Podiatry Commons^™

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 …

Actin Up And Factor’D In: ​ A Pediatric Spindle Cell Lesion Case Presentation, Michael Higham, Stephanie Campbell, Naomie Jean, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Solitary spindle cell nodules on the foot in pediatric patients are rare and diagnostically challenging. Dermatofibroma (benign fibrous histiocytoma), a common adult dermal lesion, is infrequently observed in children under 18.

The spectrum of pediatric spindle cell tumors includes reactive entities like nodular fasciitis and dermatomyofibroma, benign neoplasms such as myofibroma, and malignant tumors including spindle cell rhabdomyosarcoma, fibrosarcoma, and dermatofibrosarcoma protuberans (DFSP). Accurate differential diagnosis is essential, as DFSP requires wide excision or Mohs surgery to reduce recurrence risk.

Methods (Case Presentation): An 11-year-old boy presented with a one-year history of a non-healing lesion on the heel, initially …

Beyond The Bone: A Misdiagnosis Of Paget’S Disease Reveals Polyostotic Mazabraud Syndrome, Michael Higham, Stephanie Campbell, Amanda Killeen

School of Podiatric Medicine Publications

Introduction: Mazabraud Syndrome is a rare benign condition characterized by polyostotic fibrous dysplasia and intramuscular myxomas. Due to its overlapping radiographic features, it is frequently misdiagnosed. We present a case where Mazabraud Syndrome was misdiagnosed as Paget’s disease for nearly 6 decades.

Case Presentation: A 59-year-old woman presented to the podiatry clinic with complaints of numbness and sharp pain of the left foot while in stance. Her surgical history is positive for numerous lower extremity myxomas excised over her lifetime, beginning in adolescence, and now with non-mobile soft tissue mass at the porta pedis of the left foot for 1 …

The Dialysis Foot- The Impact Of Presenting Estimated Glomerular Filtration Rate On Clinical Outcomes In Patients Hospitalized With Diabetic Foot Infections, Arthur Tarricone, Tyler L Coye, Allen Gee, Bijan Najafi, Michael C Siah, Lawrence A Lavery

Center on Aging Staff Publications

To evaluate the association between presenting estimated glomerular filtration rate (eGFR) and clinical outcomes in patients hospitalized with diabetic foot infections. This retrospective cohort study included 344 patients with moderate to severe diabetic foot infections. Patients were categorized into three groups based on presenting estimated eGFR: eGFR ≥60 (eGFR >60 mL/min), eGFR 30-60 (eGFR 30-60 mL/min) and eGFR < 30 (eGFR < 30 mL/min). Outcomes assessed included wound healing, time to heal, re-infection, amputation, mortality and re-hospitalization for infection. Compared with patients with eGFR < 30, patients with eGFR ≥60 had significantly lower rates of retinopathy, peripheral arterial disease and use of beta blockers or calcium channel blockers. Glycated haemoglobin levels were inversely related to eGFR, decreasing as eGFR severity increased. Haemoglobin levels were significantly lower, and inflammatory markers (ESR and CRP) were significantly higher in patients with eGFR < 30. There were no significant differences among eGFR groups in rates of wound healing, time to heal, re-infection or amputation. However, mortality increased with decreasing eGFR (1.9% in eGFR ≥60 vs. 3.2% in eGFR 30-60 vs. 8.1% in eGFR < 30; p = 0.04). Similarly, re-hospitalization for infection at a different site also increased with decreasing eGFR (20.5% in eGFR ≥60 vs. 28.1% in eGFR 30-60 vs. 48.4% in eGFR < 30; p <  0.01). In diabetic foot infections, presenting eGFR severity did not affect rates of wound healing, time to heal, re-infection or amputation. However, decreasing eGFR was associated with increased mortality and re-hospitalization for infection at a different site. In this study, presenting eGFR was not a predictive value for wound healing or time until healing, however was associated with rehospitalization and overall mortality this diabetic foot population.

Limbgod(Pat. Pending): Wearable Garment For Amputation Prevention, Naomi Choi Dpm, Mba, Phuc An Dinh Bs, Ms, Eric Lee Bs, Francois M. Lokenye Dpm

Posters

Approximately 1.6 million people in the U.S. have lower limb amputations, which is expected to double by 2050 (Wong et al.). Socio-economic factors: income, education, rural residency & race, impact amputation risk (Okesina et al.), with Black Americans 70% are more likely to undergo major lower limb amputations than white Americans, even after adjusting for care access & comorbidities (Feinglass et al., Holman et al., Regenbogen et al.). Within 5 years, up to 50% of first-time amputees require another amputation (Dilingham et al., Glaser et al.) & those with comorbidities face a 77% five-year mortality rate (Fortington et al.).

Prevention Of Amputation By Minimally Invasive Surgery In A Diabetic Patient With Osteomyelitis And Peripheral Vascular Disease With A History Of Previous Amputations, Orlexia Thomas Dpm, Francois M. Lokenye Dpm, Lady Poaula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

This study aims to demonstrate the efficacy of minimally invasive surgical interventions in preventing foot amputation and promoting wound healing in a diabetic patient with osteomyelitis and peripheral vascular disease, compounded by a history of ray resection.

The Stress Of Measuring Plantar Tissue Stress In People With Diabetes-Related Foot Ulcers: Biomechanical And Feasibility Findings From Two Prospective Cohort Studies, Chantal M Hulshof, Madelyn Page, Sjef G Van Baal, Sicco A Bus, Malindu E Fernando, Lisette Van Gemert-Pijnen, Kilian D R Kappert, Scott Lucadou-Wells, Bijan Najafi, Jaap J Van Netten, Peter A Lazzarini

Center on Aging Staff Publications

Reducing high mechanical stress is imperative to heal diabetes-related foot ulcers. We explored the association of cumulative plantar tissue stress (CPTS) and plantar foot ulcer healing, and the feasibility of measuring CPTS, in two prospective cohort studies (Australia (AU) and The Netherlands (NL)). Both studies used multiple sensors to measure factors to determine CPTS: plantar pressures, weight-bearing activities, and adherence to offloading treatments, with thermal stress response also measured to estimate shear stress in the AU-study. The primary outcome was ulcer healing at 12 weeks. Twenty-five participants were recruited: 13 in the AU-study and 12 in the NL-study. CPTS data …

Traumatic Compartment Syndrome Of The Foot: A Case Report, Mansi Patel, Asim Qureshi, Matthew K. Brant

Rowan-Virtua Research Day

Compartment syndrome of the foot is a rare but limb threatening condition that is often difficult to diagnose. It is usually caused by traumatic injuries and the diagnosis requires a high clinical suspicion and timely management. Clinically, patients will present with an acute traumatic event followed by physical exam findings of non-palpable pulses, paralysis, pallor, pain out of proportion, and paresthesias. The foot contains nine compartments, which should be assessed independently for elevated pressures. The diagnostic threshold for each compartment is 30 mmHg. Pressures above this threshold require emergent fasciotomy to preserve the anatomical structures and thus the function of …

Lower Leg And Foot Contributions To Turnout In University-Level Female Ballet Dancers: A Preliminary Investigation, Sarah Carter, Alan R. Bryant, Luke Hopper

ECU Posters

Functional turnout in ballet involves maximal external rotation through the lower limb kinetic chain. Hip external rotation, is considered the primary contributor of functional turnout. However, dancers will tend to increase their functional turnout angle through additional tibiofemoral external rotation and pronation of the foot/ankle complex. Hip external rotation measures in functional turnout has received extensive examination in dance science. However, the relationship between the ‘below the hip' assessments with functional turnout is poorly understood. We hypothesis that dancers with greater passive external tibiofemoral rotation (pTFR) and/or pronated stance will have a greater functional turnout angle.

Nineteen female university-level classical …