bluuebunny/crossref_metadata_2025 huggingface dataset:
Podiatry in the 1996 Summer Olympic Games
Authors: Julien PH
Published: April 2014

The 1996 Summer Olympic Games in Atlanta, Georgia, were the largest in Olympic history, with 197 countries participating. These Centennial Games also represented podiatry's greatest involvement in the Olympics to date. The author describes the planning, organization, delivery, and outcome of podiatric medical care in an Olympic Games setting and presents data to assist in the future utilization of podiatry in other multiday, multievent sport competitions.
Measurement of the expansion of the calcaneal fat pad upon weightbearing
Authors: Fuller E , Hogge JD
Published: April 2014

The width of the calcaneal fat pad during weightbearing differs from its width during nonweightbearing. In this study, the medial-to-lateral width of the calcaneal fat pad was measured during weightbearing as well as nonweightbearing, and the two measurements were compared. The difference between weightbearing width and nonweightbearing width was found to vary widely across individuals. This measurement has implications for the manufacture of functional foot orthoses, which are made from nonweightbearing impressions of the foot. The significance of the authors' findings with regard to patient comfort is discussed.
1998 William J. Stickel Gold Award. The effects of extrinsic muscle forces on the forefoot-to-rearfoot loading relationship in vitro. Tibia and Achilles tendon
Authors: Ward ED , Phillips RD , Patterson PE , Werkhoven GJ
Published: April 2014

The effects of muscular activity on the distribution of forces under the foot, as well as within the foot, are of great importance for determining the mechanisms of foot pathologies. Limited data exist concerning muscle forces during the gait cycle and the effects of muscle forces conveyed to the ground-reactive forces of the foot. The authors developed a cadaveric loading system to determine the effects of force applied to the Achilles tendon on the forefoot-to-rearfoot loading relationship in eight cadaveric specimens. The study indicated that, during axial loading of the tibia, force was inherently transferred from the rearfoot to the forefoot. However, the observed forefoot-to-rearfoot loading relationship did not match the predicted loading relationship from a rigid-body diagram, as would be observed in a class I lever. The results indicated that, as the force was increased on the Achilles tendon, the change in loads on the forefoot and rearfoot was not linear. Specimens with calcaneal inclination angles greater than 20 degrees demonstrated a more linear increase as compared with those with inclination angles less than 20 degrees.
Retrospective analysis of minimal-incision, endoscopic, and open procedures for heel spur syndrome
Authors: Brekke MK , Green DR
Published: April 2014

Forty-four patients with recalcitrant heel spur syndrome who underwent surgical correction (54 procedures) were studied retrospectively. The results of minimal-incision, endoscopic, and open plantar fasciotomy procedures were compared. This study focuses on patient satisfaction, pain reduction, convalescence, and postoperative problems. Although all procedure groups reported high degrees of patient satisfaction and reduction of pain, some notable differences among the three groups were observed.
Clinical comparison of preinjection anesthetics
Authors: Plotkin S
Published: April 2014

To minimize injection anxiety and discomfort, the podiatric surgeon can choose from a variety of topical anesthetics. Available modalities include skin refrigerants (also referred to as vapocoolants), needleless injection systems, iontophoresis, and eutectic mixtures of topical anesthetic cream such as EMLA Cream. Many of the vapocoolants contain chlorofluorocarbons, which are known to damage the ozone layer, a stratospheric layer that filters out harmful ultraviolet B radiation. In accordance with the 1992 Montreal Protocol, which banned the manufacture of certain chlorofluorocarbon compounds, many commonly used vapocoolants will no longer be available. Some newly marketed vapocoolants produce extremely cold temperatures, limiting their use. This article discusses the properties of various vapocoolants and other topical anesthetics and compares their effectiveness in patient trials.
Post-traumatic first metatarsal reconstruction using coralline hydroxyapatite
Authors: Nesheiwat F , Brown WM , Healey KM
Published: April 2014

Autogenous bone grafting has been the standard approach to reconstruction of trauma-induced metatarsal defects. However, this treatment has well-known disadvantages related to the harvesting, size, shape, and availability of autografts. The authors used a synthetic hydroxyapatite bone-graft substitute manufactured from a marine coral with a morphology similar to that of cancellous bone in the reconstruction of a large, post-traumatic first metatarsal defect. The authors found grafting with coralline hydroxyapatite to be a safe and effective substitute for autogenous bone grafting in the post-traumatic setting.
The F-Scan system with EDG module for gait analysis in the pediatric patient
Authors: D'Amico JC
Published: April 2014

The Electrodynogram (EDG) system of foot-fall measurement has been in clinical use for more than 15 years. Recently the EDG was acquired by Tekscan, which manufactures the F-Scan system of foot-pressure analysis. The new F-Scan system with EDG module retains all of the benefits of the F-Scan system while incorporating the valuable temporal and pressure data comparisons offered by the EDG. This merging of technologies has resulted in a system that is more suitable for application in the pediatric patient than either system alone.
Wolf-Hirschhorn syndrome. Review of the literature and three case studies
Authors: Thomson P
Published: April 2014

Wolf-Hirschhorn syndrome is a rare chromosomal abnormality caused by loss of material from the distal aspect of the short arm of chromosome 4. Characteristics include marked prenatal and postnatal growth retardation with psychomotor delay, profound mental deficiency, distinctive facies, and midline defects. Features that may affect the lower limb include lordosis, scoliosis, hypotonia, talipes equinovarus, and lesser-toe anomalies. This article reviews the literature on this rare syndrome and presents three case studies.
Variability of the center of pressure pattern integral during walking
Authors: McPoil TG , Cornwall MW
Published: April 2014

The objective of this study was to measure the between-trial variability of the center of pressure pattern integral (COPPI) at the shoe-floor interface and within the shoe. Ten trials of the COPPI were recorded simultaneously at the shoe-floor interface and within the shoe as ten subjects walked over ground in standardized footwear and with two types of foot orthoses. While the results showed that the within-shoe shoe-only and soft orthoses conditions caused the greatest decrease in the COPPI, it was extremely inconsistent-between trials, whether measured at the shoe-floor interface or within the shoe. This suggests that the COPPI is not an acceptable method of assessing the effectiveness of foot orthoses.
Tarsal coalition in an adult with cavovarus feet
Authors: Knapp HP , Tavakoli M , Levitz SJ , Sobel E
Published: April 2014

Symptomatic tarsal coalition is often considered to be synonymous with peroneal spastic flatfoot. The association of the cavovarus foot type with tarsal coalition is less well established and has been described only in children. This article describes a case of an adult female with symptomatic cavovarus feet with talocalcaneal coalition. The authors theorize about the pathology of muscle spasm and pain in patients with this condition.
Lesser metatarsal V-osteotomy for chronic intractable plantar keratosis. Retrospective analysis of 40 procedures
Authors: Pontious J , Lane GD , Moritz JC , Martin W
Published: April 2014

The authors studied 40 V-osteotomies of the lesser metatarsal performed for chronic intractable plantar keratosis. They discuss the effectiveness of the V-osteotomy for this deformity as well as other findings such as whether or not fixation of the osteotomy yields a better result (i.e., a lower incidence of complications). The results show that the V-osteotomy had limited effectiveness for this condition and resulted in a high complication rate.
Making the diagnosis of osteomyelitis. The role of prevalence
Authors: Wrobel JS , Connolly JE
Published: April 2014

Clinicians may have poor sensitivity in determining whether a given diabetic patient with a foot ulcer has osteomyelitis. Thus many turn to diagnostic tests. The literature was reviewed and data on the sensitivity and specificity of five commonly used diagnostic tests were compiled. Using Bayes' theorem, the authors' analysis suggests that pretest probability may be more important in the decision-making process than individual test characteristics. Also, a positive probe-to-bone test is as predictive of osteomyelitis as the other four tests. A negative magnetic resonance imaging test most likely rules out osteomyelitis. Interpretation of any test result is greatly influenced by the pretest probability of disease. Future work needs to focus on aiding the clinician in determining the patient's probability of disease prior to testing in order to optimize patient care.
Foot and ankle injuries related to rock climbing. The role of footwear
Authors: Killian RB , Nishimoto GS , Page JC
Published: April 2014

Interest in rock climbing has grown dramatically over the past decade. Although considerable research has been conducted on upper-extremity injuries sustained during rock climbing, there has been no comprehensive evaluation of lower-extremity injuries and related biomechanics. The authors performed a retrospective investigation of rock-climbing injuries using a survey of 104 active rock climbers of varying levels of expertise. The results show that 81% of the respondents have suffered acute or chronic pain or associated pathology in the foot or ankle during or after climbing. The authors propose that this morbidity has biomechanical etiologies related to the common practice among rock climbers of wearing climbing shoes that are smaller than their street shoes.
Conservative treatment of plantar fasciitis. A prospective study
Authors: Lynch DM , Goforth WP , Martin JE , Odom RD , Preece CK , Kotter MW
Published: April 2014

A randomized, prospective study was conducted to compare the individual effectiveness of three types of conservative therapy in the treatment of plantar fasciitis. One hundred three subjects were randomly assigned to one of three treatment categories: anti-inflammatory, accommodative, or mechanical. Subjects were treated for 3 months, with follow-up visits at 2, 4, 6, and 12 weeks. For the 85 patients who completed the study, a statistically significant difference was noted between groups, with mechanical treatment with taping and orthoses proving to be more effective than either anti-inflammatory or accommodative modalities.
Magnetic resonance imaging of ankle ligament injuries correlated with time
Authors: Labovitz JM , Schweitzer ME , Larka UB , Solomon MG
Published: April 2014

Ankle sprain is one of the most commonly treated injuries of the lower extremity. The treatment depends on the severity of the injury and the time at which it occurred. The physician must rely on the history as related by the patient to determine the age of the injury. Magnetic resonance imaging has been proven to help determine the severity of the injury but has not been used to determine the age of the injury. The present study was conducted to identify the typical findings of acute and chronic ankle sprains as a means of dating an ankle sprain based on its appearance on magnetic resonance imaging.
Closed rupture of the anterior tibial tendon. A case report
Authors: Miller RR , Mahan KT
Published: April 2014

Closed subcutaneous rupture of the anterior tibial tendon is a relatively uncommon injury that requires a thorough clinical examination to diagnose correctly. The authors report a case of this disorder and provide a review of the relevant literature. A method of surgical repair not previously described in the literature is also presented.
Calcaneal gait. Etiology and clinical presentation
Authors: Sobel E , Glockenberg A
Published: April 2014

Equinus deformities are common in neuromuscular and trauma patients. In contrast, calcaneal gait disorders tend to be overlooked, and few reports characterize and review calcaneal gait problems and disabilities. In the past 3 years, the authors treated 17 patients with calcaneal gait. Six of these cases are reviewed; in addition, the general clinical characteristics of the patient with calcaneal gait pattern are described.
Household-shoe wearing and purchasing habits. A survey of people aged 65 years and older
Authors: Munro BJ , Steele JR
Published: April 2014

A mail survey was conducted to assess the types of household footwear currently being worn by a random sample of independently living men and women aged 65 years and older as well as their needs related to the purchase and wearing of household footwear. Questionnaires were completed by 128 people. The greatest number of respondents wore slippers all day around the home, purchasing these shoes because of their convenience and comfort. Respondents were not willing to purchase expensive shoes for household wear and infrequently replaced them, despite the fact that such footwear was worn for extended periods each day. It was concluded that further research is required to design a household shoe that fits well and accommodates a variety of foot pathologies typical of the elderly foot; the shoe should be comfortable, relatively inexpensive, and safe for typical household surfaces.
The effect of hallux abducto valgus surgery on the sesamoid apparatus position
Authors: Judge MS , LaPointe S , Yu GV , Shook JE , Taylor RP
Published: April 2014

A new parameter, the tibial sesamoid-second metatarsal distance, was established to determine whether the sesamoids move in relation to the foot in hallux abducto valgus surgery. The reliability of the tibial sesamoid-second metatarsal distance was assessed and shown to be excellent. Seventy-five feet underwent surgical correction of hallux abducto valgus. Four radiographic parameters--the intermetatarsal angle, the hallux abductus angle, the tibial sesamoid position, and the tibial sesamoid-second metatarsal distance--were measured before and after surgery. The hallux abductus angle, intermetatarsal angle, and tibial sesamoid position were all significantly reduced following surgery. The tibial sesamoid-second metatarsal distance was not affected by hallux abducto valgus correction. Thus the correction in sesamoid position gained with hallux abducto valgus correction is a direct result of lateral translocation of the metatarsal head, with no contribution from change in position of the sesamoid apparatus relative to the foot.
Long-term follow-up of heel spur surgery. A 10-year retrospective study
Authors: Vohra PK , Giorgini RJ , Sobel E , Japour CJ , Villalba MA , Rostkowski T
Published: April 2014

A comparative retrospective study of 48 open heel spur surgeries and 20 endoscopic plantar fasciotomies was conducted involving 59 patients over a 10-year period. There was a significant reduction in heel pain at the time of follow-up (average, 3 years) for both groups. Overall, 85% of procedures were associated with patient satisfaction with the results, and patients said that they would recommend heel spur surgery for relief of severe heel pain in 94% of cases. Factors influencing the postoperative outcome, such as duration of preoperative symptoms, extent of conservative care, and obesity, are discussed.
Cutaneous angioleiomyoma
Authors: Pastore RL , Ianiro G
Published: April 2014

Leiomyomas are smooth-muscle tumors that may be encountered in the practice of podiatric medicine when they affect the arrector pili muscles or the smooth muscle of a vessel wall. In the present case, the lesion was located on the heel, an area with no hair growth; this further supports the diagnosis, as the most likely origin of the lesion was the smooth muscle of a blood vessel. Vascular leiomyomas show a greater predilection for the lower extremities than their superficial counterparts. Surgical excision is the treatment of choice for these benign lesions, whose prognosis is excellent. When a patient presents with a painful mass in the lower extremity, the diagnosis of leiomyoma should be considered.
Evaluation of compensation filters in pedal radiographs
Authors: Jennings MB , Cohen RE , Marino JP , Jensis-Carlson ML , Pollizzi AJ , Schwartz DM , Gallentine SL
Published: April 2014

Compensation filters allow increased visibility of detail in chest, shoulder, spine, hip, knee, and foot radiographs. This study examines use of an anatomic compensation filter to improve imaging in pedal radiographs. Anteroposterior radiographs were obtained of 25 cadaveric feet at two settings with and without the compensation filter. Densitometer readings were taken at ten forefoot anatomic sites. The compensation filter produced statistically significant reductions in densitometer readings at all anatomic sites and at both radiographic settings. Filtration improved imagery of bony structures, provided excellent soft-tissue visualization, and lowered patient exposure.
Serial measurement of calcaneal pitch during midstance
Authors: Wearing SC , Urry S , Perlman PR , Dubois P , Smeathers JE
Published: April 2014

Although emerging evidence suggests a causal relationship between arch structure and musculoskeletal injury, few investigations have adequately assessed arch function during gait. In this study, digitized videofluoroscopy was used to evaluate the sagittal plane motion of the calcaneus during gait. Nine female subjects requiring diagnostic foot radiographs underwent videofluoroscopy. The calcaneal inclination angle, arch height ratio, and tarsal index were digitally analyzed for all radiographic images. Calcaneal pitch was correlated to both the arch height ratio and the tarsal index. Repeated measures analysis of variance helped to identify a significant reduction in the mean calcaneal pitch during the midstance and early propulsive periods of gait. These findings suggest that although calcaneal pitch may be used as an indicator of rearfoot position, biomechanical classification of foot types based on radiographs may result in erroneous conclusions concerning foot function.
Orthoses in the treatment of rearfoot problems
Authors: Sobel E , Levitz SJ , Caselli MA
Published: April 2014

Orthotic management is helpful in the treatment of most orthopedic conditions involving the rearfoot, including plantar fasciitis, Achilles tendon disorders, posterior tibial tendon dysfunction, flatfoot, ankle sprains, and problems associated with diabetes, arthritis, and equinus disorders. A review of the effectiveness of orthoses in the treatment of these conditions is presented here. An in-depth analysis of the orthotic management of plantar fasciitis and a critical review of foot orthoses for the pronated foot are presented. Also discussed are the rationale and effectiveness of the tension night splint in the treatment of plantar fasciitis, orthotic devices for the different stages of posterior tibial tendon dysfunction, and the various categories of orthoses for off-loading the diabetic foot. The modern ankle brace, the effectiveness of prefabricated versus prescription foot orthoses, and recent developments in the ankle-foot orthosis are also reviewed.
Biomechanics as a basis for management of intra-articular fractures of the calcaneus
Authors: Lewis G
Published: April 2014

This article presents a critical examination of biomechanics studies in the literature that could shed light on or contribute to the development of methods of managing intra-articular calcaneal fractures. An appreciation and understanding of such studies is predicated on a sound knowledge of a number of germane topics: the anatomy of the normal calcaneus, the pathomechanics of the calcaneus, fracture-classification schemes, and fracture-management methods. The first part of this review presents overviews of these topics. The biomechanics studies are then reviewed in detail. The article concludes with a description of research areas that might close the gaps identified in these studies.
The use of ultrasound in the foot and ankle
Authors: Rockett MS
Published: April 2014

Ultrasonography is an underutilized tool in the armamentarium of the foot and ankle surgeon. The purpose of this article is to review and illustrate the different applications of musculoskeletal ultrasonography of the foot and ankle. The advantages and disadvantages of this imaging modality are described.
The safety of itraconazole in the diabetic population
Authors: Albreski DA , Gross EG
Published: April 2014

This study examined the safety of itraconazole for the treatment of onychomycosis in patients with diabetes mellitus compared with standard palliative treatment. Fifty-two diabetic subjects in a large Veterans Affairs health system who had been diagnosed as having lower-extremity complications and distal dermatophytic subungual onychomycosis of the toenail were randomized to receive either intermittent itraconazole, 200 mg twice daily, or standard palliative care, consisting of toenail trimming, cleaning, and soaking. Adverse events were reported in 4 of the 27 itraconazole subjects; no adverse events were reported in the 25 palliative treatment subjects. One itraconazole subject was withdrawn from the study because of elevated liver function test results; the other three adverse events (rash, diarrhea, and pedal edema) were considered self-limiting and did not interfere with protocol completion. Analyses of prestudy and poststudy hemoglobin A1c and liver function test results in both treatment groups were comparable, with no statistically significant differences. Itraconazole was found to be safe for the treatment of distal dermatophytic subungual onychomycosis in diabetic patients with lower-extremity complications having multiple concomitant disorders and requiring concurrent pharmacologic regimens.
Footwear and postural stability in older people
Authors: Menz HB , Lord SR
Published: April 2014

Accidental falls in the older population are common and often result in serious injury. Although a number of factors have been recognized as risk factors for falling, the effect of footwear on postural stability is often overlooked. This article reviews the literature on the effect of various footwear features on postural stability and suggests areas that warrant further investigation.
Pedal giant cell tumor of tendon sheath
Authors: Paez H , Vuletin JC , Soave RL , Sellitto RV
Published: April 2014

The authors present a brief review of giant cell tumor of tendon sheath and three case reports. A discussion emphasizing the histologic characteristics of this lesion demonstrates the benign-to-malignant variability of these neoplastic growths. Special attention is directed to a case with aggressive histologic characteristics. Reexcision after surgery should be considered in cases where microscopic examination reveals a lesion with characteristics suggestive of potentially aggressive behavior.
A model to assess age-related changes in two-point discrimination of plantar skin
Authors: Lynch W , Mooney J
Published: April 2014

A device was constructed to assess two-point discrimination in the plantar skin of younger, middle-aged, and older adults. The device consisted of paired filaments, each delivering a tip force of 4.56 log units (equivalent to 3.63 g), at a fixed distance apart. Statistical analysis showed significant differences in two-point discrimination accuracy between these groups of subjects. Younger subjects showed greater accuracy of plantar two-point discrimination than either middle-aged or older subjects, with an apparent inverse linear relationship between subject age and plantar two-point discrimination ability. A model to assess age-related changes in two-point discrimination is presented.
Hydroxyapatite as a bone substitute
Authors: Mahan KT , Carey MJ
Published: April 2014

A bone substitute eliminates the need for autogenous and allogeneic bone grafting, along with the complications unique to each. Coralline hydroxyapatite is a synthetic bone void filler manufactured from marine coral, which has a natural trabecular structure similar to that of cancellous bone. While initial studies have been promising, the use of coralline hydroxyapatite may be limited in the foot and ankle owing to its inherent mechanical weakness and lack of biodegradation. In this retrospective study, 20 patients who received coralline hydroxyapatite implants were reviewed to determine associated complications and host reaction to the material. The results indicate that the material is biologically inert and safe to use as a small-defect filler in low-load applications. Long-term clinical trials are needed to determine the indications for this material in the foot and ankle.
Timing of peak plantar pressure during the stance phase of walking. A study of patients with diabetes mellitus and transmetatarsal amputation
Authors: Kelly VE , Mueller MJ , Sinacore DR
Published: April 2014

High plantar pressures contribute to skin breakdown in patients with diabetes mellitus and peripheral neuropathy. The primary purpose of this study was to determine the point during the stance phase of walking that corresponds with forefoot peak plantar pressures. Results indicate that peak plantar pressures occurred at 80% +/- 5% of the stance phase of gait in subjects with diabetes and transmetatarsal amputation, as well as in control subjects. Improved methods of footwear design or walking strategies proposed to patients should focus on the demands of the foot during the late stance phase of walking in order to increase available weightbearing area or to decrease forces, which will minimize plantar pressures and reduce trauma to the neuropathic foot.
Biomechanics of the normal and abnormal foot
Authors: Kirby KA
Published: April 2014

The foot is an engineering marvel that allows the body to perform many physical activities over a wide variety of terrain with remarkable efficiency. The functions of the foot and the lower extremity are biomechanically integrated; thus normal lower-extremity function requires normal foot function and vice versa. Because the subtalar joint is the main pedal joint allowing the triplanar translation of motion between the foot and lower extremity, normal subtalar joint function is critical to normal foot and lower-extremity function. This article provides an overview of the interrelationships between foot and lower-extremity function and mechanically based pathology of the foot and lower extremity, with an emphasis on the subtalar joint.
Sagittal plane biomechanics. American Diabetes Association
Authors: Dananberg HJ
Published: April 2014

During walking, the center of body mass must pass from behind the weightbearing foot to in front of it. For this to take place, the foot must function as a sagittal plane pivot. Because the range required for this motion is approximately five times as great as both frontal and transverse plane motion, its evaluation should become an essential part of a podiatric biomechanical assessment. Lack of proper sagittal plane motion and its sequelae are described.
The dermatopharmacologic profile of ciclopirox 8% nail lacquer
Authors: Bohn M , Kraemer K
Published: April 2014

Ciclopirox 8% nail lacquer is a recently introduced topical formulation of the hydroxypyridone antimycotic ciclopirox. In vitro data indicate that ciclopirox has activity against the important pathogenic dermatophytes responsible for onychomycosis. The lacquer delivery system provides a high concentration gradient for the transfer of the antifungal agent through the nail plate. Daily application to the toenail surface of healthy subjects resulted in good penetration and distribution within all nail layers. Systemic absorption of ciclopirox in five patients with onychomycosis was minimal.
The effectiveness of gait plates in controlling in-toeing symptoms in young children
Authors: Redmond AC
Published: April 2014

A range of patient-oriented and practitioner-oriented outcomes were used to evaluate the efficacy of "gait plate" shoe inlays in controlling symptoms associated with in-toeing in otherwise healthy children. For 18 in-toeing children, parents completed a preintervention questionnaire. Then, during randomized trials, foot placement angle was measured both with and without gait plate inlays in the children's footwear. After the children had worn the gait plates for 1 month, a simple questionnaire was used to rate parental satisfaction with a range of factors associated with control of symptoms. The use of gait plate inlays resulted in a small but statistically significant reduction in the amount of in-toeing as measured by foot placement angle. Gait plates reduced the reported frequency of tripping in 14 of the 18 cases. The reported parental satisfaction was high or very high in all but one case, suggesting that this intervention warrants further investigation as an alternative to "observational management" for symptomatic in-toeing.
Tarsal functions, movement, and stabilization mechanisms in foot, ankle, and leg performance
Authors: Vogler HW , Bojsen-M√∏ller F
Published: April 2014

The authors investigated the function of the tarsus and the skeletal segments of the foot in terms of the biomechanical significance of the individual links of the foot-ankle-leg complex. A performance model based on pressure-washed trabecular systems and the interface of the different segments making up the articular foot skeleton is presented and discussed. The biomechanical influence of these segments on each other and on their appendicular companion bones is assessed, and an explanation of their function is provided.
The evolution of the study of the mechanics of running. Relationship to injury
Authors: McClay I
Published: April 2014

The mechanics of running have been studied for hundreds of years. With the increase in interest in running as a recreational activity in recent years, running-related injuries have become common. Hundreds of studies on the mechanics of running have been conducted over the past few decades. However, the relationship between the mechanics of running and injury is still not well understood. This article describes the evolution of the study of the mechanics of running, with a focus on their relationship to injury. A brief historical review is presented, followed by a summary of the era of descriptive research and, finally, an overview of the more recent generation of hypothesis-driven research. The article concludes with suggestions for future research that may lead to greater insight into the relationship between lower-extremity biomechanics and injury.
Efficacy of foot orthoses. What does the literature tell us?
Authors: Landorf KB , Keenan AM
Published: April 2014

This paper reviews the literature relating to foot orthoses, in particular foot orthoses that attempt to alter biomechanical function. Whilst few well-controlled studies have been performed, the findings from the available literature are generally positive. The authors provide an overview of this literature and then summarise the findings. The literature is categorised into six research outcome areas: (i) patient satisfaction, (ii) pain and deformity, (iii) plantar pressures, (iv) position and motion, (v) muscle activity, and (vi) oxygen consumption. In addition, the difficulties associated with researching foot orthoses are discussed.
The association of blisters with musculoskeletal injuries in male marine recruits
Authors: Bush RA , Brodine SK , Shaffer RA
Published: April 2014

A prospective study examining the epidemiology of blisters and, in particular, the association of blisters with subsequent injuries was conducted involving 2,130 male US Marine Corps recruits participating in initial physical training at the Marine Corps Recruit Depot in San Diego, California. From January 1993 through September 1994, recruits experienced an incidence of 2.05 blisters per 100 recruit-months. Recruits with blisters were 50% more likely to experience an additional training-related injury. Blisters, in combination with other related injuries, resulted in 159 clinic visits, 103 days of assigned light duty, and 177 lost days of training. This loss of time cost a minimum of $29,529. Extrapolating to the annual population of recruits, this represents an approximate annual expense of $690,000. Aggressive blister prevention and management in this setting has the potential to greatly reduce morbidity and fiscal costs.
Use of small cannulated screws for fixation in foot surgery
Authors: Burns AE
Published: April 2014

Use of cannulated bone screws, as compared with use of traditional bone screws, has been reported to decrease surgical time, allow for more precise screw placement, and reduce sources of error. Cannulation of the smaller-size screws that are routinely used in foot surgery has not been available until the last few years. This article reports on the use of the small cannulated screws manufactured by Alphatec Manufacturing, Inc (Palm Desert, California). The screw sizes available in the Mini Lag Screw System are 2.7, 3.5, and 4.0 mm. A long-term clinical and radiographic prospective evaluation of 70 procedures performed on 49 patients was conducted. The follow-up time for all patients was 2 years. None of the 70 implants fractured, and seven procedures (in seven patients) resulted in some type of implant-fixation failure. All of the fixation failures, however, appeared to be related to an untoward event or patient noncompliance. These smaller cannulated screws proved to be a reliable and effective means of fixation in foot surgery.
Analysis of release of the first branch of the lateral plantar nerve
Authors: Goecker RM , Banks AS
Published: April 2014

The authors conducted a retrospective study of the release of the first branch of the lateral plantar nerve in the treatment of chronic heel pain unrelieved by conservative treatment modalities. A total of 17 patients (18 feet) were evaluated following external neurolysis for heel pain caused by entrapment of the first branch of the lateral plantar nerve. The average postoperative follow-up time was 32.8 months, with a range of 10 to 72 months. Every patient deemed the surgery successful. At the time of follow-up examination, nine feet were asymptomatic and nine feet experienced mild pain after extended activity. There was one postoperative complication, medial calcaneal nerve entrapment; it was successfully treated with neurectomy.
Normal values of plantar pressure measurements determined using the EMED-SF system
Authors: Bryant AR , Tinley P , Singer KP
Published: April 2014

Plantar pressure-measurement technology is being increasingly used by podiatric physicians and surgeons in both clinical practice and research. The authors present normal reference-range values for peak pressure, mean pressure, and pressure-time integral obtained from 30 healthy subjects using a two-step recording technique and the EMED-SF system, as background for proposed clinical trials. Normative data of this type are essential for clinical practice in the comparison of plantar pressure-measurement values of individual patients with those of normal, asymptomatic feet.
Velocity of the center of pressure during walking
Authors: Cornwall MW , McPoil TG
Published: April 2014

The purpose of this study was to describe the velocity of the center of pressure during walking in a sample of young, healthy individuals. The velocity of the center of pressure was recorded in 60 subjects while they walked barefoot over a floor-mounted pressure platform. The results of this study indicate that the velocity of the center of pressure follows a predictable pattern during the stance phase of walking. Intraclass correlation coefficients calculated to measure between-trial reliability for specific parameters of the velocity of the center of pressure ranged from 0.361 to 0.912. These study results suggest that velocity of the center of pressure may be a useful measurement in future gait research.
A critical review of the literature on foot orthoses
Authors: Pratt DJ
Published: April 2014

Many reports have been published on the value of foot orthoses in treating a variety of biomechanical problems. This article reports on the application of rules developed in the 1980s to assess the scientific rigor, and hence the clinical applicability, of these publications.
Manipulation method for the treatment of ankle equinus
Authors: Dananberg HJ , Shearstone J , Guillano M
Published: April 2014

Ankle equinus is a well-known clinical entity that has previously been shown to compound a variety of foot and ankle conditions. Treatments for this disorder have included surgery to lengthen the Achilles tendon and daily stretching. This article describes a method of manual manipulation that can immediately and substantially increase ankle joint dorsiflexion. Patients treated with manipulation in the current study demonstrated nearly twice as much dorsiflexion motion as that demonstrated by patients in a prior study who were treated with a 5-minute daily stretching program for 6 months.
Rehabilitation After Amputation
Authors: Esquenazi Alberto , DiGiacomo Robert
Published: April 2014

The principles of amputee rehabilitation, from preamputation to reintegration into the work force and community, are reviewed. The authors discuss exercise techniques, training programs, and environmental modifications that have been found to be helpful in the rehabilitation of the amputee. The exercise programs presented here are divided into four main components: flexibility, muscle strength, cardiovascular training, and balance and gait. The programs include interventions by the physical, occupational, and recreational therapist under the supervision and guidance of a physician. (J Am Podiatr Med Assoc 91(1): 13-22, 2001)
Differentiation and Treatment of Phantom Sensation, Phantom Pain, and Residual-Limb Pain
Authors: Finnoff Jonathan
Published: April 2014

This article defines the three major forms of postamputation sensation: 1) phantom sensation, 2) phantom pain, and 3) residual-limb pain. Proposed etiologies for phantom pain are discussed. The literature on current diagnoses and treatments for each of the three postamputation sensations is reviewed. (J Am Podiatr Med Assoc 91(1): 23-33, 2001)
Use of Prostheses and Footwear in 110 Inner-City Partial-Foot Amputees
Authors: Sobel Ellen , Japour Christopher J. , Giorgini Renato J. , Levitz Steven J. , Richardson Hugh L.
Published: April 2014

The number of partial-foot amputations performed is increasing, and many recommendations have been made regarding the use of prostheses and footwear designed to prevent higher-level amputations in this population. The present study investigated the use of prostheses and shoe inserts and the types of footwear worn by partial-foot amputees in the inner city to determine whether previous recommendations are being followed as well as whether new prosthetic styles are being used. The study surveyed 110 patients (73 men and 37 women) with a mean age of 58.6 years (range, 21 to 86 years) with partial-foot amputations of all levels. The results showed that about one-half of all patients wore a shoe-insert orthosis. Although 54% wore some form of special footwear to accommodate and protect the residual foot, no patient in this study wore a shoe with a rocker-bottom sole. Only one patient with a transmetatarsal amputation used a brace and only one patient in the entire study wore a modern cosmetic foot prosthesis. (J Am Podiatr Med Assoc 91(1): 34-49, 2001)
Subtotal Pedal Amputations
Authors: Funk Christopher , Young Gregg
Published: April 2014

Proper treatment for the compromised diabetic foot often requires surgical correction and subtotal pedal amputation. This article discusses various levels of amputation of the human foot, including digital, ray, transmetatarsal, midfoot, and Syme amputations. Surgical techniques and biomechanical considerations are presented in order to assist the surgeon in planning for the most functional outcome of the patient. A review of the literature and the experiences of the authors are presented. (J Am Podiatr Med Assoc 91(1): 6-12, 2001)
Evaluation of Pressure Threshold Prior to Foot Ulceration
Authors: Barber Mitchell A. , Conolley Janice , Spaulding Cecily M. , Dellon A. Lee
Published: April 2014

A prospective study of 29 patients with diabetic neuropathy and 47 nondiabetic patients with tarsal tunnel syndrome were evaluated with computer-assisted neurosensory testing at three sites on the foot. The sensitivity and specificity of one-point static touch thresholds for identifying the presence of large fiber axonal loss was done using the calculated thresholds for monofilaments derived from their markings. The sensitivity for one-point static touch in identifying axonal loss was 33% for the 5.07, 38% for the 4.93, 50% for the 4.17, and 60% for the 4.08 monofilament-equivalent, with a specificity of 100% at each level. Therefore, one-point static touch testing, even using monofilaments thinner than 5.07, has a high percentage of false-negative results in identifying patients with axonal loss. (J Am Podiatr Med Assoc 91(10): 508-514, 2001)
Mechanical Treatment of Plantar Fasciitis
Authors: Martin Joe E. , Hosch Jonathan C. , Goforth W. Preston , Murff Randall T. , Lynch D. Matt , Odom Richard D.
Published: April 2014

A randomized, prospective study was conducted to compare the effectiveness of three individual mechanical modalities in the treatment of plantar fasciitis. Two hundred fifty-five subjects were randomly assigned to one of three treatment groups: custom-made orthoses, over-the-counter arch supports, or tension night splints. Subjects were treated for 3 months, with follow-up visits at 2, 6, and 12 weeks. No statistically significant difference was noted among treatment groups with respect to final outcomes based on first-step pain or pain felt during the day. However, there was a statistically significant difference among the three groups with respect to early patient withdrawal from the study due to continued severe pain, noncompliance, or inability to tolerate the device. Patient compliance was greatest with the use of custom-made orthoses. (J Am Podiatr Med Assoc 91(2): 55-62, 2001)
Scientific Approach to the Axis of Rotation at the Midtarsal Joint
Authors: Nester Christopher J. , Findlow Andrew , Bowker Peter
Published: April 2014

Current biomechanical models of the midtarsal joint describe it as having two axes of rotation, the oblique and the longitudinal. The considerable freedom of movement available at the midtarsal joint means that kinematic assessment of its function and determination of its axis of rotation must be conducted under conditions that enable the joint to function as normally as possible. The assessments on which the concepts of the longitudinal and oblique axes are based do not meet this criterion. Understanding of the motions at the midtarsal joint will improve as techniques of kinematic assessment improve. Future descriptions of the midtarsal joint should adopt the standard terms applied to the other joints in the lower limb, which will facilitate the study of the midtarsal joint in relation to the function of the rest of the lower limb. (J Am Podiatr Med Assoc 91(2): 68-73, 2001)
Isolated Cuboid Fracture
Authors: Miller S. Rick , Handzel Charleen
Published: April 2014

Solitary fractures of the cuboid are rare. Proper diagnosis and treatment of subtle cuboid fractures are essential to minimize long-term disability and must begin with the appropriate clinical suspicion. Treatment of overt cuboid fractures has changed over time and now includes aggressive repair of the fracture. The authors provide an overview of cuboid fractures and report on a patient with a minimally displaced fracture who was treated conservatively. (J Am Podiatr Med Assoc 91(2): 85-88, 2001)
Efficacy of Terbinafine for Toenail Onychomycosis
Authors: Pollak Richard , Billstein Stephan A.
Published: April 2014

The efficacy of terbinafine (250 mg/day) in the treatment of toenail onychomycosis was evaluated in a large open-label, multicenter trial of 12, 18, and 24 weeks of therapy. All 1,534 patients had onychomycosis, confirmed by either positive potassium hydroxide (KOH) wet mount, positive fungal culture, or both, and all received at least 12 weeks of treatment. Treatment was continued for an additional 6 or 12 weeks, depending on the extent of the disease at follow-up. Mycologic cure rates (negative culture plus negative KOH) at week 72 were 72.1% in the 12-week treatment group, 72.5% in the 18-week group, and 77.0% in the 24-week group. In all groups, clinical cure rates were higher at week 72 than at week 48: 49.5% of the 12-week group, 49.2% of the 18-week group, and 44.6% of the 24-week group experienced clinical cure by the end of the study. Both mycologic and clinical recurrence rates were low in all treatment groups at the 72-week assessment. The results of this study confirm the efficacy of terbinafine in the treatment of toenail onychomycosis as demonstrated in previous registration and large-scale clinical trials. (J Am Podiatr Med Assoc 91(3): 127-131, 2001)
Effects of Prefabricated Foot Orthoses and Soft Insoles on Postural Stability in Professional Soccer Players
Authors: Percy Matthew L. , Menz Hylton B.
Published: April 2014

Postural stability is an important component of skilled athletic activity. However, the effects of foot orthoses on stability have not been adequately addressed. This study measured postural sway in 30 asymptomatic professional soccer players in three standing positions and four underfoot conditions. The results revealed that the underfoot condition had no significant effect on sway in the mediolateral or anteroposterior planes; however, there was a trend toward less mediolateral sway when subjects stood in a unipedal position with prefabricated orthoses. These results suggest that insoles and foot orthoses have no significant beneficial or detrimental effects on postural stability in asymptomatic subjects. Clinically, this suggests that no improvements in balance performance could be expected with prophylactic use of insoles or orthoses but that clinicians may prescribe insoles and foot orthoses without fear of impairing postural performance in elite athletes. (J Am Podiatr Med Assoc 91(4): 194-202, 2001)
A Comparison of Footprint Indexes Calculated from Ink and Electronic Footprints
Authors: Urry Stephen R. , Wearing Scott C.
Published: April 2014

Pressure platforms offer the potential to measure and record electronic footprints rapidly; however, the accuracy of geometric indexes derived from these prints has not been investigated. A comparison of conventional ink footprints with simultaneously acquired electronic prints revealed significant differences in several geometric indexes. The contact area was consistently underestimated by the electronic prints and resulted in a significant change in the arch index. The long plantar angle was poorly correlated between techniques. This study demonstrated that electronic footprints, derived from a pressure platform, are not representative of the equivalent ink footprints and, consequently, should not be interpreted with reference to literature on conventional footprints. (J Am Podiatr Med Assoc 91(4): 203-209, 2001)