bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of Superoxidized Aqueous Solution versus Saline as a Replacement Solution in the Versajet Lavage System in Chronic Diabetic Foot Ulcers
Authors: Bowling Frank L. , Crews Ryan T. , Salgami Eleanna , Armstrong David G. , Boulton Andrew J.M.
Published: April 2014

Background: The removal of necrotic tissue from chronic wounds is required for wound healing to occur. Hydrodebridement (jet lavage) and superoxidized aqueous solution have been independently used for debriding wounds. We sought to investigate the use of superoxidized aqueous solution with a jet lavage system.

Methods: Twenty patients with diabetic foot ulcers were randomly assigned in a 1:1 ratio to receive jet lavage debridement with either superoxidized aqueous solution or standard saline weekly.

Results: There was no significant difference between the two treatments in the reduction of bacterial load or wound size in 4 weeks. No adverse reactions were reported for either treatment.

Conclusions: The use of superoxidized aqueous solution for jet lavage debridement seemed to be as safe and effective as saline. Future investigations should concentrate on whether superoxidized aqueous solution may reduce the bacterial air contamination associated with hydrodebridement. (J Am Podiatr Med Assoc 101(2): 124–126, 2011)
In Vitro Antimicrobial Activity of Calcium Sulfate and Hydroxyapatite (Cerament Bone Void Filler) Discs Using Heat-Sensitive and Non–Heat-sensitive Antibiotics Against Methicillin-Resistant Staphylococcus aureus and Pseudomonas aeruginosa
Authors: Karr Jeffrey C. , Lauretta Joseph , Keriazes Georgia
Published: April 2014

Background: Several absorbable and nonabsorbable antibiotic carrier systems are available in the adjunctive surgical management of osteomyelitis of the foot, ankle, and lower leg. These carrier systems have significant limitations regarding which antibiotics can be successfully incorporated into the carrier vehicle. The calcium sulfate and hydroxyapatite Cerament Bone Void Filler is a biocompatible, absorbable ceramic bone void filler that can successfully deliver multiple heat-stable and heat-unstable antibiotics that have not been generally used before with antibiotic beads in treating musculoskeletal infections.

Methods: Cerament Bone Void Filler discs with the antibiotics rifampin, vancomycin, tobramycin, cefazolin, cefepime hydrochloride, vancomycin-tobramycin, piperacillin-tazobactam, ceftazidime, and ticarcillin-clavulanate were tested in vitro against methicillin-resistant Staphylococcus aureus.

Results: The zones of inhibition for the Cerament Bone Void Filler antibiotic discs plated against Staphylococcus aureus obtained were 33% to 222% greater than the minimum zones of inhibition breakpoints for bacteria susceptibility as defined by the standard set by the Clinical and Laboratory Standards Institute. Cerament Bone Void Filler discs with the antibiotics plated against Pseudomonas aeruginosa produced zones of inhibition of 93% to 200% greater than the minimum zones of inhibition breakpoints for bacteria susceptibility as defined by the standard set by the Clinical and Laboratory Standards Institute.

Conclusions: The calcium sulfate and hydroxyapatite Cerament Bone Void Filler was an excellent carrier vehicle for multiple antibiotics creating in vitro significant zones of inhibition, thus demonstrating susceptibility against Staphylococcus aureus and Pseudomonas aeruginosa, which holds tremendous promise in treating osteomyeilits. (J Am Podiatr Med Assoc 101(2): 146–152, 2011)
Clinical Evaluation of 35% Urea in a Water-Lipid–Based Foam Containing Lactic Acid for Treatment of Mild-to-Moderate Xerosis of the Foot
Authors: Grossman Allan B.
Published: April 2014

Background: We evaluated 35% urea in a water-lipid–based foam delivery system containing lactic acid in participants with mild-to-moderate xerosis of the foot.

Methods: This 4-week open-label study enrolled 12 participants with xerosis of the foot; six participants were diabetic and six were nondiabetic. Study medication was applied to the affected area twice daily. All adverse events were recorded. Disease severity was measured at baseline and at the end of treatment by Investigator’s Global Assessment, and investigator’s and participant’s signs and symptoms scores. At 4 weeks, compliance and participant satisfaction were determined from participant diaries and a 16-item survey instrument, respectively.

Results: Ten participants completed the study. No adverse reactions were noted with application of the foam. All of the participants who completed the study experienced an improvement in xerosis. The median Investigator’s Global Assessment score decreased significantly from baseline to the end of treatment (P = .005). The investigator and participants observed significant improvement (P < .05) in redness, scaling, and cracking from baseline to the end of treatment. Compliance with the regimen was good, and participants expressed satisfaction with the product.

Conclusions: Thirty-five percent urea in a water-lipid–based foam delivery system containing lactic acid can be an appropriate treatment option for mild-to-moderate xerosis of the foot. (J Am Podiatr Med Assoc 101(2): 153–158, 2011)
Effect of an Educational Intervention on Nurses’ Knowledge of Foot Care and on the Foot Health of Older Residents
Authors: Stolt Minna , Routasalo Pirkko , Suhonen Riitta , Leino-Kilpi Helena
Published: April 2014

Background: Older people have multiple foot health problems; therefore, nursing staff need to pay attention to the foot care of older people, especially in long-term care and nursing homes. The aim of this study was to investigate the knowledge of nursing staff (n = 16) regarding foot care, their foot-care activities, and the health of residents’ (n = 43) feet in a nursing home before and after an intervention (educational program).

Methods: Nursing staff in a nursing home received a foot-care educational program that consisted of lectures and demonstrations.

Results: After the intervention, nursing staff knowledge of foot care and foot-care activities had partially improved, which was mainly seen in residents’ skin health.

Conclusions: The results of this study indicate that an educational program can change nursing staff knowledge of foot care and their foot-care activities. However, the educational program tested in this study needs further development. (J Am Podiatr Med Assoc 101(2): 159–166, 2011)
Reliability and Validity of the INFOOT Three-dimensional Foot Digitizer for Patients with Rheumatoid Arthritis
Authors: De Mits Sophie , Coorevits Pascal , De Clercq Dirk , Elewaut Dirk , Woodburn James , Roosen Philip
Published: April 2014

Background:

Abnormal foot posture and deformities are identified as important features in rheumatoid arthritis. There is still no consensus regarding the optimum technique(s) for quantifying these features; hence, a foot digitizer might be used as an objective measurement tool. We sought to assess the validity and reliability of the INFOOT digitizer.

Methods:

To investigate the validity of the INFOOT digitizer compared with clinical measurements, we calculated Pearson correlation coefficients. To investigate the reliability of the INFOOT digitizer, we calculated intraclass correlation coefficients, SEMs, smallest detectable differences, and smallest detectable difference percentages.

Results:

Most of the 38 parameters showed good intraclass correlation coefficients, with values greater than 0.9 for 30 parameters and greater than 0.8 for seven parameters. The left heel bone angle expressed a moderate correlation, with a value of 0.609. The SEM values varied between 0.31 and 3.51 mm for the length and width measures, between 0.74 and 5.58 mm for the height data, between 0.75 and 5.9 mm for the circumferences, and between 0.78° and 2.98° for the angles. The smallest detectable difference values ranged from 0.86 to 16.36 mm for length, width, height, and circumference measures and from 2.17° to 8.26° for the angle measures. For the validity of the INFOOT three-dimensional foot digitizer, Pearson correlation coefficients varied between 0.750 and 0.997.

Conclusions:

In this rheumatoid arthritis population, good validity was demonstrated compared with clinical measurements, and most of the obtained parameters proved to be reliable. (J Am Podiatr Med Assoc 101(3): 198–207, 2011)
A Quantitative Method for Measuring Forces Applied by Nail Braces
Authors: Erdogan Fatma G.
Published: April 2014

Background:

Nail bracing is a conservative method used for ingrown nails; however, lack of objective measurements limits its use for various nails.

Methods:

Double-string nail braces with extra metal springs were applied to 12 patients with 21 chronic, thick, and overcurved ingrown nails. Force was measured with a force gauge meter. Treatment was stopped once patients stood on their tiptoes and walked in shoes pain free without braces. A force gauge meter was also used on a model nail to show the forces applied by various nail braces and to compare their pulling forces.

Results:

After 6 to 10 months of treatment, all of the patients were pain free; 600 to 1,000 centi Newtons of force were applied to the nails. As the width of the nail increased, so did the force.

Conclusions:

Braces exert more force on larger nails, which may shorten treatment durations. By measuring forces, it may be possible to standardize force and duration of treatment according to variables such as nail thickness, nail width, angle of ingrown nail, and duration of symptoms. (J Am Podiatr Med Assoc 101(3): 247–251, 2011)
Dynamic Splinting for Postoperative Hallux Limitus
Authors: John Mathew M. , Kalish Stanley , Perns Stephen V. , Willis F. Buck
Published: April 2014

Background:

Hallux limitus (HL) is a pathology of degenerative arthritis in the first metatarsophalangeal joint (MTJ) of the great toe. Chief complaints of HL include inflammation, edema, pain, and reduced flexibility. The onset of HL commonly occurs after one of the two most common surgical procedures for foot pathologies, a bunionectomy or a cheilectomy. The purpose of this study is to determine the efficacy of dynamic splinting in treating patients with postoperative hallux limitus, in a randomized, controlled trial.

Methods:

Fifty patients (ages 29 to 69) were enrolled after diagnosis of HL following surgery. The duration of this study was eight weeks, and all patients received nonsteroidal anti-inflammatory drugs, orthotics, and instructions for a home exercise program. Experimental patients were also treated with dynamic splinting for first MTJ extension (60 minutes, three times per day). The dependent variable was change in active range of motion (AROM). A repeated measures analysis of variance was used with independent variables of patient categories, surgical procedure (cheilectomy vs. bunionectomy) and duration since surgery.

Results:

There was a significant difference in change of AROM for experimental vs. control patients (P < 0.001, T = 4.224, N = 48); there was also a significant difference for patient treated within 2 months of surgery (P = 0.0221).

Conclusions:

Dynamic splinting was effective in reducing contracture of postoperative hallux limitus in this study; experimental patients gained a mean 250% improvement in AROM. This modality should be considered for standard of care in treating postoperative hallux limitus. (J Am Podiatr Med Assoc 101(4): 285–288, 2011)
Dorsal Approach to Transfer of the Flexor Digitorum Brevis Tendon
Authors: de Bengoa Vallejo Ricardo Becerro , Iglesias Marta Elena Losa , Frutos Juan Carlos Prados , Rodriguez Miguel Fuentes , Jules Kevin T.
Published: April 2014

Background:

Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw and hammer toe deformities. Only transposition of the flexor digitorum brevis tendon has been reported in the literature in a cadaveric study that used the dorsal and plantar approach. A search of the literature revealed no reports of transposition of the flexor digitorum brevis tendon for treatment of these conditions through a unique dorsal cutaneous incision. We performed a cadaveric 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 through a unique dorsal cutaneous incision.

Methods:

Transposition of the flexor digitorum brevis tendon was attempted in 156 toes of cadaveric feet (52 each second, third, and fourth toes) through a unique dorsal incision.

Results:

The flexor digitorum brevis tendon was long enough to be successfully transposed in 100% of the second, third, and fourth toes by the dorsal incision approach.

Conclusions:

Transfer of the flexor digitorum brevis tendon to the dorsum of the proximal phalanx can be performed for the correction of claw and hammer toe deformities, especially in the second, third, and fourth toes. The meticulous longitudinal incision of the flexor tendon sheath to expose the flexor digitorum brevis tendon is essential to the success of the procedure. (J Am Podiatr Med Assoc 101(4): 297–306, 2011)
Postoperative Infection After Excisional Toenail Matrixectomy
Authors: Rusmir Alen , Salerno Angelo
Published: April 2014

Background:

Excisional toenail matrixectomies are performed on the area of the foot that has been reported to have the highest concentration of resident microorganisms. A retrospective infection audit was performed to identify whether this unique area of the foot was more susceptible to postoperative infection.

Methods:

A retrospective audit reviewing the postoperative infection rate over a 6-year period after excisional nail matrixectomy in 111 patients was undertaken.

Results:

The postoperative infection rate was found to be high (18.9%) relative to that of clean orthopedic foot and ankle surgery (0.5%–6.5%).

Conclusions:

The unique concentration of resident microbes found in the nail folds could help explain the high rate of postoperative infections identified in this study. This may provide some argument to classify excisional nail matrixectomy as clean-contaminated surgery and, thus, warrant routine antibiotic prophylaxis. Further research is recommended to confirm the results of this study and to determine whether appropriately timed oral antibiotic prophylaxis will reduce the infection rate after nail surgery. (J Am Podiatr Med Assoc 101(4): 316–322, 2011)
Foot Orthoses
Authors: Chevalier Thierry Larose , Chockalingam Nachiappan
Published: April 2014

Orthoses have been broadly used by clinicians to treat mechanical misalignments, such as abnormal foot pronation. As such, the influences of orthoses on lower-limb kinematics have been studied numerous times, with many articles reporting nonsystematic results; the aim of this review, therefore, was to examine the recognized effects of foot orthoses on lower-limb kinematics. The findings from this review suggest that foot orthoses seem to have certain generic and common effects on the lower limb when designed to control rearfoot pronation. We also discuss the possible reasons behind the lack of consistent results between studies. Based on the findings, a list of recommendations is presented for future research on foot orthoses to facilitate comparisons between studies and enable the scientific and clinical communities to better comprehend the effects that these variables might have on the kinematics and, possibly, the treatment outcomes. (J Am Podiatr Med Assoc 101(4): 341–348, 2011)
Small Blue Round Cell Tumor
Authors: Devall J. Marshall , Frush Katherine M. , Steiner Lori
Published: April 2014

Small blue round cell tumors of childhood rarely present in the foot or ankle. The following is a case presentation of an 18-year-old male with a large soft-tissue mass of the foot with associated lung metastasis. A definitive diagnosis could not be fully made, even with immunohistochemical and genetic testing. Diagnosis favored poorly differentiated synovial sarcoma. (J Am Podiatr Med Assoc 101(4): 363–369, 2011)
The Charcot Foot in Diabetes
Authors: Rogers Lee C. , Frykberg Robert G. , Armstrong David G. , Boulton Andrew J. M. , Edmonds Michael , Van Georges Ha , Hartemann Agnes , Game Frances , Jeffcoate William , Jirkovska Alexandra , Jude Edward , Morbach Stephan , Morrison William B. , Pinzur Michael , Pitocco Dario , Sanders Lee , Wukich Dane K. , Uccioli Luigi
Published: April 2014

The diabetic Charcot foot syndrome is a serious and potentially limb-threatening lower-extremity complication of diabetes. First described in 1883, this enigmatic condition continues to challenge even the most experienced practitioners. Now considered an inflammatory syndrome, the diabetic Charcot foot is characterized by varying degrees of bone and joint disorganization secondary to underlying neuropathy, trauma, and perturbations of bone metabolism. An international task force of experts was convened by the American Diabetes Association and the American Podiatric Medical Association in January 2011 to summarize available evidence on the pathophysiology, natural history, presentations, and treatment recommendations for this entity. (J Am Podiatr Med Assoc 101(5): 437–446, 2011)
Foot Salvage After Loss of the First and Second Metatarsal Rays with a Free Fibular Osteocutaneous Flap
Authors: Salgado Christopher J. , Lin Chih-Hung , Fuller David A. , Duncan Alissa N. , Camison Liliana , Mardini Samir
Published: April 2014

Severely comminuted fractures of the metatarsal bones with significant bone and soft-tissue loss have commonly subjected patients to proximal amputation procedures. We describe two patients who experienced high-energy traumatic injuries to their limbs that resulted in significant destruction of their first and second metatarsal bones with overlying soft-tissue trauma not amenable to local coverage. In both cases, a vascularized free fibular osteocutaneous flap was used to reconstruct the metatarsal bone defect and traumatized soft tissues so that a proximal amputation was avoided. At an average of 14 months of follow-up, both patients had recovered well and regained independent ambulation, with one patient being able to play soccer. We show that the free fibular osteoseptocutaneous flap is useful in reconstructing significant metatarsal bone defects and in avoiding amputations in this patient population. The skin component of the flap may be used to fill soft-tissue losses, and the fibula bone may be osteotomized so that more than one ray may be reconstructed. (J Am Podiatr Med Assoc 101(6): 531–536, 2011)
Digital arthroplasty by power surgery with minimal incision
Authors: Rice JR
Published: April 2014

A description of a new method for arthroplasty of the fifth toe, its postoperative considerations, complications, reoccurrence, advantages and disadvantages has been presented.
Aloe vera and gibberellin. Anti-inflammatory activity in diabetes
Authors: Davis RH , Maro NP
Published: April 2014

Aloe vera inhibits inflammation and adjuvant-induced arthritis. The authors' laboratory has shown that A. vera improves wound healing, which suggests that it does not act like an adrenal steroid. Diabetic animals were used in this study because of their poor wound healing and anti-inflammatory capabilities. The anti-inflammatory activity of A. vera and gibberellin was measured in streptozotocin-induced diabetic mice by measuring the inhibition of polymorphonuclear leukocyte infiltration into a site of gelatin-induced inflammation over a dose range of 2 to 100 mg/kg. Both Aloe and gibberellin similarly inhibited inflammation in a dose-response manner. These data tend to suggest that gibberellin or a gibberellin-like substance is an active anti-inflammatory component in A. vera.
Long bone osteomyelitis. An overview
Authors: Mader JT , Calhoun JH
Published: April 2014

Osteomyelitis has always been a difficult disease to classify, diagnose, and treat. Its etiology and course are not fully understood. A review of the traditional aspects of osteomyelitis is presented along with the discussion of a more recent classification system.
Foot infections in patients with diabetes mellitus
Authors: Sapico FL
Published: April 2014

Foot infection is the single most common reason for hospitalization of the diabetic patient. A combination of host factors, including neuropathy, angiopathy, and immunopathy, combine to make the diabetic foot infection the most severe infection commonly seen by podiatrists. If inadequately treated, the likelihood of morbidity or mortality is high. The presence of anaerobic bacteria as a predominant type of organism makes diagnosis and antibiotic selection complicated.
Adverse effects of antibiotics
Authors: Brown RB , Levin J , Morris A
Published: April 2014

Adverse reactions to antibiotics comprise a number of classes of reactions, including toxicity, side effects, and allergy. Each one of these differs in its implication for treatment of the patient. The authors discuss some of the more common and unusual reactions to antibiotics frequently used in the practice of podiatric medicine.
Clinical and laboratory diagnosis of lower extremity infections
Authors: Joseph WS
Published: April 2014

By following a systematic approach to the patient history, physical examination, and laboratory analysis in cases of infections, rapid and accurate therapeutic intervention becomes possible. This action can prevent possibly devastating infectious complications, ranging from partial amputation to death. The current litigious climate dictates thorough evaluation and documentation of all infectious diseases of the lower extremity.
Reflex sympathetic dystrophy of the foot and ankle in children and adolescents
Authors: Schiller JE
Published: April 2014

Over a 12-year period, seven adolescent patients with reflex sympathetic dystrophy were seen in the Mayo Clinic Foot Clinic. The details of these cases are presented, and the literature pertaining to reflex sympathetic dystrophy in children is reviewed.
Coexistent gout and rheumatoid arthritis
Authors: Spector AK , Christman RA
Published: April 2014

Gout and rheumatoid arthritis are relatively common entities individually; however, the coexistence of these two conditions has been reported rarely in the literature. The authors present a case that was followed for 20 years. The patient was seen by the acknowledged internist and podiatrist. Criteria for the evaluation and diagnosis of each disease entity are discussed and correlated to the case reported. Various theories and research attempting to explain the negative coexistence of gout and rheumatoid arthritis are presented.
Potential complications of nonsteroidal anti-inflammatory drug therapy
Authors: Corrigan GD , Pantig-Felix L , Kanat IO
Published: April 2014

Since indomethacin was first marketed, some 40 years ago, the class of nonsteroidal anti-inflammatory drugs has grown larger than any other drug class in history. At present, there are at least 25 such drugs being used in the US and abroad, both clinically and in research. Despite their widespread use, their implications to health care are just beginning to be understood. The authors review updated theories on the mechanism of action, side effects, and drug interactions of nonsteroidal anti-inflammatory drug therapy. Proposed guidelines for monitoring their use are given. A more thorough understanding of the risks-to-benefits ratio is provided in an effort to achieve maximum patient satisfaction and safety.
Gait abnormalities and inhibitive casts in cerebral palsy. Literature review
Authors: Hanson CJ , Jones LJ
Published: April 2014

Although cerebral palsy is primarily a central nervous system disorder, its major manifestations are musculoskeletal. The authors focus on normal tonic reflexes of the foot and the developmental consequences of failure to inhibit these reflexes. Various gait abnormalities seen in cerebral palsy are reviewed. Finally, the use of inhibitive casts as a conservative modality for treating hyperactive reflexes in the spastic cerebral palsy child is discussed. The reduction of abnormal tone facilitates the development of a normal gait pattern in these children.
Bilateral ankle pain secondary to sarcoidosis
Authors: Julsrud M
Published: April 2014

Sarcoidosis has been described as a multisystem granulomatous disorder of unknown etiology that usually affects young adults. It can affect the foot and ankle. When erythema nodosum is present, the sarcoidosis usually is characterized by bilateral hilar lymphadenopathy, uveitis, fever, arthralgia, or arthritis. This symptom complex is referred to as L√∂fgren's syndrome. The author describes a patient who presented with bilateral medial ankle pain secondary to sarcoidosis.
Triplanar closing base wedge osteotomy for tailor's bunion
Authors: Shrum DG , Sprandel DC , Marshall H
Published: April 2014

The authors discuss mathematical evaluations when considering base wedge osteotomies to correct a tailor's bunion. A review of the literature is presented in order to use clinical results when algebraic and trigonometric functions are discussed.
Piriformis syndrome
Authors: Julsrud ME
Published: April 2014

The author presents a case of a female runner with left buttock pain aggravated by exercise. She underwent extensive testing by other physicians and received cortisone injections on two occasions. The patient was referred to the podiatry department because of continued discomfort and the inability to run. Examination revealed pain on hip flexion and abduction against resistance. Because of the possibility of piriformis syndrome, she started stretching exercises, reduced her activity, and the pain disappeared. The diagnosis of piriformis syndrome was confirmed by a general surgeon.
Congenital talonavicular synostosis. A review of the literature and a case report
Authors: Bonk JH , Tozzi MA
Published: April 2014

The diagnosis of a congenital talonavicular coalition is one that often may be little more than an incidental radiographic finding. However, the acute onset of vague midfoot symptomatology secondary to a minor traumatic event may reveal this rarely reported condition on further clinical examination. The authors present a description of the characteristic historical and clinical features of talonavicular coalitions, current diagnostic and treatment modalities available, and a case presentation of an acute painful talonavicular synostosis in an adolescent male athlete.
Gonococcal arthritis case report
Authors: Hirsch E , Sherman M , Lenet MD
Published: April 2014

In the case reported, the diagnosis of gonococcal arthritis unfolded over the course of 1 week and was not fully conclusive until presumptive therapy was initiated. Although the clinical, microbiologic, and immunologic characteristics of gonococcal arthritis can be differentiated from other types of bacterial arthritides, not all textbook symptoms are present at one time in one particular case. There also are subtle signs that are involved. In this case study, there was little definitive evidence that stood out to confirm the diagnosis. It was the interdependence of a complete history, serologic and radiographic studies, clinical presentation, and demographic considerations that led to an accurate diagnosis and timely treatment of gonococcal arthritis.
Complications following midfoot amputation in neuropathic and dysvascular feet
Authors: Sage R , Pinzur MS , Cronin R , Preuss HF , Osterman H
Published: April 2014

A review of 64 midfoot amputations performed between 1980 and 1985 revealed that complications occurred in 42% of the series. These included early wound dehiscence and late re-ulceration after the patient began walking again. By providing aggressive management and appropriate local revisions, 84% of the original group's limbs were salvaged at a functionally significant level. These findings underscore the fact that midfoot amputation requires diligent immediate and long-term follow-up if an acceptable success rate is to be achieved.
Podiatric pathology of lupus erythematosus
Authors: McCarthy DJ , Lagana FJ
Published: April 2014

Lupus erythematosus is an enigmatic disease. Its podiatric manifestations are largely cutaneous, but vasculitic involvements may produce complications. The authors review much of the histopathology of lupus erythematosus that is relevant to the podiatric physician and surgeon. Awareness of the serious systemic implications of lupus erythematosus and the internal medications used in treatment is part of the physician's responsibility in understanding the whole patient.
Juvenile fracture of tillaux. A distal tibial epiphyseal fracture
Authors: Simon WH , Floros R , Schoenhaus H , Jay RM
Published: April 2014

The juvenile fracture of Tillaux is a Salter-Harris type III fracture of the distal tibial epiphysis. The mechanism of injury is an external rotational force of the foot. The fracture fragment is avulsed from the anterolateral aspect of the distal tibial epiphysis by the anteroinferior tibiofibular ligament. Treatment is based on the amount of displacement after closed reduction techniques are attempted. If complete anatomical reduction cannot be obtained, the authors recommend open reduction with internal fixation. The method of internal fixation should be based on the skeletal maturity of the distal tibial epiphysis. The prognosis usually is good if anatomical reduction is performed. The most serious complication reported is pain and stiffness secondary to articular incongruity following inadequate closed reduction techniques. The case of a 14-year-old girl with a juvenile Tillaux fracture treated by open reduction with excellent functional results at 11 months follow-up was presented.
Kaposi's sarcoma of the foot. A review and report of 156 cases
Authors: Berlin SJ , Clancy JT , Giordano ML
Published: April 2014

The authors identify the incidence of Kaposi's sarcoma in the foot, and discuss the increasing incidence of AIDS-related cases, and the increasing chance of mortality when this lesion is seen in patients under the age of 50.
Z-bunionectomy with internal screw fixation
Authors: Zygmunt KH , Gudas CJ , Laros GS
Published: April 2014

A new procedure for the correction of hallux valgus was performed on 39 patients (66 feet). The follow-up period averaged 29 months, with a range of 24 to 32 months. The new procedure is a horizontally directed displacement Z-osteotomy in the head and shaft region of the first metatarsal. Rigid internal fixation is obtained with 3.5 or 2.7-mm bone screws. The surgeons' satisfaction rate of 79% compares favorably with the patients' complete satisfaction rate of 85%.
Neutral position casting techniques. Results of a survey
Authors: Basque MG , Nasadowski R , Johnson RE
Published: April 2014

The authors conducted a study to identify the nuances and frequencies of use for various neutral casting techniques. This was accomplished through a survey questionnaire that was sent to 300 podiatric physicians and 48 orthotic laboratories selected at random. To the best of the authors' knowledge, this has not been done previously. Survey results indicated that a difference of opinion exists among respondents in identifying critical factors in neutral position casting.
Recalcitrant heel pain. Traumatic fibrosis versus heel neuroma
Authors: Beito SB , Krych SM , Harkless LB
Published: April 2014

In 1977, Davidson et al wrote an article entitled "Heel Neuroma." Since that time there has been a strong debate on whether the heel neuroma actually exists. The authors present a study of 14 patients presenting with recalcitrant heel pain. Each patient underwent surgical excision of a plantar heel mass. Two patients had bilateral procedures. Preoperative findings are compared with postoperative results. All of the patients experienced at least 75% relief, and the overall satisfaction rate was 79%.
Malignant melanoma. A clinical and surgical review. Part I: Introduction and general discussion
Authors: Zivot ML , Kanat IO
Published: April 2014

Malignant melanoma, the leading cause of death from diseases of the skin, often is found on the lower extremity. When encountered by the podiatric physician, a thorough understanding of the disease entity is essential, as misdiagnosis or delayed diagnosis can have fatal consequences. The authors present the first of a two-part comprehensive clinical and surgical review of malignant melanoma. Part I reviews etiology, risk factors, signs, symptoms, clinical features, and growth patterns. In Part II, a pictorial lower extremity differential diagnosis will be provided, along with diagnostic and surgical criteria for the podiatric surgeon.
Three-dimensional reconstruction of the foot from computed tomography scans
Authors: Hirsch BE , Udupa JK , Roberts D
Published: April 2014

Recently developed computer programs create a new type of image from the sections created in computed tomography. These images look like actual photographs of internal structures. The authors describe the process of three-dimensional reconstruction in nonmathematical terms, and provide examples of its use in imaging the bones of the foot. They demonstrate the technique's ability to resolve small details, and its usefulness in displaying articular surfaces.
Lawrence design first metatarsophalangeal prosthesis. A complication
Authors: Hamilton SA , Boberg J , Gilula LA
Published: April 2014

A complication involving tibial sesamoid impingement within the hinge of the Lawrence first metatarsophalangeal implant is described. The authors believe that this particular problem may be accentuated by the Lawrence design, which preserves the sesamoid apparatus.
Malignant melanoma. A clinical and surgical review. Part II: Diagnosis and treatment
Authors: Zivot ML , Kanat IO
Published: April 2014

Malignant melanoma, the leading cause of death from disease of the skin, often is found on the lower extremity. A thorough understanding of the disease entity is essential, because misdiagnosis or delayed diagnosis can be fatal. In Part I of this two-part clinical and surgical review of malignant melanoma, the authors discussed etiology, risk factors, signs, symptoms, clinical features, and growth patterns. Part II places special emphasis on diagnosing malignant melanoma and differentiating it from other lesions of the lower extremity. Clinical staging of the tumor and the corresponding surgical criteria are presented from a podiatric medical standpoint.
Anatomy of uncorrected talipes equinovarus in a fifteenth-century American Indian
Authors: Mann RW , Owsley DW
Published: April 2014

Although congenital talipes equinovarus is the most common major musculoskeletal malformation in contemporary populations, its occurrence in archaeological specimens is rare. The deformity of untreated clubfoot in an adult American Indian male is discussed.
Neuropathic foot ulcer prevention in diabetic American Indians with hallux limitus
Authors: Dannels E
Published: April 2014

Infected neuropathic ulcerations are the leading cause of diabetes-related partial foot amputations at the Phoenix Indian Medical Center. Ten hallucal ulcerations in seven American Indian patients with hallux limitus were resolved by local wound care and partial first metatarsophalangeal joint resection. The average length of postsurgical follow-up care was 28.8 months. There have been no recurrences of the plantar hallux ulcerations in any of the patients.
In-shoe casting technique for specialized sports shoes
Authors: Palamarchuk HJ , Fry J
Published: April 2014

The use of vacuum casting to create better-fitting orthoses for special athletic shoes has been discussed. By vacuum-forming a negative cast within the confines of special athletic shoes, such as bicycling cleats or fencing shoes, a better-fitting orthosis can be fabricated with little or no special adjustments or modifications necessary to create the best fit and function.
Podiatric manifestations of AIDS
Authors: Burns S
Published: April 2014

Dermatologic, vascular, neurologic, and musculoskeletal complications are common among persons with acquired immunodeficiency syndrome (AIDS). These manifestations frequently involve the lower extremities and may be the initial presenting symptoms of human immunodeficiency virus (HIV) infection. It is important that practitioners of podiatric medicine be aware of these syndromes to facilitate early diagnosis of AIDS and to provide the best possible care for immunodeficient patients. The author provides a review of the manifestations of AIDS frequently encountered in podiatric practice, along with guidelines for treatment.
Epidemiology and pathogenesis of HIV infection. Approaching the second decade
Authors: Becker SL
Published: April 2014

Human immunodeficiency virus (HIV) is a retrovirus that can be transmitted through sexual activity, blood products, and perinatal exposure. The virus is composed of core, transmembrane, and envelope proteins. Cells of the immune system are the primary target of HIV, and destruction of the immune response is characteristic of end-stage disease. Although male homosexuals continue to represent the largest population of persons with acquired immunodeficiency syndrome (AIDS), transmission among intravenous drug users accounts for the rapidly growing incidence of pediatric and heterosexual AIDS patients. Control of the epidemic among intravenous drug users is the major challenge in the US today.
AIDS education for the podiatric physician. Evaluating program impact
Authors: Holmes CA
Published: April 2014

An important component in the development of any educational program is the evaluation of its effectiveness. The program described in this article was designed in such a way that its impact on practitioners' knowledge, attitudes, and clinical practices regarding human immunodeficiency virus (HIV) could be evaluated. One hundred ten participants were asked to complete pre-conference and post-conference tests in order to measure improvement that resulted from program attendance. The author presents both a description of the conference and a summary of the evaluation results, along with suggestions for improving future educational programs.
Educating podiatric medical assistants about AIDS and HIV infection
Authors: Holmes CA
Published: April 2014

In order to assess the need for acquired immunodeficiency syndrome education among podiatric assistants, comprehensive questionnaires on human immunodeficiency virus infection were distributed in February and March 1989. The findings presented here are based upon questionnaires completed and returned by 300 assistants. The purpose of the needs assessment was three-fold: to find out how much the surveyed assistants know about AIDS and HIV infection, how they feel about working with HIV-infected patients, and to what extent they understand and follow recommended infection control practices. The results of the survey reveal that many of the assistants in the sample in this study are ill-informed about HIV infection, that they have numerous concerns and fears about working with HIV-infected patients, and that they are not following recommended infection control guidelines.
Seroconversion, staging and survival. Natural history of HIV infection
Authors: Gordon S
Published: April 2014

With the discovery of human immunodeficiency virus (HIV), researchers identified the etiologic agent for acquired immunodeficiency syndrome (AIDS). Although neither a cure nor a vaccine exists for this fatal disease, considerable information is now available on the progression from HIV infection through AIDS. Understanding the natural history of this progression can facilitate early detection and intervention. Although the epidemic continues to claim lives at an accelerating rate, the timely administration of prophylactic and therapeutic modalities can significantly prolong survival time for many patients. As more effective and less toxic treatments are developed, it will become increasingly crucial for practitioners to accurately diagnose and stage HIV-infected patients.
Fixation of the Austin procedure with the Herbert screw. A modified technique
Authors: Palladino SJ
Published: April 2014

Although the Austin osteotomy is intrinsically stable, some surgeons use fixation to enhance stability. One form of fixation that may be used for this procedure is the Herbert screw. The author presents a modification of a previously reported technique, and describes it as a five-step process. The advantages and potential disadvantages of the use of the Herbert screw with the presented technique are discussed.
Foot deformities in Apert's syndrome. Review of the literature and case reports
Authors: Mason WH , Wymore M , Berger E
Published: April 2014

Two cases of Apert's syndrome (acrocephalosyndactylism), demonstrating typical foot pathology, are presented. A review of the pertinent literature is included, and the new focus on early corrective foot surgery is discussed.
Clear cell hidradenoma. A case report
Authors: Roberg S , Boykoff TJ , Danna AT
Published: April 2014

A case of clear cell hidradenoma occurring on the medial aspect of the first metatarsophalangeal joint of the right foot was presented. Common clinical data and histologic presentation were discussed. Although an infrequent tumor of the foot, this tumor should be included in a differential diagnosis of soft tissue tumors.
Research process. Planning the research project
Authors: Gabel LL
Published: April 2014

This second article in a series of six on the research process provides a guide to planning a research project from start to finish. By description and illustration, 13 steps are outlined. Although the guide is comprehensive, advice is offered at strategic points regarding the value of consulting with a research specialist or a colleague experienced in research to gain assistance or insight into the planning process. Additionally, an admonition underlies the whole process: keep it simple and succinct.
Aging integumentary system. Podiatric review
Authors: Muehlman C , Rahimi F
Published: April 2014

The authors present a concise review of age-related changes that occur in the skin and its derivatives, as they pertain to the podiatric practitioner. A brief discussion of wound healing and several common skin disorders that affect the elderly is also included.
Human myiasis caused by Phormia regina in Pennsylvania
Authors: Miller KB , Hribar LJ , Sanders LJ
Published: April 2014

A case of human myiasis caused by the black blowfly, P. regina, has been presented. Although various reports have documented the therapeutic effects of maggot infestation, infection and mortality by gas-forming anaerobic organisms also have been reported. The removal of maggots from a wound can be accomplished using various methods. The authors successfully used topical application of dichlorotetrafluoroethane.
Granular cell tumor of the heel
Authors: Finkelstein MS , Klaus MV
Published: April 2014

Although infrequently encountered, granular cell myoblastoma can occur on the foot. It should be considered in the differential diagnosis of any soft tissue nodule or mass.
Research process. Preparing a research proposal
Authors: Gabel LL
Published: April 2014

The preparation of a research proposal is often a necessary step in the research process. Research proposals are used to secure permission to undertake a study, to ensure protection of subjects, to secure needed resources, and to achieve a refined perspective of the proposed study. This third article of a series of six on the research process describes the steps involved in preparing a research proposal, demonstrating a parallel to the research planning process.
Improvements in the design of viscoelastic heel orthoses. A clinical study
Authors: Levitz SJ , Dykyj D
Published: April 2014

A heel orthosis combining the principles of weight redistribution and shock attenuation was dispensed to 30 subjects with heel pain. Relief or cessation of pain occurred in 73% of the cases. The factor most clearly and significantly associated with the effectiveness of the orthosis was a lesser degree of overweight. Within this prescriptive guideline, such a device has the potential of becoming a cost-effective and time-efficient way of treating heel pain of mechanical origin.
Biodegradable internal fixation. A literature review
Authors: Beiser IH , Kanat IO
Published: April 2014

The authors review the properties and podiatric applications of biodegradable internal fixation devices. These devices include sutures, rods, and screws. Fixation of fractures and osteotomies with absorbable materials has been shown to be as effective as fixation with more traditional means, and it also provides several advantages.
Monarthric gonococcal arthritis involving the calcaneocuboid joint
Authors: Grippo GN , Genovese MN , Piccora R
Published: April 2014

Gonococcal arthritis is a frequently occurring clinical entity that should be included routinely in a differential diagnosis of pedal joint pain. Unfortunately, the lack of specificity in the presentation makes gonococcal arthritis difficult to diagnose. Indices of suspicion should rise with any sexually active patient, particularly when septic arthritis is suspected without a detectable portal of entry. The authors emphasize again the importance of carefully choosing empiric antibiotic coverage for gonococcal arthritis. Three factors that should be considered are regional epidemiology, the anatomical site of the primary infection, and the possible coexistence of other infectious agents. Understanding the clinical staging of this condition will help to achieve a timely diagnosis and successful treatment.
Medial calcaneal nerve. An anatomical study
Authors: Didia BC , Horsefall AU
Published: April 2014

The authors studied the medial calcaneal nerve of the human foot to determine its precise origin and to establish in detail its course and distribution. Its origin and distribution were compared to those of the inferior calcaneal nerve, and the importance of the nerve in the diagnosis of heel pain was reviewed. The authors concluded that the medial calcaneal nerve occurs in all subjects. Its origin is variable, arising from either the tibial nerve or the lateral plantar nerve after the bifurcation of the former. It innervates the flexor retinaculum and the skin of the heel pad. Therefore, it is clinically a source of pain perception in the heel.
Digital amputations in neuropathic feet
Authors: Greteman B , Dale S
Published: April 2014

A retrospective study was performed on 26 patients who had undergone 27 digital amputations. All of the patients in the study had marked neuropathy. Sixty-five percent of the feet developed new ulcerations following initial hallux amputations, with 53% of the ulcerations occurring at distal digital sites. Fifty-three percent of the patients who had undergone hallux amputations required further amputations secondary to new ulcerations. In contrast, only 10% of the feet with initial lesser digit amputations developed new ulcerations. The authors discuss the biomechanics involved and the possible therapy for preventing these ulcerations and amputations.
Management of complex pedal cutaneous larva migrans
Authors: Pyatak-Hugar KM , Mendicino RW , Scott TS , Hugar DW
Published: April 2014

Although cutaneous larva migrans is more commonly seen in the southeastern US and tropical regions of the world, patients with such parasitic involvement may present in other non-endemic areas for various reasons, particularly travelers returning from tropical vacations. Awareness of the clinical presentation and symptomatology of cutaneous larva migrans is important for all physicians, including those practicing in northern climates, for prompt recognition and effective treatment of the disease. Furthermore, cutaneous larva migrans should be of particular interest to podiatrists, because the infestation commonly involves the feet, and a patient may initially present for treatment of secondary manifestations, ie, dermatitis, pruritus, or infection, as in this case report.
Residency training in the nursing home setting
Authors: Lund CA
Published: April 2014

The author discusses the establishment of the Nursing Home Care Unit at the Tampa Veterans Hospital. The role of the podiatric resident and the residency program in the care of the patients in the facility is presented.