Podiatry Commons^™

Is Your Cyst Really A Ganglion Cyst? A Case Report Of Angioleiomyoma Mimicking A Plantar Fascia Cystic Lesion, Christopher Anjorin Ms Dpmc, Joseph Bender Dpm

School of Podiatric Medicine - Student Research

Ganglion cysts are among the most common benign soft tissue masses encountered in podiatric clinical practice, and their diagnosis is often presumed based on location, clinical observation, and transillumination. However, this case highlights a diagnostic idiosyncrasy: a lesion clinically presumed to be a ganglion cyst within the plantar fascia was ultimately identified as an angioleiomyoma following surgical excision and histopathological evaluation. This finding underscores the importance of maintaining a broad differential diagnosis when assessing cystic lesions, particularly those that transilluminate, as benign vascular tumors may closely mimic more common entities in both clinical presentation and imaging. More importantly, what if …

A Prospective Study Of Hyperspectral Imaging For Lower Extremity Tissue Assessment In Normative And At-Risk Populations, Jessica Sima, Mariana Rodriguez, Stephanie Campbell, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction:  Diabetic foot ulceration and peripheral vascular disease remain major causes of morbidity and limb loss, yet early identification of tissue compromise can be challenging, particularly across diverse skin tones. Hyperspectral imaging (HSI) is a non-invasive technology that quantifies tissue oxygenation by measuring the absorption and reflection of near-infrared light.

The objective of this study is to evaluate the relationship between oxygenation, skin tone, skin temperature, and ambient skin temperature in adults with and without risks of foot ulcers.

Method: This ongoing prospective observational study recruits English- and Spanish-speaking adults aged 18 and over from campus, clinics, and community outreach …

Comparative Effectiveness Of Antiseptic And Antibiotic Irrigation Versus Normal Saline In Infected Total Ankle Arthroplasty: A Systematic Review, Madelaine Adkins, Yahan Wei, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Periprosthetic joint infection (PJI) is a rare but devastating complication following total ankle arthroplasty (TAA). Acute infections are commonly managed with debridement, antibiotics, and implant retention (DAIR), in which irrigation plays a critical role in reducing bacterial burden. Although irrigation protocols have been investigated in total hip and total knee arthroplasty, evidence specific to infected TAA remains unclear. This systematic review evaluated the available literature regarding irrigation practices in the surgical management of infected TAA.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed and Scopus were search for English-language studies published between December 2005 and …

The Role Of Mitochondria In The Pathogenesis Of Parkinson’S Disease, Oyinkansola Mudasiru, Vivian Etugbo, Bhuvana Lakkasetter, Claudia Biguetti, Reginald Adiele

School of Podiatric Medicine - Student Research

Introduction: Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by the degeneration of the dopaminergic neurons of the substantia nigra that leads to motor and non-motor dysfunctions. Emerging evidence highlights mitochondrial dysfunction as a key factor in PD pathogenesis. This project aims to investigate the pathophysiology of PD, highlighting the involvement of oxidative stress, and examining current and emerging therapeutic approaches aimed at restoring mitochondrial function.

Methodology: A systematic literature review was conducted using PubMed and Google Scholar within the 2004-2024 date range. Keywords included “Parkinson’s disease”, “mitochondrial dysfunction", “oxidative stress”, and neurodegeneration”. Data was extracted regarding …

Interaction Of Mitochondrial Bioenergetics With Nephropathy And Hepatic Insufficiency In Diabetic/ Obesity C57bl/6 Mouse Model, Oyinkansola Mudasiru, Vivian Etugbo, Bhuvana L. Chandrashekar, Reginald Adiele, Ramiro Cisneros

School of Podiatric Medicine - Student Research

Introduction/Purpose: Obesity has become an epidemic with over six million adult individuals affected by this metabolic condition, and it is associated with over 40% of deaths worldwide. Diabetic kidney disease (DKD) is a major cause of kidney disease globally and it is a major cause of mortalities associated with diabetes. In DKD, impaired glucose regulation results in hyperglycemia-induced metabolic dysfunction that culminate in abnormal energy utilization and mitochondrial dysfunction and play critical role in the pathogenesis of DKD. Incidentally, mitochondrial functions and dynamics are impaired in liver insufficiencies of multiple origins. Prevention of triglyceride and lipotoxic accumulations by hepatic mitochondria …

Agnikarma Therapy In Management Of Plantar Fasciitis (Vatakantaka): A Systematic Review Of Ayurvedic Case Reports, Karishma Sebastian, Nidhin John, Amanda Killeen

School of Podiatric Medicine - Student Research

Plantar fasciitis is a leading cause of heel pain, commonly affecting adults aged 40–60, characterized by microtears and inflammation of the plantar fascia.

Conventional treatments (NSAIDs, corticosteroids, orthotics, surgery) often provide incomplete relief or cause adverse effects.

In Ayurveda, plantar fasciitis corresponds to Vatakantaka, a Vata-dominant condition of the heel region (Khudukapradesha).

Agnikarma, a para-surgical Ayurvedic technique involving therapeutic thermal cauterization using heated metallic rods (Shalaka), is described for disorders involving ligaments, bones, and joints with chronic pain and stiffness.

This review synthesizes clinical case reports evaluating Agnikarma as a treatment for plantar fasciitis to determine its efficacy, safety, and …

Outcomes Of Deep Peroneal Neurectomy: A Scoping Review Of Complications, Postoperative Recovery, And Patient-Reported Satisfaction, Krista Elizabeth Samreth, James Hughes, Amayrani Sanchez, Nicholas Obias, Madeleine Mehaffey, Stephanie Campbell Dpm, Aacfas

School of Podiatric Medicine - Student Research

Background: Deep peroneal neurectomy (DPN) evolved as a surgical treatment alternative for patients with painful midfoot arthritis who may not tolerate more invasive surgery such as arthrodesis. This scoping review aims to display current evidence of postoperative recovery complications and patient-reported outcomes specific to alternative surgical treatment of DPN.

Methods: A scoping review was completed using PRISMA-ScR reporting standards. Investigators searched PubMed, Google Scholar, Foot & Ankle Orthopedics, and Journal of Foot and Ankle Surgery for studies from 2002 to 2025 with search terms: “deep peroneal neurectomy,” OR “deep peroneal nerve excision,” OR “peroneal neurectomies” AND “midfoot arthritis”. Exclusion criteria …

From Charcuterie Board To Clinical Ward: Pediococcus Pentosaceus As An Emerging Wound Pathogen - A Scoping Review, Jessica Sima, Mariana Rodriguez, Stephanie Campbell, Amanda Killeen

School of Podiatric Medicine - Student Research

Currently, there are 12 known species of Pediococcus, with P. Acidilactici and P. pentosaceus being the most well-known. P. pentosaceus is a Gram-positive, lactic acid bacterium, and is most often recognized for its wide usage as a probiotic and fermenter of wines and cheeses. It is also studied for its anti-inflammatory effects and antimicrobial properties against many common pathogens, such as Salmonella, Clostridium difficile, E.coli, etc.  However, the Pediococcus species can be an opportunistic pathogen in immunocompromised patients, and its resistance to glycopeptides and tetracycline limits treatment options.

We conducted a scoping review using Google Scholar and PubMed with the …

An Evaluation Of Total Navicular Implants: A Scoping Review, James Mcclure Hughes, Nicholas Belardo Obias, Amanda Killeen

School of Podiatric Medicine - Student Research

The aim of this study is to determine the efficacy and safety profile of total navicular implants based on current literature.

Navicular insults such as high-energy trauma, osteonecrosis, and Muller-Weiss syndrome may result in avascular necrosis or a critical sized bone defect, conditions that are highly difficult to manage given current treatment modalities. Total navicular implants may offer a solution to these problems. While 3D printing of implants remains investigational, its use in highly individualized cases involving the talus has had promising results with conditions like avascular necrosis, tumors, trauma, and arthritis. The navicular is unique in its attachments to …

A Novel Guide‑Free Internal Device Fixation For Transverse Tri‑Planar Distal Metatarsal Osteotomy: A Retrospective Review​, Maya D. Kaafarani, Brittney White, Graham A. Hamilton, Shannon M. Rush

School of Podiatric Medicine - Student Research

Introduction: Minimally invasive surgery (MIS) for bunion correction has gained popularity due to favorable outcomes and reduced recovery times. However, most MIS techniques rely on commercial instrumentation for osteotomy, reduction, and fixation. This retrospective study evaluates patients treated with a novel tri-planar distal metatarsal osteotomy performed without specialized MIS guides, using only standard surgical tools and a novel device.

Methods: A retrospective review was conducted on 28 patients (31 procedures, including 3 bilateral cases) who underwent MIS bunion correction from 2021 to 2024. The technique involved a 2–3 cm medial incision, transverse osteotomy at the distal surgical neck of the …

Glp-1 Receptor Agonists In Diabetic Foot And Ankle Care: Skeletal Liability Or A Blessing In Disguise? A Scoping Review, Daniela Lizbeth Avilez, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly prescribed for glycemic control and weight reduction in patients with Type 2 Diabetes Mellitus (T2DM). Patients with T2DM exhibit elevated fracture risk despite preserved bone mineral density due to impaired bone quality and microarchitectural compromise. Whether GLP-1 RA therapy exacerbates or mitigates skeletal risk remains clinically relevant to podiatric care.

Hypothesis: We hypothesized that GLP-1 RA therapy is not associated with increased lower extremity fracture risk and may demonstrate protective trends influenced by age and duration of therapy.

Methods: A review of PubMed and Google Scholar (2010–2026) was conducted. Inclusion criteria …

Rearfoot Realignment As A Prophylactic Strategy For Recurrent Lateral Column Ulcers In Diabetic Foot: A Case-Based Hypothesis, Christopher I. Anjorin Ms Dpmc, Ali-Abdul Kareem Dpm

School of Podiatric Medicine - Student Research

Lateral column ulcerations remain a persistent and complex challenge in diabetic foot management. Although procedures such as tailor’s bunionectomy may provide localized pressure relief, they often fail to address the underlying biomechanical contributors, most notably rearfoot deformities such as calcaneal varus or pes cavovarus frequently observed in diabetic patients. These structural abnormalities shift the weight‑bearing axis laterally, increasing ground reaction forces along the fifth metatarsal and predisposing individuals with diabetic peripheral neuropathy and impaired proprioception to recurrent ulceration. This case explores the hypothesis that prophylactic rearfoot realignment may offer superior long‑term outcomes by correcting the mechanical etiology of lateral column …

Selective Retention Of Birdshot Pellets In The Rearfoot: A Case Demonstrating Tissue Preservation And Functional Recovery, Yasim Zafar, Steven Bolton, Alexandria Armstrong, Hooman Mir

School of Podiatric Medicine - Student Research

Level of Evidence: III (Case Study)

Statement of Purpose: Gunshot wounds to the foot pose a unique surgical dilemma—whether to pursue aggressive foreign body removal or to preserve soft tissue integrity. This case highlights the management of a birdshot injury to the rearfoot where selective non-removal of pellets near the neurovascular bundle led to complete healing and full functional recovery. The purpose is to emphasize tissue preservation over aggressive exploration in complex ballistic foot injuries.

Case Study: A 26-year-old female sustained a birdshot gunshot wound to the right rearfoot. Multiple small entry wounds were noted on the posterior and plantar …

Complex Regional Pain Syndrome In A 21-Year-Old Male Patient Following A Gunshot Wound (Gsw), Jonathan Rodriguez, Oyinkansola Mudasiru, Alexandria Armstrong, Hooman Tabatabai-Mir

School of Podiatric Medicine - Student Research

Purpose: Complex Regional Pain Syndrome (CRPS) is a pain disorder that typically follows several forms of trauma, including surgery or fractures. The diagnostic gold standard for CRPS is the Budapest diagnostic criteria. In the general population, CRPS is 3-4 times more common in middle-aged women. Regarding incidence following injury, it most often occurs after a fracture. CRPS secondary to ballistic trauma is rarer, particularly in the case of a young male individual. The purpose of our case study is to follow a 21-year-old male patient who suffered an accidental self-inflicted gunshot wound to the left foot and detail the presentation …

Foot And Ankle Biomaterials: A Comprehensive Review Of Current Applications, Challenges, And Future Directions, Peter Elvin, Amayrani Sanchez, Anthony Allen Reyes, Hagner L. Andrade, Meelad Karami, Hooman Mir, Javier La Fontaine, Danieli Rodrigues, Claudia Biguetti

School of Podiatric Medicine Publications

Metallic biomaterials enable successful reconstruction and fixation of skeletal tissues by supporting repair, load-bearing function, and anatomical alignment in foot and ankle surgery. However, the unique anatomic and biomechanical demands of this region, combined with challenging pathologies such as flatfoot and Charcot neuroarthropathy, present distinct challenges, with effective intervention requiring targeted biomaterial solutions and precise indications. Furthermore, metallic biomaterials currently represent the most predominant and clinically validated fixation systems in foot and ankle surgical reconstructions, while also generating the largest body of outcome-based evidence. This review summarizes and discusses their contemporary applications, outcomes, limitations, unmeet needs, and future directions based …

Multiplanar First-Ray Deformity And Its Impact On Tibial Sesamoid Assessment: A Radiographic Analysis​, Yasim Zafar, Madelaine Adkins, Jessica Sima

School of Podiatric Medicine - Student Research

This study evaluated whether discrepancies in tibial sesamoid position (TSP) between anteroposterior (AP) and sesamoid axial radiographs are associated with first-ray deformity parameters: first metatarsal rotation angle (MRA), sesamoid rotation angle (SRA), intermetatarsal angle (IMA), and hallux valgus angle (HVA). We hypothesized that increased frontal-plane external rotation of the first metatarsal would be the primary contributor to AP–axial TSP mismatch.

This secondary analysis used deidentified radiographs from Shibuya et al. (J Foot Ankle Surg. 2019). Adults aged 18–80 with measurable TSP on both AP and axial views were included; patients with prior foot trauma or osseous surgery were excluded. Only …

Liposclerosing Myxofibrous Tumor Of The Foot: A Case Report, Mohammad Junayed Khan, Sufiyan Mannan Ahmed, Asad Mustafa, Sairah Asghar, Mohammad Tanjim Hossain

School of Podiatric Medicine - Student Research

Statement of Purpose: This case presents a rare sclerosing-type atypical lipomatous tumor with myxomatous features—the first and only known reported case of an ALT in the foot—along with its pathology, treatment, and management.

Case Study: Atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) represents the most common liposarcoma subtype, with recurrence and dedifferentiation risk influenced by tumor location. Retroperitoneal tumors recur frequently, while those in the lower extremity rarely do. Liposarcoma of the foot is exceedingly rare.

A 61-year-old male presented with a slowly enlarging, mildly tender lump on the right plantar heel. Radiographs demonstrated a 3 cm oval soft-tissue thickening without calcification. …

Midfoot Reconstruction For Avascular Necrosis Of The Navicular Bone​, Jessica Sima, Srilalitha Lanka, Merlin Sajeev, Shannon Rush, Graham Hamilton

School of Podiatric Medicine - Student Research

Background: Avascular necrosis (AVN) of the tarsal navicular, particularly with collapse, presents a complex surgical challenge due to compromised vascularity and the need to restore medial column length. This retrospective case series evaluates three distinct surgical approaches to midfoot reconstruction in patients with navicular AVN.

Methods: Three patients with navicular AVN were treated using individualized grafting strategies. Etiologies included chronic protease inhibitor use for HIV, Müller-Weiss syndrome, and post-resection of a giant cell tumor. All procedures utilized a medial utility incision with debridement to viable bleeding bone. Two cases were reconstructed using a combination of proximal tibial autograft, patellar allograft, …

Evaluating Factors Associated With Increased Citations Of Publications In The Journal Of Foot And Ankle Surgery, Asad Mustafa, Sarah Weisbrodt, Demian Rodriguez, Naohiro Shibuya

School of Podiatric Medicine - Student Research

Introduction: As the field of foot and ankle surgery advances, it is valuable to identify qualities of research publications that get more attention. Evaluating the factors that contribute to the traction would also help emerging authors identify areas of focus to improve visibility of their work in the profession. Our study aims to evaluate the relationship between the number of citations by articles published in the Journal of Foot and Ankle Surgery (JFAS) and the level of clinical evidence (LOE), article access level, the type of publication, the authors’ institution, and the country of submission.

Methods: We used Scopus to …

Prospective Comparison Of Wbc Spect/Ct And Conventional Mri For Diagnosing Osteomyelitis And Monitoring Treatment Response In Diabetic Foot Infections, Orhan Oz, Amber M. Sherwood, Peter A. Crisologo, Amanda L. Killeen, Kavita Bhavan, Javier La Fontaine, Katie L. Rubitschung, Helena Hwang, Robert W. Haley, Lawrence A. Lavery

School of Podiatric Medicine Publications

Aims/hypothesis: Osteomyelitis is a common complication of diabetic foot ulcers and a leading cause of lower limb amputations globally. Accurate diagnosis of diabetic foot osteomyelitis (DFO) is essential for effective infection management and improving prognosis. This study aimed to compare the performance of white blood cell (WBC)-single photon emission computed tomography (SPECT)/computed tomography (CT) and conventional MRI in the initial diagnosis of DFO and in detecting residual infection during treatment monitoring, using bone biopsy as the reference standard.

Methods: In this prospective clinical study, 47 patients with foot wounds suspicious for DFO underwent 99mTc-WBC SPECT/CT and MRI, followed by bone …

Bone Healing During A Dysregulated Inflammatory Phase: Comparative Skeletal Features In 5-Lipoxygenase Knockout And Wild Type Mice, Marco Hernandez, Nidhin John, Bhuvana L. Chandrashekar, Mariza A. Matsumoto, Naohiro Shibuya, Claudia Biguetti

School of Podiatric Medicine - Student Research

Background: High-risk patients, such as those with diabetic neuropathy, often experience prolonged and dysregulated inflammation during bone healing. The 5-lipoxygenase (5LO) pathway is a key mediator of inflammation and bone resorption and may influence these outcomes. Therefore, understanding the skeletal features associated with 5LO genetic deletion may help identify therapeutic opportunities to improve healing in high-risk patients.

Objective: To determine how genetic deletion of 5LO affects skeletal structure and macrophage phenotypes, with the goal of identifying therapeutic targets to improve bone healing in high-risk patients.

Materials and Methods: A total of 10, adult (3 months old), 129/SvEv male mice were …

Walking The Line How Social Forces Shape Diabetic Foot Outcomes In The Texas Rio Grande Valley, Amanda L. Killeen, Stephanie N. Campbell, Naomie Jean, Juan Lopez-Alvarenga, Xuan Wang, Cyaandi Dove, Caroline E. Fife

School of Podiatric Medicine Publications

• Diabetes in the Rio Grande Valley is widespread and severe. Nearly 1 in 3 adults is affected, with foot ulcers and amputations occurring at rates far above state and national averages.
• Social drivers of health (SDOH) strongly influence outcomes. Poverty, uninsurance, limited education, transportation barriers, and distance from specialty centers delay care and increase amputation risk.
• Living conditions amplify risk. Colonias, unincorporated settlements often lacking clean water, sewer systems, or reliable electricity, make diabetes management and preventive foot care especially challenging.
• Data-driven identification of high-risk populations is critical. Zip code–level SDOH data, integrated into electronic medical records, can serve as …

Comparative Analysis Of M1 And M2 Macrophage Distribution And Localization In Chronic Wounds Of Metabolically Healthy And Diabetic Hosts Using A C57bl/6 Mouse Model, Bryan Liu, Ramiro Cisneros, Nathaniel Primous, Estephania Garcia, Bhuvana Lakkasetter Chandrashekar, Claudia Biguetti

School of Podiatric Medicine - Student Research

Introduction/Purpose: Type 2 diabetes and obesity are major risk factors for delayed wound healing in chronic foot ulcers. This study investigated whether a high-fat diet induces diabetes-like metabolic dysfunction in mice and characterized associated morphological changes and macrophage polarization during wound healing. Macrophages exist as pro-inflammatory M1 and anti-inflammatory M2 phenotypes that regulate tissue repair.

Methods: Ten male C57BL/6J mice (8 weeks old) were divided into high-fat diet (HFD) and regular diet (RD) (IACUC Protocol 22-33) groups.  After 12 weeks, body weight and intraperitoneal glucose tolerance test were measured to confirm metabolic phenotypes, after which a 6mm dorsal excision wound …

Expression Of 5-Lo In Chronic Wounds In A Preclinical Murine Model Of Obesity And Type 2 Diabetes, Joshua Wu, Ramiro Cisneros, Nathaniel Primous, Estephania Garcia, Bhuvana Lakkasetter, Claudia Biguetti

School of Podiatric Medicine - Student Research

Introduction: Diabetes is associated with impaired wound healing and a high incidence of chronic, non-healing ulcers, largely driven by persistent low-grade inflammation. Leukotriene B4 (LTB4), a product of the 5-lipoxygenase (5-LO) pathway, has emerged as a key mediator of this chronic inflammatory state. Hence, this study investigated the role of the 5-LO pathway in cutaneous wound healing under normoglycemic and diabetic conditions using a murine model.

Methods: Twelve 8-week-old male C57BL/6J mice were fed with high-fat diet (HFD; 60% kcal fat) or low-fat diet (LFD; 10% kcal fat) for 12 weeks (IACUC 22-33). Body weight (BW) and fasting blood glucose …

Optimization Of Actuator Stiffness And Actuation Timing Of A Passive Ankle Exoskeleton: A Case Study Using A Musculoskeletal Modeling Approach, Jania Williams, Cody P. Anderson, Arash Mohammadzadeh Gonabad, Farahnaz Fallahtafti, Sara A. Myers, Hafizur Rahman

School of Podiatric Medicine Publications

Objective: A modeling and simulation tool, OpenSim, was used to determine the optimal relationship between actuator stiffness and actuation timing of a passive ankle exoskeleton for reducing metabolic costs during walking. We hypothesized that the absolute minimum in total metabolic cost would exist at an actuation timing of 15% of stance and at a spring stiffness of 7.5 kN/m. We also hypothesized that a local minimum in total metabolic cost would exist at an actuation timing of 50% of stance. Methods: Bilateral kinematics and kinetics data were collected on a healthy male walking overground wearing his regular tennis shoe. The …

Medial Artery Calcification As A Hidden Driver Of Osteomyelitis: The Impact Of Sad-Mac On Microvascular Perfusion And Antibiotic Delivery In The Diabetic Foot, Yasim Zafar, Paul Tran, Ofsman Quintana, Dustin Prins, Hooman Mir

School of Podiatric Medicine - Student Research

Purpose: To evaluate the association between small arterial disease with medial artery calcification (SAD-MAC) and increased risk of osteomyelitis in diabetic foot patients. This study explores how impaired microvascular perfusion contributes to ischemic ulcers, infection progression, and reduced antibiotic efficacy, leading to poor healing and higher amputation rates.

Methods: A retrospective review was conducted on nine diabetic patients with chronic kidney disease, hypertension, and peripheral vascular disease who presented with ischemic or gangrenous toes. Patients lacking radiographs or with non-diabetic ischemic etiologies were excluded. Radiographs were evaluated for small arterial disease with medial artery calcification (SAD-MAC) and graded using the …

The Impact Of Minor Amputation On Occurrence Of Major Amputation In Patients With Diabetic Foot Ulcers, Nivan Wadhawan, Naohiro Shibuya, Daniel C. Jupiter

School of Podiatric Medicine Publications

Diabetic foot ulcers (DFU) may lead to lower extremity amputation (LEA). Although minor LEAs (at or distal to the ankle) can carry a higher risk of perioperative complications compared to major LEAs (proximal to the ankle), they can increase patient independence and quality of life. This study aims to elucidate the impact of minor LEA on the time between DFU occurrence and major LEA to help determine the safer and more efficacious LEA choice for a given clinical situation. Data from 4,199 DFU patients from the TriNetX research platform were utilized. Kaplan-Meier curves and Cox regression were conducted to evaluate …

Providencia Rettgeri As An Unusual Pathogen In Diabetic Foot Osteomyelitis: A Case Report And Literature Review, Stephanie N. Campbell, Madeleine Mehaffey, Nikita Gambhir, Amanda L. Killeen

School of Podiatric Medicine Publications

Providencia rettgeri is a Gram-negative bacterium, rarely reported as a cause of diabetic wound infections. Its frequent resistance to β-lactams and carbapenems limits treatment options, especially in immunocompromised patients. We present the case of a 59-year-old unhoused male living with diabetes, peripheral artery disease, and prior bilateral transmetatarsal amputations who presented with a University of Texas 3B diabetic foot ulcer. Magnetic resonance imaging showed osteomyelitis of metatarsals 2–4, and bone biopsy grew Providencia rettgeri and Proteus mirabilis. The patient declined further surgery and was treated with 6 weeks of cefepime and metronidazole, with outpatient wound care, achieving wound closure …

Use Of Prophylaxis For Deep Venous Thrombosis And Pulmonary Embolism In Isolated Foot And Ankle Trauma, Regina Hansen, Alexander P. Rader, Naohiro Shibuya, Daniel C. Jupiter

School of Podiatric Medicine Publications

Background: Deep venous thrombosis (DVT) and pulmonary embolism (PE) are relatively rare after foot and ankle surgery, especially after trauma. Diagnosing DVT is difficult, and even when it is discovered it does not necessarily clinically manifest on, for example, duplex ultrasound. Thus, it is often recommended that prophylaxis use be assessed on a case-by-case basis based on risk profile rather than being uniformly given or not prescribed.

Methods: We searched the National Trauma Data Bank Trauma Quality Programs Participant Use File for patients experiencing foot and ankle trauma from 2013 to 2017. Patients were identified using the International Classification of …

Enhancing Surgical Understanding Of Diabetic Foot Ulcer Classification Through Anatomage Integration: A Digital Approach To Wagner Grading, Nidhin John, Hooman Mir

School of Podiatric Medicine - Student Research

Background: Diabetic foot ulcers often lead to amputation, and accurate Wagner classification requires strong spatial understanding. Anatomage, a 3D digital anatomy tool, may improve this learning.

Methods: Thirty-six surgical trainees completed a pretest, explored digitally reconstructed Wagner grade 0–5 ulcers on Anatomage, and completed a posttest. Paired-sample analysis measured changes in accuracy, comprehension, and confidence.

Results: Classification accuracy improved from 61% to 89% (p < 0.05), with the greatest gains in higher Wagner grades. Participants reported clearer visualization of wound depth, bone involvement, and infection spread.

Conclusion: Anatomage enhances understanding and diagnostic precision of Wagner ulcer classification, supporting more effective limb-preservation education