Midfoot relast for Charcot foot deformity, shown with foot cast and custom foot orthosis. By Erick J. Janisse, CO, CPed  Much has been written about the problem of less-than-ideal patient adherence to use of therapeutic and custom footwear for management and prevention of diabetic foot complications. Over the last few decades, there have been numerous research projects, surveys, and studies designed to parse out the exact reasons for low adherence and to create real world, implementable solutions. Some researchers conclude that the lack of perceived value or benefit of specialized footw ..read more

Orthopedic researchers from the University of Michigan and the Toledo (Ohio) College of Medicine and Life Sciences recently reported that young adults with Achilles tendon ruptures (ATR) may be considered for either operative or nonoperative management. In this single institution retrospective cohort study of young adults (18-30 years at time of injury), 28 operative and 14 nonoperative patients participated. Data collected from their medical records included demographics, smoking status, body mass index (BMI), Charlson Comorbidity Index (CCI), rate of deep venous thrombosis (DVT) after treatm ..read more

Care fragmentation (CF) is a known risk factor for unplanned readmission, morbidity, and mortality after surgery. The goal of this study was to evaluate the impact of CF on outcomes of major lower extremity amputation for peripheral vascular disease. Health-care Cost and Utilization Project Database for NY (2016) and MD/FL (2016-2017) were queried using International Classification of Diseases 10th edition to identify patients who underwent above the knee-, through the knee-, and below the knee-amputation for peripheral vascular disease. Patients with CF were identified as those with admission ..read more

Figure. Candidate gene prioritization and validation using a phenotype-wide association study (PheWAS). A Density plots displaying the distribution of the average distances of 120 random genes (Drandom) to known inflammatory bowel disease (IBD, in purple) and known Parkinson’s disease (PD, in green) genes obtained from 10,000 resampling iterations. Dashed lines represent the average distance of the candidate gene set (Dcandidate, n = 120) to known IBD and PD genes. B Circos plot showing the candidate genes identified by four complementary pathway and biological relatedness approaches. Final c ..read more

Initiating a new prescription for blood pressure medications may serve to more than double the risk of life-threatening bone fractures, according to a recent study of more than 30,000 nursing home residents. The study, which was published in JAMA Internal Medicine, asked whether the initiation of antihypertensive medications is associated with increased fracture risk among long-term Veterans Health Administration (VA) nursing home residents. The retrospective cohort study used data derived from 29,648 older VA nursing home residents from 2006-2019.Average age was 78.0 and the group was 97.7% m ..read more

Figure: Mice treated with trisulfide-derived lipid nanoparticle mRNA therapy showed accelerated wound healing compared to untreated mice. Image credit: Lab of Yizhou Dong, PhD, at Icahn Mount Sinai. Researchers at the Icahn School of Medicine at Mount Sinai in New York City have designed a regenerative medicine therapy to speed up diabetic wound repair. Using tiny fat particles loaded with genetic instructions to calm down inflammation, the treatment was shown to target problem-causing cells and reduce swelling and harmful molecules in mouse models of damaged skin. Details on their findings ..read more

Ankle sprains are the most common lower-leg musculoskeletal injuries, frequently occurring among athletes and other physical activity individuals. This study sought to compare the ankle range of motion and dynamic stability of healthy and injured athletes for their dominant and nondominant legs. A cross-sectional study design was selected to investigate this study with 32 male soccer players with average age: 22.6 ± 3.3 years, weight: 69.6 ± 5.7 kg, height: 176.8 ± 5.32 cm,with a history of a lateral ankle sprain on the dominant leg for the past 2 years. Ankle range of motion was determined us ..read more

Case Study: A 54-year-old male had diabetes and dorsum DFU on the left foot. (A) After stage I debridement, the wound was covered with bone cement. (B) During stage II, after ALBC’s removal and tendon exposure, the formation of an ‘induction membrane’ could be seen. (C) A free VLMS flap was used to cover the wound. (D) The thigh STSG was used to cover the muscle. (E) At the 12-month postoperative follow-up, the flap showed a full and soft appearance. (F) The donor site scar was minor and easily concealed. Diabetic foot ulcers (DFUs) present significant challenges due to associated amputation ..read more

In a unique longitudinal study out of China, researchers looked at the development of the arch structure in children in 3 scans (Footscan® plantar pressure system) over 2 years. They looked at gait data from 33 normal weight children and 26 children with persistent obesity. Children with persistent obesity did not exhibit a significant decrease in the arch index during this important period of development had significantly higher plantar pressure values than the normal weight children in the third check showed increased load accumulation in the lateral rearfoot, first metatarsophalangeal join ..read more

By Mathias B. Forrester, BS Background: Falls are a leading cause of non-fatal injuries in the United States (US). There are a variety of fall risk factors, among which are pets. Tens of thousands of fall injuries associated with dogs are treated at US hospital emergency departments (EDs) each year. The objective of this study is to describe dog-related falls affecting the lower extremity treated at US hospital EDs. Methods: Dog-related falls affecting the lower extremity during 2000-2023 were identified using the National Electronic Injury Surveillance System (NEISS), a database of consumer ..read more