Podiatry Commons^™

Towards A Remote Patient Monitoring Platform For Comprehensive Risk Evaluations For People With Diabetic Foot Ulcers, Gozde Cay, M G Finco, Jason Garcia, Jill L Mcnitt-Gray, David G Armstrong, Bijan Najafi

Center on Aging Staff Publications

Diabetic foot ulcers (DFUs) significantly affect the lives of patients and increase the risk of hospital stays and amputation. We suggest a remote monitoring platform for better DFU care. This system uses digital health metrics (scaled from 0 to 10, where higher scores indicate a greater risk of slow healing) to provide a comprehensive overview through a visual interface. The platform features smart offloading devices that capture behavioral metrics such as offloading adherence, daily steps, and cadence. Coupled with remotely measurable frailty and phenotypic metrics, it offers an in-depth patient profile. Additional demographic data, characteristics of the wound, and clinical …

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 …

Peripheral Artery Disease Causes Consistent Gait Irregularities Regardless Of The Location Of Leg Claudication Pain, Hafizur Rahman, Todd Leutzinger, Mahdi Hassan, Molly Schieber, Panagiotis Koutakis, Matthew A. Fuglestad, Holly Despiegelaere, G. Matthew Longo, Philippe Malcolm, Jason M. Johanning

School of Podiatric Medicine Publications

Highlights

• Peripheral artery disease (PAD) is a multi-level disease.

• PAD diffusely impairs the performance of leg muscles.

• PAD causes similar irregularities in gait biomechanics regardless of where claudication pain is located in the leg.

Abstract

Background

The most common symptom of peripheral artery disease (PAD) is intermittent claudication that involves the calf, thigh, and/or buttock muscles. How the specific location of this leg pain is related to altered gait, however, is unknown.

Objectives

We hypothesized that because the location of claudication symptoms uniquely affects different leg muscle groups in people with PAD, this would produce distinctive walking patterns.

Methods

A …

A Rare Occurrence Of Digital Fibromyxoma To The Hallux Distal Phalanx, Heather V. Tran, Nikita Gambhir, Craig J. Verdin, Luis Caporusso, Stephanie N. Campbell

School of Podiatric Medicine Publications

A paucity of literature exists for superficial acral fibromyxoma, which typically affects the acral regions of the hands and feet. Because of its indolent nature and clinical mimicry of other ungual and periungual tumors, delays in diagnosis are common. This report aims to augment our understanding of this pathology and improve recognition for prompt diagnosis, as well as provide an addition to the literature.

Effectiveness Of Concurrent Ankle Arthroscopy During Open Reduction And Internal Fixation Of Malleolar Fractures In Prevention Of Common Short-Term Complications, Naohiro Shibuya, Daniel C. Jupiter

School of Podiatric Medicine Publications

Rotational malleolar fractures result in a high prevalence of intra-articular pathologies; therefore, routine arthroscopic assessment may be beneficial in the surgical treatment of ankle fractures. However, the clinical studies regarding the effectiveness of arthroscopy thus far have mixed results. We investigated the efficacy of concurrent arthroscopy during the treatment of malleolar fractures using a large U.S. healthcare data set. Those who had arthroscopy were compared with those who did not, during the surgical treatment of malleolar fractures, while adjusting for covariates of clinical relevance. The analysis showed that concurrent arthroscopy is protective against postoperative repeat surgery (OR = 0.13, 95CI …

Bioengineered Skin For Diabetic Foot Ulcers: A Scoping Review, Nathaniel R. Primous, Peter Elvin, Kathleen V. Carter, Hagner L. Andrade, Javier La Fontaine, Naohiro Shibuya, Cláudia Cristina Biguetti

School of Podiatric Medicine Publications

Diabetic foot ulcers (DFUs) pose a significant threat to individuals with diabetes mellitus (DM), such as lower limb amputation and severe morbidity. Bioengineered skin substitutes (BSS) are alternatives to traditional interventions for treating DFUs, but their efficacy compared to standard wound care (SWC) or other treatment types, such as allografts, remains unknown. A scoping review of human studies was conducted to identify current approaches in the treatment of DFUs using BSS as compared with other treatment options. Systematic searches in PubMed, Cochrane Library, and Web of Science were conducted to identify comparative studies that enrolled 10 or more patients and …

Offloading And Adherence Through Technological Advancements: Modern Approaches For Better Foot Care In Diabetes, Sicco A Bus, Neil D Reeves, David G Armstrong, Bijan Najafi

Center on Aging Staff Publications

Objective: This manuscript aims to provide a review and synthesis of contemporary advancements in footwear, sensor technology for remote monitoring, and digital health, with a focus on improving offloading and measuring and enhancing adherence to offloading in diabetic foot care.

Methods: A narrative literature review was conducted by sourcing peer-reviewed articles, clinical studies, and technological innovations. This paper includes a review of various strategies, from specifically designed footwear, smart insoles and boots to using digital health interventions, which aim to offload plantar pressure and help prevent and manage wounds more effectively by improving the adherence to such offloading.

Results: In-house …

A Rare Case Of A Giant Cell Tumor Of The Peroneal Tendon Sheath, Francois M. Lokenye Dpm, Breana Marine Dpm, Orlexia Thomas Dpm, Mariam Kamil Bs

Posters

This case report discusses a 31-year-old male with TGCT in the peroneal tendon sheath, detailing clinical and radiological features.

his study explores the surgical interventions, diagnostic challenges, treatment options, and outcomes of TGCT, emphasizing its consideration in the differential diagnoses of painful foot and ankle masses.

Case Study: Post-Traumatic Calcaneonavicular Coalition, Jihae Kim, James Clancy

East Florida Division GME Research Day 2024

No abstract provided.

Range Of Motion Of Medial Column Joints After Proximal Hallux Valgus Correction Procedures, Chris Zimmer, Blake Lieberman, Warren Windram

East Florida Division GME Research Day 2024

No abstract provided.

From Heel To Toe: Investigating Plantar Fasciitis Causes, Diagnosis, And Treatment Strategies, Breanna Littlejohn

Undergraduate Honors Theses

This presentation informs plantar fasciitis patients. The cause of plantar fasciitis is multifactorial but most cases result from overuse stress. The cause of plantar fasciitis is multifactorial but most cases result from overuse stress. The classic presentation is of sharp localized pain at the heel. In some cases, a heel spur may be found. This presentation explains how exercise can improve plantar fasciitis. Reviewing risk factors will help you identify and manage plantar fasciitis when undergoing treatment. Understanding plantar fasciitis is crucial as it is a common and painful condition affecting the bottom of the foot. This inflammation of the …

Comminuted Talar Neck And Body Fracture: A Case Report, Chris Zimmer, Roshni Patel, Warren Windram

East Florida Division GME Research Day 2024

Format: Case study

Length of follow up: 12 months

Level of evidence: IV

Classification: Trauma

Purpose: A combination of talar neck and body fractures are extremely rare which make up approximately <1% of all fractures in the body. They are most commonly associated with high energy trauma such as falling from a great height, motor vehicle accident, etc. Talar fractures are challenging problems to treat in terms of fixation, rates of avascular necrosis and much more. The purpose of this case report is to demonstrate that even with a severe talar fracture salvage is possible with proper surgical technique and understanding of the unique fracture pattern.

Case study: One patient underwent ORIF of a comminuted talar neck and body fracture with a lateral bridge plate and medial based interfragmentary compression screw.

Procedures: Open reduction internal fixation of talar neck and body fracture.

Results: 1 patient who demonstrated clinical and radiographic signs of healing of a talar neck and body fracture.

Analysis & Discussions: The rates of avascular necrosis of talar neck and body fractures varies …

Public Perceptions Of Peripheral Nerve Surgery On Social Media: A Narrative Review, Nicholas Obias, James Hughes

School of Podiatric Medicine - Student Research

Objective: The intent of this study is to conduct a Narrative review of the Public Perceptions of Peripheral Nerve Surgery on Social Media.

Introduction: Peripheral nerve surgery is an effective therapeutic modality for difficult diagnoses such as peripheral neuropathy, neuromas, and complex regional pain syndrome. This study aims to explore public perceptions of peripheral nerve surgery on Instagram, a popular social media site. Information on posts such as authorship, relevance, accuracy, and purpose were collected. Conclusions from this study may direct efforts to enhance medical advice and improve patient education for extremity nerve surgeons.

Methods: Searches were conducted in September …

Effects Of The Injury Recovery Process On Neuromuscular Activation In An Uninjured Ankle, Mark Tankersley

CMC Senior Theses

This study was conducted to observe the effects of changed activity levels due to a major lower extremity injury on ankle function in the uninjured leg. Neuromuscular activation in the Gastric Medialis (GAS) and Tibialis Anterior (TA), the muscles primarily responsible for movement at the ankle, was assessed in 8 athletes at the Claremont Colleges while walking on a flat surface, stepping up a 15º incline, and stepping up a 27º incline. Athletes were split into two groups based on injury condition: a “recovered” group (n=4) who had suffered a major lower extremity injury in the last two years in …

Comparative Effect Of Zoledronic Acid, High Glucose Levels, And Oxidative Stress On Macrophage Viability, Bryan Liu, Denae Cantu, Deborah Seixas, Cláudia Cristina Biguetti

School of Podiatric Medicine - Student Research

Introduction and Hypothesis: Zoledronate (Zol) is an antiosteoclastic drug widely utilized for osteoporosis and bone metastases, and it may be used off-label for managing diabetic Charcot neuroarthropathy¹. Since macrophages share common precursors with osteoclasts, their function may also be affected by Zol. Herein, we hypothesize that Zol impairs macrophage responses, potentially hindering their viability and host defense in diabetic conditions.

Methodology: Raw 264.7 macrophages were seeded at 2.5 x 10³ in 96-well plates for viability assays. Cells were tested under normal glucose (25 mM), high glucose (ranging from 45 to 70 mM), and high oxidative stress (ranging …

Energy Expenditure In Partial-Foot Amputees With Diabetes: A Scoping Review, Nicholas Obias, Madeleine G. Mehaffey, Amanda Killeen

School of Podiatric Medicine - Student Research

Objective: The energy cost of walking in amputees is often cited in modern scientific literature and clinical rationales for determining amputation levels. However, many referenced papers do not study diabetic populations with partial foot amputations (PFAs) – relatively widespread conditions in podiatric patient populations. Commonly cited papers include Waters (1976), which is significantly dated, Goktepe (2010), which studies traumatic PFAs in a military academy, and Jeans (2011), which studies traumatic PFAs in pediatric populations. These papers do not study diabetic populations and PFAs specifically. We hoped to find a study population more reflective of diabetic patients with PFAs.

Methods: …

Do We Need Another Frame? A Scoping Review On External Fixator Reuse, Nicholas Obias, James Hughes, Dustin Prins, Amanda Killeen

School of Podiatric Medicine - Student Research

Statement of Purpose: External fixators in the United States are sold as single-use devices. Though their efficacy is well documented, they remain underutilized due to expense. The aim of this study is to determine if it is safe to reprocess and reuse external fixator components to lower the cost burden of surgeries using external fixation.

Introduction: External fixation is a critical but costly modality for upper and lower limb pathologies, such as trauma, deformity correction, and nonunion. Despite the clinical effectiveness of external fixation using delta, ilizarov, and hexapod frames, its application in the United States as a single-use device …

Prediction Of Recurrent Lateral Ankle Sprain And Ankle Pain Using Applied Care Strategies And Patient-Reported Outcomes, Ryan S. Mccann, Elisabeth Ohrnberger, Kyle B. Kosik, Phillip A. Gribble

Rehabilitation Sciences Faculty Publications

Context

Patients with lateral ankle sprains (LASs) often have deficient patient-reported outcomes (PROs) at return to activity (RTA), potentially increasing risk for recurrent LAS and ankle pain. Additionally, applied care strategies are known to correct impairments, but their ability to mitigate risk for long-term consequences remains unknown.

Objective

To determine if applied care strategies and PRO scores at RTA and 6 months after RTA predict recurrent LAS and ankle pain 12 months after an acute LAS. DESIGN: Prospective cohort study.

Setting

Online survey.

Patients or Other Participants

We enrolled 63 individuals within 1 week of sustaining an acute LAS.

Main …

Amniotic Graft Applications On A Healthy Elderly Patient With Neglected Chronic Wound Due To Trauma, Maya D. Kaafarani, Brittney White, Amanda L. Killeen

School of Podiatric Medicine - Student Research

Introduction: AM grafts are angiogenic, anti-inflammatory, anti-fibrotic, anti-microbial, non-immunogenic, and decrease the total time for complex, chronic wounds to heal. This poster will explore a single case study using an AM graft on an elderly male with a chronic wound and provide a brief overview of the general application of AM in chronic wounds.

Case Report: A healthy 92-year-old male sustained a traumatic wound to the dorsum of his foot after dropping a heavy welding torch. The wound was chronically neglected and progressed to tendons before he was taken in for evaluation and treatment. Through a series of amniotic …

Use Of A Borate-Based Bioactive Glass Martix On Infected, Exposed Hardware, Stephanie N. Campbell, Cyaandi V. Dove, Connor Krolikowski

School of Podiatric Medicine Publications

Hardware exposure is a challenging complication following foot and ankle surgery due to the high risk of infection, biofilm formation, and delayed healing. In two consecutive cases, the bioactive glass matrix combined with particulate micromatrix successfully eradicated the wound infection and biofilm, resulting in full granulation of the wound and successful wound closure. Here we present a novel bioactive glass matrix that successfully managed exposed hardware in an infected foot, providing a promising treatment strategy for managing these complications and preventing further morbidity.