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Tomoya Sato, Yuichiro Yana, Shigeru Ichioka
BACKGROUND: Although free flap is gaining popularity for the reconstruction of diabetic foot ulcers, it is unclear whether free flap reconstruction increases the chances of postoperative independent ambulation. The aim of this study is to evaluate the relationship between free flap success and postoperative ambulation. METHODS: This study reviewed 23 cases of free flap reconstruction for diabetic foot ulcers between January 2007 and March 2014. Free rectus abdominis, latissimus dorsi, and anterolateral thigh flaps were used in ten, eight, and five patients, respectively...
December 2017: Journal of Plastic Surgery and Hand Surgery
Jun-Chao Guo, Li-Zhen Wang, Wei Chen, Cheng-Fei Du, Zhong-Jun Mo, Yu-Bo Fan
Orthopedic insole was important for partial foot amputation (PFA) to achieve foot balance and avoid foot deformity. The inapposite insole orthosis was thought to be one of the risk factors of reamputation for foot valgus patient, but biomechanical effects of internal tissues on valgus foot had not been clearly addressed. In this study, plantar pressure on heel and metatarsal regions of PFA was measured using F-Scan. The three-dimensional finite element (FE) model of partial foot evaluated different medial wedge angles (MWAs) (0...
2016: Computer Methods in Biomechanics and Biomedical Engineering
Jamal Ahmad
Diabetic foot problems are responsible for nearly 50% of all diabetes-related hospital bed days. Approximately 10-15% of diabetic patients developed foot ulcers at some state in their life and 15% of all load in amputations are performed in patients with diabetes. There is a need to provide extensive education to both primary care physicians and the patients regarding the relationship between glucose control and complications encountered in the foot and ankle. The management of diabetic foot disease is focussed primarily on avoiding amputation of lower extremities and should be carried out through three main strategies; identification of the "at risk" foot, treatment of acutely diseased foot, and prevention of further problems...
January 2016: Diabetes & Metabolic Syndrome
Lawrence A Lavery, Javier La Fontaine, Paul J Kim
Prevention is overlooked and underused, even in very high-risk patients. Prevention is best achieved within a multispecialty group of providers that have a common objective. Ideally, the team approach should include educators; physical therapists; nurses; internist; pedorthists; and vascular, orthopedic, and podiatric surgeons. The basic elements involve education, foot examination, risk classification, therapeutic shoes and insoles, and regular foot care. High-risk patients need additional assessment for vascular disease and intensive disease management, and corrective vascular and foot surgery when necessary...
September 2013: Medical Clinics of North America
Bernd Kinner, Stefanie Tietz, Franz Müller, Lukas Prantl, Michael Nerlich, Christina Roll
BACKGROUND: In 1997, H. Zwipp. proposed a 5-point scoring system for the classification of complex trauma of the foot. However, outcome and quality of life after this type of injury have not been studied systematically. PATIENTS: Seventy-four patients with a complex injury of the foot were treated between 2001 and 2007. Fifty patients met the inclusion criteria for a prospective cross-sectional study. American Foot and Ankle Society score, the Short Form 12, and the Visual Analogue Scale-Foot and Ankle Score were recorded...
January 2011: Journal of Trauma
Dennis J Janisse, Erick J Janisse
Amputations in patients with diabetes, while often preventable, are unfortunately a far too common outcome. The roles of the certified or licensed pedorthist, certified orthotist, and the certified prosthetist should not be undervalued in the prevention of diabetic foot complications (eg, amputations, revisions, and foot infections secondary to skin ulcerations) and in returning the patient a normal, active, and productive lifestyle in the event of an amputation. This article highlights the roles these specialists play in treating patients with partial foot amputation...
September 2010: Foot and Ankle Clinics
Shawn Verity, Michael Sochocki, John M Embil, Elly Trepman
BACKGROUND: Removable walker braces have been used successfully to treat acute and chronic foot and ankle conditions including diabetic foot ulcers. We hypothesized that a removable walker brace may be successfully used in the management of the Charcot foot and ankle. METHODS: Twenty-five feet and ankles with Charcot arthropathy in 21 patients (bilateral in 4 patients) were treated with a prefabricated, pneumatic removable walker brace fitted with a custom orthotic insole...
2008: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Karen Farid, Mark Farid, Claire M Andrews
Although total contact casting provides pressure relief and a moist wound-healing modality that allows patients to resume mobility while the wound is healing, it is not as widely used as it should be, in part because Board-certified pedorthists with relevant skills are scarce. As a result, clinicians may not appreciate the positive impact total contact casting has on the patient's overall condition. This case study of a 75-year-old woman with a potentially life-threatening diabetic foot ulcer offers a comprehensive picture of pervasive physiological changes in a context of challenging comorbidities...
June 2008: Ostomy/wound Management
Leslie C Trotter, Michael Raymond Pierrynowski
BACKGROUND: We examined the ability of foot care professionals to consistently capture the forefoot-to-rearfoot angular relationship of a single-cast foot. METHODS: Eleven Canadian certified pedorthists each cast a single foot twice using the plaster of Paris and foam box techniques. Three independent raters subsequently measured the resultant casts. Statistical analysis of the data provided generalizability coefficient estimates (rho(2)) of the intracaster, intercaster, and rater reliabilities...
January 2008: Journal of the American Podiatric Medical Association
Nick A Guldemond, Pieter Leffers, Fred H M Nieman, Antal P Sanders, Nicolaas C Schaper, Geert H I M Walenkamp
BACKGROUND: Identification of locations with elevated plantar pressures is important in daily foot care for patients with rheumatoid arthritis, metatarsalgia and diabetes. The purpose of the present study was to evaluate the proficiency of podiatrists, pedorthists and orthotists, to distinguish locations with elevated plantar pressure in patients with metatarsalgia. METHODS: Ten podiatrists, ten pedorthists and ten orthotists working in The Netherlands were asked to identify locations with excessively high plantar pressure in three patients with forefoot complaints...
2006: BMC Musculoskeletal Disorders
Nick A Guldemond, Pieter Leffers, Nicolaas C Schaper, Antal P Sanders, Fred H M Nieman, Geert H I M Walenkamp
BACKGROUND: There is a need for evidence of clinical effectiveness of foot orthosis therapy. This study evaluated the effect of foot orthoses made by ten podiatrists, ten pedorthists and eleven orthotists on plantar pressure and walking convenience for three patients with metatarsalgia. Aims were to assess differences and variability between and within the disciplines. The relationship between the importance of pressure reduction and the effect on peak pressure was also evaluated. METHODS: Each therapist examined all three patients and was asked to rate the 'importance of pressure reduction' through a visual analogue scale...
2005: BMC Musculoskeletal Disorders
Cynthia Dodgen Schraer, Daniel Weaver, Julien Louise Naylor, Ellen Provost, Ann Marie Mayer
OBJECTIVE: The prevalence of diabetes is increasing rapidly among Alaska's Indian, Eskimo and Aleut populations. Approximately half the Native people with diabetes have no road access to hospitals or physicians, presenting a challenge in the attempt to prevent lower extremity amputation as a complication. In late 1998 funding became available for diabetes prevention and treatment among Native Americans. The tribal health corporations in Alaska decided to use a portion of this funding to implement a high-risk foot program to decrease the amputation rate...
2004: International Journal of Circumpolar Health
Michael S Pinzur, Mark P Slovenkai, Elly Trepman, Naomi N Shields
Foot infection is the most common reason for hospital admission of diabetic patients in the United States. Foot ulceration leads to deep infection, sepsis, and lower extremity amputation. Prophylactic foot care has been shown to decrease patient morbidity, decrease the utilization of expensive resources, and decrease the risk for amputation and premature death. The Diabetes Committee of the American Orthopaedic Foot and Ankle Society has developed guidelines for the implementation of this type of prophylactic foot care...
January 2005: Foot & Ankle International
Ted Colaizzi
The pedorthist works from a physician's prescription, which includes a diagnosis, modality, and desired goals. The pedorthist's and the physician's combined efforts result in the patient's foot, shoe, shoe modifications, and foot orthoses working together as one unit.
June 2002: Foot and Ankle Clinics
L E Hendricks, R T Hendricks
No abstract text is available yet for this article.
November 2001: Diabetes Educator
H S Steb, R Marzano
Conservative management of PTTD can present from fairly simple to quite complex based on the wide range of clinical presentation that is inherent to this pathology. Treatment for PTTD ranges from the use of orthopedic footwear to the use of PTB AFOs, which certainly substantiates the prevalence of this disorder and the high rate of conservative management. With the increase in the population number and the fitness and health awareness that pervades our society, PTTD will more than likely continue to be a large part of the conservative footcare practitioner's practice in the future...
July 1999: Clinics in Podiatric Medicine and Surgery
J B McGuire
An anatomic classification for lower extremity bracing is presented, along with a review of brace components and their use in the treatment of neurologic or muscular disorders. An approach to bracing that employs the concepts of balance and flexibility has been suggested rather than rigid formulas calculated from poorly defined or established neutral positions for the various affected joints. A team-management approach, including a podiatric, osteopathic, and allopathic physician, therapist, orthotist, and pedorthist, is always recommended to prevent confusion and reduce unnecessary expenses often incurred when different disciplines are involved in the treatment of complex neuromusculoskeletal disorders...
January 1999: Clinics in Podiatric Medicine and Surgery
H Boer, E R Seydel
OBJECTIVES: To get insight into medical opinions about the use of orthopaedic footwear and the medical and social factors related to the prescription of orthopaedic footwear by orthopaedists and rehabilitation practitioners. METHODS: In this study 85 orthopaedists and 96 rehabilitation practitioners filled out a questionnaire measuring perceived desirability of prescribing orthopaedic footwear in specific medical conditions, the perceived advantages of orthopaedic footwear, the perceived disadvantages of orthopaedic footwear, the attitude to orthopaedic footwear and satisfaction with the co-operation with the pedorthist...
June 1998: Clinical Rehabilitation
D J Janisse
The Board Certified Pedorthist can be a valuable member of the team of healthcare professionals involved in the treatment of arthritis of the foot and ankle. In addition to providing prescription footwear, the pedorthist can assist in educating the patient, postoperative care, and long term monitoring of the patient's progress. The objectives in the pedorthic care of arthritis of the foot and ankle are to reduce shock and shear; to relieve excessive pressure from sensitive or painful areas; to accommodate, correct, and support deformities; and to control or limit painful motion of joints...
April 1998: Clinical Orthopaedics and related Research
J E McDermott
Diabetes remains the world's leading cause of amputation. Like many other major health problems, prevention is the key to successful management. Patient education efforts coupled with a team approach of aggressive early management represent the optimum current strategy. Multidisciplinary physician teams consisting of orthopaedic and vascular surgeons, supported by consultation, serve as the focus for leadership and decision making. Their efforts are supported by allied health personnel, nurses, physician's assistants, and physical therapists trained in foot evaluation, pedicare, and nail trimming, assisted by competent trained shoe technicians, orthotists, or pedorthists...
1993: Instructional Course Lectures
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