Journal of the American Podiatric Medical Association

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APMA PAC

by Christian A. Robertozzi

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 84; https://doi.org/10.7547/0980084 - 1 Jan 2008

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Long Leg Calcaneal Axial and Hindfoot Alignment Radiographic Views for Frontal Plane Assessment

by Robert W. Mendicino, Alan R. Catanzariti, Shine John, Brandon Child and Bradley M. Lamm

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 75-78; https://doi.org/10.7547/0980075 - 1 Jan 2008

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Reconstructive surgery for hindfoot, ankle, and leg deformities is facilitated by proper radiographic analysis. The long leg calcaneal axial and hindfoot alignment views have been proved to be useful in deformity planning at The Foot and Ankle Institute at The Western Pennsylvania Hospital. [...] Read more.

Reconstructive surgery for hindfoot, ankle, and leg deformities is facilitated by proper radiographic analysis. The long leg calcaneal axial and hindfoot alignment views have been proved to be useful in deformity planning at The Foot and Ankle Institute at The Western Pennsylvania Hospital. These radiographic views can be attained in an office setting or in any hospital radiology department. The details provided herein of this radiographic technique will be useful to physicians, office staff, and radiology technicians to facilitate proper imaging of hindfoot, ankle, and leg deformities. (J Am Podiatr Med Assoc 98(1): 75–78, 2008) Full article

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Synovial Osteochondromatosis Involvement in Post-traumatic Ankle Injury

by Daniel K. Lee, Louis Louk and Bryan L. Bell

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 70-74; https://doi.org/10.7547/0980070 - 1 Jan 2008

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Ankle involvement by synovial chondromatosis is unusual. It is unknown whether a post-traumatic event to the ankle induces the formation and development of these lesions. Synovial osteochondromatosis associated with post-traumatic ankle events are rare but suggest trauma to the synovial tissues as being [...] Read more.

Ankle involvement by synovial chondromatosis is unusual. It is unknown whether a post-traumatic event to the ankle induces the formation and development of these lesions. Synovial osteochondromatosis associated with post-traumatic ankle events are rare but suggest trauma to the synovial tissues as being causative, although this has never been statistically confirmed owing to the lack of reports and frequency. We report a case of primary synovial osteochondromatosis involving the tibiotalar joint with painful symptoms after a history of ankle injury, including magnetic resonance imaging findings of this unusual condition. (J Am Podiatr Med Assoc 98(1): 70–74, 2008) Full article

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Elephantiasis Nostras Verrucosa or “Mossy Foot Lesions” in Lymphedema Praecox. Report of a Case

by Amy L. Duckworth, Jugnoo Husain and Patrick DeHeer

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 66-69; https://doi.org/10.7547/0980066 - 1 Jan 2008

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Elephantiasis nostras verrucosa is a rare disorder that results from chronic obstructive lymphedema. It is characterized clinically by deforming, nonpitting edema; malodorous hyperkeratosis with generalized lichenification; cobblestoned papules; and verrucous changes, that often result in extreme enlargement of the involved body part. Although [...] Read more.

Elephantiasis nostras verrucosa is a rare disorder that results from chronic obstructive lymphedema. It is characterized clinically by deforming, nonpitting edema; malodorous hyperkeratosis with generalized lichenification; cobblestoned papules; and verrucous changes, that often result in extreme enlargement of the involved body part. Although elephantiasis nostras verrucosa is striking in clinical appearance, biopsy reveals only moderately abnormal findings: pseudoepitheliomatous hyperplasia with dilated lymphatic spaces in the dermis, accompanied by chronic inflammation and fibroblast proliferation. The term elephantiasis nostras (nostras means “from our region”) has traditionally been used to differentiate temperate zone disease from the classic disease process, elephantiasis tropica, which is defined by chronic filarial lymphatic obstruction caused by Wuchereria bancrofti, Wuchereria malayi, or Wuchereria pacifica. We present a case report of elephantiasis nostras verrucosa arising as a result of lymphedema praecox. (J Am Podiatr Med Assoc 98(1): 66–69, 2008) Full article

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First Metatarsal Callus Distraction

by J. Christopher Benson and Alan S. Banks

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 51-60; https://doi.org/10.7547/0980051 - 1 Jan 2008

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We describe the results in seven patients who underwent surgery to lengthen a short first metatarsal via callus distraction. The increased length achieved ranged from 13 to 48 mm, with an average of 20.2 mm. The technique was successful in restoring length and [...] Read more.

We describe the results in seven patients who underwent surgery to lengthen a short first metatarsal via callus distraction. The increased length achieved ranged from 13 to 48 mm, with an average of 20.2 mm. The technique was successful in restoring length and improving symptoms, although several complications were encountered. (J Am Podiatr Med Assoc 98(1): 51–60, 2008) Full article

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Transmissions Within the Tarsal Gearbox

by Peter Wolf, Alex Stacoff, Roger Luechinger, Peter Boesiger and Edgar Stuessi

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 45-50; https://doi.org/10.7547/0980045 - 1 Jan 2008

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Background: The dependence of the movements of the calcaneus, cuboid, navicular, and talus on each other have been described as the tarsal gearbox. To provide a basis of its modeling, data on transmissions between tarsal joint rotations within this gearbox are required. The [...] Read more.

Background: The dependence of the movements of the calcaneus, cuboid, navicular, and talus on each other have been described as the tarsal gearbox. To provide a basis of its modeling, data on transmissions between tarsal joint rotations within this gearbox are required. The feasibility of tibiocalcaneal rotations to predict tarsal joint rotations is of interest because a meaningful relation would allow the use of common motion analysis with skin markers to investigate rearfoot kinematics. Methods: We performed linear regression analyses between tarsal joint and tibio-calcaneal rotations on the basis of magnetic resonance imaging of tibia and tarsal bone positions during quasi-static foot pronation and supination. Results: In the frontal plane and transverse planes, linear models were found to predict tarsal joint rotations quite well (r 2 = 0.83–0.97 for the frontal plane and r 2 = 0.73–0.95 for the transverse plane). For each degree of talocalcaneal rotation, there was 1.8° of talonavicular rotation in the frontal plane and 1.6° in the transverse plane; each degree of talocalcaneal rotation resulted in 0.6° of calcaneal-cuboid rotation in the frontal plane and 0.7° in the transverse plane; each degree of calcaneo-cuboid rotation resulted in 3° of talonavicular rotation in the frontal plane and 2.8° in the transverse; each degree of tibio-calcaneal rotation resulted in 0.9° of talo-calcaneal rotation in the frontal plane and 0.9° in the transverse plane; and each degree of tibiocalcaneal rotation resulted in 1.6° of talonavicular rotation in the frontal plane and 1.3° in the transverse plane. Conclusion: The present study provides a basis on which the tarsal gearbox in the frontal and the transverse planes under quasi-static conditions can be modeled. Furthermore, it is concluded that tibiocalcaneal rotations are practical for predicting tarsal joint rotations during quasi-static motions. (J Am Podiatr Med Assoc 98(1): 45-50, 2008) Full article

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Effect of Cushioned Insoles on Impact Forces During Running

by Katherine O’Leary, Kristin Anderson Vorpahl and Bryan Heiderscheit

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 36-41; https://doi.org/10.7547/0980036 - 1 Jan 2008

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Background: The use of cushioned or shock-absorbing insoles has been suggested as a mechanism to reduce the impact forces associated with running, thereby protecting against overuse injuries. The purpose of this study was to determine whether the use of cushioned insoles reduced impact [...] Read more.

Background: The use of cushioned or shock-absorbing insoles has been suggested as a mechanism to reduce the impact forces associated with running, thereby protecting against overuse injuries. The purpose of this study was to determine whether the use of cushioned insoles reduced impact forces during running in healthy subjects. Methods: Sixteen recreational runners (9 females and 7 males) ran at a self-selected pace for five trials with and without the use of cushioned insoles. During each trial, ground reaction forces, tibial accelerations, lower-extremity kinematics, and subjectperceived comfort were recorded. All variables were tested with the level of statistical significance set at α = .05. Results: The use of cushioned insoles resulted in significant reductions in mean vertical ground reaction force peak impact (6.8%) and ground reaction force loading rate (8.3%), as well as peak tibial acceleration (15.8%). Spectral analysis of the tibial acceleration data in the frequency range associated with impact accelerations (12–25 Hz) revealed no change in the predominant frequency or the power of the predominant frequency. The knee flexion angle at initial contact and perceived comfort were similar for the two conditions. Conclusions: This study demonstrates the effectiveness of one type of cushioned insole in reducing peak impact force and tibial acceleration at initial foot-ground contact during running. The impact reduction observed was independent of knee kinematic adjustments or changes in perceived comfort. Further study is required to determine whether the reduction in loading that accompanied the use of the cushioned insoles can affect the incidence of running-related injuries. (J Am Podiatr Med Assoc 98(1): 36-41, 2008) Full article

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Transfer of the Flexor Digitorum Brevis Tendon

by Ricardo Becerro de Bengoa Vallejo, Fermín Viejo Tirado, Juan Carlos Prados Frutos, Marta Elena Losa Iglesias and Kevin T. Jules

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 27-35; https://doi.org/10.7547/0980027 - 1 Jan 2008

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Background: Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw or hammer toe deformities. In contrast, a search of the literature revealed no previous reports of transposition of the flexor digitorum brevis tendon for treatment [...] Read more.

Background: Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw or hammer toe deformities. In contrast, a search of the literature revealed no previous reports of transposition of the flexor digitorum brevis tendon for treatment of these conditions. We performed a cadaver study to determine whether the flexor digitorum brevis tendon is long enough to be transferred to the dorsum of the proximal phalanx of the toe from its lateral or medial aspect. Methods: Transposition of the flexor digitorum brevis tendon was attempted in 180 toes of cadaver feet: 45 second toes, 45 third toes, 45 fourth toes, and 45 fifth toes. Results: The flexor digitorum brevis tendon was long enough to be successfully transposed in 100% of the second, third, and fourth toes and in 42 (93.3%) of the fifth toes. In the three remaining fifth toes (6.7%), the flexor digitorum brevis tendon was absent, a known anatomical variation. Conclusions: Transfer of the flexor digitorum brevis tendon to the dorsum of the proximal phalanx can be performed for correction of claw or hammer toe deformities, especially in the second, third, and fourth toes. The transverse aponeurotic fibers originating from the extensor digitorum longus impede the transfer of the flexor digitorum brevis tendon, and meticulous excision of these fibers is essential to the success of the procedure. (J Am Podiatr Med Assoc 98(1): 27-35, 2008) Full article

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Functional Outcome of Meniscal-Bearing Total Ankle Replacement. A Gait Analysis Study

by Maria Grazia Benedetti, Alberto Leardini, Matteo Romagnoli, Lisa Berti, Fabio Catani and Sandro Giannini

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 19-26; https://doi.org/10.7547/0980019 - 1 Jan 2008

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Background: Most clinical studies on total ankle replacement (TAR) report assessments based on traditional clinical scores or radiographic analysis. Only a few studies have used modern instrumentation for quantitative functional analysis during the execution of activities of daily living. The aim of this [...] Read more.

Background: Most clinical studies on total ankle replacement (TAR) report assessments based on traditional clinical scores or radiographic analysis. Only a few studies have used modern instrumentation for quantitative functional analysis during the execution of activities of daily living. The aim of this study was to use gait analysis to compare the functional performance of patients who underwent TAR versus a control population. Methods: A retrospective analysis was performed of ten consecutive patients who had undergone meniscal-bearing TAR. Clinical and functional assessments were performed at a mean follow-up of 34 months with a modified Mazur scoring system and state-ofthe- art gait analysis. Results: Gait analysis assessment of TAR at medium-term follow-up showed satisfactory results for all patients, with adequate recovery of range of motion. Because the literature reports unsatisfying long-term results, it is important to evaluate these patients over a longer follow-up period. Conclusions: This study showed that TAR yields satisfactory, but not outstanding, general functional results at nearly 3 years’ follow-up. These gait analysis results highlight the importance of integrating in vivo measurements with the standard clinical assessments of patients who underwent TAR while they perform activities of daily living. These results also emphasize the importance of evaluating the functional outcome of TAR over time. (J Am Podiatr Med Assoc 98(1): 19-26, 2008) Full article

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Ability of Foot Care Professionals to Cast Feet Using the Nonweightbearing Plaster and the Gait-Referenced Foam Casting Techniques

by Leslie C. Trotter and Michael Raymond Pierrynowski

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 14-18; https://doi.org/10.7547/0980014 - 1 Jan 2008

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Background: We examined the ability of foot care professionals to consistently capture the forefoot-to-rearfoot angular relationship of a single-cast foot. Methods: Eleven Canadian certified pedorthists each cast a single foot twice using the plaster of Paris and foam box techniques. Three independent raters [...] Read more.

Background: We examined the ability of foot care professionals to consistently capture the forefoot-to-rearfoot angular relationship of a single-cast foot. Methods: Eleven Canadian certified pedorthists each cast a single foot twice using the plaster of Paris and foam box techniques. Three independent raters subsequently measured the resultant casts. Statistical analysis of the data provided generalizability coefficient estimates (ρ2) of the intracaster, intercaster, and rater reliabilities. Results: Intracaster reliabilities were excellent when the plaster and foam box techniques were used (ρ2 = 0.831 and 0.939, respectively). The casters were more intrareliable when foam was used (F = 2.755, P = .003). Intercaster reliabilities were poor for both techniques (ρ2 = 0.410 and 0.425). Although, intrarater reliability was excellent (ρ2 = 0.882), interrater reliability was poor (ρ2 = 0.418). Conclusion: Although plaster of Paris casting is widely perceived by the foot care community as the gold standard, other casting techniques may prove to be equally reliable. (J Am Podiatr Med Assoc 98(1): 14-18, 2008) Full article

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Reliability of the Modified Foot Posture Index

by Mark W. Cornwall, Thomas G. McPoil, Michael Lebec, Bill Vicenzino and Jodi Wilson

J. Am. Podiatr. Med. Assoc. 2008, 98(1), 7-13; https://doi.org/10.7547/0980007 - 1 Jan 2008

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Background: The Foot Posture Index (FPI) has been advocated as a simple and convenient tool to assess static foot posture in a clinical setting. Although published studies have indicated that the FPI has good intrarater reliability and moderate interrater reliability, these studies were [...] Read more.

Background: The Foot Posture Index (FPI) has been advocated as a simple and convenient tool to assess static foot posture in a clinical setting. Although published studies have indicated that the FPI has good intrarater reliability and moderate interrater reliability, these studies were conducted on a previous version of the tool that used eight criteria to score a patient’s foot posture. The revised tool has only six criteria (FPI-6). The purpose, therefore, of this study was to investigate the intrarater and interrater reliability of the revised version of the FPI. Methods: Three different raters used the FPI-6 to twice evaluate 92 feet from 46 individuals. Results: Intrarater reliability was high but interrater reliability was only moderate. In addition, using the raw score generated by the FPI-6 to classify feet into one of five categories did not improve agreement between raters. Conclusions: The FPI-6 should be used with extreme caution and may actually have limited value, especially from a research perspective. (J Am Podiatr Med Assoc 98(1): 7-13, 2008) Full article

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J. Am. Podiatr. Med. Assoc., Volume 98, Issue 1 (01 2008) – 11 articles , Pages 7-84

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