bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Three- or Four-Cortex Syndesmotic Fixation in Ankle Fractures
Authors: Karapinar Hasan , Kalenderer Onder , Karapinar Levent , Altay Taskin , Manisali Metin , Gunal Izge 
Published: April 2014

Background: There is no study comparing how Weber type C ankle fractures treated with either three- or four-cortex syndesmotic fixation affects the structure of the syndesmosis.
Methods: In a retrospective study, 46 patients were separated into two groups: 22 patients with three-cortex fixation and 24 patients with four-cortex fixation. All of the patients were evaluated clinically and radiographically at least 1 year after removal of the syndesmosis screws.
Results: There were three types of joint space obliteration: type 1, synostosis on plain radiographs; type 2, an incomplete bony bridge on magnetic resonance imaging with normal plain radiographs; and type 3, fibrous obliteration of the joint space. Although obliteration of the joint space was significant (P &lt; .005) after four-cortex fixation, radiologic results did not affect the clinical outcome.
Conclusion: Four-cortex fixation for diastasis after an ankle fracture should not be a routine procedure. We advocate three-cortex fixation because the clinical results are no different and there is less syndesmotic space obliteration postoperatively. (J Am Podiatr Med Assoc 97(6): 457–459, 2007)
Static Response of Maximally Pronated and Nonmaximally Pronated Feet to Frontal Plane Wedging of Foot Orthoses
Authors: Pascual Huerta Javier , Ropa Moreno Juan Manuel , Kirby Kevin A. 
Published: April 2014

Background: Research on foot orthoses has shown that their effect on the kinematics of the rearfoot is variable, with no consistent patterns of changes being demonstrated. It has also been hypothesized that the mechanical effect of foot orthoses could be subject specific. The purpose of our study was to determine if maximally pronated feet have a different response to frontal plane wedging of foot orthoses than do nonmaximally pronated feet during static stance.
Methods: One hundred six feet of 53 healthy asymptomatic subjects were divided into two groups (maximally pronated and nonmaximally pronated) on the basis of their subtalar joint rotational position during relaxed bipedal stance. Functional foot orthoses were constructed for each subject and the relaxed calcaneal stance position was measured while standing on five separate frontal plane orthosis wedging conditions, 10° valgus, 5° valgus, no wedging, 5° varus, and 10° varus, to assess changes in calcaneal position.
Results: Relative to the no-wedging condition, there were statistically significant differences (P &lt; .05) in calcaneal position between the maximally pronated and the nonmaximally pronated feet with the 10° valgus and the 10° varus wedging conditions. No significant differences in calcaneal position were found with the 5° varus and the 5° valgus wedging conditions.
Conclusions: Our study shows that the response to foot orthoses is variable between individuals. Maximally pronated subjects do not exhibit the same response to frontal plane wedging of foot orthoses as do nonmaximally pronated with 10° wedging. Intrinsic biomechanical factors such as subtalar joint position may influence the response to foot orthoses. (J Am Podiatr Med Assoc 99(1): 13–19, 2009)
Effect of Coexisting Foot Deformity on Disability in Women with Knee Osteoarthritis
Authors: Guler Hayal , Karazincir Sinem , Turhanoglu Ayse Dicle , Sahin Gunsah , Balci Ali , Ozer Cahit 
Published: April 2014

Background: Knee osteoarthritis, a common musculoskeletal disorder, can cause considerable pain and disability. This study investigates the effect of certain foot deformities on the functional status of women with knee osteoarthritis.
Methods: The common foot deformities pes planus and hallux valgus were evaluated in 115 women with knee osteoarthritis and Kellgren-Lawrence grade 2 and 3 osteoarthritis. Anteroposterior and lateral foot-ankle standard radiographs were obtained bilaterally. A lateral talometatarsal angle greater than 4° was defined as pes planus. A hallux valgus angle greater than 21° was defined as hallux valgus. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to objectively assess functional impairment. Knee pain intensity was measured with a visual analog scale.
Results: Fifty-nine patients had bilateral pes planus, hallux valgus, or both. The mean visual analog scale value was higher for the deformity group, but the difference was not statistically significant. There was a significant difference in WOMAC scores between the group with foot deformities versus the group without (P = .000). Visual analog scale scores were positively correlated with WOMAC scores (r = 0.499, P = .000). Also, there was a significant correlation between WOMAC scores and lateral talometatarsal angle (r = 0.266, P = .004) and hallux valgus angle (r = 0.362, P = .000) values.
Conclusions: There is a significant correlation between indicators of pain and disability (visual analog scale and WOMAC scores). Also, the presence of foot deformities increased disability levels in women with knee osteoarthritis. (J Am Podiatr Med Assoc 99(1): 23–27, 2009)
Metatarsal Protrusion Angle
Authors: Domínguez Gabriel , Munuera Pedro V. , Lomas Mercedes 
Published: April 2014

Background: We performed an adaptation of the system of evaluation of metatarsal protrusion described by Oller in 1994 to study the metatarsal parabola group.
Methods: The system of measurement was applied to the five metatarsals of 169 normal feet (72 feet of women and 97 feet of men) according to the inclusion criteria established.
Results: The mean ± SD metatarsal protrusion angle with respect to the second ray in women was 87.49° ± 5.48° for metatarsal I, 70.00° ± 5.74° for metatarsal III, 63.47° ± 4.17° for metatarsal IV, and 56.38° ± 3.27° for metatarsal V. In men, the values were 85.30° ± 6.75° for metatarsal I, 68.00° ± 6.72° for metatarsal III, 60.56° ± 4.61° for metatarsal IV, and 54.13° ± 3.75° for metatarsal V. The comparative analysis between women and men showed significant differences (P &lt; .05) for all of the values of metatarsal protrusion.
Conclusions: The comparative analysis between women and men indicates a possible difference between the anthropometric values of these variables in humans, suggesting a possible repercussion on the biomechanical patterns by sex. (J Am Podiatr Med Assoc 99(1): 49–53, 2009)
An Appraisal of Potential Drug Interactions in Cigarette Smokers and Alcohol Drinkers
Authors: Smith Robert G. 
Published: April 2014

Background: Many health-care providers may overlook or be unaware of most drug-to-drug interactions. Recognizing the existence of drug interactions with cigarette smoking and alcohol ingestion can empower a clinician with knowledge to avoid dangerous interactions that may result in hazardous, negative patient outcomes. Cigarette smoking and alcohol use can reduce the efficiency of certain drugs or make drug therapy more unpredictable.
Methods: This review offers the physician information regarding prescription drug interactions with cigarette smoking and alcohol use. First, mechanisms found in the medical literature of potential drug interactions in cigarette smokers and alcohol drinkers are presented. Second, the 100 most frequently prescribed medications in 2006 are reviewed regarding cigarette smoking effects and alcohol effects as cited in the medical literature. Lastly, a table of these 100 medications and any reported effects of cigarette smoking or alcohol consumption on each drug is provided.
Results: The actual number of different medications reviewed was 78. Drug interactions resulting from the effects of cigarette smoking occurred with 33.3% of the drugs (n = 26), and drug interactions resulting from the effects of alcohol consumption occurred with 76.9% of the drugs (n = 60). Finally, resource information regarding smoking cessation and alcohol abuse recovery is summarized so that physicians may empower their patients to avoid potential drug-interaction events.
Conclusions: Cigarette smoke and alcohol may interact with medications through pharmacokinetic or pharmacodynamic mechanisms. Engaging in both of these social activities can reduce the efficiency of certain drugs or can make drug therapy unpredictable. This review offers the health-care provider information regarding potential prescription drug interactions. Empowered with this information, clinicians may assist their patients to maximize pharmacologic outcomes by avoiding these reported harmful interactions. (J Am Podiatr Med Assoc 99(1): 81–88, 2009)
Histologic Evaluation of a 6-Month GraftJacket Matrix Biopsy Used for Achilles Tendon Augmentation
Authors: Liden Brock A. , Simmons Melitta 
Published: April 2014

Background: Assessing implanted biological reinforcement graft success in soft-tissue repairs is typically limited to noninvasive measurements and functional outcome measures. However, there are times when a histologic snapshot of the graft incorporation may be possible owing to a nongraft-related postoperative complication, such as hardware failure.
Methods: We histologically evaluated a 6-month biopsy sample from an Achilles tendon repair augmented with an acellular human dermal matrix (AHDM). A 57-year-old woman was treated for Haglund’s deformity of the Achilles tendon. The Achilles tendon was fixed to the calcaneus using a plate, and an AHDM was used to augment the primary repair of the tendon. At 6 months, the hardware was removed owing to prominence, and a biopsy of the AHDM was performed. The specimen was prepared and stained using hematoxylin and eosin, Verhoeff-van Gieson, Movat’s pentachrome, and toluidine blue stains.
Results: Visually, the graft appeared normal and incorporated with the native tendon. No repeated tear was observed, and results of tests for infection were negative. Histologically, the graft was infiltrated predominantly with fibroblasts and demonstrated numerous blood vessels. Positive proteoglycan staining in the AHDM and at sites of vascularity indicated probable transformation to tendon-like tissue.
Conclusions: These histologic findings suggest that the AHDM is highly biocompatible, supports revascularization and repopulation with noninflammatory host cells, and becomes incorporated by surrounding tendon tissue. (J Am Podiatr Med Assoc 99(2): 104–107, 2009)
Knowledge, Beliefs, and Use of Complementary and Alternative Medicine by Australian Podiatric Physicians
Authors: Wilkinson Jenny M. , Tinley Paul 
Published: April 2014

Background: Complementary and alternative medicine (CAM) is one of the fastest growing areas of health care. This has necessitated an increased awareness and understanding of CAM by conventional health professionals.
Methods: A questionnaire seeking information about use of and attitudes toward CAM was mailed to 1,365 Australian podiatric physicians.
Results: Ninety-one percent of Australian podiatric physicians surveyed have used at least one CAM therapy in the past 12 months, and 93% have treated patients with CAM or have recommended its use to patients. Overall, the respondents rated their knowledge of various CAM therapies as “average,” and responses on the CAM Health Belief Questionnaire indicated that respondents tended not to endorse CAM health beliefs, with statements about CAM therapies being seen as “a threat to public safety” and effects being “usually due to the placebo effect” producing the strongest responses.
Conclusions: Complementary and alternative medicine therapies are already being used in podiatric medical practice, and there are significant opportunities for further research into CAM education and clinical research relevant to podiatric medicine. (J Am Podiatr Med Assoc 99(2): 121–128, 2009)
Definitions of Hammer Toe and Claw Toe
Authors: Schrier Joost C.M. , Verheyen Cees C.P.M. , Louwerens Jan Willem 
Published: April 2014

Background: Lesser toe surgery is among the most conducted interventions in general orthopedic practice. However, the definitions of hammer toe and claw toe are not uniform. The objective of this literature study is to propose clear definitions for these deformities to establish unambiguous communication.
Methods: A literature search was performed in the PubMed database (May 2006). Of 81 eligible articles, 42 that stated a clear definition of hammer toe or claw toe were selected.
Results: In all 35 articles in which hammer toe was clearly defined, flexion in the proximal interphalangeal joint was part of the definition. Seventeen articles (49%) defined hammer toe as a combination of metatarsophalangeal extension and proximal interphalangeal flexion. Thirteen articles showed flexion of the proximal interphalangeal joint as the single criterion. Twenty-three articles with a clear definition of claw toe were selected. Twenty-one articles (91%) showed metatarsophalangeal extension as part of the claw toe deformity. Twelve articles (52%) regarded metatarsophalangeal extension and flexion of the proximal interphalangeal and distal interphalangeal joints as the essential characteristics. Seven articles described a claw toe as metatarsophalangeal extension with flexion in the proximal interphalangeal joint.
Conclusions: There are variations in the definitions of lesser toe deformities in the literature. We propose that extension of the metatarsophalangeal joint is the discriminating factor and essential characteristic for claw toe. Claw toe and hammer toe should be characterized by flexion in the proximal interphalangeal joint, which is the single criterion for a hammer toe. The flexibility of these joints could be a basic factor in discriminating between these deformities. The development of these deformities should be regarded as a continuum in the same pathophysiologic process. (J Am Podiatr Med Assoc 99(3): 194–197, 2009)
Biomechanical Comparison of Achilles Tenotomy and Achilloplasty Techniques in Young Rats
Authors: Dogan Ali , Korkmaz Mahmut , Cengiz Nurettin , Kalender A. Murat , Gokalp M. Ata 
Published: April 2014

Background: Tendo Achillis lengthening is performed by means of Z-plasty in the classic treatment of clubfoot. In the Ponseti method for treating clubfoot, Achilles tenotomy is performed percutaneously for residual equine deformity. A randomized study was designed to compare tendon healing after tenotomy versus Z-plasty.
Methods: Thirty-six Sprague-Dawley rats were divided randomly into two groups. On the first day, while the right tendo Achillis of group 1 rats underwent tenotomy, those of group 2 rats underwent Z-plasty. Nine rats from each group were humanely killed on days 21 and 45 postoperatively. The two groups were compared with each other biomechanically and histologically. The Achilles tendons of eight rats in each group were evaluated biomechanically, and the remaining rat in each group underwent histologic evaluation.
Results: Mean ± SD maximum load at rupture of the treated tendons on days 21 and 45 in the tenotomy group was 26.38 ± 7.31 N and 47.16 ± 15.36 N, respectively, and in the Z-plasty group was 27.37 ± 5.20 N and 45.27 ± 9.59 N, respectively. The biomechanical evaluation revealed no significant difference in terms of breaking forces between the two groups. The difference between breaking forces on days 21 and 45 was statistically significant for both groups.
Conclusions: Tendons in the tenotomy group healed as well as those in the Z-plasty group, and Achilles tenotomy in the rat was similar to Z-plasty for Achilles tendon lengthening. Human correlation may or may not exist, but this study suggests that it should be considered and investigated. (J Am Podiatr Med Assoc 99(3): 216–222, 2009)
Improving Preventive Foot Care for Diabetic Patients Participating in Group Education
Authors: Sun Pi-Chang , Jao Shyh-Hua Eric , Lin Hong-Da , Chan Rai-Chi , Chou Chen-Liang , Wei Shun-Hwa 
Published: April 2014

Background: Diabetic foot care has yet to be enhanced in a universal health-care system in which specialized podiatric medical services are unavailable. This baseline assessment surveyed diabetic patients attending group education to improve current foot-care practices.
Methods: Of 302 diabetic patients receiving usual outpatient care, 155 received group patient education on general diabetes-related information, which included foot care and an annual checkup by a diabetes association during the previous 2 years, and 147 did not. Patient foot-care behaviors, physician practice patterns, and patient self-perceived foot risk as cross-checked with the neurologic and vascular assessments were investigated by conducting retrospective medical record reviews and structured interviews.
Results: More than half of the patients in both groups reported inappropriate self-care behaviors (eg, walking barefoot and heating or soaking their feet). The percentages of patients receiving documented examinations and referrals for foot problems were low in both groups and were not significantly different. Among at-risk patients, 56% of the diabetes association group but only 30% of the non–diabetes association group perceived themselves to be at risk for future foot problems (P &lt; .01).
Conclusions: Many diabetic patients were not offered adequate foot-specific information during group lectures, even those with high-risk foot problems. To improve this, combining caregiver and patient education in foot-care practices is important, and systems of networked multidisciplinary professionals are believed to be needed, particularly in delivering customized interventions to at-risk patients based on the initial evaluation. (J Am Podiatr Med Assoc 99(4): 295–300, 2009)
A Review of the Theoretical Unified Approach to Podiatric Biomechanics in Relation to Foot Orthoses Therapy
Authors: Harradine Paul , Bevan Lawrence 
Published: April 2014

Background: Diverse theories of orthoses application have evolved with the continual development of podiatric biomechanics and orthotic management. This theoretical disparity can lead to confusion in clinical, educational, and research situations. However, although approaches are varied, the common consensus is that foot orthoses outcomes are generally positive.
Methods: Three main podiatric theories exist: the foot morphology theory, the sagittal plane facilitation theory, and tissue stress theory. By researching the available literature, the perspectives of all three theories are summarized, emphasizing areas of conflict and agreement.
Results: Through a unified theory, we introduce a premise by which the similar orthotic outcomes obtained from the three main podiatric theories may be explained.
Conclusions: It remains up to the individual podiatric physician to decide which method to use to prescribe a foot orthosis. It may be of benefit to encompass all approaches rather than be dogmatic or exclusive. (J Am Podiatr Med Assoc 99(4): 317–325, 2009)
In-toeing in Children with Type I Osteogenesis Imperfecta
Authors: Losa Iglesias Marta Elena , Becerro de Bengoa Vallejo Ricardo , Salvadores Fuentes Paloma 
Published: April 2014

Background: Osteogenesis imperfecta is an autosomal-dominant disorder of the connective tissue. Also known as brittle bone disease, it renders those affected susceptible to fractures after minimal trauma. Therefore, it is important to minimize the risk of falls and subsequent fractures in patients with this disease. In-toeing is a common condition in children that can result from various pathologic entities, including anteversion, internal tibial torsion, and metatarsus adductus. These conditions can result in frequent tripping and other functional problems.
Methods: A descriptive study was undertaken to determine the prevalence of in-toeing gait attributable to tibial or femoral torsion or metatarsus adductus in children with type I osteogenesis imperfecta. The study involved orthopedic and biomechanical examination of 15 children (9 girls and 6 boys) aged 4 to 9 years with confirmed type I osteogenesis imperfecta. Patients who used assistive ambulatory devices, such as canes, crutches, and wheelchairs, were excluded from the study.
Results: Of the 15 children studied, 12 (80%) demonstrated previously undiagnosed in-toeing gait attributable to torsional deformity or metatarsus adductus in all but one child.
Conclusions: Many children with confirmed type I osteogenesis imperfecta have in-toeing gait caused by torsional deformity or metatarsus adductus. Detection and control of in-toeing gait in children with osteogenesis imperfecta is important to prevent fractures resulting from trauma directly related to these conditions. (J Am Podiatr Med Assoc 99(4): 326–329, 2009)
Classification of Frontal Plane Rearfoot Motion Patterns During the Stance Phase of Walking
Authors: Cornwall Mark W. , McPoil Thomas G. 
Published: April 2014

Background: Classification of rearfoot motion patterns would assist in understanding normal rearfoot motion and would facilitate the identification of abnormal motion. We sought to identify common frontal plane rearfoot motion patterns in an asymptomatic population.
Methods: Frontal plane rearfoot motion was measured with an electromagnetic motion analysis system in 279 asymptomatic individuals during barefoot walking. The coefficient of multiple correlation and visual observation were used to identify similar patterns of rearfoot motion.
Results: Four distinct rearfoot motion patterns were identified: pattern 1 consisted of 176 individuals (63.1%) and was labeled “typical” eversion, pattern 2 consisted of 87 individuals (31.2%) and was labeled “prolonged eversion,” pattern 3 consisted of nine individuals (3.2%) and was labeled “delayed eversion,” and pattern 4 consisted of seven individuals (2.5%) and was labeled “early eversion.”
Conclusions: Asymptomatic frontal plane rearfoot motion can be classified into four distinct patterns, but most individuals (94.3%) exhibit one of two motion patterns (typical or prolonged eversion). (J Am Podiatr Med Assoc 99(5): 399–405, 2009)
Dynamic Changes in Matrix Metalloproteinase 9 and Tissue Inhibitor of Metalloproteinase 1 Levels During Wound Healing in Diabetic Rats
Authors: Yang Chuan , Zhu Ping , Yan Li , Chen Lihong , Meng Ren , Lao Guojuan 
Published: April 2014

Background: We investigated the mechanism of delayed would healing caused by diabetes and measured the dynamic changes in matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase 1 (TIMP-1) levels. We noted differences in the ratio of MMP-9 to TIMP-1 in the wounds of diabetic and nondiabetic rats.Methods: Forty-two Sprague-Dawley rats weighing 250 g were randomly assigned to either the control group or the streptozotocin-induced diabetes group. Then, full-thickness excision wounds were created on the middle of the back of each animal. Skin biopsy specimens were obtained on days 0, 3, 7, and 14 after incision. The content of collagen was quantified by Masson’s staining and the macrophage marker, and CD68 was detected by immunohistochemical analysis. Messenger RNA and protein expression of MMP-9 and TIMP-1 was measured by reverse transcriptase–polymerase chain reaction and Western blot, respectively.Results: Diabetic rats exhibited slower wound healing than control animals (P &lt; .05). On days 3, 7, and 14 after incision, higher levels of MMP-9 messenger RNA and protein expression were detected in the diabetic group compared with the control group (P &lt; .05), and expression of TIMP-1 messenger RNA and protein was significantly decreased. In addition, the ratio of MMP-9 to TIMP-1 was stable in controls, whereas there was a marked increase in the ratio in diabetic skin wounds.Conclusions: The balance between MMP-9 and its inhibitor, TIMP-1, is disturbed in diabetic skin tissue after injury, which may lead to histologic abnormality of diabetic skin and delayed wound healing. (J Am Podiatr Med Assoc 99(6): 489–496, 2009)