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Ashu Rastogi, Kirti Gupta, Mahesh Prakash, Anil Bhansali
Invasive mycotic infection presenting as "foot lump" in an immunocompetent patient is extremely rare. The case highlights the difficulty in diagnosis of fungal infections of foot including attempts to isolate the fungus and non-response to anti-fungal agents. A 64-year-old lady with T2DM for four years presented with painless, gradually progressive swelling over plantar aspect of left mid-foot for six months. Foot examination revealed soft-to-firm lump over the plantar aspect of left mid-foot obscuring the lateral longitudinal arch...
November 28, 2018: Foot
Kazunori Okamura, Shusaku Kanai, Kengo Fukuda, Satoshi Tanaka, Takeya Ono, Sadaaki Oki
BACKGROUND: Strengthening exercises of the plantar intrinsic foot muscles (PIFMs) are often prescribed to flat-footed subjects because of the capacity of the PIFMs to support the medial longitudinal arch (MLA). However, it is unclear whether the capacity of the PIFMs to support the MLA is enough to change the foot kinematics in flat-footed subjects. To confirm this, the current study examined changes in foot kinematics in flat-footed subjects during standing and gait accompanied by changes in the activity of the PIFMs...
November 6, 2018: Foot
Gwendolyn Vuurberg, Lauren M Wink, Inger N Sierevelt, Sjoerd Jens, Robert Hemke, Maarten A de Boer, Ellen den Butter, Gino M M J Kerkhoffs, M Maas
BACKGROUND: Chronic ankle instability (CAI) is a multifactorial disabling condition. Ideally all factors contributing to CAI are identified and implemented in a risk assessment model. However, they need to meet strict reliability requirements. To assess usability of radiographic factors for this risk assessment model and future clinical practice, the objective of the current study was to assess the intra and inter observer reliability of three radiographic measurements. METHODS AND METHODS: The radiographs of 39 consecutive patients, at least 16years, who visited the Emergency Department after sustaining a LAS, were assessed by four observers...
November 6, 2018: Foot
David R W MacDonald, David Neilly, Joseph Littlechild, Fraser Harrold, Sam C Roberts
Acute Achilles tendon rupture is frequently treated conservatively using functional rehabilitation protocols in which the ankle is held in equinus. Equinus is achieved using a variety of means including equinus casts and rigid boots with heel wedges. Concerns have been raised that rigid boots with heel wedges do not achieve adequate equinus. Patients presenting to our institutions with an acute Achilles tendon rupture were randomised to treatment with an equinus cast or rigid boot with heel wedges. After application of these lateral radiographs of the hindfoot and ankle were taken, and these used to measure tibiotalar angle (TTA), tibio-1st metatarsal angle (TMA) and posterior malleolar to calcaneal tip height (PCH)...
October 12, 2018: Foot
Charles Parks, Sandy Nguyen
Diabetic patients with foot infections were evaluated over a 5-year period from April 2005 to March 2010. Cultures were obtained from 92 patients after surgical debridement. All of the patients were classified as "severe" diabetic foot infections (DFIs) and PEDIS grade 4. Wound specimens were collected by bone biopsy and sent to San Francisco VA Medical Center Microbiology Department for aerobic and anaerobic cultures. Among the 92 cases, the study resulted in a total of 410 pathogens, which 203 pathogens were from bone cultures and 207 pathogens were from soft tissue cultures...
October 9, 2018: Foot
C Formosa, N Chockalingam, A Gatt
BACKGROUND: Healthcare options for people with diabetes is still not uniform both within and between countries. This is particularly evident for diabetic foot disease. The number of existing documents/guidelines, together with discrepancies which exist between different organizations or countries can lead to confusion for both practicing health care professionals and new countries or organizations who are in the process of developing local clinical guidelines. This study was aimed at exploring different stakeholder perspectives with a view to develop and introduce culturally competent foot screening guidelines...
October 6, 2018: Foot
H Waizy, C Jowett, V Andric
BACKGROUND: The calcaneal osteotomies is often performed to correct asymptomatic hindfoot deformities. More recently minimally invasive techniques have been described with promising clinical outcomes. In a prospective study we compared the intraoperative parameters of the open and minimalinvasive (MICO) techniques, which has not previously been reported. METHODS: 60 consecutive with calcaneal osteotomy (33 open and 27 MICO) and a minimum follow up of 12 weeks were included...
December 2018: Foot
Sonal Sekhar M, Unnikrishnan M K, Gabriel Sunil Rodrigues, Navya Vyas, Chiranjay Mukhopadhyay
PURPOSE: Diabetic foot infections (DFIs) are major public health concerns. In the view of the ever increasing burden of multidrug-resistant (MDR) organisms, improving the use of antimicrobial agents (AMAs) is a national priority. Objective of the study was to determine antimicrobial susceptibility (AMS) pattern of aerobes in DFIs. METHODS: A cross-sectional study was conducted for a period of 3 years at Department of Surgery, Kasturba hospital, Manipal, India during which, 260 diabetic foot ulcer (DFU) patients admitted in the general surgery wards were enrolled for the study...
December 2018: Foot
Surendra U Kamath, Jose Austine
The lack in consensus with regard to qualitative use of standard radiographs and their predictive value in evaluating congenital talipes equinovarus among infants continues to be apparent in clinical practice. Since standard radiographs continue to play a role in the assessment of clubfoot it is essential to ensure that the values measured are reliable and reproducible keeping in mind acceptable tolerances for clinical application. This study was undertaken to assess the inter-observer and the intra-observer reliability in estimation of talocalcaneal and talo-first metatarsal angles on standard radiographs done according to Simon's method...
December 2018: Foot
Tun Hing Lui
Os calcaneus secundarius is an accessory ossicle resulting from a secondary ossification center of the anterior facet of the calcaneus. It may cause chronic pain and limitation in inversion motion after inversion ankle sprain. Excision of the ossicle is indicated if the symptoms do not resolve with conservative treatment. A case of symptomatic os calcaneus secundarius, which was successfully resected endoscopically, is presented.
December 2018: Foot
Seyed Majid Alavi-Mehr, AmirAli Jafarnezhadgero, Fatemeh Salari-Esker, Matteo Zago
BACKGROUND: Flatfoot is a structural and functional abnormality of the foot that may cause lower limb mechanical damage during walking. The aim of this study was to investigate the acute effect of foot orthoses on the frequency domain of ground reaction forces in children with flatfeet during the stance phase of walking. METHODS: Bilateral gait data were collected from fifteen male children suffering from flatfeet syndrome. Two Kistler force platforms were used to record the ground reaction forces of each limb during level walking...
December 2018: Foot
Eva Lehtonen, Harshadkumar Patel, Sierra Phillips, Martim Correia Pinto, Sameer Naranje, Ashish Shah
INTRODUCTION/AIM: Recent comparisons of suture versus metal staple skin closure on the rates of wound complications in orthopaedic surgeries have yielded conflicting results. Several studies have since started to approach this question based on anatomic location, comparing suture versus staple closure in total hip and knee arthroplasty and acetabulum fracture surgery. Ankle fractures are one of the most commonly treated fractures by orthopaedic surgeons with unique challenges to skin closure due to the lack of subcutaneous support...
December 2018: Foot
J Pohl, T Jaspers, M Ferraro, F Krause, H Baur, P Eichelberger
INTRODUCTION: Variations of gait speed influence kinematic variables that may have an effect on dynamic foot deformation. The influence of gait speed on the navicular drop has not yet been investigated. METHODS: The navicular drop was evaluated in static and dynamic conditions using a 3D-motion capture system. The dynamic navicular drop was evaluated on a treadmill while walking and running at three different speeds. A repeated measures ANOVA and post-hoc tests were conducted to evaluate the differences in dynamic navicular drop, corresponding unloaded navicular height at foot strike and loaded navicular height during stance...
September 2018: Foot
Robert Trevethan, Sylvia McAra
OBJECTIVE: To be effective in screening, prognostic, and monitoring contexts, the toe-brachial index (TBI) should not be susceptible to large sporadic fluctuations from one time to another. In order to identify whether those fluctuations exist in people who have suboptimal TBIs, the temporal stability of their TBIs was examined in detail across 6 months. METHODS: TBI readings from SysToe and Omron automated devices were taken from 21 participants at baseline and at 2- and 6-month timepoints subsequently...
September 2018: Foot
Caleb Araguas Garcia, Francisco Corbi Soler
Tactile information picked up by plantar receptors provides afferent sensory information that is fundamental for controlling body balance. Plantar hyperkeratoses may alter the quality and quantity of such information, thereby modifying balance. AIM: Analyse how plantar hyperkeratosis debridement affects static body balance in subjects of 65 years of age or older. METHODS: In order to analyse the impact of hyperkeratoses on balance, 50 older people took part in this study...
September 2018: Foot
James Kennedy, Andrew Berg, Luke Welsh, Jaysheel Mehta
The role of lateral release is widely accepted and regarded as a key step in the management of hallux valgus. There remains however debate in the literature in regards to which structures should be divided and the method of approach. As such, a technique of lateral release using a curved blade placed inferior to the metatarsal head to divide the lateral metatarsosesamoid suspensory ligament and incise the lateral joint capsule has been developed. This technique was performed on fourteen fresh frozen cadaveric specimens which were then dissected...
September 2018: Foot
Laurence Wicks, Radwane Faroug, Danielle Richler-Potts, Ashley Bowden, Renjit Issac, Jitendra Mangwani
BACKGROUND: Should pre-manipulation radiographs be obtained in ankle fracture-dislocations? This question remains controversial. The twelfth British Orthopaedic Association Standard for Trauma (BOAST-12) published in August 2016 states that 'Reduction and splinting should be performed urgently for clinically deformed ankles. Radiographs should be obtained before reduction unless this will cause an unacceptable delay'.2 We quantify the delay caused by obtaining a pre-manipulation radiograph, and additionally determine whether a pre-manipulation radiograph influences the adequacy of initial reduction...
September 2018: Foot
Angela Blasimann, Patric Eichelberger, Nicole Lutz, Lorenz Radlinger, Heiner Baur
BACKGROUND: The lack of reliable parameters to evaluate dynamic foot function, emphasizes the need for a deeper insight in foot biomechanics. The aims were to investigate the reliability of a new parameter (dynamic navicular rise dNR), and its relationship with the dynamic navicular drop (dND). METHODS: Twenty healthy participants (mean age 30.2±8.1years) had to walk on even ground and downstairs. Data of ten trials per task on two measurement days were recorded...
August 22, 2018: Foot
Marabelle L Heng, Priathashini Krishnasamy, Pui W Kong
BACKGROUND: While posterior tibial tendon dysfunction (PTTD) commonly presents with flat feet and has been thought to be associated with first ray mobility, many flat-footed individuals are asymptomatic and do not experience any symptoms of PTTD. Thus, there is a need to control for foot type when studying factors related to PTTD. This study aimed to clarify if first ray mobility differed between flat-footed individuals with and without symptoms of PTTD. It was hypothesized that PTTD patients would display higher mobility of the first ray than asymptomatic flat-footed controls...
August 3, 2018: Foot
Neil A Segal, Lauren N Neuman, Maria C Hochstedler, Howard L Hillstrom
INTRODUCTION: Anthropometric changes to the feet with pregnancy may increase risk for musculoskeletal disease. Customized arch-supportive orthoses to prevent anthropometric changes could potentially provide an inexpensive means to prevent musculoskeletal impairments and improve quality of life for women during their post-reproductive years. The objective of this prospective, randomized controlled trial was to determine whether customized foot orthoses can prevent arch collapse during pregnancy...
July 27, 2018: Foot
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