Podiatry Commons^™

Adipose Injectable Filler With Use Of Meshed Dermal Matrix And Porcine Urinary Bladder Matrix For The Management Of A Complex Achilles Wound, Francois M. Lokenye Dpm, Orlexia Thomas Dpm, Mariam Kamil Bs, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

Chronic Achilles wounds present a significant clinical challenge due to limited vascularity, high mechanical stress, and the complex anatomy of the posterior lower leg.

Regenerative medicine offers a promising alternative to traditional wound management through the use of advanced biologic materials.

This case highlights a novel approach utilizing a combination of adipose-derived injectable filler, acellular dermal matrix, and porcine urinary bladder matrix to enhance tissue regeneration, provide structural support, and promote wound healing.

The Multiple Roles Of 5-Lo In Tissue Regeneration – Insights From Translational Animal Models Utilizing Pharmacological And Genetic Approaches, Roel Navarro, Nidhin John, Claudia Biguetti

School of Podiatric Medicine - Student Research

Inflammation following tissue injury is a natural physiological response, where its course, duration, and intensity help determine whether it promotes beneficial or detrimental outcomes in tissue healing. Arachidonic acid (AA) serves as a substrate for5-lipoxygenase (5-LO) pathway, which synthesizes metabolites such as leukotrienes that influence both acute and chronic inflammatory response.  AA and its product's inhibitors are currently used to treat hypersensitivity reactions. However, literature suggests potential therapeutic efficacy in tissue healing.

Wound Dehiscence Rate Between Chevron Osteotomy Procedure Vs. Lapidus For Correction Of Hallux Valgus Deformity, Isabella V. Strash, Abelardo Osuna, Madelaine Adkins

School of Podiatric Medicine - Student Research

Format: Scientific

Length of follow-up: n/a

Level of Evidence: Cross-Sectional Study (Level III)

Classification: Surgery

Purpose: Distal metatarsal osteotomies, like the chevron procedure, were once preferred for their stability and faster recovery in hallux valgus correction. However, recent advancements have increased the use of proximal procedures, such as the lapidus. This study aims to compare complications between distal and proximal hallux valgus surgeries.

Methodology & Procedure: Data was downloaded from the TriNetX Research Network on February 2, 2023 using CPT codes 28296 (chevron) and 28297 (lapidus). Inclusion criteria consisted of patients between 18 and 60 years of age and required …

Antibiotics Vs Surgical Resection In Foot And Ankle Osteomyelitis, Travis Rich, Marshall G. Solomon

Posters

Osteomyelitis, a serious bone infection, is particularly challenging in diabetic patients due to poor vascularization and impaired immune response.1 Timely and effective treatment is essential to prevent severe complications, including limb loss or even death.2 This study aims to evaluate the likelihood of surgical excision or amputation versus antibiotic treatment alone in diabetic patients with bone biopsyconfirmed acute osteomyelitis of the lower extremity.

Case Report Of Surgical Management For Charcot Foot Medial Column Beaming With Stj Arthrodesis, Prachi Patel, Randy Semma

Posters

Medial column beaming is a surgical procedure that involves inserting a metallic beam to the medial column of the foot to treat the Charcot deformity of the foot.

A surgeon will use a large diameter screw to insert a beam into medial column which includes the first metatarsal, medial cuneiform, navicular and talus (fig 3) The beam shares the load of weightbearing with the foot's ligaments and joints, reducing the abnormal loss of structural integrity that can occur in Charcot arthropathy of the foot.

Subtalar joint fusion is often performed concurrently with medial column beaming to enhance the overall stability …

Sole Searching: The Mystery Of A Left Foot Mood Swing Unraveled Patient, Kaitlin Sebranek

Posters

About 0.2% of patients in the Diabetic population have Charcot Neuroarthropathy.

When the gold standard of offloading in a total contact cast fails for CN patients, surgical treatment can be considered to achieve a stable, plantigrade, and functional foot.

Due to the complexity of the condition, potential complications such as hardware breakage, nonunion, and infection can result over time.

The Diagnosis Of Polyarteritis Nodosa In The Setting Of Lower Extremity Lesions: A Case Report, Eric Li, Jihan Toma

Posters

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis affecting medium-sized arteries, involving multiple organs, with the most frequently affected tissues being skin and peripheral nerves (1). The distinct pearl neckless pattern led to the naming of this condition (2). Cutaneous polyarteritis nodosa (CPAN) is a variant of PAN confined to the skin, muscles and peripheral nerves in the absence of any systemic involvement (1). This rare form of systemic necrotizing vasculitis is limited to the medium-sized arteries of the skinand has a more favorable prognosis (1). PAN is also linked to Hepatitis B(2).The current diagnostic criteria for CPAN were proposed …

Stepping Into Relief: Conquering Rheumatoid Arthritic Foot Pain With Podiatric Management, Natalie Diaz, Marshall Solomon, Inocencio Cuesta

Posters

Rheumatoid arthritis (RA) is a chronic multifactorial autoimmune disease that causes progressive joint destruction along with causing cutaneous manifestations such as nodules. RA negatively impacts life by producing pain, impairing quality of life and biomechanical function of the lower extremities.

Antibiotics Vs Surgical Resection In Foot And Ankle Osteomyelitis, Travis Rich, Marshall G. Solomon

Posters

Osteomyelitis, a serious bone infection, is particularly challenging in diabetic patients due to poor vascularization and impaired immune response.1 Timely and effective treatment is essential to prevent severe complications, including limb loss or even death.2 This study aims to evaluate the likelihood of surgical excision or amputation versus antibiotic treatment alone in diabetic patients with bone biopsyconfirmed acute osteomyelitis of the lower extremity.

Kaposi Sarcoma: Case Study, Mohamed Elshebiny, Marshall G. Solomon

Posters

Kaposi Sarcoma (KS) is a vascular tumor usually caused by a herpestype virus HHV-8

Lesions often appear as flat or raised purple-colored, and depending on the stage may be nodular and break the skin when they ulcerate.

Stages of KS are Patch stage (early stage), Plaque stage, and Nodular stage (tumor/late stage).

Can be one of four types:

–AIDS related KS – infected with HIV (AKS)

– Transplant-associated – in immunosuppressed pts

Classic – often in pts Eastern-European, Mediterranean/Middle Eastern descent

– Endemic

The Curious Case Of Ainhum Dactolysis Spontanea, Jesse Miller, Michele Bertele-Semma, Randy Semma

Posters

HPI

• 46 yoAfrican male, no major PMH.
• Pt presents with severe pain in the right 5thtoe.
• Pt had used a corn remover at home treatment 2 years ago which they stated started the progression in the pain of the patient.
• Pt states that the toe has progressively become more constricted and painful.
• Pt states that they want their toe amputated to relieve the pain.

Repair Of Achilles Tendon Re-Rupture With Fhl Transfer: A Case Study, Taylor Allison, Joshua Kazdan

Posters

The Achilles tendon consists of the soleus muscle and two heads of the gastrocnemius muscle. Loss of its function can result in loss of plantarflexion strength, which can impact activities of daily living. In a study by Scheller et al, Achilles tendon ruptures were missed on initial evaluation on 25% of their patients. Other studies have reported a similar incidence of misdiagnoses. Patients may also delay treatment due to decreased pain after the initial injury. Ruptures diagnosed 4 weeks from injury are often considered chronic, and many of these patients benefit from surgical repair. A flexor hallucis longus (FHL) transfer …

Complications And Formation Of Sinus Tracts Due To Presence Of Lead From Foreign Bodies Insoft Tissue: A Case Report, Peter J. Godoy, Marshall G. Solomon

Posters

A cornerstone of lower extremity limb salvage is to avoid development of wound complicationsinvolved in soft tissue infections .

Predicting probability of sinus tract development due to presence of lead in soft tissues from foreign bodies. Inthis particular case a bulletfragment from a previous gunshot wound was noted to be the catalyst disrupting multiple biologic processes and impairing the function of soft tissues to heal. Predicting a level of contamination in this particular case leadbelieved to cause oxidative stress and inflammation and prompt excisional removal canavoid sinus tract formations and complications.

This study presents a unique case that demonstratesbeneficial patient …

Successful Limb Salvage In A Severe Diabetic Foot Infection: A Case Study Of Aggressive Surgical Intervention And Grafting Technique, Stephanie N. Campbell, Amanda Killeen, Michael Sobolevsky

Research Symposium

Background: Severe necrotizing diabetic foot infections are known to have high morbidity, high amputation risk, and high complication rates. Efforts at preserving the limb require significant surgical efforts and lengthy wound care. This process is more complicated in patients with significant housing instability.

Case Presentation: A 53-year-old male with uncontrolled diabetes (A1c 7.9%), housing insecurity, food insecurity presented with severe necrotizing diabetic foot infection with ascending cellulitis, infectious hemorrhagic bullae, multi-compartment abscesses of the foot and anterior leg. It is known that patients with diabetes are at increased risk of both amputation and surgical interventions than patients without diabetes. This …

Investing In Limb Preservation: A Case Report In Avoiding Bilateral Amputation In A Vasculopathy Patient, Stephanie N. Campbell, Craig J. Verdin, Heather V. Tran, Nikita Gambhir

Research Symposium

Background: Limb salvage and prosthetics play vital roles in restoring function and mobility for patients with severe injuries or metabolic conditions. Limb salvage involves surgical techniques aimed at preserving a limb rather than resorting to amputation, while prosthetics provide artificial devices to replace lost limbs. Key considerations for limb salvage include restoring a functional foot, maintaining patient independence, minimizing hospitalizations, and avoiding bilateral lower limb amputations.

Case Presentation: The patient, already at single-limb status, presented with a necrotic heel ulcer, exposed calcaneus, and necrotic Achilles tendon. After vascular optimization, the risks and benefits of final aggressive measures were discussed, leading …

Train Foot: History Of The Migrant Worker, Stephanie N. Campbell, Heather V. Tran, Nikita V. Gambhir, Luis Caporusso

School of Podiatric Medicine Publications

Immigrant labor has a long history in the United States, comprised of millions of workers from various ethnic and cultural backgrounds supporting multiple industries from farm work to steel. As of 2019, 25.6% of total migrant workers employed in the Americas [1,2]. Crush injuries or “pinch points” are events when a body part is entangled within machinery or under or between an object [3]. After a series of crush related injuries of young (20s), male Latino patients across Texas to a level 1 trauma center, case review was performed for 2 patients for which follow up could be evaluated. The …

Under Pressure: A Rare Presentation Of Crude Oil Injection Injury To The Foot Secondary To Pressure Washer Injury, Stephanie N. Campbell, Heather V. Tran, Nikita V. Gambhir, Connor Krolikowski

School of Podiatric Medicine Publications

No abstract provided.

Investing In Limb Preservation: A Case Report In Avoiding Bilateral Amputation In A Vasculopathy Patient, Stephanie N. Campbell, Craig J. Verdin, Heather V. Tran, Nikita Gambhir

School of Podiatric Medicine Publications

Limb salvage and prosthetics play vital roles in restoring function and mobility for patients with severe injuries or metabolic conditions. Limb salvage involves surgical techniques aimed at preserving a limb rather than resorting to amputation, while prosthetics provide artificial devices to replace lost limbs. Key considerations for limb salvage include restoring a functional foot, maintaining patient independence, minimizing hospitalizations, and avoiding bilateral lower limb amputations.

Successful Limb Salvage In A Severe Diabetic Foot Infection: A Case Study Of Aggressive Surgical Intervention And Grafting Technique, Stephanie N. Campbell, Amanda Killeen, Michael Sobolevsky

School of Podiatric Medicine Publications

A 53-year-old male with uncontrolled diabetes (A1c 7.9%), housing insecurity, food insecurity presented with severe necrotizing diabetic foot infection with ascending cellulitis, infectious hemorrhagic bullae, multi-compartment abscesses of the foot and anterior leg. It is known that patients with diabetes are at increased risk of both amputation and surgical interventions than patients without diabetes. This patient underwent aggressive surgical intervention to avoid primary below knee amputation.

Synovial Chondromatosis: Unraveling The Pathogenesis, Diagnosis, And Management Of An Atypical Benign Tumor, Francois M. Lokenye Dpm, Narayan Athira Md

Oral Presentations

No abstract provided.

Prevention Of Transmetatarsal Amputation In A Diabetic Patient With A Chronic Foot Ulcer Including Osteomyelitis By Minimally Invasive Surgery Floating Lesser Metatarsal Osteotomies In Conjunction With Adipose Injectable Filler, Francois M. Lokenye Dpm, Orlexia Thomas Dpm, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

Problem: Diabetic foot ulcers (DFUs) complicated by osteomyelitis often result in transmetatarsal amputations, leading to significant morbidity.

Objective: To evaluate a minimally invasive surgical approach combining floating lesser metatarsal osteotomies with adipose injectable filler to prevent transmetatarsal amputation, enhance wound resolution, and improve foot biomechanics

The Effects Of Capsaicin On Vascularization In Patients With Diabetes Mellitus: A Literature Review, Karen Hernandez, Leslie Guerrero, Myra Mudassar, Amanda L. Killeen

School of Podiatric Medicine Publications

Diabetes Mellitus (DM) is a metabolic disorder affecting 11.6% of the United States population and 43.95% of the population in the Rio Grande Valley of Texas. A common complication of diabetes mellitus is neuropathy, a type of nerve damage that affects as many as half of the people with this condition. Vascular factors and metabolic interactions are major influencers of the pathogenesis of diabetic neuropathy. This literature review evaluates the therapeutic role of capsaicin, a known component of capsicum pepper, commonly used as a treatment for neuropathic pain. However, several studies show that in addition to pain management, capsaicin counters …

New Vs. Reprocessed: A Scoping Review On Ilizarov Frame Reuse, James Hughes, Nicholas Obias, Dustin Prins, Amanda Killeen

School of Podiatric Medicine - Student Research

This review examines current literature regarding the viability of reused/reprocessed Ilizarov External Fixation (IEF) – with the end-goal of improving surgical options for complex limb pathologies in austere environments. We hypothesize this review will find no statistically significant difference between clinical outcomes of reused vs. new IEFs

IEF is an important but costly modality for complex limb pathologies, such as trauma, deformity, and nonunion (Chironga et al., 2023). Though effective, the cost of IEF is exacerbated by its single-use deployment (Chironga et al., 2023). A proposed cost-control measure is IEF reuse/reprocessing via (1) antiseptic pre-treatment, (2) structural stability assessment, (3) …

Allograft Reconstruction For Fluoroquinolone-Induced Achilles Rupture: A Case Study, Val Haddon, Brandon Mojica, Joel Santana, Marjory Jones

West Florida Division GME Research Day 2025

No abstract provided.

Early Tissue Changes Linked To Diabetes: Insights From A Preclinical Model, Bryan Liu, Ramiro Cisneros, Estephania Garcia, Jimena Mora, Sumedha Guha, Evelin Rios, Krishna Prajapati, Danieli Rodrigues, Bhuvana Lakkasetter Chandrashekar, Claudia Biguetti

School of Podiatric Medicine - Student Research

Introduction and Hypothesis: The aim of this study is to compare soft tissue morphology and fibrosis pathology of different organs between diabetic and non-diabetic rats. Type 2 diabetes causes soft tissue remodeling in organ systems including heart, kidney, spleen, and pancreas. Fibrotic remodeling is a common pathological mechanism seen in diabetes-related organ dysfunction. By understanding fibrotic pathology in rats, it serves as a foundation to develop lower limb models applicable to podiatry. These systemic changes caused by diabetes may also play a role in lower limb changes such as diabetic ulcers and delayed wound healing.

Methodology: Male Lewis rats (6 …

Demographic And Clinical Characteristics Of Patients With Charcot Neuro-Osteoarthropathy In People With Diabetes Mellitus In Six Countries: A Multicenter Observational Study From 1996 To 2022, E. B. Jude, C. Siafarikas, A. Rastogi, R. Bem, T. Tankova, M. -F. Kong, Javier La Fontaine, J. Pappachan, N. Tentolouris

School of Podiatric Medicine Publications

Aim: To describe the demographic and clinical characteristics of patients with Charcot neuro-osteoarthropathy (CNO) and to examine for differences between participants with Type 1 diabetes mellitus (DM) (T1DM) and Type 2 diabetes mellitus (T2DM).

Materials and Methods: Multicenter observational study in eight diabetic foot clinics in six countries between January 1, 1996, and December 31, 2022. Demographic, clinical, and laboratory parameters were obtained from the medical records. Analyses were performed using parametric or nonparametric statistical tests for variables with normally or nonnormally distributed values, respectively. Comparisons of the qualitative data were performed using the chi-square test.

Results: Seven hundred seventy-four …

Rare Case Of Osteomyelitis Caused By Achromobacter Xylosoxidans, Christopher P. Girgis, Tyler L. Coye, Elizabeth Ansert, Amanda L. Killeen, Peter A. Crisologo

School of Podiatric Medicine Publications

Achromobacter xylosoxidans is a rare opportunistic aerobe that has rarely been documented in the literature as a causative agent for osteomyelitis. It can present with antibiotic resistance, making treatment without operative management challenging. We present the case of a 51-year-old male with a past medical history of uncontrolled type 2 diabetes. The patient presented to a clinic with a grade 2 infection to the right fifth digit, as defined by the International Working Group on the Diabetic Foot, and was subsequently admitted for intravenous antibiotics and operative management. Magnetic resonance imaging revealed abnormal signal of the phalanges of the fifth …

Comparative Effectiveness Of Conservative Versus Early Surgical Treatments On Wound Healing Outcomes Of Diabetic Foot Ulcers: A Literature Review, Paul Tran, Yasim Zafar, Andrea Piña, Stephanie N. Campbell

School of Podiatric Medicine Publications

Diabetic foot ulcers (DFUs) are a severe complication of diabetes mellitus and the leading cause of lower extremity amputations worldwide. Peripheral neuropathy and peripheral arterial disease secondary to complications of diabetes mellitus may result in ulcers going unnoticed, increasing the risk of severe osteomyelitis, necrotizing infection, hospitalization, amputation, and sepsis. While conservative management of DFUs remains the first-line approach—emphasizing wound care, infection control, glycemic management, and offloading—there is growing debate about whether delaying simple surgical interventions worsens long-term outcomes. Surgeries such as tenotomy, digital amputation, and tendo-Achilles lengthening are minimally invasive options that can correct deformities, prevent recurrence, and promote …

The Infected Diabetic Foot: Incidence And Risk Factors For Dehiscence After Surgery For Diabetic Foot Infections, Lawrence A Lavery, Mario C Reyes, Bijan Najafi, Tyler L Coye, Jayer Chung, Michael C Siah, Arthur N Tarricone

Center on Aging Staff Publications

Our objective was to assess the incidence, risk factors and clinical outcomes of dehiscence after foot surgery in diabetic patients. We used pooled patient‐level data from two randomised clinical trials with 240 diabetic patients who required foot surgery for infections. Most patients (n = 180, 75.0%) had surgical wound closure. We defined dehisced surgical wounds (DSW) when the surgical site was not completely epithelialized with no drainage after sutures/staples were removed with a 2‐week validation of healing. We evaluated the time to heal, re‐infection, re‐ulceration, hospital admissions and amputations. Moderate and severe infection was based on criteria of the …

Lipid Discovery Enabled By Sequence Statistics And Machine Learning, Priya M. Christensen, Jonathan Martin, Aparna Uppuluri, Luke R. Joyce, Yahan Wei, Ziqiang Guan, Faruck Morcos, Kelli L. Palmer

School of Podiatric Medicine Publications

Bacterial membranes are complex and dynamic, arising from an array of evolutionary pressures. One enzyme that alters membrane compositions through covalent lipid modification is MprF. We recently identified that Streptococcus agalactiae MprF synthesizes lysyl-phosphatidylglycerol (Lys-PG) from anionic PG, and a novel cationic lipid, lysyl-glucosyldiacylglycerol (Lys-Glc-DAG), from neutral glycolipid Glc-DAG. This unexpected result prompted us to investigate whether Lys-Glc-DAG occurs in other MprF-containing bacteria, and whether other novel MprF products exist. Here, we studied protein sequence features determining MprF substrate specificity. First, pairwise analyses identified several streptococcal MprFs synthesizing LysGlc-DAG. Second, a restricted Boltzmann machine-guided approach led us to discover an …