bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Biofeedback-Assisted Relaxation Training on Foot Ulcer Healing
Authors: Rice Birgitta , Kalker Alan J. , Schindler Jay V. , Dixon Russell M.
Published: April 2014

A prospective, randomized study was conducted to determine the effect of biofeedback-assisted relaxation training on foot ulcer healing. For patients with chronic nonhealing foot ulcers, medical care was combined with a standardized biofeedback-assisted relaxation training program in the experimental group. The intervention was designed to increase peripheral perfusion, thereby promoting healing. A total of 32 patients with chronic nonhealing ulcers participated in the study. In the experimental group, 14 out of 16 ulcers (87.5%) healed, as compared with 7 out of 16 ulcers (43.8%) in the control group. (J Am Podiatr Med Assoc 91(3): 132-141, 2001)
Changes in Foot Function with the Use of Root and Blake Orthoses
Authors: Reed Lloyd , Bennett Paul J.
Published: April 2014

This study examined the effects of two designs of rigid foot orthoses on plantar pressure measurements and identified differences between the devices. While wearing modified Root- and Blake-style orthoses, 27 subjects were examined with the Electrodynogram (EDG) in-shoe pressure measurement system. Reliability testing was performed on the EDG data. Significant changes were observed in the temporal parameters of gait when subjects wore the orthoses. When the devices were used, the duration of some of the components of stance phase was altered, and the initiation of loading beneath the medial forefoot was delayed. A reduction in the total duration of loading at discrete sites beneath the heel and forefoot was also observed. The effects of the two orthoses were similar, with only small differences observed between the devices. (J Am Podiatr Med Assoc 91(4): 184-193, 2001)
Wound Healing and Infection in Nail Matrix Phenolization Wounds
Authors: Dovison Russell , Keenan Anne-Maree
Published: April 2014

After nail matrix ablation using phenolization, a medicated wound dressing (10% povidone iodine), an amorphous hydrogel dressing (Intrasite Gel), and a control dressing (paraffin gauze) were evaluated. Forty-two participants, randomly divided into three dressing groups, were evaluated. Healing time did not differ between the 10% povidone iodine (33 days), amorphous hydrogel (33 days), and the control dressing (34 days). For all groups, the clinical infection rate was lower than in previous studies, and there was no clinical difference between groups (one infection in the povidone iodine and control groups; none in the amorphous hydrogel group). However, in the amorphous hydrogel group, other complications, such as hypergranulation, were more likely. This investigation indicated that medicated or hydrogel dressings did not enhance the rate of healing or decrease infection rates. (J Am Podiatr Med Assoc 91(5): 230-233, 2001)
The Effect of High-Dye and Low-Dye Taping on Rearfoot Motion
Authors: Keenan Anne-Maree , Tanner Craig M.
Published: April 2014

High-Dye and low-Dye taping are commonly used by clinicians to treat a variety of foot and ankle pathologies, particularly those associated with excessive rearfoot pronation. While the effects of taping on end range of motion have been extensively studied, relatively little is understood about the effect of the two styles of taping on rearfoot motion. Eighteen participants were analyzed in three conditions: 1) barefoot, 2) with high-Dye taping, and 3) with low-Dye taping. Two-dimensional motion of the rearfoot was assessed for each condition. The results indicated maximum inversion was increased with both high-Dye and low-Dye taping as compared with no taping. Only high-Dye taping, however, significantly reduced the maximum eversion of the rearfoot. The results suggest that high-Dye taping is an appropriate taping choice when control of eversion of the rearfoot is desired. (J Am Podiatr Med Assoc 91(5): 255-261, 2001)
Reliability of Navicular Displacement Measurement as a Clinical Indicator of Foot Posture
Authors: Vinicombe Ann , Raspovic Anita , Menz Hylton B.
Published: April 2014

This study evaluated two methods for quantifying foot posture: navicular drop and navicular drift. Five clinicians measured 20 nonpathological participants on two occasions. Intraclass correlation coefficients ranged from 0.33 to 0.76 for navicular drop and from 0.31 to 0.62 for navicular drift. The standard error of measurement, as a 95% confidence interval, ranged from ±1.5 mm to ±3.5 mm for navicular drop and ±3 mm to ±5 mm for navicular drift. Intratester reliability was slightly better than intertester reliability for both measurements. These results indicate that both techniques are only moderately reliable, and physicians using these measurements in clinical practice should interpret the values in light of the magnitude of error associated with them. (J Am Podiatr Med Assoc 91(5): 262-268, 2001)
The Distribution of Plantar Pressures in American Indians with Diabetes Mellitus
Authors: McPoil Thomas G. , Yamada Wesley , Smith Wayne , Cornwall Mark
Published: April 2014

The primary purpose of this study was to determine the magnitude and duration of plantar pressures acting on the feet of American Indians with diabetes mellitus. A secondary purpose was to determine whether differences in the range of motion of the ankle and first metatarsophalangeal joints existed between American Indians with and without diabetes. Three groups of American Indian subjects were tested: a control group (n = 20); a group with diabetes but no peripheral neuropathy (n = 24); and a group with diabetes and peripheral neuropathy (n = 21). A floor-mounted pressure sensor platform was used to collect plantar pressure data while subjects walked barefoot. The results indicated that American Indians with diabetes have 1) a pattern of peak plantar pressure similar to patterns previously reported for non–American Indians with diabetes and 2) a reduction in ankle and first metatarsophalangeal joint range of motion in comparison with nondiabetic American Indians. (J Am Podiatr Med Assoc 91(6): 280-287, 2001)
Acute Charcot Foot Changes versus Osteomyelitis
Authors: Boc Steven F. , Brazzo Keith , Lavian Dana , Landino Thomas
Published: April 2014

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)
Brachymetatarsia of the Third and Fourth Metatarsals
Authors: Goforth William P. , Overbeek Troy D.
Published: April 2014

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)
Flake-Austin Modification of the STA-Peg Arthroereisis
Authors: Forg Patricia , Feldman Kent , Flake Edward , Green Donald R.
Published: April 2014

The Smith subtalar arthroereisis implant (STA-peg) is used to correct severe collapsing pes valgoplanus in children. Flake and Austin modified the placement of this implant to block the leading wall of the lateral talus. Twenty-one patients with a total of 40 STA-peg procedures were evaluated subjectively and objectively. The average age at the time of surgery was 9.7 years (4 to 16 years). The follow-up period averaged 36 months (12 to 90 months). The subjective, objective, and radiographic results were positive and the complication rate was low. A significant advantage of the Flake-Austin modification of the STA-peg placement in transverse planar dominant foot types is also noted. (J Am Podiatr Med Assoc 91(8): 394-405, 2001)
The Diagnosis of Onychomycosis in a Geriatric Population
Authors: Scherer William P. , McCreary Jon P. , Hayes Walter W.
Published: April 2014

An investigative study was performed to determine the diagnosis of onychomycosis in a South Florida geriatric population. In this study, 450 cases of suspected onychomycosis involving men and women 65 years of age and older from a private practice office and two nursing home settings were used. Samples were taken from the hallux toenail and sent to a mycology laboratory for fluorescent potassium hydroxide (KOH) preparation and microscopic examination of a fungal culture. Of the 450 cases studied, 46.4% of the patients had a single fungal organism cultured, 30.4% had a mixed fungal infection cultured, and 23.1% had no fungal growth. Saprophytes were found in 59.9% of the 526 total fungal organisms cultured while dermatophytes were found in only 23.8%. The results of this investigation demonstrate that there may be a shift from isolated dermatophyte infection to mixed saprophyte infections in a geriatric population with onychomycosis. (J Am Podiatr Med Assoc 91(9): 456-464, 2001)
A Conceptual Model for Public Health Education in Podiatric Medicine
Authors: Helfand Arthur E. , Hausman Alice J.
Published: April 2014

This article discusses the need for and the advantages of a dual degree program between podiatric medicine and public health. The authors expand on the existing program for public health education at the first professional degree level to include a conceptual model for a dual degree program developed at Temple University’s Department of Health Studies, through the Graduate School and the School of Podiatric Medicine. The model combines didactic and clinical education at the graduate level to ensure that clinicians involved in determining health policy are prepared to represent the profession in the restructuring of the health-care system. (J Am Podiatr Med Assoc 91(9): 488-495, 2001)
Third-Party Reimbursement for Lower-Extremity Wound Care
Authors: Goldsmith Harry , Garoufalis Matthew G.
Published: April 2014

This article describes the treatment of lower-extremity wounds, specifically foot and ankle ulcerations, in the context of reimbursement for treatments rendered. Therefore, such issues as standard of care, documentation, classification of foot wounds, coding, and reimbursement are discussed. (J Am Podiatr Med Assoc 92(1): 54-58, 2002)
Retrocalcaneal Exostosis
Authors: Boberg Jeffrey S. , Anania Michelle C.
Published: April 2014

Various procedures have been described for removing a retrocalcaneal exostosis. These procedures require partial or complete detachment of the insertion of the Achilles tendon and ultimate resection of the exostosis. The authors introduce a simplified technique to surgically excise a retrocalcaneal exostosis based on an important and newly reported anatomical relationship. The procedure is performed through a posterior transverse incision and requires little or no reflection of the Achilles tendon. Overall, the 14 patients studied retrospectively wore shoes and returned to usual activities fairly rapidly after this procedure; however, time until patients were free of pain averaged nearly 12 months. Two patients did not obtain relief and required additional surgery despite complete removal of the exostosis. These results challenge the assumption that retrocalcaneal pain is secondary to exostosis formation. (J Am Podiatr Med Assoc 92(10): 537-542, 2002)
Hammer Toe Correction by Arthrodesis of the Proximal Interphalangeal Joint Using a Cortical Bone Allograft Pin
Authors: Miller Stephen J.
Published: April 2014

In hammer toe correction by means of digital fusion, fixation so that the bone can unite while maintaining appropriate realignment can be a challenge. Metal fixation pins can be associated with many problems and potential complications. The author presents a method of rigid internal fixation using 2.4-mm-diameter pins fashioned out of freeze-dried allogeneic cortical bone. These devices avoid most of the risks of metal pins. Proximal interphalangeal joint arthrodesis using cortical bone pins was performed on 26 toes in 18 patients with very few complications. The author concludes that use of cortical bone pins can yield successful results in most cases. The outcomes of the fusions can be further enhanced by using flexor digitorum longus tendon transfer. (J Am Podiatr Med Assoc 92(10): 563-569, 2002)
Tendon Reconstruction in Posterior Tibial Tendon Dysfunction
Authors: Zirm Richard J.
Published: April 2014

Successful treatment of posterior tibial tendon dysfunction depends on accurate staging and the appropriate selection of surgical procedures. Magnetic resonance imaging is the most sensitive diagnostic modality for evaluating the tendon and is also the best predictor of clinical outcome following surgery. Procedural selection for patients with posterior tibial tendon dysfunction depends on many factors, including the underlying cause, age, weight, apex of the deformity, and relative integrity of the posterior tibial tendon. (J Am Podiatr Med Assoc 92(10): 570-574, 2002)
Kinematics of the Midtarsal Joint During Standing Leg Rotation
Authors: Nester Christopher , Bowker Peter , Bowden Peter
Published: April 2014

Building on previous work that was cadaver based or involved invasive techniques, this study quantifies the kinematics of an approximation of the midtarsal joint with a noninvasive method. Three-dimensional kinematic data describing the motion of the forefoot and heel during transverse plane rotation of the leg were collected from 25 subjects by means of reflective markers and four infrared cameras. The motion between these segments was assumed to be the best possible clinical approximation of the midtarsal joint. The kinematic characteristics of the midtarsal joint were described in terms of the range and direction of motion in each cardinal body plane, the ratio of the range of motion in each plane, and the orientation of the axis of rotation. The characteristics of the midtarsal joint changed during the range of motion; thus, multiple axes of rotation could be calculated and joint characteristics were varied among subjects. The results of this in vivo method were generally consistent with those of cadaver studies and invasive in vivo studies. (J Am Podiatr Med Assoc 92(2): 77-81, 2002)
Limb Salvage in Recurrent Synovial Sarcoma of the Right Ankle and Lower Leg
Authors: Sobel Ellen , Giorgini Renato , Oropeza Ruben , Bapat Kalyani , Richardson Hugh
Published: April 2014

Synovial sarcoma of the extremities represents 7% of all soft-tissue sarcomas. This article presents the case of a patient who was treated for a synovial sarcoma of the lateral aspect of the distal lower leg extending to the ankle and involving the fibular bone. The patient underwent a wide excision of the tumor, including the fibular bone, followed by radiation and chemotherapy, rather than undergo an amputation of the right leg. Consideration is also given to the traumatic etiology of the tumor. (J Am Podiatr Med Assoc 92(2): 90-96, 2002)
Variations in the Origin of the Medial Calcaneal Nerve
Authors: Dellon A. Lee , Kim Jaesuk , Spaulding Cecily M.
Published: April 2014

Previous anatomic studies of the medial heel region were done on embalmed human cadavers. Here, the innervation of the medial heel region was studied by dissecting living tissue with the use of 3.5-power loupe magnification during decompression of the medial ankle for tarsal tunnel syndrome in 85 feet. The medial heel was found to be innervated by just one medial calcaneal nerve in 37% of the feet, by two medial calcaneal nerves in 41%, by three medial calcaneal nerves in 19%, and by four medial calcaneal nerves in 3%. An origin for a medial calcaneal nerve from the medial plantar nerve was found in 46% of the feet. This nerve most often innervates the skin of the posteromedial arch, where it is at risk for injury during calcaneal spur removal or plantar fasciotomy. Knowledge of the variations in location of the medial calcaneal nerves may prevent neuroma formation during surgery and provide insight into the variability of heel symptoms associated with tarsal tunnel syndrome. (J Am Podiatr Med Assoc 92(2): 97-101, 2002)
A Comparative Study of Lactic Acid 10% and Ammonium Lactate 12% Lotion in the Treatment of Foot Xerosis
Authors: Jennings Maureen B. , Logan Loretta , Alfieri Donna M. , Ross Charles F. , Goodwin Susan , Lesczczynski Christine
Published: April 2014

Xerotic skin is a pattern of reaction to a variety of disorders that have abnormalities of desquamation in common. This double-blind, randomized clinical trial investigated the effect of Lactinol (Pedinol Pharmaceuticals, Farmingdale, New York) versus Lac-Hydrin 12% (Bristol-Myers Squibb, Princeton, New Jersey) lotion in mild to moderate foot xerosis. Clinical assessment of xerosis was performed at baseline visit, and the designated sites were evaluated at 2 and 4 weeks after treatment began. Of the 53 patients enrolled, 18 were excluded from analysis. Although both treatment groups had significantly improved xerosis scores after 2 and 4 weeks of treatment, no statistically significant difference was observed. Of the 44% of patients who did express a preference, 72% preferred Lactinol, which may account for the 20% increase in its overall use in the study. (J Am Podiatr Med Assoc 92(3): 143-148, 2002)
Enhanced Tenodesis for Retrocalcaneal Surgery
Authors: Yu Gerard V. , Weinfeld Glenn D. , Gorby Paul O. , Dujela Michael D. , Frania Stephen
Published: April 2014

Retrocalcaneal surgery is complex and difficult. Over the years, many different approaches to retrocalcaneal surgery have been described. Partial or total release of the tendo Achillis is often necessary, with reattachment being of paramount importance to allow for optimal function following surgery. Although numerous anchoring devices have been introduced for tendo Achillis reattachment, the authors have found the DePuy TiMAX Spider Plate (DePuy ACE, Warsaw, Indiana) to be superior. This article describes the Spider Plate and associated surgical technique, which have greatly enhanced the outcome of retrocalcaneal surgery. (J Am Podiatr Med Assoc 92(4): 200-209, 2002)
Evaluation and Treatment of Stage 0 Charcot’s Neuroarthropathy of the Foot and Ankle
Authors: Yu Gerard V. , Hudson Justin R.
Published: April 2014

Charcot’s neuroarthropathy is a relatively common disease in patients with diabetic neuropathy. If unrecognized or left untreated, Charcot’s neuroarthropathy can result in a severely misshapen and unstable foot and ankle. Ulceration, soft-tissue infection, and osteomyelitis frequently ensue, and partial or complete amputation of the foot is not uncommon. A high index of suspicion and proper interpretation of clinical and diagnostic findings are essential to establish a timely and accurate diagnosis and to institute appropriate treatment. The pathogenesis of neuroarthropathy is reviewed and diagnosis and treatment of the stage 0 diabetic Charcot foot are presented. (J Am Podiatr Med Assoc 92(4): 210-220, 2002)
Achilles Tendon Rupture as a Result of Oral Steroid Therapy
Authors: Hersh Bryan L. , Heath Nicholas S.
Published: April 2014

Spontaneous Achilles tendon rupture associated with long-term oral steroid use is not uncommon, particularly in older patients who use these drugs daily to treat systemic diseases. Rupture often results in a large defect, which complicates surgical repair. The authors review Achilles tendon rupture associated with systemic and local steroid use and present a case of rupture due to chronic oral steroid use in a patient with Addison’s disease. (J Am Podiatr Med Assoc 92(6): 355-358, 2002)
Maggot Debridement Therapy
Authors: Armstrong David G. , Mossel Jeff , Short Brian , Nixon Brent P. , Knowles E. Ann , Boulton Andrew J. M.
Published: April 2014

Treatment of chronic wounds of the lower extremity requires a systematic, multidisciplinary approach as well as flexibility in order to achieve acceptable, consistent short-term and long-term results. Maggots, once considered an obsolete therapeutic modality, can be a useful addition to the armamentarium of the foot and ankle specialist. This article describes the use of maggot debridement therapy for intractable wounds of the lower extremity. (J Am Podiatr Med Assoc 92(7): 398-401, 2002)
How and Why to Surgically Debride Neuropathic Diabetic Foot Wounds
Authors: Armstrong David G. , Lavery Lawrence A. , Vazquez Jeffrey R. , Nixon Brent P. , Boulton Andrew J. M.
Published: April 2014

Wound debridement, when systematically performed, may be as important as off-loading in reducing the prevalence of chronic inflammatory by-products in a wound and thus in converting a chronic wound into an acute one. Although it has been suggested that aggressive surgical debridement of wounds may be beneficial, there have been few, if any, technical descriptions of this aspect of therapy. It is therefore the purpose of this article to describe the general principles, process, and technique of outpatient surgical debridement of noninfected, nonischemic neuropathic diabetic foot wounds performed at the authors’ institutions. The authors hope to foster further discussion leading to improvement in the process and the prevalence of such debridement. (J Am Podiatr Med Assoc 92(7): 402-404, 2002)
Recognition of the Flexor Digitorum Accessorius Longus
Authors: Deroy Alan R. , Clause Chad C. , Baskin Eric S. , Bauer Gary R.
Published: April 2014

The flexor digitorum accessorius longus muscle was observed during a cadaveric surgery course on the foot and ankle for third-year podiatric medical students. The cadaveric foot had been amputated just proximal to the ankle level so that the muscle origin could not be determined; its insertion, however, was found to be into the flexor digitorum longus tendon, just before the tendon split into its digital slips. This article reviews the literature on the muscle and its clinical implications and describes and shows the muscle as it was seen in this case. (J Am Podiatr Med Assoc 92(8): 463-466, 2002)
External Thermoregulation of Wounds Associated with Lower-Extremity Osteomyelitis
Authors: Karr Jeffrey C.
Published: April 2014

External thermoregulation using noncontact normothermic wound therapy accelerates wound closure by second intention in areas of existing osteomyelitis before surgical excision compared with standard wound care. This pilot study consisted of two arms. The control arm received standard wound care, which resulted in complete ulcer healing at an average of 127 days. The treatment arm received noncontact normothermic wound therapy, which resulted in complete ulcer healing at an average of 59 days, or 54% faster than in the control arm. This new treatment allows the physician to decrease the rate of limb loss and recurrent osteomyelitis by decreasing the morbidity of bone reinfection through the wound bed. There have been no published studies or case presentations addressing thermoregulation in the management of wounds associated with osteomyelitis. Although noncontact normothermic wound therapy is not a direct treatment for osteomyelitis, this new treatment option results in significantly accelerated healing of wounds associated with osteomyelitis. (J Am Podiatr Med Assoc 93(1): 18-22, 2003)
Fall-Contributing Adverse Effects of the Most Frequently Prescribed Drugs
Authors: Smith Robert G.
Published: April 2014

The 200 most frequently prescribed medications in 2000 were reviewed for adverse effects that have the potential to cause fall injuries. The actual number of different medications reviewed was 169 after eliminating duplicates due to listing of medications by both brand and generic names. Of these 169 medications, adverse effects of documented traumatic injuries and falls were reported for 9.5% (n = 16). Four hundred forty-eight adverse effects were identified and organized into 13 broad categories representing drug-induced changes in nervous, circulatory, and muscular systems. These changes were reported for 157 medications reviewed (92.9%) and could result in fall injuries. The accompanying list of medications can serve as a ready reference for podiatric physicians and other health-care professionals when monitoring and counseling patients regarding the potential for medication-induced fall injuries, which are especially common in the elderly population. (J Am Podiatr Med Assoc 93(1): 42-50, 2003)
Fracture of the Second Metatarsal Base
Authors: Morris Gregory , Nix Kelly , Goldman Flair D.
Published: April 2014

Fracture of the second metatarsal is a cause of chronic midfoot pain that has not been thoroughly examined in the literature. A retrospective review of medical charts and imaging studies was undertaken to investigate this phenomenon. The clinical presentation, differential diagnosis, results of imaging studies, and treatment modalities are described for eight patients with midfoot pain who were treated for a mean of 3.7 months (range, 0 to 12 months) before imaging studies showed a nondisplaced transverse fracture of the second metatarsal base. Initial radiographs indicated fracture in only one patient. Two patients later had surgical bone grafting, two patients had asymptomatic nonunion, and three patients eventually healed. At the last follow-up examination, one patient was continuing treatment with immobilization and electrical bone stimulation. For the seven patients in whom symptoms resolved, the mean recovery period was 14 months (range, 5 to 23 months). Further research is needed to improve treatment and outcomes for this condition. (J Am Podiatr Med Assoc 93(1): 6-10, 2003)
Effect of the Low-Dye Strap on Pronation-Sensitive Mechanical Attributes of the Foot
Authors: Whitaker Jeffrey M. , Augustus Kazuto , Ishii Suzanne
Published: April 2014

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. (J Am Podiatr Med Assoc 93(2): 118-123, 2003)
Topical Treatments for Onychomycosis
Authors: Bodman Myron A. , Feder Lisa , Nace Angela M.
Published: April 2014

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. (J Am Podiatr Med Assoc 93(2): 136-141, 2003)
Reliability of the Foot Posture Index and Traditional Measures of Foot Position
Authors: Evans Angela M. , Copper Alexander W. , Scharfbillig Rolf W. , Scutter Sheila D. , Williams Marie T.
Published: April 2014

Repeatable measures are essential for clinicians and researchers alike. Both need baseline measures that are reliable, as intervention effects cannot be accurately identified without consistent measures. The intrarater and interrater reliability of the new Foot Posture Index and current podiatric measures of foot position were assessed using a same-subject, repeated-measures study design across three age groups. The Foot Posture Index total score showed moderate reliability overall, demonstrating better reliability than most other current measures, although navicular height (normalized for foot length) was the single most reliable measure in adults. None of the tested measures exhibited adequate reliability in young children, and, with less-than-desirable reliability being demonstrated, most measures need to be interpreted accordingly when repeated measures are involved. (J Am Podiatr Med Assoc 93(3): 203-213, 2003)
Hyperbaric Oxygen Therapy for Lower-Extremity Soft-Tissue Sports Injuries
Authors: Kanhai Alicia , Losito James M.
Published: April 2014

Lower-extremity injuries have become increasingly common as sports performance demands have risen. Hyperbaric oxygen therapy is one method used to return athletes to competition as quickly as possible, but it has received criticism and lacks support. This review examines the literature on hyperbaric oxygen therapy and soft-tissue sports injuries. In the various studies, the location of the injury seemed to influence the effectiveness of treatment. Injuries at areas of reduced perfusion such as muscle–tendon junctions and ligaments seemed to benefit more from hyperbaric oxygen treatment than injuries at the muscle belly. Differences in the magnitude of the injury and in the time between injury and treatment may also affect outcomes. The authors sought to explore these variables as they relate to soft-tissue sports injuries and to weigh the benefits of hyperbaric oxygen therapy against its potential risks and high cost. More randomized controlled clinical trials with larger sample sizes must be conducted before hyperbaric oxygen can be established as a safe adjunctive therapy for soft-tissue sports injuries. (J Am Podiatr Med Assoc 93(4): 298-306, 2003)
Glancing Back, Striding Ahead
Authors: Bouché Richard T.
Published: April 2014

This article provides a succinct but comprehensive review of the history of the American Academy of Podiatric Sports Medicine. Three time periods are described: the pre-academy era, the early years of podiatric sports medicine leading up to the academy’s founding, and the academy’s founding and the 1970s. An appreciation of the academy’s past facilitates understanding of its present state and future direction. (J Am Podiatr Med Assoc 93(4): 315-320, 2003)
Differential Diagnosis of Leg Pain in the Athlete
Authors: Fredericson Michael , Wun Cindy
Published: April 2014

Leg pain in the athlete is common and has many different etiologies. The most common causes include muscle or tendon injury, medial tibial stress syndrome, stress fracture, and exertional compartment syndrome. Less common causes of leg pain include lumbosacral radiculopathy, lumbosacral spinal stenosis, focal nerve entrapment, vascular claudication from atherosclerosis, popliteal artery entrapment syndrome, and venous insufficiency. This article reviews the essential history and physical examination findings and the various causes of leg pain to help the clinician pinpoint the diagnosis and facilitate the athlete’s return to sport participation. (J Am Podiatr Med Assoc 93(4): 321-324, 2003)
Distally Based Capsule-Periosteum Interpositional Arthroplasty for Hallux Rigidus
Authors: Roukis Thomas S. , Landsman Adam S. , Ringstrom James B. , Kirschner Peter , Wuenschel Markus
Published: April 2014

Twelve patients (15 feet) with severe hallux rigidus underwent distally based capsule-periosteum interpositional arthroplasty of the first metatarsophalangeal joint (mean ± SD follow-up, 16.8 ± 7.0 months). Subjective evaluation was based on a modified version of the American Orthopaedic Foot and Ankle Society’s 100-point Hallux Metatarsophalangeal-Interphalangeal Joint Scale. Objective evaluation consisted of preoperative and postoperative physical examinations (first metatarsophalangeal joint range of motion and axial grind testing) and radiographic evaluations (joint space width). The short-term results of this novel procedure showed subjective patient improvement and satisfaction, increased first metatarsophalangeal joint dorsal range of motion, maintained hallux plantar range of motion and power, and improved joint space width on anteroposterior and lateral radiographs. None of the patients developed a hallux hammer toe or extensus deformity or lesser metatarsalgia, and none required further surgical intervention. After describing the indications of the procedure and the surgical technique, the authors compare the results with those of the various other procedures available for the surgical treatment of hallux rigidus. (J Am Podiatr Med Assoc 93(5): 349-366, 2003)
Do Clinical Examination Variables Predict High Plantar Pressures in the Diabetic Foot?
Authors: Wrobel James S. , Birkmeyer Nancy J. , Dercoli Jennifer L. , Connolly John E.
Published: April 2014

Elevated plantar pressures are an important predictor of diabetic foot ulceration. The objective of this study was to determine which clinical examination variables predict high plantar pressures in diabetic feet. In a cross-sectional study of 152 male veterans with diabetes mellitus, data were collected on demographics, comorbid conditions, disease severity, neuropathy status, vascular disease, and orthopedic and gait examinations. Univariate predictors included height, weight, body surface area, body weight per square inch of foot surface area, bunion deformity, hammer toe, Romberg’s sign, insensitivity to monofilament, absent joint position sense, decreased ankle dorsiflexion, and fat pad atrophy. Variables that remained significantly associated with high plantar pressures (≥4 kg/cm2) in multivariate analysis included height, body weight per square inch of foot surface area, Romberg’s sign, and insensitivity to monofilament. These results may be useful in identifying patients who would benefit from interventions designed to decrease plantar foot pressures. (J Am Podiatr Med Assoc 93(5): 367-372, 2003)
Onychauxic Dystrophic Toenails Requiring Debridement in Medicare Patients
Authors: Frank Seymour C. , Freer Helene L.
Published: April 2014

Six hundred twenty-nine Medicare patients were evaluated for the presence of onychauxic toenails that in the judgment of the examiners required reduction. Forty-two percent of this group had five or fewer toenails requiring reduction and 24.3% had six or more toenails requiring reduction. Statistics reported by a regional Medicare-contracted carrier for the years 1997 to 1999 showed that 95% of claims submitted for nail debridement were for six or more nails and 5% were for five or fewer nails. The 1999 Medicare Part B data listed the top 300 Current Procedural Terminology (CPT) foot-care codes in order of utilization. Code 11721 (debridement of six or more nails) was number one. National statistics from the Health Care Financing Administration in 1999 indicated approximately a 5:1 ratio in favor of CPT code 11721 (six or more nails). In contrast, this study found a ratio of 2:1 in favor of CPT code 11720 (five or fewer nails). (J Am Podiatr Med Assoc 93(5): 388-391, 2003)
Chigger Mite Infestation
Authors: Axman Wayne R. , Brummer John J.
Published: April 2014

This article reports on a 45-year-old woman who presented with pruritus and was diagnosed as having chigger mite infestation, a rare condition. The chigger mite larvae were encountered while the patient was traveling in South America. A small erythematous area with a well-circumscribed papule in the sulcus of the second digit of the right foot was incised and drained. Follow-up examination showed relief of all symptoms, including pain and pruritus. This unusual case presentation underscores the need for all podiatric physicians to obtain a comprehensive history, including history of travel, along with performing a thorough physical examination. (J Am Podiatr Med Assoc 93(5): 399-401, 2003)
Skin Temperatures as a One-time Screening Tool Do Not Predict Future Diabetic Foot Complications
Authors: Armstrong David G. , Lavery Lawrence A. , Wunderlich Robert P. , Boulton Andrew J. M.
Published: April 2014

This prospective longitudinal study assessed whether baseline mean skin temperature measurements are useful in predicting the most common foot-related complications of diabetes mellitus. We evaluated the mean of baseline skin temperatures taken bilaterally from six plantar sites in 1,588 patients with diabetes. There was no difference in skin temperature based on neuropathy, foot laterality, or foot risk category or between people with and without foot deformity and elevated plantar foot pressure. Whereas people with Charcot’s arthropathy had slightly but significantly higher mean temperatures (84.8° ± 3.5° F versus 82.5° ± 4.7° F), this was not true for those who developed ulcers or infections or who underwent amputations. The presence of vascular disease was not associated with lower skin temperatures. Mexican Americans (83.0° ± 4.6° F) and blacks (83.6° ± 4.5° F) had higher mean skin temperatures at baseline than did non-Hispanic whites (81.8° ± 4.6° F). Baseline measurement of nonfocal mean skin temperatures is not an effective means of screening people for future events. Regular assessment of skin temperatures, using the contralateral site as a physiologic control, may be a better use of this technology. (J Am Podiatr Med Assoc 93(6): 443-447, 2003)
Criterion Validation of Four Criteria of the Foot Posture Index
Authors: Scharfbillig Rolf , Evans Angela M. , Copper Alexander W. , Williams Marie , Scutter Sheila , Iasiello Hala , Redmond Anthony
Published: April 2014

The Foot Posture Index is a new multidimensional and multiplanar tool aimed at quantifying the degree of pronation to supination of the foot, comprising eight criteria that sum to produce a final “score” of foot posture. In an initial study involving 31 subjects, angulations measured from dorsoplantar and lateral radiographs were compared with the corresponding Foot Posture Index criteria using Spearman’s rho and the generalized linear model of analysis of variance. Eleven of the participants from Study 1 completed a second study in which wedges were used to alter foot position to determine whether changes to foot position were sensitively reflected in Foot Posture Index criterion scores and associated radiographic images. Study 1 demonstrated a significant correlation for only one criterion (talar head palpation), while Study 2 demonstrated intrasubject sensitivity to overall changes from supinated to pronated and supinated to resting positions but insensitivity to changes from resting to pronated positions. The results suggest that although the Foot Posture Index could be a useful tool to broadly classify foot postures, it is not sensitive to all small movements when assessed by this method. (J Am Podiatr Med Assoc 94(1): 31-38, 2004)
Proximal Oblique Crescentic Osteotomy in Hallux Valgus
Authors: Pehlivan Ozcan , Akmaz Ibrahim , Solakoglu Can , Kiral Ahmet , Kaplan Haluk
Published: April 2014

Twenty-six patients with moderate-to-severe hallux valgus deformities were evaluated before and after treatment. All of the patients had incongruent great toe joints. The patients underwent modified proximal crescentic osteotomy, which was termed proximal oblique crescentic osteotomy. The results were evaluated at an average follow-up time of 55 weeks. Objective criteria were hallux valgus angle, intermetatarsal angle, shortening of the first metatarsal, and angulation at the osteotomy site. Clinical evaluation was made according to the rating system of the American Orthopaedic Foot and Ankle Society. The mean correction of the hallux valgus and intermetatarsal angles was 22.1° and 9.9°, respectively. Short-term results indicate that proximal oblique crescentic osteotomy is effective in the treatment of hallux valgus; its advantages over other procedures include its technical ease and low rate of complications. (J Am Podiatr Med Assoc 94(1): 43-46, 2004)
Effects of Changes in Heel Fat Pad Thickness and Elasticity on Heel Pain
Authors: Özdemır Hakan , Söyüncü Yetkın , Özgörgen Mete , Dabak Kürşat
Published: April 2014

The heel fat pad has a unique structure that is important for its shock-absorbing function. Loss of elasticity and changes in the thickness of the heel pad have been suggested as causes of heel pain. The present study of a population with heel pain shows the relationship between the thickness and elasticity of the heel fat pad and age, sex, obesity, duration of symptoms, subcalcaneal spurs, and noninvasive conservative treatment. Of 182 patients with heel pain who visited an outpatient clinic during a 3-year period, 50 (67 heels) fulfilling specific criteria were treated with a combination of nonsteroidal anti-inflammatory drugs, contrast baths, stretching exercises, and change of footwear habits. Patients were followed up for 1 year. Delayed healing, increased thickness, and decreased elasticity of the heel fat pad were found in patients who were older than 40 years, who had symptoms for longer than 12 months before treatment, and who had a large subcalcaneal spur. An increase in heel fat pad thickness with aging and increased body weight reduce the elasticity of the heel fat pad. In addition, subcalcaneal spurs diminish the elasticity of the heel fat pad and play a role in the formation of heel pain. (J Am Podiatr Med Assoc 94(1): 47-52, 2004)
Does Footwear Affect Ankle Coordination Strategies?
Authors: Kurz Max J. , Stergiou Nicholas
Published: April 2014

The hypothesis of this study was that shoe hardness and footwear affect ankle coordinative strategies during the running stance period. Subjects ran at a self-selected pace under three conditions—barefoot, wearing a hard shoe, and wearing a soft shoe—while sagittal and frontal view kinematic data were collected. Dynamic systems theory tools were used to explore ankle coordinative strategies under the three conditions. No significant differences in coordination were found between the two shoe conditions. However, significant differences in ankle coordinative strategies existed between the shoe conditions and the barefoot condition. Changes in coordinative strategies may be related to different mechanisms to attenuate impact forces while running barefoot. (J Am Podiatr Med Assoc 94(1): 53-58, 2004)
Neurothekeoma in the Foot
Authors: Persich Gianni , Portela Margaret
Published: April 2014

Neurothekeoma is a benign cutaneous neoplasm of nerve sheath origin. This seldom-seen entity is especially rare in the foot. We provide an overview of neurothekeoma and describe a patient with an occurrence in the foot that was effectively treated by complete excision of the mass. (J Am Podiatr Med Assoc 94(1): 59-60, 2004)
Common Neurologic Disorders Affecting the Foot
Authors: Woods Rochelle J. , Cervone Richard L. , Fernandez Hubert H.
Published: April 2014

Podiatric physicians care for a wide spectrum of patients with neurologic illness. Often, patients with neurologic disease present to their podiatric physician with unrelated complaints that can be easily separated from their underlying neurologic condition. However, some neurologic conditions predictably lead to podiatric disease and, as such, are best treated in the context of the broader disease process. Neuropathies, spastic disorders, and cerebral palsy are examples of common neurologic disorders that can be associated with substantial podiatric manifestations; therefore, it is important for podiatric physicians to be familiar with these conditions. This article reviews the pathophysiology, clinical manifestations, and management of the common neurologic disorders affecting the foot. (J Am Podiatr Med Assoc 94(2): 104-117, 2004)
Management of Hyperglycemia in the Hospitalized Podiatric Medical Patient
Authors: Hein Michael David
Published: April 2014

With the growing prevalence worldwide of diabetes mellitus and hyperglycemia, hospital-based health-care professionals will encounter patients with these conditions with increasing frequency. It is well known that long-term control of blood glucose reduces the rate and severity of complications in patients with diabetes, but there is also mounting evidence that even short-term glycemic control in hospitalized diabetic patients can significantly lower morbidity and mortality in many areas, from nosocomial infection to postoperative course. The results of traditional approaches to controlling blood glucose in hospitalized patients have been disappointing owing to a variety of factors, including the use of oral agents that are difficult or dangerous to use in inpatients, older insulin preparations with unphysiologic modes of action, and even provider reluctance to accept glycemic control as an essential element of the care of the diabetic hospitalized patient. This article provides guidelines for the effective management of hyperglycemia in these patients throughout the hospital stay, with specific recommendations for the perioperative, operative, and postoperative periods. (J Am Podiatr Med Assoc 94(2): 135-148, 2004)
Geriatric Pharmacology
Authors: Wright Rollin M. , Warpula Rick W.
Published: April 2014

Adverse drug effects are common in elderly patients but can often be avoided. Judicious prescribing practices require the clinician to be aware of age-related changes in drug absorption, distribution, metabolism, and elimination. Clinicians may need to adjust drug dose, frequency, or the choice of drug altogether as they consider the physiologic changes of aging. This article reviews prescribing situations with elderly patients commonly encountered by the podiatric physician. Strategies for medication management are provided to minimize the risk of adverse drug events in the older patient. (J Am Podiatr Med Assoc 94(2): 90-97, 2004)
The pros and cons of degeneracy
Authors: Goaillard Jean-Marc , Dufour Martial A
Published: April 2014

Drugs could treat neuropathic pain more effectively if they simultaneously targeted two or more types of ion channel.
Measurement of Autophagy by Flow Cytometry
Authors: Warnes Gary
Published: April 2014

In recent years, flow cytometry has been used to detect the presence of autophagy mainly by the fluorescent antibody labeling of the autophagy marker, the microtubule associated protein LC3‐II. Here we describe the indirect antibody labeling of LC3‐II in cells displaying drug‐induced autophagy by the use of rapamycin and chloroquine, as well as cells undergoing serum starvation. Although the mechanism of action of LysoTracker dyes is not fully understood, lysosomal mass increases during the autophagic process to enable the cell to produce autolysosomes. Given that LC3‐II and LysoTracker are measuring different biological events in the autophagic process, they surprisingly both up‐regulated during autophagic process. This approach shows that although LysoTracker dyes do not specifically label lysosomes or autophagosomes within the cell, they allow the simultaneous measurement of an autophagy related process and other live cell functions, which is not possible with the standard LC3‐II antibody technique. Curr. Protoc. Cytom. 68:9.45.1‐9.45.10. © 2014 by John Wiley & Sons, Inc.