Journal of the American Podiatric Medical Association

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Acceptance Address APMA House of Delegates Washington, DC. Saluting the Present, Envisioning an Even Brighter Future March 25, 2007

by Christian A. Robertozzi

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 254-257; https://doi.org/10.7547/0970254 - 1 May 2007

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Abstract

It is truly humbling to be here in front of you today as I prepare to assume the presidency of the American Podiatric Medical Association. APMA is at the strongest point in its history in every facet of its operations. Many of you [...] Read more.

It is truly humbling to be here in front of you today as I prepare to assume the presidency of the American Podiatric Medical Association. APMA is at the strongest point in its history in every facet of its operations. Many of you would think that it would be best for APMA to just hold the line given our current success [...] Full article

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Address to APMA’s House of Delegates

by David M. Schofield

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 252-253; https://doi.org/10.7547/0970252 - 1 May 2007

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Mr. Speaker from the great state of New York, Dr. Mark Schilansky, honored guests, APMA staff, members of the House of Delegates, dear family and friends: This is really much more difficult than my acceptance address one short year ago [...] Full article

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Guidelines for Authors

by Warren S. Joseph

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 249-251; https://doi.org/10.7547/0970249 - 1 May 2007

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No matter what type of manuscript is submitted, all share a few common components. Whenever writing a paper, authors should have a point to be made [...] Full article

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Public Health and Podiatric Medicine: Principles and Practice

by Irvin O. Kanat

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 248; https://doi.org/10.7547/0970248 - 1 May 2007

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In this book, Arthur E. Helfand, DPM, presents an irrefutable argument on behalf of podiatric medicine and the critical role it plays in the delivery of highquality public health services [..] Full article

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Atypical Gout in the Foot and Ankle Secondary to Primary Hyperparathyroidism

by Michael S. Nirenberg and Michael C. Carroll

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 245-247; https://doi.org/10.7547/0970245 - 1 May 2007

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To the Editor: It is well established that primary adenomatous hyperparathyroidism is associated with hyperuricemia and overt gout [...] Full article

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A Simple Technique for Performing Percutaneous Fixation of Fifth Metatarsal Base Fractures

by Thomas S. Roukis, Dave Graner and Thomas Zgonis

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 244-245; https://doi.org/10.7547/0970244 - 1 May 2007

Cited by 3 | Viewed by 51

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To the Editor: The treatment of fifth metatarsal base fractures, specifically Jones type and Torg types I and II, continues to be a topic of debate [...] Full article

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Arthroscopic Removal of a Subperiosteal Osteoid Osteoma of the Talus

by Taner Gunes, Mehmet Erdem, Cengiz Sen, Erkal Bilen and Kursad Yeniel

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 238-243; https://doi.org/10.7547/0970238 - 1 May 2007

Cited by 17 | Viewed by 47

Abstract

We report a case of a subperiosteal osteoid osteoma on the talar neck that was removed arthroscopically. Intralesional excision, en bloc resection, and percutaneous ablation techniques have all been used for the treatment of osteoid osteoma. For intra-articular osteoid osteomas, arthroscopy-assisted removal of [...] Read more.

We report a case of a subperiosteal osteoid osteoma on the talar neck that was removed arthroscopically. Intralesional excision, en bloc resection, and percutaneous ablation techniques have all been used for the treatment of osteoid osteoma. For intra-articular osteoid osteomas, arthroscopy-assisted removal of the tumor has been described in a few case reports. Obtaining a nidus fragment for pathologic evaluation is important during arthroscopic removal of intra-articular osteoid osteomas. Sometimes it is not possible to obtain a specimen for pathologic examination. In the present case, the osteoid osteoma on the talar neck was easily located, the nidus was completely removed, and the tumor was extirpated. (J Am Podiatr Med Assoc 97(3): 238–243, 2007) Full article

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Exercise-Induced Rhabdomyolysis

by Gregorio Caban, Luis Marin and Frederick Scavone

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 234-237; https://doi.org/10.7547/0970234 - 1 May 2007

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Rhabdomyolysis is a debilitating condition that promotes muscle breakdown and eventually leads to renal dysfunction if not properly managed. The initial presentation may involve lower-extremity muscles, making the foot and ankle specialist one of the first specialists to recognize and diagnose this condition. [...] Read more.

Rhabdomyolysis is a debilitating condition that promotes muscle breakdown and eventually leads to renal dysfunction if not properly managed. The initial presentation may involve lower-extremity muscles, making the foot and ankle specialist one of the first specialists to recognize and diagnose this condition. Proper management of renal function is the primary concern; however, the underlying muscle breakdown needs to be addressed and the condition managed to prevent future problems. In this article we discuss treatment of a patient with exercise-induced rhabdomyolysis; a rehabilitation regimen is presented whose purpose is to condition muscles in order to prevent recurrence of exercise-induced muscle destruction after an acute event. (J Am Podiatr Med Assoc 97(3): 234–237, 2007) Full article

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Post-traumatic Myositis Ossificans Circumscripta. An Unusually Large Example

by William Todd, Philip J. Gianfortune and Todd Laughner

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 229-233; https://doi.org/10.7547/0970229 - 1 May 2007

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A 66-year-old woman presented with painful gait and a large, firm, nonmobile mass in her right foot. She had undergone four previous surgeries to remove a recurring “calcified hematoma” that resulted from an injury sustained 3 decades previously. An unusually large ossific mass [...] Read more.

A 66-year-old woman presented with painful gait and a large, firm, nonmobile mass in her right foot. She had undergone four previous surgeries to remove a recurring “calcified hematoma” that resulted from an injury sustained 3 decades previously. An unusually large ossific mass (7.0 × 7.0 × 2.0 cm) consistent with post-traumatic myositis ossificans circumscripta was excised. After 3 years of follow-up, there was no return of the symptoms or the mass. (J Am Podiatr Med Assoc 97(3): 229–233, 2007) Full article

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Giant Cell Tumor of the Talar Neck

by Hakan Selek, Hamza Özer, Sacit Turanli and Özlem Erdem

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 225-228; https://doi.org/10.7547/0970225 - 1 May 2007

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We describe a patient with a giant cell tumor in the talar head and neck of the left foot who was diagnosed as having osteochondritis dissecans and treated with arthroscopic drilling in this same location 3 years earlier. Giant cell tumors can be [...] Read more.

We describe a patient with a giant cell tumor in the talar head and neck of the left foot who was diagnosed as having osteochondritis dissecans and treated with arthroscopic drilling in this same location 3 years earlier. Giant cell tumors can be confused with several conditions, including giant cell reparative granulomas, brown tumors, and aneurysmal bone cysts. Giant cell tumors of bone typically occur in the epiphysis of long bones, including the distal femur and proximal tibia. They are uncommonly found in the small bones of the foot or ankle, and talar involvement is rare. Despite this rarity, the radiographic appearance and clinical signs of talar lesions should be considered in the differential diagnosis of nontraumatic conditions in the foot. (J Am Podiatr Med Assoc 97(3): 225–228, 2007) Full article

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Chondromyxoid Fibroma of the Calcaneus

by Mohamad H. Ebrahimzadeh and Seyed R. Sharifi Dallouei

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 223-224; https://doi.org/10.7547/0970223 - 1 May 2007

Cited by 6 | Viewed by 58

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Chondromyxoid fibroma is a rare, benign, aggressive bone tumor whose localization in the calcaneus is even rarer. We report a case of chondromyxoid fibroma in the calcaneus of a 10-year-old Iranian boy who was treated with extended curettage. After 3 years of follow-up, [...] Read more.

Chondromyxoid fibroma is a rare, benign, aggressive bone tumor whose localization in the calcaneus is even rarer. We report a case of chondromyxoid fibroma in the calcaneus of a 10-year-old Iranian boy who was treated with extended curettage. After 3 years of follow-up, the patient had experienced no recurrence. (J Am Podiatr Med Assoc 97(3): 223–224, 2007) Full article

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An Uncommon Presentation of Malignant Fibrous Histiocytoma of the Calcaneus

by Bahtiyar Demiralp, Kaan Erler, Engin Kutay Ozturan, Dogan Bek, Taner Ozdemir and Bulent Kurt

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 218-222; https://doi.org/10.7547/0970218 - 1 May 2007

Cited by 5 | Viewed by 57

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Malignant fibrous histiocytoma of bone is the osseous counterpart of the tumor in soft tissue. It is a rare primary bone tumor, and there have been conflicting reports on its grades of malignancy. The appendicular skeleton, especially the femur, is the most common [...] Read more.

Malignant fibrous histiocytoma of bone is the osseous counterpart of the tumor in soft tissue. It is a rare primary bone tumor, and there have been conflicting reports on its grades of malignancy. The appendicular skeleton, especially the femur, is the most common site of involvement, whereas the calcaneus is rarely involved. We describe a primary malignant fibrous histiocytoma of the calcaneal bone in a 21-year-old man. The patient underwent neoadjuvant and adjuvant chemotherapy and below-the-knee amputation, and no local recurrence or metastasis was noted after 2 years of follow-up. (J Am Podiatr Med Assoc 97(3): 218–222, 2007) Full article

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Foot Pathology and Inappropriate Footwear as Risk Factors for Falls in a Subacute Aged-Care Hospital

by Rebecca L. Jessup

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 213-217; https://doi.org/10.7547/0970213 - 1 May 2007

Cited by 27 | Viewed by 48

Abstract

Background: Falls are a major clinical problem in the hospital setting. This study examined the prevalence of foot pathology and footwear type likely to increase the risk of falls in two subacute-care hospital wards serving elderly patients. Methods: Two wards of [...] Read more.

Background: Falls are a major clinical problem in the hospital setting. This study examined the prevalence of foot pathology and footwear type likely to increase the risk of falls in two subacute-care hospital wards serving elderly patients. Methods: Two wards of a subacute aged-care hospital were selected for study. Patients were assessed for the presence of foot pathology, and their footwear was evaluated for characteristics identified in the literature as placing individuals at increased risk of falls. Results: Of 44 patients assessed, 98% had foot pathology, and 41% had foot pathology requiring podiatric medical management. Eighty-six percent of inpatients wore footwear that was likely to increase their risk of falls, with 66% wearing slippers or moccasins. Conclusions: The results of this study demonstrate the need for hospital inpatients who are identified as being at high risk for falling, or have a history of falls, to undergo an assessment of their foot pathology and footwear so that appropriate measures can be taken to address these risk factors. (J Am Podiatr Med Assoc 97(3): 213-217, 2007) Full article

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Relationship Between Positive Clinical Outcomes of Foot Orthotic Treatment and Changes in Rearfoot Kinematics

by Gerard V. Zammit and Craig B. Payne

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 207-212; https://doi.org/10.7547/0970207 - 1 May 2007

Cited by 22 | Viewed by 52

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Background: Previous two-dimensional kinematic studies that assessed the effect of foot orthoses on rearfoot motion have yielded mixed results regarding whether control of rearfoot motion is related to symptom relief. Methods: We sought to determine the effect of foot orthoses on [...] Read more.

Background: Previous two-dimensional kinematic studies that assessed the effect of foot orthoses on rearfoot motion have yielded mixed results regarding whether control of rearfoot motion is related to symptom relief. Methods: We sought to determine the effect of foot orthoses on rearfoot motion and to correlate these changes with the degree of symptom improvement in 22 individuals with excessive rearfoot pronation (17 women and 5 men; mean ± SD age, 44.3 ± 16.7 years; mean ± SD weight, 74.9 ± 15.9 kg). Two-dimensional motion-analysis software was used to assess frontal plane rearfoot motion with and without foot orthoses. The mean ± SD Foot Posture Index of the left foot was 8.83 ± 3.54 and of the right foot was 9.22 ± 3.64). The pain and function subscales of the Foot Health Status Questionnaire were then used to determine the degree of symptom relief associated with the orthoses at baseline and 4 weeks later. Results: Orthoses had a small but statistically significant effect on rearfoot motion, although no significant correlations were found between differences in rearfoot motion with and without foot orthoses and the improvements demonstrated in the Foot Health Status Questionnaire subscales of pain and function. Conclusions: The effect of orthoses on frontal plane rearfoot motion is considered small and probably insufficient to account for the extent of symptom reduction found in this study. Other parameters of orthotic function, such as kinetic and neuromechanical variables, should be further investigated. (J Am Podiatr Med Assoc 97(3): 207-212, 2007) Full article

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Efficacy of Chemical Neurolysis for the Treatment of Interdigital Nerve Compression of the Foot. A Retrospective Study

by John D. Mozena and Jared T. Clifford

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 203-206; https://doi.org/10.7547/0970203 - 1 May 2007

Cited by 26 | Viewed by 63

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Background: Dilute alcohol injection has been described as a nonsurgical treatment option for interdigital nerve compression of the foot, also known as “Morton’s neuroma.” This study reviews the efficacy of the procedure in 49 feet at one treatment center. Methods: In [...] Read more.

Background: Dilute alcohol injection has been described as a nonsurgical treatment option for interdigital nerve compression of the foot, also known as “Morton’s neuroma.” This study reviews the efficacy of the procedure in 49 feet at one treatment center. Methods: In this historical cohort study, data from 42 patients who had undergone alcohol injection therapy were obtained from clinic records. A total of 49 feet were reviewed. Results: Symptoms were improved or resolved in 30 (61%) of 49 feet. Nineteen feet (39%) were unimproved, with 12 of those progressing to surgical neurectomy. Feet that received five or more injections were more likely to improve (74%) than those that received fewer than five injections (39%). Three patients reported mild complications associated with dilute alcohol injection, all of which resolved spontaneously within 2 days of the injection. Conclusions: Dilute alcohol injection is a safe and effective treatment option for patients with Morton’s neuroma who want to avoid a surgical procedure and any associated complications. The procedure may be more successful if the patient receives at least five injections. (J Am Podiatr Med Assoc 97(3): 203-206, 2007) Full article

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Ciclopirox 8% Nail Lacquer Topical Solution for the Treatment of Onychomycosis in Patients with Diabetes. A Multicenter, Open-Label Study

by Marc A. Brenner, Lawrence B. Harkless, Robert W. Mendicino and Jeffrey C. Page

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 195-202; https://doi.org/10.7547/0970195 - 1 May 2007

Cited by 32 | Viewed by 125

Abstract

Background: An open-label, noncomparative study was conducted to assess the safety and efficacy of ciclopirox 8% nail lacquer topical solution in patients with type 2 diabetes mellitus. Methods: Forty-nine diabetic patients with distal subungual onychomycosis were treated once daily for 48 weeks with [...] Read more.

Background: An open-label, noncomparative study was conducted to assess the safety and efficacy of ciclopirox 8% nail lacquer topical solution in patients with type 2 diabetes mellitus. Methods: Forty-nine diabetic patients with distal subungual onychomycosis were treated once daily for 48 weeks with ciclopirox 8% nail lacquer, a topical nail solution approved for the treatment of patients with mild-to-moderate onychomycosis. Results: Treatment resulted in clinical improvement in 63.4% of patients. Most patients (85.7%) had a mycologic outcome of improvement or cure, with 54.3% attaining mycologic cure. Consideration of mycologic and clinical outcomes generated a treatment outcome of improvement, success, or cure in 84.4% of patients. Moreover, patients experienced improvement in the diseased area of the nail (63.4%), nail surface (56.1%), nail color (48.8%), and nail thickness (65.9%). Ciclopirox 8% nail lacquer was safe, with treatment- related adverse events limited to infection in one patient, which resolved in 15 days; the patient completed the study. No treatment-related serious adverse events were observed. Conclusion: Ciclopirox 8% nail lacquer is a safe and effective treatment for distal subungual onychomycosis in patients with type 2 diabetes mellitus receiving insulin or oral hypoglycemic therapy. (J Am Podiatr Med Assoc 97(3): 195-202, 2007) Full article

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Complications Associated with Distraction Osteogenesis for the Correction of Brachymetatarsia. A Review of Five Procedures

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

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 189-194; https://doi.org/10.7547/0970189 - 1 May 2007

Cited by 21 | Viewed by 68

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Background: Congenital brachymetatarsia is often treated with callus distraction. This technique is associated with a variety of complications. We investigated complications encountered in treatment of brachymetatarsia in four female patients and reviewed adjunctive procedures performed to treat these complications. Methods: We [...] Read more.

Background: Congenital brachymetatarsia is often treated with callus distraction. This technique is associated with a variety of complications. We investigated complications encountered in treatment of brachymetatarsia in four female patients and reviewed adjunctive procedures performed to treat these complications. Methods: We reviewed five distraction osteogenesis procedures performed in four female patients with congenital shortening of the fourth metatarsal over a 3-year period. Serial radiographs were obtained weekly until bone consolidation was achieved, at which time the external fixator was removed. Follow-up ranged from 5 to 10 months. Results: Three patients (four metatarsals) were satisfied with the cosmetic and functional outcomes of their procedure. One patient was dissatisfied with the cosmetic result owing to a short digit from a short proximal phalanx but was completely functional and resumed all of her normal activities. Complications associated with callus distraction were decreased range of motion and stiffness at the metatarsophalangeal joint, flexion deformity of the digit, angulation of the metatarsal, prolonged distraction time due to pain, fracture of the bone callus, pin-site infection, and an undesirable cosmetic appearance due to a short proximal phalanx. Adjunctive procedures were needed in some of these cases and yielded good results. Conclusions: Callus distraction is an effective treatment for congenital shortening of the fourth metatarsal, but the procedure is associated with a number of complications. Because most patients proceed with surgery for cosmetic reasons, it is important to present the possible complications and the adjunctive surgical procedures that may be necessary for a desirable outcome. (J Am Podiatr Med Assoc 97(3): 189-194, 2007) Full article

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Analysis of Dynamic Angle of Gait and Radiographic Features in Subjects with Hallux Abducto Valgus and Hallux Limitus

by Julie Taranto, Michael J. Taranto, Alan R. Bryant and Kevin P. Singer

J. Am. Podiatr. Med. Assoc. 2007, 97(3), 175-188; https://doi.org/10.7547/0970175 - 1 May 2007

Cited by 22 | Viewed by 58

Abstract

Background: Hallux abducto valgus and hallux limitus are two commonly encountered foot deformities causing altered structure and function of the first metatarsophalangeal joint and subsequent compensatory mechanisms. This study was undertaken to determine the relationships between these two deformities and transverse plane [...] Read more.

Background: Hallux abducto valgus and hallux limitus are two commonly encountered foot deformities causing altered structure and function of the first metatarsophalangeal joint and subsequent compensatory mechanisms. This study was undertaken to determine the relationships between these two deformities and transverse plane position of the foot, or angle of gait, and several radiographic angular and linear parameters with established reliability. Methods: A convenience sample of 23 subjects with hallux abducto valgus, 22 subjects with hallux limitus, and 20 control subjects was used. Radiographic parameters were standardized weightbearing views and included lateral stressed dorsiflexion of the first metatarsophalangeal joint, composite, dorsoplantar, and lateral views. Angle of gait was obtained from powdered footprints recorded on paper. Two left and two right footprints identified on each trial were used to calculate angle of gait. Results: The findings of the study suggest that an association between angle of gait and the presence of hallux abducto valgus or hallux limitus does not exist. Possible explanations may relate to the large variability of normal angle of gait, the need to identify factors extrinsic to the foot capable of affecting transverse plane orientation of the foot, and the addition of information relating to symptoms. Conclusions: In this study, the presence of hallux abducto valgus or hallux limitus did not correspond to an association with a particular angle of gait. Length and elevation of the first metatarsal were associated in subjects with hallux abducto valgus and hallux limitus. (J Am Podiatr Med Assoc 97(3): 175-188, 2007) Full article

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J. Am. Podiatr. Med. Assoc., Volume 97, Issue 3 (05 2007) – 18 articles , Pages 175-257

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