bluuebunny/crossref_metadata_2025 huggingface dataset:
Hallux Valgus Surgery May Produce Early Improvements in Balance Control
Authors: Sadra Saba , Fleischer Adam , Klein Erin , Grewal Gurtej S. , Knight Jessica , Weil Lowell Scott , Weil Lowell , Najafi Bijan
Published: April 2014

Background:

Hallux valgus (HV) is associated with poorer performance during gait and balance tasks and is an independent risk factor for falls in older adults. We sought to assess whether corrective HV surgery improves gait and balance.

Methods:

Using a cross-sectional study design, gait and static balance data were obtained from 40 adults: 19 patients with HV only (preoperative group), 10 patients who recently underwent successful HV surgery (postoperative group), and 11 control participants. Assessments were made in the clinic using body-worn sensors.

Results:

Patients in the preoperative group generally demonstrated poorer static balance control compared with the other two groups. Despite similar age and body mass index, postoperative patients exhibited 29% and 63% less center of mass sway than preoperative patients during double-and single-support balance assessments, respectively (analysis of variance P =.17 and P =.14, respectively [both eyes open condition]). Overall, gait performance was similar among the groups, except for speed during gait initiation, where lower speeds were encountered in the postoperative group compared with the preoperative group (Scheffe P = .049).

Conclusions:

This study provides supportive evidence regarding the benefits of corrective lower-extremity surgery on certain aspects of balance control. Patients seem to demonstrate early improvements in static balance after corrective HV surgery, whereas gait improvements may require a longer recovery time. Further research using a longitudinal study design and a larger sample size capable of assessing the long-term effects of HV surgical correction on balance and gait is probably warranted. (J Am Podiatr Med Assoc 103(6): 489–497, 2013)
Balance Rehabilitation
Authors: Grewal Gurtej S. , Sayeed Rashad , Schwenk Michael , Bharara Manish , Menzies Robert , Talal Talal K. , Armstrong David G. , Najafi Bijan
Published: April 2014

Background:

Individuals with diabetic peripheral neuropathy frequently experience concomitant impaired proprioception and postural instability. Conventional exercise training has been demonstrated to be effective in improving balance but does not incorporate visual feedback targeting joint perception, which is an integral mechanism that helps compensate for impaired proprioception in diabetic peripheral neuropathy.

Methods:

This prospective cohort study recruited 29 participants (mean ± SD: age, 57 ± 10 years; body mass index [calculated as weight in kilograms divided by height in meters squared], 26.9 ± 3.1). Participants satisfying the inclusion criteria performed predefined ankle exercises through reaching tasks, with visual feedback from the ankle joint projected on a screen. Ankle motion in the mediolateral and anteroposterior directions was captured using wearable sensors attached to the participant’s shank. Improvements in postural stability were quantified by measuring center of mass sway area and the reciprocal compensatory index before and after training using validated body-worn sensor technology.

Results:

Findings revealed a significant reduction in center of mass sway after training (mean, 22%; P = .02). A higher postural stability deficit (high body sway) at baseline was associated with higher training gains in postural balance (reduction in center of mass sway) (r = −0.52, P < .05). In addition, significant improvement was observed in postural coordination between the ankle and hip joints (mean, 10.4%; P = .04).

Conclusions:

The present research implemented a novel balance rehabilitation strategy based on virtual reality technology. The method included wearable sensors and an interactive user interface for real-time visual feedback based on ankle joint motion, similar to a video gaming environment, for compensating impaired joint proprioception. These findings support that visual feedback generated from the ankle joint coupled with motor learning may be effective in improving postural stability in patients with diabetic peripheral neuropathy. (J Am Podiatr Med Assoc 103(6): 498–507, 2013)
Peroneal tendon balance procedure
Authors: Grumbine NA , Van Enoo RE , Santoro JP
Published: April 2014

The authors introduce the peroneal tendon balance procedure and discuss normal and hypermobile function of the first ray. The procedure is based on the theory that the peroneus longus tendon is a primary retrograde stabilizer of the proximal portion of the first ray. The theory emphasizes that abnormal pronation results in a positional weakness of the peroneus longus tendon, which induces first ray hypermobility. This surgical procedure involves an anastomosis of the peroneus longus to the peroneus brevis tendon. It is designed to increase the force of the peroneus longus tendon in order to reduce first ray hypermobility.
Infectious complications and therapy of bite wounds
Authors: Goldstein EJ
Published: April 2014

Bite wounds of the lower extremities present a challenge in diagnosis and management. Primary care of the initial injury remains controversial. Innocuous as these wounds may appear, severe infections are frequent. The microbial flora of the animal mouth harbor a multitude of unusual bacteria, aerobic and anaerobic, that make antibiotic selection difficult. A protocol for initial management and antibiotic selection is presented.
Diagnosis and treatment of staphylococcal diseases
Authors: Tan JS , File TM
Published: April 2014

Staphylococcus is, by far, the most commonly seen organism in podiatric infections. Although common, staphylococcal infections are difficult to understand and treat. These bacteria have undergone significant changes in their pathogenicity and antibiotic susceptibility over the last few years. Methicillin-resistant strains, once relatively rare, are becoming a major therapeutic dilemma in some centers.
Positive identification based on radiographic examination of the leg and foot. A case report
Authors: Owsley DW , Mann RW
Published: April 2014

The authors have presented a forensic anthropology case that established positive identification by comparison of antemortem and postmortem x-rays of the legs and feet. This case illustrates one method of ascertaining the identity of a burned and skeletonized victim. By careful reconstruction and examination of the skeleton, the investigators were able to determine not only age, race, and sex, but also trauma sustained to the head and left arm at the time of death. This case highlights the importance and application of clinical radiography in a legal context.
Os subcalcaneum
Authors: Varounis G , Pasternack WA
Published: April 2014

An 11-year-old female presented with a history of pain in the left heel. Radiologic studies of both feet displayed a bony mass unilaterally. This bony mass had been identified radiologically as being separate from the posterior portion of the calcaneus. Clinically, the os subcalcaneum displayed a syndesmotic attachment to the calcaneus. Removal of the ossicle rendered the patient aysmptomatic.
Chondroid syringoma. A review of the literature and case report
Authors: Toback TG , Toback CJ
Published: April 2014

The third documented case of chondroid syringoma occurring in a toe, involving the largest tumor of the three, along with a review of the literature, has been presented. The possibility of a mixed tumor should be kept in mind when considering the differential diagnosis of a solid nodule in the skin, particularly if it is of long duration. These tumors usually will present as simple, asymptomatic, subcutaneous nodules that are shelled out easily during surgical excision. However, there is a tendency toward local recurrence that usually is attributed to incomplete surgical removal, which easily may occur because of the lobulation of the tumor. Complete excision of the primary tumor always is recommended, as diagnosis can be made only by histopathologic examination. Six reported cases revealed that the recurrence of the lesion following primary excision resulted in malignant degeneration. In nine reported cases where metastasis had occurred, the initial site of metastasis in five patients was the regional lymph nodes, and, in four patients, there was metastasis in the lung. The period of time between the removal of the primary lesion and the malignant local recurrence or metastasis has been reported to be from 1 to 4 years. Recognition of chondroid syringoma is clinically difficult because of its rarity. Its diagnosis requires histologic examination.
An improved approach to evacuation of subungual hematoma
Authors: Palamarchuk HJ , Kerzner M
Published: April 2014

An improved approach to subungual hematoma evacuation has been presented. Hand-held cautery is a cost-effective, precise method of treatment of subungual hematoma. Its use decreases the likelihood of unnecessary delay in the regrowth of the nail plate and secondary dystrophy that might result from pressure on the matrix caused by accumulated blood under the nail. The high temperature and fine tip make the cautery an excellent instrument to precisely and painlessly burn a small hole in the nail plate, allowing for evacuation of subungual hematoma.
Lower extremity peripheral vascular disease. Part 2: Light and transmission electron microscopy
Authors: McCarthy DJ , Abell N , Reed T
Published: April 2014

In spite of the most vigorous efforts to intervene medically and surgically when peripheral vascular disease threatens a patient, amputation of the extremity may be the only option left to arrest the progression of the disease. In a previous study, the authors assessed amputations, examined gross pathology, and identified scanning electron microscopic features associated with atherosclerotic disease. In the present study, the authors discuss this disease in terms of conventional light microscopy and transmission electron microscopy.
Short limb and the ball-and-socket ankle deformity
Authors: Harris EJ
Published: April 2014

Congenital ball-and-socket ankle deformity is a complex pediatric orthopedic deformity that usually is associated with a short limb, a short fibula, distal tibial dysplasia, rearfoot coalition, and ray deficiency. The author reviews the literature on this orthopedic complex, presents two cases, and discusses the practical clinical management of this syndrome.
Volume injection adhesiotomy
Authors: Grumbine NA , Radovic PA
Published: April 2014

The authors present a modified method for treating painful cicatrix nerve entrapments. A series of three high-volume injections of local anesthetic, steroid, and hyaluronidase are used to perform percutaneous adhesiotomies and extraneural fibrosis decompression. If special attention is given to the tissue plane level in performing the sequential injections, circumferential neural trunk decompression or cicatrix adhesiotomy can be obtained. The procedure may decrease or eliminate pain sufficiently to circumvent surgical intervention.
Compartment syndrome. A dorsal pedal presentation
Authors: Bartolomei FJ , Colley JO
Published: April 2014

Compartment syndrome presents an emergency situation to the surgeon. Inordinate delay in performing a fasciotomy poses potential loss of limb or irreversible neuromuscular damage. Recognizing those injuries that may cause a compartment syndrome and careful monitoring of the at-risk patient during the early post-traumatic period are mandatory.
Effects of pulsed argon laser energy on bone
Authors: Coster AA , Fox KR
Published: April 2014

Several investigators have reported that the presence of calcium may totally preclude resection of plaque material from the lumen of an occluded vessel. Because the authors did not support these findings, they tested the hypothesis and studied the effects of pulsed argon ion laser energy on other non-plaque but dense calcified tissue, such as cortical bone, and found that bone can be cut with ease and safety. Fresh bovine specimens were irradiated with a Spectra Physics model 170 argon ion laser, and the irradiated areas were examined, measured, and photographed.
Multi-beat clonus in a patient without an upper motor neuron lesion. A case report
Authors: Adams SE , Hoffman AF
Published: April 2014

The authors present a case of five-beat clonus in the absence of a central nervous system pathologic condition. As data obtained from the literature demonstrate, clinicians should be aware that multi-beat clonus is not always associated with upper motor neuron lesions.
Charcot foot
Authors: Banks AS , McGlamry ED
Published: April 2014

Successful management of the Charcot foot is one of the most challenging undertakings faced by physicians. However, many times such patients undergo prolonged and attentive care only to develop further deformity, and in many cases succumb to amputation. Research in the past few years has yielded a new understanding of the Charcot process that should serve as the basis for improved therapeutic measures. The authors discuss these more recent developments and how this knowledge may be applied to better serve the patient. In addition, surgical reconstruction of the diabetic Charcot foot is introduced and discussed.
Chronic high velocity projectile injury to the foot
Authors: Scartozzi G , Hoffman L
Published: April 2014

Acute projectile injuries to the foot can present a challenge for the podiatric physician, especially in terms of their chronic effects. The case of a shrapnel wound to the right foot and ankle that resulted in recurrent episodes of soft tissue infection and disability is presented. Treatment consisted of excision of the shrapnel fragment, debridement, and primary closure of the sinus tract created by the projectile. The authors discuss the acute and chronic effects of projectile injuries, factors responsible for determining the severity of these wounds, and various methods of treatment.
Benign schwannoma of the foot
Authors: Pace JF , Spinosa FA
Published: April 2014

Schwannoma is a relatively uncommon tumor of the nerve sheath and is rare in the foot. The lesion is almost always benign, but when a major nerve is involved, parasthesia and anesthesia may result. In addition, the unlikely appearance of multiple schwannoma may signal the onset of von Recklinghausen's disease.
Electrical stimulation of cutaneous ulcerations. A literature review
Authors: Dayton PD , Palladino SJ
Published: April 2014

The effect of electrical currents on living cellular systems has been studied by many researchers and is becoming useful in clinical medicine. Alteration of cellular activity with externally applied currents can positively or negatively influence the status of a healing tissue, thereby directing the healing process to a desired outcome. A review of the literature pertaining to the effect of electrical currents on tissue healing is presented and the relevance of this modality to ulcer healing is discussed.
Calcaneus secundarius. Variation of a common accessory ossicle
Authors: Mann RW
Published: April 2014

The calcaneus secundarius is an accessory ossicle of the anterior calcaneal facet. Dry bone examination of 1,367 calcanei revealed this trait 47 times (3.4%). Familiarity with the calcaneus secondarius may prove to be of clinical and radiographic value in distinguishing pathologic from normal variants in the calcaneus.
Smoking and peripheral vascular disease. Epidemiology and podiatric perspective
Authors: Levy LA
Published: April 2014

Virtually no attention has been given in public education efforts to the potentially devastating effects of smoking on the lower extremities. An analysis of the epidemiologic studies that have been done by the Office of the Surgeon General and other clinical investigators has been presented, leading to the conclusion that cigarette smoking is the single most powerful risk factor for peripheral vascular disease. In the care of patients with peripheral vascular disease, the podiatric physician has an opportunity to be a participant in efforts to solve one of the nation's major public health problems.
Cavernous hemangioma of the foot. Case report and literature review
Authors: Castillenti TA
Published: April 2014

Theories about the nature of cavernous hemangiomas have been reviewed. Most authors believe that such vascular tumors are congenital. The influence of pregnancy on the growth of these tumors was exemplified in a case report, and explanatory mechanisms were offered. Occurrences of cavernous hemangiomas that involve the foot were reported in the literature, ranging from 4.9% to 28.5% of all cases reviewed. X-ray findings of phleboliths and the importance of angiography in planning treatment were emphasized. In the authors' case report, a satisfactory surgical result was obtained in a plantar foot lesion that would otherwise have required amputation.
Unicameral bone cyst of the talus
Authors: Chieppa WA , Shinder M
Published: April 2014

The authors present a rare case of a talar unicameral bone cyst in a 9-year-old boy. This is the first such case presented in podiatric literature; the lesion has been cited infrequently in world literature. A brief review of the literature is discussed, along with the diagnostic tests, possible complications, and proper therapy for this lesion.
Pedal polydactyly. A case report
Authors: Sonoga AL , Guttmann GG
Published: April 2014

Polydactyly is a common pedal deformity with great variation in clinical presentation. There is a tendency toward a higher incidence in previously affected families, but the actual occurrence rate of the different forms of polydactyly has not been agreed upon in the literature to date. Most authors agree that the isolated deformity is an expression of an autosomal dominant gene with varied penetrance. Syndromatically associated polydactyly is inherited as an autosomal recessive trait. Surgical intervention should be attempted as early as possible. Correction should be undertaken only after a thorough clinical and radiographic evaluation has been performed. The patient's postoperative goals should always be considered. It is not necessary to remove the supernumerary digit if it does not interfere with the foot's function and comfort. Cosmesis should not be the chief consideration. The surgeon should strive to return the foot to a more normal contour while maintaining or improving foot function.
Toothpick foreign body in the foot. A case report
Authors: Newman JT , Hunt DW
Published: April 2014

A case report of a wooden toothpick as a foreign body in the foot was presented. Such lesions are visualized poorly, if at all, on standard radiographs, and localization of the foreign body may not be possible. Computed tomography, with its superior soft tissue imaging capabilities, can detect this otherwise radiolucent wood material and make accurate localization of the foreign body possible.
HIV infection control for podiatric practitioners
Authors: Newlin B
Published: April 2014

Although significant advances have been made in the treatment of acquired immunodeficiency syndrome (AIDS), neither a curative therapy nor a vaccine is available. Protecting practitioners, medical staff members, and patients from infection with human immunodeficiency virus (HIV) remains a particularly important issue. Fortunately, this virus is not readily transmitted in the health care setting. Adequate protection can be accomplished through the strict implementation of universal infection control policies in the treatment of all patients. Understanding these procedures, providing access to necessary equipment and supplies, and monitoring adherence to universal infection control measures will minimize the risk of exposure.
Ethical dilemmas in HIV infection
Authors: Lo B
Published: April 2014

As the AIDS epidemic continues to claim lives, the issues of testing, confidentiality, and refusal to care for seropositive patients generate increasing debate and concern among health care workers, legislators, and the general public. Protecting the uninfected from exposure to HIV, providing adequate medical care and counseling to HIV-positive persons, and preventing discrimination are necessary and immediate goals. Adherence by practitioners to both the current legislation on AIDS and the ethical imperatives of the health professions will facilitate adequate access to health care for all persons with AIDS. It will also provide necessary guidelines for issues of confidentiality.
Diagnosis of deep vein thrombosis using real-time B-mode ultrasound imaging
Authors: Derner R , Brantigan CO
Published: April 2014

The authors discuss real-time B-mode imaging in reference to the diagnosis of deep vein thrombosis. This technique is noninvasive, reproducible, painless, and accurate in diagnosing deep vein thrombosis. A case report demonstrating the effectiveness of this modality is presented. The authors believe this diagnostic tool will soon become the procedure of choice in the diagnosis of deep vein thrombosis.
Efficacy of twice-daily dosing of econazole nitrate 1% cream for tinea pedis
Authors: Brenner M
Published: April 2014

This study was conducted to determine the efficacy of twice-daily applications of econazole nitrate 1% for the treatment of tinea pedis within a typical podiatric practice. The study showed that twice-daily application of econazole nitrate 1% is an effective therapy and is especially successful at preventing immediate fungal recurrence.
Epidermal inclusion cyst of the heel
Authors: Marczak L
Published: April 2014

An inclusion cyst develops from the introduction of epidermal fragments into a heterotopic location, where it grows through accumulation of epithelial and keratinous debris. This is caused by a combination of increased physical activity and the imposition on the site. Inclusion cysts are seen most frequently in younger and more active patients, rather than in older individuals. This case is unique because the epidermal inclusion cyst occurred on the plantar aspect of the foot of an elderly, sedentary patient who had not sustained any injury to the area.
Peroneal sheath reconstruction in the growing child
Authors: Agostinelli JR , Ruda RJ
Published: April 2014

The authors recommend the procedure described above specifically for children with congenital or acquired subluxation or dislocation of the peroneal tendons, but they advise against using this procedure alone when calcaneovalgus deformity is present and anterior dislocation of the peroneal tendons occurs as a result of spasticity. It may, however, have a place as part of a combined procedure to correct the spastic deformity. Reconstruction of the superior peroneal retinaculum is accomplished with a strong ligamentous structure, appropriately oriented and directed, without loss of lateral ankle stability. The authors believe that the complication of partial or complete fibular physeal arrest can be avoided, and that redislocation of the peroneal tendons as the child grows out of the repair can be eliminated. Therefore, this procedure is suggested as the procedure of choice for a growing child with anterior luxation or dislocation of the peroneal tendons and an intact calcaneofibular ligament. Properly performed, it will enable these children to return to the vigorous physical activity they desire.
Friction blisters and sock fiber composition. A double-blind study
Authors: Herring KM , Richie DH
Published: April 2014

A longitudinal double-blind study was conducted to determine the effect of sock fiber composition on the frequency and size of blistering events in long-distance runners. Thirty-five long-distance runners participated in this study. Two different socks were tested, which were identical in every aspect of construction except fiber composition. One test sock was composed of 100% acrylic fibers, and the other test sock was composed of 100% natural cotton fibers. The results showed that acrylic fiber socks were associated with fewer blistering events and smaller blisters (mm2), when compared directly to cotton fiber socks.
Traumatic lesions of some accessory bones of the foot in sports activity
Authors: Maffulli N , Lepore L , Francobandiera C
Published: April 2014

Six athletes suffering from different lesions of some accessory bones of the foot are reported. Four of them were treated surgically, with removal of the os trigonum, the os tibiale externum, and the os subfibulare, while in the other two cases, conservative treatment was effective. In caring for athletes suffering from these kinds of disorders, their degree of involvement in sports, the level at which they are playing, and their desire to take the shortest possible length of time off must be taken into account in planning a therapeutic program.
Kaposi's sarcoma of the lower extremity as the first sign of AIDS
Authors: Cohen EJ , Cole D , Stewart DM , Weiss G , Kosinski M , Giorgini R
Published: April 2014

The authors review four cases of Kaposi's sarcoma that were presented to the Foot Clinics of New York and affiliated North General Hospital during a 1-year period from the fall of 1987 to the fall of 1988. The authors conclude that it is sometimes difficult to diagnose Kaposi's sarcoma and to differentiate between the acquired immunodeficiency (AIDS) form and the classic form. Guidelines for diagnosis and a profile of the AIDS-related and non-AIDS-related Kaposi's sarcoma patient are discussed.
Anatomical and histologic investigation of the syndesmotic area in the ankle joint
Authors: Sabacinski KA , Walter JH , Saffo GM
Published: April 2014

The syndesmotic area in the ankle joint is analyzed by reviewing the literature and by examining its gross anatomy and histology. Seventy-five ankles were dissected and examined, with an emphasis on the syndesmotic area. The gross anatomical results of this study differ somewhat with those of other authors. The average height, attachments, consistency, color, and shape are reported. In addition to gross examination, four ankles were examined histologically, and the findings are discussed. The results of this study define in detail the anatomy of the syndesmotic area.
Library technology supports resident education
Authors: Bernal NE , Renner IA
Published: April 2014

The authors discuss new library services and support for a podiatric residency program. They present information on how to conduct medical literature searches through the use of MEDLINE and CD-ROM MEDLINE. Information on interlibrary loans also is provided.
Medical management of symptomatic peripheral vascular disease
Authors: Skelton NK , Skelton WP
Published: April 2014

As our society becomes older, peripheral vascular disease assumes greater significance. Many patients are not surgical candidates and, therefore, must opt for medical management. The podiatrist often assumes the role of primary health care provider, and a knowledge of the disease process, its consequences, and treatment alternatives becomes paramount. The authors detail the events leading to and the treatment options for symptomatic peripheral vascular disease.
Managing chronic foot pain. A case report
Authors: McCain J , Hagan SJ
Published: April 2014

The management of chronic pain may be enhanced by a multidisciplinary approach. When this method is effective, patients report significant improvement in their quality of life. A case report involving a multidisciplinary approach is presented.
Peroneus longus tendon and peroneus brevis tendon dislocation. A case report
Authors: Montes MD , Black JR
Published: April 2014

Trauma that produces recurrent dislocation of the peroneal tendons often is mistaken for an ankle sprain, or occurs in conjunction with an inversion ankle sprain. Self-diagnosis and self-treatment may preclude accurate diagnosis and management. The authors present a case that illustrates this scenario and review anatomical considerations, the mechanism of the injury, and therapeutic options.
Long-term results of proximal metatarsal osteotomy in hallux valgus
Authors: L√ºthje P
Published: April 2014

The author presents the long-term results of a proximal metatarsal osteotomy in hallux valgus. The results are based on clinical findings and radiographs.
Preoperative and perioperative anesthesia considerations for the diabetic patient
Authors: Addante JB , Coby ME , Wondro ME , Baker RE
Published: April 2014

Surgery involving diabetic patients requires special consideration of the possible effects of anesthesia. The authors discuss factors that affect the choice of anesthetic agent and recommendations for preparing the diabetic patient for surgery, along with potential complications.
Bilateral congenital absence of the fibula
Authors: Berenter R , Morris J , Yee B
Published: April 2014

The syndrome caused by congenital absence of the fibula has a number of pathologic abnormalities frequently associated with it, which are illustrated by the case reported. Postsurgical therapy on the involved extremity should take into account the patient's lack of joint motion within the tarsal region. With this in mind, special shoes or accommodative insoles, alone or in combination, should be prescribed in order to facilitate an increase in weightbearing activity with minimal discomfort.
LaPorta great toe implant. Long-term study of its efficacy. Student Research Group
Authors: Dobbs B
Published: April 2014

The purpose of this study was to evaluate the long-term function of the LaPorta design great toe implant. Eight cases were evaluated preoperatively and on a short-term (mean = 3.6 months) and a long-term basis (mean = 20.5 months) postoperatively. Findings of clinical importance included decreased hallux dorsiflexion and radiographic evidence of hyperostosis formation at the implant hinge. However, all of the patients studied were satisfied with their results.
Physical examination of musculoskeletal pain
Authors: Wilson G , Adelman KA
Published: April 2014

The authors present information on how to conduct an examination of musculoskeletal structures with the purpose of accurately locating the source of a patient's symptoms when musculoskeletal pathology is suspected. An accurate identification of the structure at fault will enable the physician to formulate a more specific and effective treatment program.
Guidelines for podiatric services in long-term care facilities
Authors: Helfand AE
Published: April 2014

The inclusion of appropriate podiatric services in long-term care programs often will produce dramatic effects. Immobility can be replaced by activity. Quality of care translates into quality of life. Support and encouragement can be directed to independence and a strong sense of personal identity and worth. Isolation can be replaced by interaction. When the quality of life decreases as a result of disease, disability, or age, those precious aspects of dignity must be restored to a maximum level by caring staff and people. Because walking is a catalyst for life, podiatric care can help restore some of the lost dignity by keeping patients walking and moving about, so that they can accept and participate in the social activities provided by the facility.
Tarsal tunnel syndrome. Comprehensive review of 87 cases
Authors: Grumbine NA , Radovic PA , Parsons R , Scheinin GS
Published: April 2014

The results of the study indicate that tarsal tunnel syndrome is a pathologic condition in which there are multiple etiologies, which in some cases are poorly defined. In order to arrive at a definitive diagnosis, all available tests, including pathology reports, are important. Where proper diagnosis is made and followed with appropriate adjunctive care, the probability of recurrence will be minimized. Statistical information in itself is of some value, because it may help the podiatrist to more clearly diagnose and treat the patients in whom vague or general symptoms may exist.
Treatment of verrucae via radio wave surgery
Authors: Valinsky MS , Hettinger DF , Gennett PM
Published: April 2014

Verrucae are common skin lesions seen mainly in younger patients. They often are seen on the plantar surface of the foot. Many different types of treatments have been used over the years, with varying levels of success. The authors present a thorough review of previous treatments and present a new and effective method of surgical excision using radio wave technique. The success of this treatment is high, and the postsurgical pain and complication level is minimal.
Stress fracture of the tarsal middle cuneiform bone. A case report
Authors: Creighton R , Sonoga A , Gordon G
Published: April 2014

The authors have presented what they believe is the only reported case of a stress fracture of the tarsal middle cuneiform bone. Stress fracture pathogenesis, as well as diagnosis and treatment, were reviewed. It has been proposed that the middle cuneiform may be subject to increased stress in the runner during the propulsive phase, as this is the midfoot bone that transmits weight proximally in the medial column. This is evident by studying the cancellous structure of the tarsal bones. The ligamentous and osseous architecture of this region also can produce a midfoot buckling when the foot is plantarflexed against resistance. Prompt diagnosis and treatment is the key in preventing the stress fracture from becoming a chronic source of discomfort.
Cutaneous angiosarcoma. A literature review and case report
Authors: Wolf K , Pasquino J
Published: April 2014

A case of angiosarcoma of the lower extremity was presented. This rare but highly malignant soft tissue tumor usually presents as a raised pigmented lesion. Wide surgical excision or amputation is the treatment of choice. Radiotherapy may offer some relief in cases that are inoperable.
Unilateral ectrodactyly, metatarsal synostosis, and hypoplasia in an Eskimo
Authors: Keenleyside A , Mann RW
Published: April 2014

A unilateral foot deformity in an archaeological specimen from Point Hope, Alaska, is presented. Radiographic and gross examination of the bones of the malformed left foot suggests that this adult female suffered from a rare and possibly unique limb deficiency presenting as unilateral congenital absence of the phalanges, synostosis and hypoplasia of the metatarsals, and mild hypoplasia of the calcaneus.
Electrocution injuries. A case report
Authors: Addante JB , Chin M , Eto J , Baker RE
Published: April 2014

A case study of a high-voltage injury was presented. The short period that the patient was in contact with the electrical source prevented further systemic injury and may have saved her life. The patient's present neuritis is indicative of long-term sequelae of electrocution injury, in which ischemic necrosis of the surrounding nerves can occur near or at the site of the exit wound.
Foot orthosis for the severe flatfoot in sports
Authors: Blake RL , Ferguson H
Published: April 2014

The control of excessively pronating feet in athletes can be a prolonged and frustrating experience for both the doctor and the patient. The inverted orthotic technique has previously been described for making a device that has two basic applications: to control excessive subtalar joint pronation, especially where a Root or modified Root device cannot, and to invert the entire lower limb for such problems as medial knee pain. The authors present two case histories that highlight the indications of this orthotic device for the athletic population.
Bullosis diabeticorum. A report of two cases with a review of the literature
Authors: Bodman M , Friedman S , Clifford LB
Published: April 2014

Bullosis diabeticorum is a rare complication of long-standing diabetes mellitus. Bullous lesions, which appear like burn-induced blisters, occur suddenly without trauma in the feet. These bullae heal spontaneously without scarring; however, recurrence is common. The etiology of bullosis diabeticorum remains unknown. Several theories exist as to causal and contributory factors related to this cutaneous manifestation of diabetes mellitus.
Juxtamalleolar lipoma with intermediate dorsal cutaneous nerve entrapment
Authors: Nicklas BJ , Schwein J
Published: April 2014

From a review of the literature, it would appear that lipomas of the foot are relatively rare and that, when they do exist, they are of little clinical significance other than cosmetic appearance. The authors presented a case in which the size, location, and character of the mass predisposed the patient to entrapment syndrome of the intermediate dorsal cutaneous nerve. It is important to emphasize, however, that in these cases symptoms are related to a pressure phenomenon and are not a direct result of tumor physiology.
Reflex sympathetic dystrophy. Objective clinical signs in diagnosis and treatment
Authors: Van Wyngarden TM , Bleyaert AL
Published: April 2014

Diagnosis and follow-up treatment of reflex sympathetic dystrophy is difficult because of the subjective, nonspecific nature of its primary symptom, burning pain. Early diagnosis and aggressive treatment of reflex sympathetic dystrophy with epidural nerve blocks improves clinical resolution. Temperature difference between extremities and dependent cyanosis are reliable objective signs for clinical diagnosis and the evaluation of progress for treatment for reflex sympathetic dystrophy.
Digital fractures. A comprehensive review
Authors: Galant JM , Spinosa FA
Published: April 2014

Fractures of the phalanges of the feet are the most common types of injury to the forefoot. There is, however, little available literature concerning pedal digital fractures. There is a misconception that fractured toes will heal by themselves. In fact, mistreated digital fractures can lead to many painful and serious complications. A review of the classifications, mechanisms of injury, clinical presentation, complications, and various treatments of digital fractures is presented.
The Biofix absorbable rod. A preliminary report
Authors: Yen RG , Giacopelli JA , Granoff DP , Steinbroner RJ
Published: April 2014

An introduction to the biodegradable Biofix rod for use in podiatric surgery is presented. Its application for Austin-type bunionectomies is described. The advantages and shortcomings are compared to traditional internal fixation. For procedures necessitating osteotomy stability, the Biofix rod is another option for the podiatric surgeon.
A study of the properties of materials used in podiatry
Authors: Rome K
Published: April 2014

This study was performed to provide insight into the functioning of a selection of materials used in the fabrication of orthoses. A series of mechanical and physical tests was performed on five materials, under strict laboratory conditions. The results demonstrate that the polyurethane foams are the most promising material in the design of foot orthoses. The results also suggest that an agglomeration of properties, not just one specific property, can influence the behavior of materials.
Apophysitis of the fifth metatarsal base. Iselin's disease
Authors: Schwartz B , Jay RM , Schoenhaus HD
Published: April 2014

Apophysitis of the fifth metatarsal base, or Iselin's disease, is an overuse osteochondrosis seen in growing children. Although amenable to treatment, it is a self-limiting disorder, disappearing spontaneously with completion of growth.
The hopscotch position. A screening test
Authors: Ganley JV
Published: April 2014

The author discusses an examination method that is performed in a matter of seconds by either the physician or the parent. When the child is placed in a specific "hopscotch" position, otherwise obscure leg and foot deformities become readily apparent, and early treatment is then made possible.
A systematic approach for radiographically evaluating joint disease in the foot
Authors: Christman RA
Published: April 2014

A methodic analysis of foot radiographs is valuable when evaluating for joint disease. The author presents a system that allows the interpreter to establish a list of expected differential diagnoses. This is especially useful when the arthritide does not present with its classic radiographic appearance.
The effect of various forms of immobilization on plantar foot pressure
Authors: Beiser I , Light M , Lynch T , Kanat I
Published: April 2014

In this study, 16 subjects wore different types of immobilization devices while peak pressures on the plantar aspect of the foot were measured using the Electrodynogram (E.D.G.) system. Objective and subjective data were generated and analyzed. Peak pressures decreased on the plantar aspect of the foot as the form of immobilization progressed up the leg.
Modification of high-heeled shoes to decrease pronation during gait
Authors: Phillips RD , Reczek DM , Fountain D , Renner J , Park DB
Published: April 2014

One of the reasons that high heels may contribute to the formation of halux valgus is that the wearers pronate during propulsion. This pilot study was performed to determine whether relocation of the heel under the counter of a fashion high-heeled pump could change the degree of pronation of the foot during the gait cycle. The authors report that more foot stability was experienced by the subjects when the center of the heel was offset between 2 and 4 mm medial to the center of the heel counter. This study is designed to promote further research into whether the shoe industry should change the design parameters of high-heeled fashion shoes in order to improve foot function.
Syndactylization for the treatment of fifth toe deformities
Authors: Marek L , Giacopelli J , Granoff D
Published: April 2014

The authors describe a procedure to syndactylize the fourth and fifth toes for the correction of failed fifth toe arthroplasty, flail fifth toe, overriding fifth toe, cocked-up fifth toe, heloma molle, and congenital digitus minimus varus. The procedure is technically simple and produces good cosmetic results.
The isolation of an active inhibitory system from an extract of aloe vera
Authors: Davis RH , Parker WL , Samson RT , Murdoch DP
Published: April 2014

An Aloe vera extract was prepared with 50% ethanol. The resultant supernatant and precipitate were tested for anti-inflammatory activity using the croton oil-induced ear-swelling assay. The supernatant fraction decreased inflammation, when applied topically, by 29.2%, and the precipitate decreased inflammation by 12.1%. The authors have shown that the anti-inflammatory activity (inhibitory system) resides in the supernatant of a 50% ethanol extract.
Structural biomechanics of the foot bones
Authors: Hirsch BE
Published: April 2014

The structure of the tarsal and metatarsal bones reflects the functional demands placed on them. Their shape and the arrangement of compact and trabecular bone within them help them resist the normal forces of everyday life. When the limits of their strength are exceeded, failure can occur.
An unusual intermetatarsal coalition
Authors: Kashuk KB , Hanft JR , Schabler JA , Wolosky B
Published: April 2014

Synostoses commonly occur in the midfoot and rearfoot. However, metatarsal synostosis is a less common phenomenon. Several etiologies have been described. The authors present a case of a fourth-fifth intermetatarsal bar, which does not fit into one of the established categories, along with the surgical technique used in its correction.
Bilateral styloid fracture. A case report
Authors: Noeller KR , Adams SE
Published: April 2014

Styloid fractures are common, and their treatment is relatively straightforward. This case demonstrated delayed healing because of continuous pathologic motion aggravating the styloid fractures.
Magnetic resonance imaging of traumatized ligaments of the ankle
Authors: Oloff LM , Sullivan BT , Heard GS , Thornton MC
Published: April 2014

The clinical examination of acute soft tissue injuries of the ankle does not necessarily help to delineate the extent of injury. Ankle stress radiographs and arthrography have been applied for a more accurate assessment of the actual degree of ligamentous damage. However, these studies do not define the level of the ligament tear of the relationship of torn ligament ends to one another. This information would seem to be valuable in deciding whether a conservative or surgical approach would be advisable. The following study evaluated the possible role of magnetic resonance imaging in assessment of these injuries. The ability to assess ankle ligaments was first undertaken. Once this was successfully performed, magnetic resonance imaging was used to assess the degree of ligament damage in 15 patients. Magnetic resonance imaging proved to be comparable to arthrography. It also provided additional valuable information.
Limb length discrepancies
Authors: Blake RL , Ferguson H
Published: April 2014

Examining for a possible limb length discrepancy is an important part of the podiatric biomechanical examination. The authors present a review of the literature pertaining to the definition of and examination for a limb length discrepancy. They present a typical rationale for lift therapy in the treatment of this pathology.
The long plantar wing distal metaphyseal osteotomy
Authors: Elleby DH , Barry LD , Helfman DN
Published: April 2014

The authors introduce the long plantar wing distal metaphyseal osteotomy of the first metatarsal through a medial plantar approach. This procedure for mild-to-moderate hallux valgus is capable of correcting an increased proximal articular set angle and first intermetatarsal angle concomitantly. The biomechanical, surgical, and clinical rationale for this procedure are discussed.
Dynamic plantar pressure analysis. Comparing common insole materials
Authors: Sanfilippo PB , Stess RM , Moss KM
Published: April 2014

A comparison of five commonly used insole materials (Spenco, PPT, Plastazote, Nickelplast, and Pelite) was made to evaluate their effectiveness in reducing plantar vertical pressures on human subjects during walking. With the use of the EMED-SF pedograph force plate system, dynamic measures of vertical force, force-time integral, peak plantar pressure, pressure-time integral, and area of foot-to-ground contact were compared with the force plate covered with each of the insole materials and without any interface material.
Avulsion fracture at the plantar lateral base of the first metatarsal. Two case reports
Authors: Hodor L , Murphy RD , Eskandari NB
Published: April 2014

The anatomy, mechanism, and two treatment approaches of an avulsion fracture at the plantar lateral base of the first metatarsal without any joint dislocation were discussed. The authors presented an injury that has not been reported in the literature but has only been seen as a part of Lisfranc's fracture dislocation types B and C.
Maffucci's syndrome. Review of the literature and case report
Authors: Unroe BJ , Kissel CG , Rosenberg JC
Published: April 2014

Maffucci's syndrome, a rarely occurring congenital disorder, may present early in life as either a pathologic fracture, an incidental radiographic finding, or primarily as multiple hemangiomas. Patients endure years of orthopedic complications, and are faced with a grim prognosis, with the majority developing either skeletal or extra-skeletal malignancies by the end of their fourth decade.
Primary care podiatric medicine and entry level residency. The new millennium
Authors: Levy LA
Published: April 2014

The author presents the perspective that the nation's health care initiatives demand that greater attention be given to primary care providers. Inasmuch as the credibility of the podiatric medical profession must function in a health care environment dominated by allopathic and osteopathic physicians, the podiatric primary care initiative must be pursued within the guidelines and definitions for primary care that are present in all of mainstream medicine. The author argues that primary care podiatric medicine must establish itself as a specialty that stands as an equal along side of the other recognized specialties in podiatric medicine. Also, in keeping with the essential educational needs for specialty training, the development of residencies in primary podiatric medicine is crucial to assuring a credible area of special practice.