bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of Anthropometric Foot Characteristics in Children
Authors: Morrison Stewart C. , Durward Brian R. , Watt Gordon F. , Donaldson Malcolm D. C. 
Published: April 2014

Background: The establishment of growth reference values is needed in pediatric practice where pathologic conditions can have a detrimental effect on the growth and development of the pediatric foot. This study aims to use multiple regression to evaluate the effects of multiple predictor variables (height, age, body mass, and gender) on anthropometric characteristics of the peripubescent foot.
Methods: Two hundred children aged 9 to 12 years were recruited, and three anthropometric measurements of the pediatric foot were recorded (foot length, forefoot width, and navicular height).
Results: Multiple regression analysis was conducted, and coefficients for gender, height, and body mass all had significant relationships for the prediction of forefoot width and foot length (P = .05, r = 0.7). The coefficients for gender and body mass were not significant for the prediction of navicular height (P = .05), whereas height was (P = .05).
Conclusions: Normative growth reference values and prognostic regression equations are presented for the peripubescent foot. (J Am Podiatr Med Assoc 99(6): 497–502, 2009)
Effect of Foot Orthoses Contour on Pain Perception in Individuals with Patellofemoral Pain
Authors: McPoil Thomas G. , Vicenzino Bill , Cornwall Mark W. 
Published: April 2014

Background: Foot orthoses have been described as a possible intervention for individuals with patellofemoral joint pain. No study has attempted to quantify the perceived comfort and support of foot orthoses when used as an intervention for patellofemoral joint pain.
Methods: A randomized case-control trial with crossover between contoured and flat orthoses was conducted on ten individuals with patellofemoral pain and ten healthy participants. All of the participants completed a comfort-support assessment and had in-shoe plantar pressure data collected before and after 3 weeks of wear. A 1-week washout period was used to minimize any continued treatment effect between orthotics testing. The patellofemoral pain group also completed a numeric rating scale to assess pain reduction after using each orthosis.
Results: All of the participants perceived that greater support was provided by the contoured orthoses in the heel and arch regions. Even with a 30% difference in material hardness between the two orthoses, all of the participants rated cushioning as equivalent. Six individuals in the patellofemoral pain group reported a clinically significant reduction in knee pain as a result of wearing foot orthoses.
Conclusions: A key factor in the selection of contoured foot orthoses versus flat inserts is the amount of support that an individual perceives in the arch and heel regions. In addition, clinicians using foot orthoses as an intervention for patellofemoral pain should expect an individualistic, nonsystematic response. (J Am Podiatr Med Assoc 101(1): 7–16, 2011)
Soft-Tissue Movement at the Foot During the Stance Phase of Walking
Authors: Chen Shing-Jye , Mukul Mukherjee , Chou Li-Shan 
Published: April 2014

Background: Soft-tissue movement has challenged the use of noninvasive skin-based markers that are assumed to be rigidly attached to the underlying bony landmarks. We assessed soft-tissue movement in multiple foot segments by calculating the relative changes in the intermarker distances of the hindfoot, midfoot, and forefoot segments during the early, middle, and late stances of walking compared with the intermarker distances measured while participants remained still during standing.
Methods: Seven healthy young adults with no previous lower-limb injury were tested while walking barefoot at a comfortable pace. Skin-based markers were placed on three foot regions (hindfoot-calcaneus, midfoot-navicular, and forefoot–first to fifth metatarsals). A motion system sampled at 120 Hz was used to capture the foot markers during the stance phase of walking.
Results: Soft-tissue movement was found in the forefoot region characterized by shortened distances, specifically during early (breaking) stance and late (propulsion) stance. In the hindfoot region, soft-tissue movement was characterized by shortened and elongated distances during the early and late stance periods, respectively. All of the foot regions showed the least intermarker distance changes during midstance.
Conclusions: The dynamics of soft-tissue movement in multiple foot segments were characterized by the greatest changes in the intermarker distances in the forefoot and hindfoot during the early and late stance phases and the least changes in the foot segments during midstance. The results provide a feasible and accessible measurement for assessing soft-tissue movement in the foot when skin-based motion markers are used. (J Am Podiatr Med Assoc 101(1): 25–34, 2011)
Distally Based Adipofascial Sural Flap for Foot and Ankle Reconstruction
Authors: Mojallal Ali , Shipkov Christo D. , Braye Fabienne , Breton Pierre 
Published: April 2014

Background: This retrospective study of a case series analyzed the results from the application of a distally based adipofascial sural flap for nonweightbearing defects of the foot and ankle.
Methods: Twenty-eight patients with post-traumatic ankle and foot defects (ten women and 18 men; age range, 17–63 years) underwent surgery between November 1, 2003, and November 30, 2008. Distally based adipofascial sural flaps were used in ten open fractures, 14 soft-tissue post-traumatic defects, and four deep burns. Defects were on the dorsal side of the foot (eight cases), the lateral malleolus (four cases), the medial malleolus and inframalleolar region (four cases), the Achilles tendon region (eight cases), and the anterior surface of the ankle (four cases). Surgical procedures were performed by a single surgeon (A.M.).
Results: All of the flaps healed uneventfully. There was no partial or total flap loss. All 28 patients walked normally at the time of follow-up. Three delayed healings occurred at the donor site.
Conclusions: This is a homogeneous series of lower-limb reconstructions with the distally based adipofascial sural flap, which permits better analysis of the results. This flap has a constant and reliable blood supply. It can be used for the reconstruction of nonweightbearing foot and ankle regions to avoid the bulky volume of the fasciocutaneous flap in this area and to minimize the donor site scar. (J Am Podiatr Med Assoc 101(1): 41–48, 2011)
The Economic Value of Specialized Lower-Extremity Medical Care by Podiatric Physicians in the Treatment of Diabetic Foot Ulcers
Authors: Carls Ginger S. , Gibson Teresa B. , Driver Vickie R. , Wrobel James S. , Garoufalis Matthew G. , DeFrancis Roy R. , Wang Shaohung , Bagalman J. Erin , Christina James R. 
Published: April 2014

Background: We sought to examine the economic value of specialized lower-extremity medical care by podiatric physicians in the treatment of diabetic foot ulcers by evaluating cost outcomes for patients with diabetic foot ulcer who did and did not receive care from a podiatric physician in the year before the onset of a foot ulcer.
Methods: We analyzed the economic value among commercially insured patients and Medicare-eligible patients with employer-sponsored supplemental medical benefits using the MarketScan Databases. The analysis consisted of two parts. In part I, we examined cost or savings per patient associated with care by podiatric physicians using propensity score matching and regression techniques; in part II, we extrapolated cost or savings to populations.
Results: Matched and regression-adjusted results indicated that patients who visited a podiatric physician had $13,474 lower costs in commercial plans and $3,624 lower costs in Medicare plans during 2-year follow-up (P &lt; .01 for both). A positive net present value of increasing the share of patients at risk for diabetic foot ulcer by 1% was found, with a range of $1.2 to $17.7 million for employer-sponsored plans and $1.0 to $12.7 million for Medicare plans.
Conclusions: These findings suggest that podiatric medical care can reduce the disease and economic burdens of diabetes. (J Am Podiatr Med Assoc 101(2): 93–115, 2011)
A Diabetic Foot Ulcer Pilot Study
Authors: Westphal Cara , Neame Ingrid M. , Harrison Jessica C. , Bower Virginia M. , Gurr Joel M. 
Published: April 2014

Background: Silicone gel sheeting is an effective therapeutic intervention in the management of scar tissue. This pilot study was designed to examine the effect of silicone gel sheeting in preventing reulceration at former wound sites in diabetic patients.
Methods: Thirty patients with diabetes and a healed plantar neuropathic foot ulcer were enrolled and investigated in this randomized controlled trial. Participants with a newly healed ulcer were assigned to use either silicone gel sheeting or emollient cream daily for 3 months.
Results: Compared with emollient cream use, the use of silicone gel sheeting did not diminish and may have potentially increased the risk of reulceration.
Conclusions: Silicone gel sheeting does not seem to reduce the risk of reulceration in diabetic patients. The results of this trial should be viewed with caution given the small sample size. (J Am Podiatr Med Assoc 101(2): 116–123, 2011)
Contralateral Peak Plantar Pressures with a Postoperative Boot
Authors: Mieras Jamie N. , Singleton Tanya J. , Barrett Stephen L. 
Published: April 2014

Background: Frequent use of walking boots in podiatric medicine often elicits patient complaints and sequelae from the imposed limb-length discrepancy. This study was designed primarily to determine whether peak plantar pressures are decreased in the contralateral foot when a moderately worn athletic shoe is worn opposite a high-calf walking boot and, if so, secondarily to determine whether a specialized surgical shoe worn on the contralateral foot can also effectively reduce this pressure. The pressure reductions were then compared to determine whether significantly greater plantar pressure reduction was provided by either the athletic shoe or the surgical shoe.Methods: Participants without a foot abnormality walked on a treadmill in four footwear combinations: barefoot bilaterally, high-calf rocker-bottom sole (HCRB) walking boot/ barefoot, HCRB walking boot/athletic shoe, and HCRB walking boot/modified walking boot shoe. Measurements were taken with the participants wearing socks. Peak plantar calcaneal pressures were collected.Results: Peak plantar pressures under the calcaneus opposite the HCRB walking boot were significantly reduced from barefoot pressures when either an athletic shoe or the modified walking boot shoe was worn. However, no significant difference was seen when comparing the reduction by the athletic shoe with that by the modified walking boot.Conclusions: Wearing an athletic shoe on the foot opposite an HCRB walking boot reduces calcaneal pressures; however, wearing a modified device with structural properties of an HCRB walking boot sole is no better than an athletic shoe at reducing peak calcaneal pressures. (J Am Podiatr Med Assoc 101(2): 127–132, 2011)
Sever’s Disease
Authors: Scharfbillig Rolf W. , Jones Sara , Scutter Sheila 
Published: April 2014

Background: Sever’s disease, also known as calcaneal apophysitis, is thought to be an inflammation of the apophysis of the heel, which is open in childhood. This condition has been commented on and looked at in a retrospective manner but has not been examined systematically. We assembled the most commonly cited theoretical causative models identified from the literature and tested them to determine whether any were risk factors.
Methods: Children with Sever’s disease were compared with a similarly aged nonsymptomatic population to determine whether identifiable risk factors exist for the onset of Sever’s disease. Areas raised in the literature and, hence, compared were biomechanical foot malalignment, as measured by Root et al–type foot measurements and the Foot Posture Index; ankle joint dorsiflexion, measured with a modified apparatus; body mass index; and total activity and types of sport played.
Results: Statistically significant but small odds ratios were found in forefoot to rearfoot determination and left ankle joint dorsiflexion.
Conclusions: This study suggests that there is no evidence to support that weight and activity levels are risk factors for Sever’s disease. The statistically significant but clinically negligible odds ratio (0.93) on the left side for decreased ankle joint dorsiflexion and statistically significant and clinically stronger odds ratio bilaterally for forefoot to rearfoot malalignment suggest that biomechanical malalignment is an area for further investigation. (J Am Podiatr Med Assoc 101(2): 133–145, 2011)
Surgical Treatment of Pressure Ulcers of the Heel in Skilled Nursing Facilities
Authors: Han Paul Y. , Ezquerro Ruben 
Published: April 2014

Background: Chronic nonhealing pressure ulcers of the heel in nursing homes are frequent occurrences among bedridden patients with lower-extremity contractures of varying degrees of severity. Conservative local wound care for these patients can be time consuming, ineffective, costly, and may only delay an eventual major leg amputation. This study evaluates the efficacy of limb salvage surgical procedures, partial calcanectomy, total calcanectomy, and excision of the entire calcaneus and talus, for heel ulcers.
Methods: We performed a retrospective review of 57 nursing home residents who had chronic infected nonhealing pressure ulcers of the heel that we had treated over 12 years. Forty-three patients underwent partial calcanectomy, nine underwent total calcanectomy, and five underwent excision of the entire calcaneus and talus. Average postoperative follow-up was 15 months. Also included in this study are representative surgical cases.
Results: Forty-three patients completed follow-up. Complete healing occurred in 25 patients (58%). Failure to resolve the heel ulcer owing to persistent infection, or recurrence was seen in 18 patients (42%) who eventually had a below-the-knee or above-the-knee amputation. All of the patients with heel pressure ulcers were found to have lower-extremity contractures.
Conclusions: In the nonambulatory contracted patient with a heel ulcer, partial or total calcanectomy or excision of the entire calcaneus and talus offer a viable alternative not only for resolution of infection but also for prevention of limb loss. An aggressive plan must also be instituted to address the lower-extremity contractures in order to prevent recurrence. (J Am Podiatr Med Assoc 101(2): 167–175, 2011)
Freiberg’s Disease
Authors: Chun Kyung Ah , Oh Hyung Keun , Wang Kook Hyun , Suh Jin Soo 
Published: April 2014

Background:
The extent of necrosis is the main determining factor in the outcome of osteonecrosis. There is no method for measuring the extent of osteonecrosis of the metatarsal head in Freiberg’s disease. The purpose of this study was to determine the reliability and prognostic ability of a new method for measurement of the extent of osteonecrosis in Freiberg’s disease on three-dimensional computed tomography.

Methods:
A retrospective review of 11 cases with symptomatic Freiberg’s disease in ten patients (5 males and 5 females; mean age, 27 years) undergoing computed tomography between July 2005 and September 2007 was performed. Two investigators (K.A.C. and H.K.O.) used a new method to measure the necrotic extent of the metatarsal head: the necrotic angle ratio of necrotic arc angle to normal arc angle of the articular surface on the sagittal reconstruction image of computed tomography. The interobserver reliability was determined for computed tomography measurement. Correlation between the Smillie staging using radiographs and the necrotic angle ratio on computed tomography was also evaluated.

Results:
One patient presented with stage I disease (Smillie staging), one with stage II, two with stage III, five with stage IV, and two with stage V, respectively. The necrotic angle ratio of the metatarsal head was 14% in stage I, 21% in stage II, 34% in stage III, 43% in stage IV, and 53% in stage V. The interobserver reliability for computed tomography measurement was high (Cronbach α=0.96). We found the increase of the necrotic extent in proportion to the Smillie stage. The Smillie staging using radiographs and the necrotic angle ratio on computed tomography were significantly correlated. (P&lt;0.05)

Conclusions:
Three-dimensional computed tomography measurement of the necrotic extent of the metatarsal head is a reliable and useful method in evaluating the staging of Freiberg’s disease and may eventually help to optimize treatment. (J Am Podiatr Med Assoc 101(4): 335–340, 2011)
Stabilization of Joint Forces of the Subtalar Complex via HyProCure Sinus Tarsi Stent
Authors: Graham Michael E. , Parikh Rachit , Goel Vijay , Mhatre Devdatt , Matyas Aaron 
Published: April 2014

Background:The foot is the foundation of the body. The stability of the osseous hindfoot structure is crucial in bipedal locomotion. The subtalar joint is responsible for conversion of the rotatory forces of the lower extremities and dictates the movements of the midtarsal joints and the forefoot. In a hyperpronated foot, excessive abnormal pronation results in partial to full obliteration of the sinus tarsi. The hypothesis is that the HyProCure device will prevent obliteration of the sinus tarsi, thereby stabilizing the subtalar joint complex and eliminating the excessive forces to the proximal and distal musculoskeletal system that occur with every step.Methods:Five fresh-frozen human foot cadaver specimens that represented pathologic hindfoot and midfoot instability and partial to full obliteration of the sinus tarsi were axially compressed to 2,000 N and internally rotated by 15° to produce maximum pronation of the subtalar joint using a biaxial materials testing machine. The forces were measured across the posterior and anterior talocalcaneal joint facets before and after placement of the HyProCure stent.Results:The subtalar joint stabilized after placement of the HyProCure sinus tarsi stent. The mean ± 1 SD forces in the posterior talocalcaneal joint increased from 795.88 ± 106 N to 1,004.86 ± 72.41 N (P &lt; 0.05, two-tailed paired t test). The mean ± SD forces at the anterior talocalcaneal joint decreased from 520.15 ± 127.18 N to 394.56 ± 73.83 N (P &lt; 0.05), shifting the contact area posteriorly.Conclusions:Placement of the HyProCure subtalar stabilization stent in a hyperpronated foot prevents excessive talar subluxation and assists in proper distribution of the axial loads on the subtalar facet joints. (J Am Podiatr Med Assoc 101(5): 390–399, 2011)
Evaluating Intratester Reliability of Manual Masking of Plantar Pressure Measurements Associated with Chronic Gout
Authors: Rome Keith , Survepalli David George , Lobo Maria , Dalbeth Nicola , McQueen Fiona , McNair Peter J. 
Published: April 2014

Background:
Plantar pressure measurements are commonly used to evaluate foot function in chronic musculoskeletal conditions. However, manually identifying anatomical landmarks is a source of measurement error and can produce unreliable data. The aim of this study was to evaluate intratester reliability associated with manual masking of plantar pressure measurements in patients with gout.

Methods:
Twenty-five patients with chronic gout (mean disease duration, 22 years) were recruited from rheumatology outpatient clinics. Patients were excluded if they were experiencing an acute gout flare at the time of assessment, had lower-limb amputation, or had diabetes mellitus. Manual masking of peak plantar pressures and pressure-time integrals under ten regions of the foot were undertaken on two occasions on the same day using an in-shoe pressure measurement system. Test-retest reliability was assessed by using intraclass correlation coefficients, SEM, 95% limits of agreement, and minimal detectable change.

Results:
Mean peak pressure intraclass correlation coefficients ranged from 0.92 to 0.97, with SEM of 8% to 14%. The 95% limits of agreement ranged from−150.3 to 133.5 kPa, and the minimal detectable change ranged from 30.8 to 80.6 kPa. For pressure-time integrals, intraclass correlation coefficients were 0.86 to 0.94, and SEM were 5% to 29%, with the greater errors observed under the toes. The 95% limits of agreement ranged from −48.5 to 48.8 kPa/sec, and the minimal detectable change ranged from 6.8 to 21.0 kPa/sec.

Conclusions:
These findings provide clinicians with information confirming the errors associated with manual masking of plantar pressure measurements in patients with gout. (J Am Podiatr Med Assoc 101(5): 424–429, 2011)
Validation of the Talar–Second Metatarsal Angle as a Standard Measurement for Radiographic Evaluation
Authors: Graham Michael E. , Chikka Avanthi , Jones Paul C. 
Published: April 2014

Background:Radiographs provide valuable information for assessing osseous foot deformities and aid in accurate diagnosis. The radiographic angular measurements can be used to establish a relationship between the forefoot and the hindfoot that will present valuable information about normal versus pathologic alignment of the foot. The talar–first metatarsal (T1M) angle is frequently used as one of these angles in this capacity; however, there are limitations to the anteroposterior T1M angle. We present a more consistent, reproducible, and accurate measurement for determining foot abnormalities in the transverse plane using the T2M angle instead of the T1M angle.Methods:Seventy feet in 35 participants (12 men and 23 women) were considered for this study. Individuals were selected on the basis of the established inclusion and exclusion criteria. Anteroposterior radiographs were taken in the angle and base of gait, the neutral calcaneal stance position (NCSP), and the resting calcaneal stance position (RCSP). Three observers measured these angles using three different methods.Results:The mean ± SD T2M angle was 2.95° ± 7.16° in NCSP and 18.61° ± 7.21° in RCSP. No significant differences were found among the measurements made by the three observers using slightly varying procedures in NCSP and RCSP (P &gt; .05). The intraclass correlation coefficients among the measurements were 0.905 in NCSP and 0.937 in RCSP. Bland-Altman plots showed very good agreement between the measurements made by the three observers.Conclusions:The anteroposterior T2M angle gives a consistent and reproducible measurement that provides accurate information about foot alignment. (J Am Podiatr Med Assoc 101(6): 475–483, 2011)