Journal of the American Podiatric Medical Association

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Open AccessArticle

It Was a Very Good Year

by Harold B. Glickman

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 89; https://doi.org/10.7547/0960089 - 1 Jan 2006

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Our Association enjoyed one of its finest years in 2005, the 93rd year of our existence. On every level and in every endeavor, APMA did more than merely excel; we were hitting home runs [...] Full article

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Open AccessLetter

Letter to the Editor. Maggot Therapy in “Lower-Extremity Hospice” Wound Care. Author’s Response

by David G. Armstrong

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 83; https://doi.org/10.7547/0960083 - 1 Jan 2006

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Abstract

To the Editor: My coauthors and I greatly appreciate the comments made by Dr. Steenvoorde and colleagues and are grateful for the opportunity to respond. We actually agree with the majority of the comments made [...] Full article

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Open AccessLetter

Letter to the Editor. Maggot Therapy in “Lower-Extremity Hospice” Wound Care

by Pascal Steenvoorde, Catharina E. Jacobi and Jacques Oskam

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 82-83; https://doi.org/10.7547/0960082 - 1 Jan 2006

Cited by 1 | Viewed by 115

Abstract

To the Editor: In the article “Maggot Therapy in ‘Lower-Extremity Hospice’ Wound Care: Fewer Amputations and More Antibiotic-Free Days” by David G. Armstrong, DPM, MSc, PhD, Precious Salas, Brian Short, DPM, [...] Full article

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Open AccessArticle

Congenital Absence of the Lateral Sesamoid

by Yakup Yildirim and Baransel Saygi

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 78-81; https://doi.org/10.7547/0960078 - 1 Jan 2006

Cited by 4 | Viewed by 118

Abstract

Congenital absence of the lateral sesamoid is an extremely rare condition. We present a case of congenital absence of the lateral sesamoid in which magnetic resonance imaging was performed. The literature is reviewed regarding the clinical significance of this anomaly. (J Am Podiatr [...] Read more.

Congenital absence of the lateral sesamoid is an extremely rare condition. We present a case of congenital absence of the lateral sesamoid in which magnetic resonance imaging was performed. The literature is reviewed regarding the clinical significance of this anomaly. (J Am Podiatr Med Assoc 96(1): 78–81, 2006). Full article

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Open AccessArticle

NuGen Fx Bioabsorbable Screws. A Preliminary Report of Their Use in Foot Surgery

by Timothy C. Ford, Kevin Brown, Trinity Mereau and David Seligson

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 73-77; https://doi.org/10.7547/0960073 - 1 Jan 2006

Cited by 1 | Viewed by 125

Abstract

A single prospective group study in adults was performed using a new bioabsorbable screw, the NuGen Fx screw (Linvatec Biomaterials Ltd, Tampere, Finland). This multisite study included five sites and 50 patients (10 patients per site). The goal of this study was to [...] Read more.

A single prospective group study in adults was performed using a new bioabsorbable screw, the NuGen Fx screw (Linvatec Biomaterials Ltd, Tampere, Finland). This multisite study included five sites and 50 patients (10 patients per site). The goal of this study was to evaluate the efficiency and safety of the NuGen Fx screw system in the fixation of osteotomies, arthrodeses, and fractures in the foot and ankle. We discuss our own results from 12 patients treated at the Kentucky Podiatric Residency Program at Norton Audubon Hospital, Louisville. The number of patients in the study, screw sizes, instrumentation, radiologic evaluation findings, and our overview of this implant are presented. (J Am Podiatr Med Assoc 96(1): 73–77, 2006). Full article

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Open AccessArticle

Necrotizing Fasciitis in a Patient with Type 2 Diabetes Mellitus

by David M. Kanuck, Thomas Zgonis and Gary Peter Jolly

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 67-72; https://doi.org/10.7547/0960067 - 1 Jan 2006

Cited by 5 | Viewed by 182

Abstract

Necrotizing fasciitis is a soft-tissue infection characterized by extensive necrosis of subcutaneous fat, neurovascular structures, and fascia. In general, fascial necrosis precedes muscle and skin involvement, hence its namesake. Initially, this uncommon and rapidly progressive disease process can present as a form of [...] Read more.

Necrotizing fasciitis is a soft-tissue infection characterized by extensive necrosis of subcutaneous fat, neurovascular structures, and fascia. In general, fascial necrosis precedes muscle and skin involvement, hence its namesake. Initially, this uncommon and rapidly progressive disease process can present as a form of cellulitis or superficial abscess. However, the high morbidity and mortality rates associated with necrotizing fasciitis suggest a more serious, ominous condition. A delay in diagnosis can result in progressive advancement highlighted by widespread infection, multiple-organ involvement, and, ultimately, death. We present a case of limb salvage in a 52-year-old patient with type 2 diabetes mellitus and progressive fascial necrosis. A detailed review of the literature is presented, and current treatment modalities are described. Aggressive surgical debridement, comprehensive medical management of the sepsis and comorbidities, and timely closure of the resultant wound or wounds are essential for a successful outcome. (J Am Podiatr Med Assoc 96(1): 67–72, 2006). Full article

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Open AccessArticle

Stress Fractures of the Lesser Metatarsals After a Wilson Osteotomy for Correction of Hallux Valgus Deformity

by John M. Kirkos, Margaritis J. Kyrkos and George A. Kapetanos

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 63-66; https://doi.org/10.7547/0960063 - 1 Jan 2006

Cited by 2 | Viewed by 190

Abstract

This article describes a patient with lesser-metatarsal stress fractures resulting from an oblique Wilson displacement first metatarsal osteotomy. The shortening of the first metatarsal forces the lesser metatarsals to bear the weight previously borne by the first ray and increases the compression stress [...] Read more.

This article describes a patient with lesser-metatarsal stress fractures resulting from an oblique Wilson displacement first metatarsal osteotomy. The shortening of the first metatarsal forces the lesser metatarsals to bear the weight previously borne by the first ray and increases the compression stress on the adjacent metatarsal heads. The proximal displacement of the osteotomy must be minimized in order to limit the risk of stress fracture of the lesser metatarsals. (J Am Podiatr Med Assoc 96(1): 63–66, 2006). Full article

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Open AccessArticle

Synovial Chondromatosis of the Subtalar Joint and Tenosynovial Chondromatosis of the Posterior Ankle

by Phi Van, Peter M. Wilusz, David S. Ungar and Guy R. Pupp

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 59-62; https://doi.org/10.7547/0960059 - 1 Jan 2006

Cited by 20 | Viewed by 252

Abstract

Synovial chondromatosis is a rare, generally benign condition characterized by the formation of multiple cartilaginous nodules in the synovium of joints and occasionally on the tendon sheath or bursae. If the nodules are intra-articular, the condition is referred to as synovial chondromatosis; if [...] Read more.

Synovial chondromatosis is a rare, generally benign condition characterized by the formation of multiple cartilaginous nodules in the synovium of joints and occasionally on the tendon sheath or bursae. If the nodules are intra-articular, the condition is referred to as synovial chondromatosis; if extra-articular, tenosynovial chondromatosis. This space-occupying lesion can lead to chronic pain and limit the function of involved joints. We report a case of synovial chondromatosis involving the subtalar joint and tenosynovial chondromatosis involving the posterior ankle and review current definitions of this uncommon lower-extremity condition. (J Am Podiatr Med Assoc 96(1): 59–62, 2006). Full article

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Open AccessArticle

Treatment for Simple Plantar Verrucae. Monochloroacetic Acid and 10% Formaldehyde versus 10% Formaldehyde Alone

by Maureen B. Jennings, James Ricketti, John Guadara, Wendy Nach and Susan Goodwin

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 53-58; https://doi.org/10.7547/0960053 - 1 Jan 2006

Cited by 18 | Viewed by 348

Abstract

Verrucae are small, benign, highly vascular epithelial neoplasms that occur singly or in a multiple presentation. Plantar verrucae are usually caused by infection with human papillomavirus types 1, 2, and 4. A clinical trial was conducted to assess the safety and efficacy of [...] Read more.

Verrucae are small, benign, highly vascular epithelial neoplasms that occur singly or in a multiple presentation. Plantar verrucae are usually caused by infection with human papillomavirus types 1, 2, and 4. A clinical trial was conducted to assess the safety and efficacy of monochloroacetic acid and 10% formaldehyde versus 10% formaldehyde alone in the treatment of simple plantar verrucae. Of 57 patients enrolled in the study, 26 were in the monochloroacetic acid and 10% formaldehyde group and 31 were in the 10% formaldehyde alone group. The overall cure rate for this population was 61.4%. There was no statistically significant difference in the cure rate between treatment groups. (J Am Podiatr Med Assoc 96(1): 53–58, 2006). Full article

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Open AccessArticle

Evaluating Costs for Onychomycosis Treatments. A Practitioner’s Perspective

by Erin M. Warshaw

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 38-52; https://doi.org/10.7547/0960038 - 1 Jan 2006

Cited by 17 | Viewed by 473

Abstract

Onychomycosis is a common problem. The desired outcome of treatment for patients and clinicians is complete cure (negative culture and negative potassium hydroxide examination results plus a completely normal nail). This cost analysis sought to determine the cost-effectiveness of treatments for onychomycosis using [...] Read more.

Onychomycosis is a common problem. The desired outcome of treatment for patients and clinicians is complete cure (negative culture and negative potassium hydroxide examination results plus a completely normal nail). This cost analysis sought to determine the cost-effectiveness of treatments for onychomycosis using complete cure as a unit of effectiveness. A simplified cost-effectiveness analysis was conducted using complete cure rates from randomized, blinded clinical trials involving at least 50 participants. Trials were identified by searching the literature, manually searching for review articles, and reviewing medication package inserts. For each trial that met the entry criteria, three levels of cost were used to calculate medication cost per complete cure: commercial price, average wholesale price, and Veterans Affairs pharmacy price. In addition, a computerized economic model was used to determine total cost per complete cure, including all medical costs. The most cost-effective treatments were those that involved terbinafine: pulse, continuous, or in combination with other agents. Itraconazole, griseofulvin, and fluconazole were less cost-effective. Ciclopirox nail lacquer was at least three times more expensive than all other agents when evaluating total costs per complete cure. Overall, the lowest cost per complete cure resulted from terbinafine treatment, with most evidence supporting 3 months of continuous therapy. (J Am Podiatr Med Assoc 96(1): 38–52, 2006). Full article

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Open AccessArticle

Effect of Foot Posture and Inverted Foot Orthoses on Hallux Dorsiflexion

by Shannon E. Munteanu and Adam D. Bassed

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 32-37; https://doi.org/10.7547/0960032 - 1 Jan 2006

Cited by 12 | Viewed by 441

Abstract

A pronated foot posture is considered to be a factor in limitation of dorsiflexion at the first metatarsophalangeal joint during weightbearing. Customized foot orthoses are widely used to increase dorsiflexion at the first metatarsophalangeal joint in people with pronated feet. However, the effect [...] Read more.

A pronated foot posture is considered to be a factor in limitation of dorsiflexion at the first metatarsophalangeal joint during weightbearing. Customized foot orthoses are widely used to increase dorsiflexion at the first metatarsophalangeal joint in people with pronated feet. However, the effect of foot posture and customized foot orthoses on maximum first metatarsophalangeal joint dorsiflexion has not been widely investigated. This study sought to determine 1) the relationship between foot posture and static maximum first metatarsophalangeal joint dorsiflexion and 2) the effect of customized foot orthoses on static maximum first metatarsophalangeal joint dorsiflexion in people with pronated feet. Foot posture was assessed using the Foot Posture Index. Static maximum first metatarsophalangeal joint dorsiflexion of the right foot was determined using a goniometer while participants stood relaxed with and without Blake-style inverted (30°) foot orthoses positioned under their feet. There was a significant negative correlation between Foot Posture Index and static maximum first metatarsophalangeal joint dorsiflexion (r = −0.587). Inverted (30°) foot orthoses increased the magnitude of static maximum first metatarsophalangeal joint dorsiflexion from 83.4° to 85.3° in participants with an excessively pronated foot posture. However, this difference was not statistically significant. People with pronated feet are more likely to exhibit limitation of dorsiflexion at the first metatarsophalangeal joint during gait, and inverted foot orthoses are unlikely to be effective in increasing dorsiflexion at the first metatarsophalangeal joint in these people. (J Am Podiatr Med Assoc 96(1): 32–37, 2006). Full article

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Open AccessArticle

Clinical and Experimental Models of the Midtarsal Joint. Proposed Terms of Reference and Associated Terminology

by Christopher J. Nester and Andrew H. Findlow

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 24-31; https://doi.org/10.7547/0960024 - 1 Jan 2006

Cited by 9 | Viewed by 465

Abstract

Recent debate and literature have provided impetus to the growing body of thought that we should not model the midtarsal joint as having two simultaneous axes of rotation but as having a single instantaneous axis of rotation. Building on this concept, we present [...] Read more.

Recent debate and literature have provided impetus to the growing body of thought that we should not model the midtarsal joint as having two simultaneous axes of rotation but as having a single instantaneous axis of rotation. Building on this concept, we present new reference terminology and propose that descriptions of midtarsal joint kinetics and kinematics relate to moments and motion in the cardinal body planes as defined by the x-, y-, and z-axes of the local reference system of the calcaneus. This replaces the existing terminology that describes the oblique and longitudinal axes for the midtarsal joint. The purpose of the new terms of reference and terminology is to aid in the communication of ideas and concepts regarding the biomechanics of the midtarsal joint among clinicians and between researchers and clinicians. It will also allow integration of the midtarsal joint into the emerging biomechanical model of the lower limb, promote consistency in discussions of the joint, and ease understanding of the interrelationships between the kinetics and the kinematics of the articulations in the foot and lower limb and their relationship to pathology and clinical practice. (J Am Podiatr Med Assoc 96(1): 24–31, 2006). Full article

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Open AccessArticle

Endoscopic Decompression of Intermetatarsal Nerve Entrapment. A Retrospective Study

by Stephen L. Barrett and Amy S. Walsh

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 19-23; https://doi.org/10.7547/0960019 - 1 Jan 2006

Cited by 26 | Viewed by 473

Abstract

Sixty-nine patients who had 96 interspaces decompressed were retrospectively reviewed to assess the efficacy of the endoscopic decompression of the intermetatarsal nerve procedure. Cases were evaluated between October 1, 1993, and December 31, 1999. Of the 69 patients, 14 were men and 55 [...] Read more.

Sixty-nine patients who had 96 interspaces decompressed were retrospectively reviewed to assess the efficacy of the endoscopic decompression of the intermetatarsal nerve procedure. Cases were evaluated between October 1, 1993, and December 31, 1999. Of the 69 patients, 14 were men and 55 were women, and their average age was 50.6 years. Of the 96 interspaces released, 39 were second interspaces and 57 were third interspaces. Nine interspaces were lost to follow-up. There were 75 interspaces with excellent or good results (86%) and 12 with poor results (14%). Of the interspaces with poor results, five required further surgery. Those five interspaces, in five patients, were treated with traditional neurectomy. The other patients, accounting for seven interspaces, who classified their result as poor declined any further surgery. Evaluation of these cases was by means of medical chart review only, where the patient’s success or failure was based on the patient’s subjective assessment. None of the patients who underwent decompression developed a true amputation neuroma. (J Am Podiatr Med Assoc 96(1): 19–23, 2006). Full article

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Open AccessArticle

Casting Methods and Plantar Pressure. Effects of Custom-made Foot Orthoses on Dynamic Plantar Pressure Distribution

by Nick A. Guldemond, Pieter Leffers, Antal P. Sanders, Hans Emmen, Nicolaas C. Schaper and Geert H. I. M. Walenkamp

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 9-18; https://doi.org/10.7547/0960009 - 1 Jan 2006

Cited by 36 | Viewed by 162

Abstract

Foot orthoses are widely used to treat various foot problems. A literature search revealed no publications on differences in plantar pressure distribution resulting from casting methods for foot orthoses. Four casting methods were used for construction of orthoses. Two foam box techniques were [...] Read more.

Foot orthoses are widely used to treat various foot problems. A literature search revealed no publications on differences in plantar pressure distribution resulting from casting methods for foot orthoses. Four casting methods were used for construction of orthoses. Two foam box techniques were used: accommodative full weightbearing method (A) and functional semiweightbearing method (B). Also, two suspension plaster casting techniques were used: accommodative casting (C) and functional subtalar joint neutral position (Root) method (D). Their effects on contact area, plantar pressure, and walking convenience were evaluated. All orthoses increased the total contact area (mean, 17.4%) compared with shoes without orthoses. Differences in contact areas between orthoses for total plantar surface were statistically significant. Peak pressures for the total plantar surface were lower with orthoses than without orthoses (mean, 22.8%). Among orthoses, only the difference between orthoses A and B was statistically significant. Differences between orthoses for the forefoot were small and not statistically significant. The gait lines of the shoe without an insole and of the accommodative orthoses are more medially located than those of functional orthoses. Walking convenience in the shoe was better rated than that with orthoses. There were no differences in perception of walking convenience between orthoses A, B, and C. Orthosis D had the lowest convenience rating. The four casting methods resulted in differences between orthoses with respect to contact areas and walking convenience but only slight differences in peak pressures. (J Am Podiatr Med Assoc 96(1): 9–18, 2006). Full article

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Open AccessArticle

Power Spectral Analysis of Heart Rate Variability in Patients with Charcot’s Neuroarthropathy

by Alexandra Jirkovská, Petr Boucek, Stephanie Wu, Jana Hosová, Robert Bém, Vladimira Fejfarova and Jelena Skibová

J. Am. Podiatr. Med. Assoc. 2006, 96(1), 1-8; https://doi.org/10.7547/0960001 - 1 Jan 2006

Cited by 8 | Viewed by 572

Abstract

Charcot’s or neuropathic osteoarthropathy is one of the most debilitating orthopedic sequelae of diabetes mellitus. Distinguishing Charcot’s neuroarthropathy from clinically similar conditions may be challenging. The neurovascular theory postulates that Charcot’s neuroarthropathy may be secondary to sympathetic denervation of the lower-extremity vasculature. A [...] Read more.

Charcot’s or neuropathic osteoarthropathy is one of the most debilitating orthopedic sequelae of diabetes mellitus. Distinguishing Charcot’s neuroarthropathy from clinically similar conditions may be challenging. The neurovascular theory postulates that Charcot’s neuroarthropathy may be secondary to sympathetic denervation of the lower-extremity vasculature. A convenient method for assessing autonomic neuropathy in patients with Charcot’s neuroarthropathy is needed. Short-term power spectral analysis (PSA) of heart rate variability (HRV), a noninvasive and quantitative method for assessing autonomic neuropathy, may be advantageous compared with the traditionally used Ewing’s cardiovascular reflex tests. However, there are limitations to the clinical use of PSA of HRV because of poor standardization. We standardized PSA of HRV and assessed autonomic neuropathy in 17 people with acute Charcot’s neuroarthropathy using PSA of HRV versus Ewing’s tests. More patients with Charcot’s neuroarthropathy were diagnosed as having autonomic neuropathy with PSA of HRV than with Ewing’s tests (94% versus 82%); however, no significant difference between the two methods was found. The results of this study suggest that PSA of HRV requires minimal patient collaboration and time expenditure compared with Ewing’s tests and may be useful in detecting autonomic neuropathy in patients with Charcot’s neuroarthropathy. (J Am Podiatr Med Assoc 96(1): 1–8, 2006). Full article

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J. Am. Podiatr. Med. Assoc., Volume 96, Issue 1 (01 2006) – 15 articles , Pages 1-89

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