-based system has the added advantage of making students responsible for their own learning, providing them with a sense of ownership of the data collected. Full article

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Open AccessArticle

Reliability and Validity of Center-of- Pressure Quantification

by Mark W. Cornwall and Thomas G. McPoil

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 142-149; https://doi.org/10.7547/87507315-93-2-142 - 1 Mar 2003

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Abstract

The purpose of this study was to determine the reliability and validity of two center-of-pressure quantification methods. One hundred five individuals (33 men and 72 women) with a mean age of 26.7 years participated in phase 1 of the study. Two measures of [...] Read more.

The purpose of this study was to determine the reliability and validity of two center-of-pressure quantification methods. One hundred five individuals (33 men and 72 women) with a mean age of 26.7 years participated in phase 1 of the study. Two measures of the center-of-pressure pattern, the lateral-medial area index and the lateral-medial force index, were calculated from plantar pressure data collected on all subjects. Betweentrial reliability of the two measurements was assessed using intraclass correlation coefficients. In phase 2, frontal plane motion of the rearfoot was recorded in 30 individuals. Pearson correlation coefficients were then calculated between the two center-of-pressure indices and the magnitude of rearfoot eversion obtained from each subject during walking. Intraclass correlation coefficient values ranged from 0.374 to 0.889 for the lateral-medial area index and from 0.215 to 0.905 for the lateral-medial force index. Pearson correlation coefficients between the two center-ofpressure indices and the rearfoot kinematic variables ranged from 0.050 to 0.165. The lateral-medial area index and the lateral-medial force index may have adequate between-trial reliability but are not related to the magnitude of frontal plane rearfoot eversion during the stance phase of walking. Full article

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Open AccessArticle

Topical Treatments for Onychomycosis. A Historical Perspective

by Myron A. Bodman, Lisa Feder and Angela M. Nace

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 136-141; https://doi.org/10.7547/87507315-93-2-136 - 1 Mar 2003

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Abstract

Topical treatment of onychomycosis, in contrast to systemic oral therapy, allows the patient to apply medication directly to the affected area, thereby decreasing the potential for adverse events and drug interactions. Historically, several topical antifungal agents have been used in the treatment of [...] Read more.

Topical treatment of onychomycosis, in contrast to systemic oral therapy, allows the patient to apply medication directly to the affected area, thereby decreasing the potential for adverse events and drug interactions. Historically, several topical antifungal agents have been used in the treatment of onychomycosis; however, the evidence for their effectiveness is based on very limited data or anecdotal reports. Recently, the development of new, effective topical agents has renewed interest in this form of therapy. As clinical experience with newer topical agents expands, they may be found to be an effective option for the treatment of onychomycosis. Full article

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Open AccessArticle

Position of the Subtalar Joint Axis and Resistance of the Rearfoot to Supination

by Craig Payne, Shannon Munteanu and Kathryn Miller

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 131-135; https://doi.org/10.7547/87507315-93-2-131 - 1 Mar 2003

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Abstract

Determination of the position of the subtalar joint axis is being more widely used clinically to facilitate the prescription of foot orthoses and the understanding of foot function, but clinical determination of the axis has not been widely investigated. The aim of this [...] Read more.

Determination of the position of the subtalar joint axis is being more widely used clinically to facilitate the prescription of foot orthoses and the understanding of foot function, but clinical determination of the axis has not been widely investigated. The aim of this study was to determine the relationship between clinical determination of the subtalar joint axis and the amount of force needed to supinate the foot. The transverse plane position of the subtalar joint axis was determined in 47 subjects. The sagittal plane orientation of the subtalar joint axis was determined using the relative amounts of forefoot adduction and abduction obtained when the rearfoot was supinated and pronated. The amount of force needed to supinate the foot was measured using a device designed to measure resistance to supination. The only two parameters that were correlated to supination resistance of the rearfoot were body weight (r = 0.52) and the perpendicular distance from the fifth metatarsal head to the subtalar joint axis (r = 0.59). The model on which determination of the subtalar joint axis is based may not be valid, but it might help determine how much force is needed to supinate a foot using foot orthoses. Full article

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Open AccessArticle

The Influence of Geriatrics Education on Knowledge, Attitudes, and Career Aspirations of Podiatric Medical Students

by Hylton B. Menz

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 124-130; https://doi.org/10.7547/87507315-93-2-124 - 1 Mar 2003

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Abstract

A survey of podiatric medical students in Australia was undertaken prior to and following the completion of a compulsory geriatrics course to evaluate the effect of geriatrics education on knowledge of aging, attitudes toward older people, perceptions of treatment efficacy, and desire to [...] Read more.

A survey of podiatric medical students in Australia was undertaken prior to and following the completion of a compulsory geriatrics course to evaluate the effect of geriatrics education on knowledge of aging, attitudes toward older people, perceptions of treatment efficacy, and desire to specialize in geriatrics. Students had a reasonable knowledge of aging and favorable attitudes toward older people prior to undertaking the course, but few wanted to specialize in geriatrics. General knowledge of aging and attitudes toward older people improved after completion of the course, but career aspirations remained unchanged. Students generally considered geriatrics to be a low-profile specialty, and less than half stated that they would be interested in pursuing continuing education in geriatrics. These results provide further evidence that students’ lack of desire to specialize in geriatrics may be primarily due to limited recognition within the profession, rather than unfavorable attitudes toward older people or lack of interest in geriatrics during their undergraduate education. Full article

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Open AccessArticle

Effect of the Low-Dye Strap on Pronation-Sensitive Mechanical Attributes of the Foot

by Jeffrey M. Whitaker, Kazuto Augustus and Suzanne Ishii

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 118-123; https://doi.org/10.7547/87507315-93-2-118 - 1 Mar 2003

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Abstract

The low-Dye strap is used routinely to temporarily control pronation of the foot and, thereby, to diagnose and treat pronatory sequelae. However, the exact biomechanical effects of this strapping technique on the foot are not well documented. The main purpose of this study [...] Read more.

The low-Dye strap is used routinely to temporarily control pronation of the foot and, thereby, to diagnose and treat pronatory sequelae. However, the exact biomechanical effects of this strapping technique on the foot are not well documented. The main purpose of this study was to establish the specific mechanical effects of the low-Dye strap on the pronatory foot. Within this context, the specific aim was to assess the effect of the low-Dye strap on three distinct pronation-sensitive mechanical attributes of the foot in the weightbearing state: 1) calcaneal eversion, 2) first metatarsophalangeal joint range of motion, and 3) medial longitudinal arch height. Weightbearing measurements of these three attributes were made before and after application of a low-Dye strap, and statistical comparisons were made. The results of this study indicate that the low-Dye strap is effective in reducing calcaneal eversion, increasing first metatarsophalangeal joint range of motion, and increasing medial longitudinal arch height in the weightbearing state. Knowledge of the exact mechanisms of action of the low-Dye strap will provide practitioners with greater confidence in the use of this modality. Full article

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Open AccessArticle

Relationship Between “Growing Pains” and Foot Posture in Children. Single-Case Experimental Designs in Clinical Practice

by Angela M. Evans

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 111-117; https://doi.org/10.7547/87507315-93-2-111 - 1 Mar 2003

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Abstract

Many young children present to the podiatric physician with the complaint of aching legs. Many of these children are clinically assessed as having a pronated foot posture. This foot posture is thought to be deleterious and is often treated with in-shoe devices such [...] Read more.

Many young children present to the podiatric physician with the complaint of aching legs. Many of these children are clinically assessed as having a pronated foot posture. This foot posture is thought to be deleterious and is often treated with in-shoe devices such as triplane wedges or orthoses. Intervention aiming to reduce the amount of foot pronation in both stance and gait has been reported by parents and children to reduce, and in many cases eliminate, the episodes of aching legs. To test this theory and establish a degree of causality, a single-case experimental design was used in conjunction with age-appropriate pain scores for the children and independent parental ratings. Single-case experimental design is a useful research tool for the clinical practice setting that can identify cause-effect relationships and obviates large sample sizes. Eight complete single-case experimental designs were performed in the clinical setting. The in-shoe intervention proved efficacious for children with a pronated foot posture and aching legs. These findings may provide the impetus for a more rigorous examination of the possible relationship between pronation and “growing pains.”
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Open AccessArticle

Subchondral Thickness Does Not Vary with Cartilage Degeneration on the Metatarsal

by Doreen Raudenbush, Dale R. Sumner, Parimal M. Panchal and Carol Muehleman

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 104-110; https://doi.org/10.7547/87507315-93-2-104 - 1 Mar 2003

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Abstract

Osteoarthritis is a disease of synovial joints that involves articular cartilage breakdown with accompanying bone changes, including subchondral sclerosis and osteophytosis. However, conflicting data have been reported concerning the cause-and-effect relationship, if any, between these changes. The authors studied the subchondral plate (subchondral [...] Read more.

Osteoarthritis is a disease of synovial joints that involves articular cartilage breakdown with accompanying bone changes, including subchondral sclerosis and osteophytosis. However, conflicting data have been reported concerning the cause-and-effect relationship, if any, between these changes. The authors studied the subchondral plate (subchondral bone plus calcified cartilage) in relation to the degree of articular cartilage degeneration on the distal articular surface of the first metatarsal, a region prone to osteoarthritis. No correlation was found between subchondral plate thickness or porosity and the degree of cartilage degeneration in the study sample of 96 metatarsals. Owing to the suggestion that initiation of cartilage fibrillation may be a result of steep stiffness gradients in the subchondral bone, the ratios of subchondral plate thickness in adjacent regions of the metatarsal head were examined in detail, but no correlation was found with subchondral degeneration. Thus increases in subchondral bone thickness are not associated with increases in cartilage degeneration on the first metatarsal, which may imply that subchondral bone changes do not cause osteoarthritis in this joint. Full article

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Open AccessArticle

Clinical and Biomechanical Risk Factors of Patients Diagnosed with Hallux Valgus

by Thomas W. Kernozek, Abdulaziz Elfessi and Steven Sterriker

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 97-103; https://doi.org/10.7547/87507315-93-2-97 - 1 Mar 2003

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Abstract

The purpose of this study was to identify the clinical and plantar loading variables related to hallux valgus. Fifty-one healthy control subjects and 40 subjects with a diagnosis of moderate hallux valgus deformity of similar age and body weight were recruited for this [...] Read more.

The purpose of this study was to identify the clinical and plantar loading variables related to hallux valgus. Fifty-one healthy control subjects and 40 subjects with a diagnosis of moderate hallux valgus deformity of similar age and body weight were recruited for this study. Clinical measurements of pain, first metatarsophalangeal joint range of motion, and singleleg resting calcaneal stance position were obtained. Biomechanical measurements were obtained using a capacitive pressure platform. Plantar loading variables were calculated for seven regions of the plantar surface. A univariate analysis followed by a stepwise logistic regression was used to analyze the data. The results indicated that high values for pain, single-leg resting calcaneal stance position, hallux region peak pressure and force–time integral, and central forefoot region force–time integral increased the likelihood of hallux valgus. Full article

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Open AccessArticle

Bone Scintigraphic Findings in Patients with Foot Ulcers and Normal Plain Film Radiographs

by Arnold F. Jacobson and Joan E. Williams

J. Am. Podiatr. Med. Assoc. 2003, 93(2), 91-96; https://doi.org/10.7547/87507315-93-2-91 - 1 Mar 2003

Cited by 1 | Viewed by 66

Abstract

A prospective study was performed to examine the performance of bone scintigraphy in the earliest stage of soft-tissue foot ulceration with potential risk for progression to osteomyelitis. Twenty-three podiatry clinic patients with new or recurrent foot ulcers but negative plain film radiographs of [...] Read more.

A prospective study was performed to examine the performance of bone scintigraphy in the earliest stage of soft-tissue foot ulceration with potential risk for progression to osteomyelitis. Twenty-three podiatry clinic patients with new or recurrent foot ulcers but negative plain film radiographs of the foot underwent 24 (one patient was studied twice) multiphase bone scans (flow, blood pool, and 3- and 24-hour delayed images) that were visually scored for severity of increased uptake on a scale of 0 to 3+, with 0 indicating normal and 3+ indicating severe. Twenty-one scans (88%) showed abnormal uptake on at least one phase, with 17 (71%) having increased bone uptake on late images. Ulcer healing without complications occurred in 20 cases (83%), whereas 4 cases had adverse outcomes, 3 requiring surgical resection for failure to heal and 1 having radiographic progression to frank osteomyelitis. All three patients whose bone scans showed severe abnormal uptake had an adverse clinical outcome. Full article

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J. Am. Podiatr. Med. Assoc., Volume 93, Issue 2 (03 2003) – 14 articles , Pages 91-166

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