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Sample records for foot deformities

  1. [Neurogenic foot deformities].

    PubMed

    Senst, S

    2010-01-01

    There is a multitude of neurological diseases which may lead to neuro-orthopaedic problems and subsequently to neurogenic foot deformities. For this reason the diagnostician will be consistently surprised that there is a great multitude of different foot abnormalities and that not only the typical spastic talipes equines dominates. Of particular significance here is that these deformities almost always develop progressively, whereas most diseases persist per se, cerebral palsy being a typical case in point. However, in MMC (myelomeningocele) patients, there is also the danger of a worsening of the basic problem in the case of tethered cord syndrome. Unlike congenital talipes equinovarus, neuro-orthopaedic talipes equinovarus often shows over- or undercorrection postoperatively due to a shift in muscle imbalance. It is important, therefore, that the basis of conservative therapy include regular physiotherapy and orthoses during the day and, if necessary, at night. Botulinum toxin has been established as an additional measure for spasticity; however, this cannot always prevent surgical intervention, but is able to delay this to a better point in the development of the child/patient. The present article describes the diversity of neurological deformities and presents conservative as well as surgical therapeutic approaches.

  2. Ultrasound evaluation of foot deformities in infants.

    PubMed

    Miron, Marie-Claude; Grimard, Guy

    2016-02-01

    Foot deformity in infants is the most common congenital musculoskeletal condition. A precise diagnosis can sometimes be impossible to establish clinically. Radiologic imaging plays a major role in the evaluation of musculoskeletal abnormalities. However conventional imaging techniques, such as plain radiographs of the foot, are of very little help in this age group because of the lack of ossification of the tarsal bones. US presents a significant advantage because it permits the visualization of cartilaginous structures. This leads to the detailed assessment of foot deformities in infants. Furthermore, US can also be used as a dynamic imaging modality. Different scanning views are beneficial to evaluate the complete anatomy of the foot; depending on the suspected clinical diagnosis, some planes are more informative to display the pathological features of a specific deformity. We describe the US findings of five of the most common foot deformities referred to our pediatric orthopedic clinic (clubfoot, simple metatarsus adductus, skewfoot, and oblique and vertical talus). For each deformity we propose a specific imaging protocol based on US to provide an accurate diagnosis. US is a complementary tool to the clinical examination for determining the diagnosis and the severity of the deformity and also for monitoring the efficacy of treatment. Radiologists investigating foot deformities in infants should consider using US for the detailed assessment of the foot in this age group.

  3. Quantifying foot deformation using finite helical angle.

    PubMed

    Pothrat, Claude; Goislard de Monsabert, Benjamin; Vigouroux, Laurent; Viehweger, Elke; Berton, Eric; Rao, Guillaume

    2015-10-15

    Foot intrinsic motion originates from the combination of numerous joint motions giving this segment a high adaptive ability. Existing foot kinematic models are mostly focused on analyzing small scale foot bone to bone motions which require both complex experimental methodology and complex interpretative work to assess the global foot functionality. This study proposes a method to assess the total foot deformation by calculating a helical angle from the relative motions of the rearfoot and the forefoot. This method required a limited number of retro-reflective markers placed on the foot and was tested for five different movements (walking, forefoot impact running, heel impact running, 90° cutting, and 180° U-turn) and 12 participants. Overtime intraclass correlation coefficients were calculated to quantify the helical angle pattern repeatability for each movement. Our results indicated that the method was suitable to identify the different motions as different amplitudes of helical angle were observed according to the flexibility required in each movement. Moreover, the results showed that the repeatability could be used to identify the mastering of each motion as this repeatability was high for well mastered movements. Together with existing methods, this new protocol could be applied to fully assess foot function in sport or clinical contexts.

  4. Diabetic foot disease is associated with reduced erythrocyte deformability.

    PubMed

    Cahn, Avivit; Livshits, Leonid; Srulevich, Ariel; Raz, Itamar; Yedgar, Shaul; Barshtein, Gregory

    2016-08-01

    The pathogenesis of diabetic foot disease is multifactorial and encompasses microvascular and macrovascular pathologies. Abnormal blood rheology may also play a part in its development. Using a cell flow analyser (CFA), we examined the association between erythrocyte deformability and diabetic foot disease. Erythrocytes from diabetic patients with no known microvascular complications (n = 11) and patients suffering from a diabetic foot ulcer (n = 11) were isolated and their average elongation ratio (ER) as well as the ER distribution curve were measured. Average ER was decreased in the diabetic foot patients compared with the patients with diabetes and no complications (1·64 ± 0·07 versus 1·71 ± 0·1; P = 0·036). A significant rise in the percentage of minimally deformable red blood cells RBCs in diabetic foot patients compared with the patients with no complications was observed (37·89% ± 8·12% versus 30·61% ± 10·17%; P = 0·039) accompanied by a significant decrease in the percentage of highly deformable RBCs (12·47% ± 4·43% versus 17·49% ± 8·17% P = 0·046). Reduced erythrocyte deformability may slow capillary flow in the microvasculature and prolong wound healing in diabetic foot patients. Conversely, it may be the low-grade inflammatory state imposed by diabetic foot disease that reduces erythrocyte deformability. Further study of the rheological changes associated with diabetic foot disease may enhance our understanding of its pathogenesis and aid in the study of novel therapeutic approaches.

  5. Spinal dysraphism and cavovarus foot deformity: a case report

    PubMed Central

    Hains, François; Dzus, Ann K; Cassidy, J David

    1992-01-01

    Neurological impairment secondary to spinal dysraphism most commonly presents as unilateral cavovarus foot in children. The deformity usually develops in the growing child around the age of five or six. The presence of a cavovarus foot of unknown origin in a child should lead to a complete neurological examination, including an assessment of the spine for spinal dysraphism. The early recognition of pathology may prevent severe neurological sequelae. A case of lipomyelomeningocele is presented to illustrate that cord damage in children with spinal dysraphism can present initially as a cavovarus foot. ImagesFigure 1 (a, b and c)Figure 2Figure 3Figure 4

  6. A study of structural foot deformity in stroke patients

    PubMed Central

    Jang, Gwon Uk; Kweon, Mi Gyoug; Park, Seol; Kim, Ji Young; Park, Ji Won

    2015-01-01

    [Purpose] The aim of this study was to evaluate the structural deformity of the foot joint on the affected side in hemiplegic patients to examine factors that affect this kind of structural deformity. [Subjects and Methods] Thirty-one hemiplegic patients and 32 normal adults participated. The foot posture index (FPI) was used to examine the shape of the foot, the modified Ashworth scale test was used to examine the degree of ankle joint rigidity, the navicular drop test was used to investigate the degree of navicular change, and the resting calcaneal stance position test was used to identify location change of the heel bone. [Results] The FPIs of the paretic side of the hemiplegic patients, the non-paretic side of the hemiplegic patients, and normal participants were −0.25 ± 2.1, 1.74 ± 2.3, and 2.12 ± 3.4 respectively. [Conclusion] Our findings indicated that in stroke-related hemiplegic patients, the more severe the spasticity, the more supinated the foot. Further, the smaller the degree of change in the navicular height of hemiplegic patients is, the more supinated the paretic side foot is. Additionally, a greater change in the location of the calcaneus was associated with greater supination of the overall foot. PMID:25642071

  7. Correction of poliomyelitis foot deformities with Ilizarov method.

    PubMed

    Kirienko, Alexander; Peccati, Andrea; Abdellatif, Ibrahim; Elbatrawy, Yasser; Mostaf, Zayed Mahmoud A; Necci, Valentina

    2011-11-01

    Poliomyelitis is an infectious disease caused by a neurotrophic virus targeting anterior horn cells of lower motor neurons resulting in flaccid paralysis and represents a common condition in developing countries, and even nowadays, most of both treated and untreated cases result in foot deformities. Between 1994 and 2007, 27 patients were treated by classic ring Ilizarov fixator, aiming at producing a stable plantigrade and cosmetically acceptable foot and followed up for meanly 7.17 years. Additional procedures were performed if needed. The mean time in frame was 4.2 months. All the patients were satisfied with their gait, compared to preoperative status. A painless and plantigrade foot was obtained in all patients, and limb-length discrepancy was always corrected where present. No major complications were encountered. In conclusion, the Ilizarov method allows simultaneous progressive correction of all components of severe foot deformities associated with limb-lengthening discrepancy with minimal surgery, reducing risks of cutaneous or neurovascular complications and avoiding important shortening of the foot.

  8. Severe Skew Foot Deformity in a Patient With Freeman-Sheldon Syndrome

    PubMed Central

    Kaissi, Ali Al; Klaushofer, Klaus; Grill, Franz

    2011-01-01

    We report on a 3-year-old boy with the full phenotypic features of Freeman Sheldon syndrome (FSS). Severe skew foot deformity has been recognized as additional skeletal abnormality. Parents were first degree cousins, raising the possibility of autosomal recessive pattern of inheritance. To the best of our knowledge this is the first report of severe skew foot deformity in a patient with (FSS). Keywords Freeman-Sheldon syndrome; Skew foot deformity; Metatarsus adductus PMID:22383916

  9. Treatment of complex foot deformities in children with the taylor spatial frame.

    PubMed

    Eidelman, Mark; Katzman, Alexander

    2008-10-01

    The Taylor spatial frame is a relatively new external fixator able to correct 6-axis deformities with computer accuracy using a virtual hinge. The Taylor spatial frame has gained tremendous popularity, but its use for the correction of foot deformities is still limited. Various ring configurations and a new foot program have recently become available and allow correction of the most difficult foot deformities. This article reports the results of 13 patients (15 frames) with various foot deformities treated at our institution with 3 different Taylor spatial frame configurations (standard rings construction, miter frame, and butt frame). Treatment goals were achieved in 11 patients, while mild residual deformities persisted in 2 patients. Most complications during treatment consisted of pin tract infections. One patient had premature consolidation, which was treated with additional midtarsal osteotomy; 1 had metatarsophalangeal joint subluxation, which was fixed with tendon lengthening and pining of the joint; and 1 had talar subluxation, which was reduced with residual program correction. Based on our experience, we believe the Taylor spatial frame is a very powerful and accurate surgical modality with a relatively short learning curve for the correction for most difficult foot deformities.

  10. Intrinsic foot muscles have the capacity to control deformation of the longitudinal arch

    PubMed Central

    Kelly, Luke A.; Cresswell, Andrew G.; Racinais, Sebastien; Whiteley, Rodney; Lichtwark, Glen

    2014-01-01

    The human foot is characterized by a pronounced longitudinal arch (LA) that compresses and recoils in response to external load during locomotion, allowing for storage and return of elastic energy within the passive structures of the arch and contributing to metabolic energy savings. Here, we examine the potential for active muscular contribution to the biomechanics of arch deformation and recoil. We test the hypotheses that activation of the three largest plantar intrinsic foot muscles, abductor hallucis, flexor digitorum and quadratus plantae is associated with muscle stretch in response to external load on the foot and that activation of these muscles (via electrical stimulation) will generate sufficient force to counter the deformation of LA caused by the external load. We found that recruitment of the intrinsic foot muscles increased with increasing load, beyond specific load thresholds. Interestingly, LA deformation and muscle stretch plateaued towards the maximum load of 150% body weight, when muscle activity was greatest. Electrical stimulation of the plantar intrinsic muscles countered the deformation that occurred owing to the application of external load by reducing the length and increasing the height of the LA. These findings demonstrate that these muscles have the capacity to control foot posture and LA stiffness and may provide a buttressing effect during foot loading. This active arch stiffening mechanism may have important implications for how forces are transmitted during locomotion and postural activities as well as consequences for metabolic energy saving. PMID:24478287

  11. Foot deformation during walking: differences between static and dynamic 3D foot morphology in developing feet.

    PubMed

    Barisch-Fritz, Bettina; Schmeltzpfenning, Timo; Plank, Clemens; Grau, Stefan

    2014-01-01

    The complex functions of feet require a specific composition, which is progressively achieved by developmental processes. This development should take place without being affected by footwear. The aim of this study is to evaluate differences between static and dynamic foot morphology in developing feet. Feet of 2554 participants (6-16 years) were recorded using a new scanner system (DynaScan4D). Each foot was recorded in static half and full weight-bearing and during walking. Several foot measures corresponding to those used in last construction were calculated. The differences were identified by one-way ANOVA and paired Student's t-test. Static and dynamic values of each foot measure must be considered to improve the fit of footwear. In particular, footwear must account for the increase of forefoot width and the decrease of midfoot girth. Furthermore, the toe box should have a more rounded shape. The findings are important for the construction of footwear for developing feet.

  12. Distraction osteogenesis for complex foot deformities: Gigli saw midfoot osteotomy with external fixation.

    PubMed

    Lamm, Bradley M; Gourdine-Shaw, Monique C; Thabet, Ahmed M; Jindal, Gaurav; Herzenberg, John E; Burghardt, Rolf D

    2014-01-01

    Open midfoot wedge osteotomy correction can cause neurovascular compromise, requires extensive exposure, sacrifices normal joints, and shortens the foot. We used a minimally invasive technique to treat complex foot deformities by combining percutaneous Gigli saw midfoot osteotomy, circular external fixation, and acute, gradual, or gradual with acute manipulation correction. The medical records of 23 patients (26 feet) with complex foot deformities (congenital, 18 feet; neuromuscular, 4 feet; post-traumatic, 3 feet; malunion, 1 foot) who had undergone treatment within an 18-year period (1990 through 2007) were retrospectively reviewed. We also performed the procedure on 10 cadaveric limbs to determine whether anatomic structures were at risk. Correction was achieved in all feet. The mean duration of external fixation treatment was 4.2 (range 3 to 7) months. The mean follow-up duration was 4.7 (range 2 to 18) years. A significant difference was observed in the pre- and postoperative, lateral view, talar-first metatarsal angle (p = .001). Minor complications (4 feet) consisted of bony exostoses. Major complications included recurrent deformity in 3 feet and sural nerve entrapment in 1 foot. Two patients had mild and one moderate foot pain. Three patients had impaired gait function; the remaining patients had functional gait. The mean interval until wearing regular shoes after external fixation removal was 2.3 (range 1 to 4) months. All but 1 of the patients were satisfied with the final results. We observed no cadaveric neurovascular injury. Our results have shown that percutaneous Gigli saw midfoot osteotomy can be performed without neurovascular injury and is capable of successfully correcting complex foot deformities.

  13. Movement within foot and ankle joint in children with spastic cerebral palsy: a 3-dimensional ultrasound analysis of medial gastrocnemius length with correction for effects of foot deformation

    PubMed Central

    2013-01-01

    Background In spastic cerebral palsy (SCP), a limited range of motion of the foot (ROM), limits gait and other activities. Assessment of this limitation of ROM and knowledge of active mechanisms is of crucial importance for clinical treatment. Methods For a comparison between spastic cerebral palsy (SCP) children and typically developing children (TD), medial gastrocnemius muscle-tendon complex length was assessed using 3-D ultrasound imaging techniques, while exerting externally standardized moments via a hand-held dynamometer. Exemplary X-ray imaging of ankle and foot was used to confirm possible TD-SCP differences in foot deformation. Results SCP and TD did not differ in normalized level of excitation (EMG) of muscles studied. For given moments exerted in SCP, foot plate angles were all more towards plantar flexion than in TD. However, foot plate angle proved to be an invalid estimator of talocrural joint angle, since at equal foot plate angles, GM muscle-tendon complex was shorter in SCP (corresponding to an equivalent of 1 cm). A substantial difference remained even after normalizing for individual differences in tibia length. X-ray imaging of ankle and foot of one SCP child and two typically developed adults, confirmed that in SCP that of total footplate angle changes (0-4 Nm: 15°), the contribution of foot deformation to changes in foot plate angle (8) were as big as the contribution of dorsal flexion at the talocrural joint (7°). In typically developed individuals there were relatively smaller contributions (10 -11%) by foot deformation to changes in foot plate angle, indicating that the contribution of talocrural angle changes was most important. Using a new estimate for position at the talocrural joint (the difference between GM muscle–tendon complex length and tibia length, GM relative length) removed this effect, thus allowing more fair comparison of SCP and TD data. On the basis of analysis of foot plate angle and GM relative length as a function

  14. Congenital foot deformation alters the topographic organization in the primate somatosensory system

    PubMed Central

    Liao, Chia-Chi; Qi, Hui-Xin; Reed, Jamie L.; Miller, Daniel J.; Kaas, Jon H.

    2015-01-01

    Limbs may fail to grow properly during fetal development, but the extent to which such growth alters the nervous system has not been extensively explored. Here we describe the organization of the somatosensory system in a 6-year-old monkey (Macaca radiata) born with a deformed left foot in comparison to the results from a normal monkey (Macaca fascicularis). Toes 1, 3, and 5 were missing, but the proximal parts of toes 2 and 4 were present. We used anatomical tracers to characterize the patterns of peripheral input to the spinal cord and brainstem, as well as between thalamus and cortex. We also determined the somatotopic organization of primary somatosensory area 3b of both hemispheres using multiunit electrophysiological recording. Tracers were subcutaneously injected into matching locations of each foot to reveal their representations within the lumbar spinal cord, and the gracile nucleus (GrN) of the brainstem. Tracers injected into the representations of the toes and plantar pads of cortical area 3b labeled neurons in the ventroposterior lateral nucleus (VPL) of the thalamus. Contrary to the orderly arrangement of the foot representation throughout the lemniscal pathway in the normal monkey, the plantar representation of the deformed foot was significantly expanded and intruded into the expected representations of toes in the spinal cord, GrN, VPL, and area 3b. We also observed abnormal representation of the intact foot in the ipsilateral spinal cord and contralateral area 3b. Thus, congenital malformation influences the somatotopic representation of the deformed as well as the intact foot. PMID:25326245

  15. Congenital foot deformation alters the topographic organization in the primate somatosensory system.

    PubMed

    Liao, Chia-Chi; Qi, Hui-Xin; Reed, Jamie L; Miller, Daniel J; Kaas, Jon H

    2016-01-01

    Limbs may fail to grow properly during fetal development, but the extent to which such growth alters the nervous system has not been extensively explored. Here we describe the organization of the somatosensory system in a 6-year-old monkey (Macaca radiata) born with a deformed left foot in comparison to the results from a normal monkey (Macaca fascicularis). Toes 1, 3, and 5 were missing, but the proximal parts of toes 2 and 4 were present. We used anatomical tracers to characterize the patterns of peripheral input to the spinal cord and brainstem, as well as between thalamus and cortex. We also determined the somatotopic organization of primary somatosensory area 3b of both hemispheres using multiunit electrophysiological recording. Tracers were subcutaneously injected into matching locations of each foot to reveal their representations within the lumbar spinal cord, and the gracile nucleus (GrN) of the brainstem. Tracers injected into the representations of the toes and plantar pads of cortical area 3b labeled neurons in the ventroposterior lateral nucleus (VPL) of the thalamus. Contrary to the orderly arrangement of the foot representation throughout the lemniscal pathway in the normal monkey, the plantar representation of the deformed foot was significantly expanded and intruded into the expected representations of toes in the spinal cord, GrN, VPL, and area 3b. We also observed abnormal representation of the intact foot in the ipsilateral spinal cord and contralateral area 3b. Thus, congenital malformation influences the somatotopic representation of the deformed as well as the intact foot.

  16. Surgical Treatment Guidelines for Digital Deformity Associated With Intrinsic Muscle Spasticity (Intrinsic Plus Foot) in Adults With Cerebral Palsy.

    PubMed

    Boffeli, Troy J; Collier, Rachel C

    2015-01-01

    Intrinsic plus foot deformity has primarily been associated with cerebral palsy and involves spastic contracture of the intrinsic musculature with resultant toe deformities. Digital deformity is caused by a dynamic imbalance between the intrinsic muscles in the foot and extrinsic muscles in the lower leg. Spastic contracture of the toes frequently involves curling under of the lesser digits or contracture of the hallux into valgus or plantarflexion deformity. Patients often present with associated pressure ulcers, deformed toenails, shoe or brace fitting challenges, and pain with ambulation or transfers. Four different patterns of intrinsic plus foot deformity have been observed by the authors that likely relate to the different patterns of muscle involvement. Case examples are provided of the 4 patterns of intrinsic plus foot deformity observed, including global intrinsic plus lesser toe deformity, isolated intrinsic plus lesser toe deformity, intrinsic plus hallux valgus deformity, and intrinsic plus hallux flexus deformity. These case examples are presented to demonstrate each type of deformity and our approach for surgical management according to the contracture pattern. The surgical approach has typically involved tenotomy, capsulotomy, or isolated joint fusion. The main goals of surgical treatment are to relieve pain and reduce pressure points through digital realignment in an effort to decrease the risk of pressure sores and allow more effective bracing to ultimately improve the patient's mobility.

  17. Gastrocnemius recession or tendo-achilles lengthening for equinus deformity in the diabetic foot?

    PubMed

    Greenhagen, Robert M; Johnson, Adam R; Bevilacqua, Nicholas J

    2012-07-01

    Contracture of the Achilles-gastrocnemius-soleus complex leading to ankle equinus has been linked to the development of various foot disorders. Decrease in ankle dorsiflexion results in an increase in plantar pressures and in diabetes and neuropathy, increased pressures can lead to ulceration and possibly the formation of Charcot foot. Surgical management of the equinus deformity corrects this abnormality and has the potential to avert the development of Charcot foot or ankle. Gastrocnemius recession, tendo-Achilles lengthening, and Achilles tenotomy have all been offered as surgical solutions to this condition. This article reviews ankle equinus and compares the treatment options available. A video of Hoke's triple hemisection has been included with this article and can be viewed at www.podiatric.theclinics.com.

  18. Ultrasound anatomy in the normal neonatal and infant foot: an anatomic introduction to ultrasound assessment of foot deformities.

    PubMed

    Aurell, Y; Johansson, A; Hansson, G; Wallander, H; Jonsson, K

    2002-09-01

    The aim of this study was to establish guidelines for US assessment of the talo-crural, the talo-navicular and the calcaneo-cuboid joints during the first year of life, which could serve as a reference while studying foot deformities. The feet of 54 healthy children were examined at birth and at the age of 4, 7 and 12 months by using three easily defined and reproducible US projections. With a medial projection the relation of the navicular in relation to the medial malleolus and the head of the talus was studied. A lateral projection revealed the calcaneo-cuboid relationship and a dorsal projection the talo-navicular alignment in the sagittal plane. Normal values for measurements of these cartilaginous relationships were established for the different age groups. Intra- and inter-observer reliability was assessed and found to be acceptable ( r=0.53-0.90, Pearson correlation coefficient). With US it is possible to obtain reproducible planes of investigation that give reliable information about the talo-crural, the talo-navicular and the calcaneo-cuboid relationships during the first year of life.

  19. Effects of hallux valgus deformity on rear foot position, pain, function, and quality of life of women

    PubMed Central

    Coşkun, Gürsoy; Talu, Burcu; Bek, Nilgün; Bayramlar, Kezban Yigiter

    2016-01-01

    [Purpose] To investigate the relationship between hallux valgus (HV) deformity and the position of rearfoot joints, and its effects on the quality of life, pain, and related functional status of women with bilateral hallux valgus (HV). [Subjects and Methods] The subjects were 27 right-dominant women. Demographic data, HV angle, weight-bearing and non-weight-bearing subtalar pronation (SP), and navicular height were recorded. Visual Analog Pain Scale, Foot Function Index (FFI), and the American Orthopaedic Foot and Ankle Society (AOFAS) first metatarsophalangeal- interphalangeal (MTP-IP) and AOFAS Mid foot (MF) Scales, and SF-36 were also used. [Results] HV angle, weight-bearing SP, and pain intensity of the left foot were higher. HV angle of left foot was correlated with all sub-scales of FFI, the pain parameter of AOFAS MTP-IP, and pain and total scores of AOFAS-MF Scale. HV angle of the left foot correlated with physical role, pain, and social function sub-domains of SF-36. Right HV angles were correlated with right foot pain and non-weight-bearing SP. [Conclusion] Increasing HV angle and pathomechanical changes in the rear foot are correlated, resulting in increasing pain and thus decreasing functional status as well as decreasing quality of life. Although all the participants were right-dominant, their left foot problems were more prominent. PMID:27134358

  20. [Neurogenic deformities of the foot due to congenital malformations of the lumbosacral spine. Their clinical and therapeutic characteristics].

    PubMed

    De Palma, L; Serra, F; Coletti, V

    1990-01-01

    The authors illustrate the different types of nervous disorders of the foot caused by congenital deformations of the lumbosacral spine. They classify these clinical forms according to the level of the neurological lesions, although emphasizing that more complex neurological damage may cause very atypical deformities that are difficult to classify. Today the treatment of nervous disorders of the foot caused by congenital deformations of the lumbosacral spine seems almost promising when compared to neurological and urological problems which have therapeutic priority. Possible methods of surgical correction, as well as indications that differ according to the age of the patient and the type and extent of the deformity, are discussed. These deformities of the foot evolve very quickly; treatment must be timely or reduction is difficult. Furthermore, their peculiar tendency to relapse necessitates periodic comprehensive follow-up exams and regular maintenance therapy (orthetic and physiatric). Special care must be taken before and during treatment to prevent trophic skin lesions. For this reason, solutions other than casts (external fixation, for example) may be preferable for the maintenance of the correction. The treatment of these deformities, whether conservative or surgical, should aim primarily to achieve adequate plantar support for future aided or autonomous ambulation.

  1. Foot deformities in Renaissance paintings. A mystery of symbolism, artistic licence, illusion and true representation in five renowned Renaissance painters.

    PubMed

    Lazzeri, D; Castello, M F; Grassetti, L; Dashti, T; Zhang, Y X; Persichetti, P

    2015-01-01

    Although Renaissance artists were skilled in representing normal anatomy, a close look at some paintings reveals anatomical variations in the depiction of the feet of human figures. A systematic review has identified 25 paintings by five artists in which the presumptive medico-artistic diagnosis of congenital or acquired foot deformity seems to be varyingly present. The connection between these five painters and what factors have influenced artists' style in the depiction of such deformities is discussed. The possible iconography and medical-historical meaning of such variations, as well as the possibility of artistic licence and real representation that drove the painters to depict these deformities, is explored and debated.

  2. Minimally Invasive Early Operative Treatment of Progressive Foot and Ankle Deformity Associated With Charcot-Marie-Tooth Disease.

    PubMed

    Boffeli, Troy J; Tabatt, Jessica A

    2015-01-01

    Charcot-Marie-Tooth disease is a neuromuscular disorder that commonly results in a predictable pattern of progressive bilateral lower extremity weakness, numbness, contracture, and deformity, including drop foot, loss of ankle eversion strength, dislocated hammertoes, and severe cavus foot deformity. Late stage reconstructive surgery will be often necessary if the deformity becomes unbraceable or when neuropathic ulcers have developed. Reconstructive surgery for Charcot-Marie-Tooth deformity is generally extensive and sometimes staged. Traditional reconstructive surgery involves a combination of procedures, including tendon lengthening or transfer, osteotomy, and arthrodesis. The described technique highlights our early surgical approach, which involves limited intervention before the deformity becomes rigid, severe, or disabling. We present 2 cases to contrast our early minimally invasive technique with traditional late stage reconstruction. Charcot-Marie-Tooth disease affects different muscles at various stages of disease progression. As 1 muscle becomes weak, the antagonist will overpower it and cause progressive deformity. The focus of the early minimally invasive approach is to decrease the forces that cause progressive deformity yet maintain function, where possible. Our goal has been to maintain a functional and braceable foot and ankle, with the hope of avoiding or limiting the extent of future major reconstructive surgery. The presented cases highlight the patient selection criteria, the ideal timing of early surgical intervention, the procedure selection criteria, and operative pearls. The early minimally invasive approach includes plantar fasciotomy, Achilles tendon lengthening, transfer of the peroneus longus to the fifth metatarsal, Hibbs and Jones tendon transfer, and hammertoe repair of digits 1 to 5.

  3. Deformation and stress distribution of the human foot after plantar ligaments release: a cadaveric study and finite element analysis.

    PubMed

    Liang, Jun; Yang, Yunfeng; Yu, Guangrong; Niu, Wenxin; Wang, Yubin

    2011-03-01

    The majority of foot deformities are related to arch collapse or instability, especially the longitudinal arch. Although the relationship between the plantar fascia and arch height has been previously investigated, the stress distribution remains unclear. The aim of this study was to explore the role of the plantar ligaments in foot arch biomechanics. We constructed a geometrical detailed three-dimensional (3-D) finite element (FE) model of the human foot and ankle from computer tomography images. The model comprised the majority of joints in the foot as well as bone segments, major ligaments, and plantar soft tissue. Release of the plantar fascia and other ligaments was simulated to evaluate the corresponding biomechanical effects on load distribution of the bony and ligamentous structures. These intrinsic ligaments of the foot arch were sectioned to simulate different pathologic situations of injury to the plantar ligaments, and to explore bone segment displacement and stress distribution. The validity of the 3-D FE model was verified by comparing results with experimentally measured data via the displacement and von Mise stress of each bone segment. Plantar fascia release decreased arch height, but did not cause total collapse of the foot arch. The longitudinal foot arch was lost when all the four major plantar ligaments were sectioned simultaneously. Plantar fascia release was compromised by increased strain applied to the plantar ligaments and intensified stress in the midfoot and metatarsal bones. Load redistribution among the centralized metatarsal bones and focal stress relief at the calcaneal insertion were predicted. The 3-D FE model indicated that plantar fascia release may provide relief of focal stress and associated heel pain. However, these operative procedures may pose a risk to arch stability and clinically may produce dorsolateral midfoot pain. The initial strategy for treating plantar fasciitis should be non-operative.

  4. Triceps surae muscle-tendon unit length changes as a function of ankle joint angles and contraction levels: the effect of foot arch deformation.

    PubMed

    Iwanuma, Soichiro; Akagi, Ryota; Hashizume, Satoru; Kanehisa, Hiroaki; Yanai, Toshimasa; Kawakami, Yasuo

    2011-09-23

    The purpose of this study was to clarify how foot deformation affects the relationship between triceps surae muscle-tendon unit (MTU) length and ankle joint angle. For six women and six men a series of sagittal magnetic resonance (MR) images of the right foot were taken, and changes in MTU length (the displacement of the calcaneal tuberosity), foot arch angle, and ankle joint angle were measured. In the passive session, each subject's ankle joint was secured at 10° dorsiflexed position, neutral position (NP), and 10° and 20° plantar flexed positions while MR images were acquired. In the active session, each subject was requested to perform submaximal isometric plantar flexions (30%, 60%, and 80% of voluntary maximum) at NP. The changes in MTU length in each trial were estimated by two different formulae reported previously. The changes of the measured MTU length as a function of ankle joint angles observed in all trials of the active session were significantly (p<0.05) larger than corresponding values in the passive session and by the estimation formulae. In the passive session, MTU length changes were significantly smaller than the estimated values when the ankle was plantar flexed. The foot arch angle increased as the contraction level increased from rest (117 ± 4°) to 80% (125 ± 3°), and decreased as the ankle was positioned further into plantar flexion in the passive session (115 ± 3°). These results indicate that foot deformation profoundly affects the triceps surae MTU length-ankle joint angle relationship during plantar flexion.

  5. Talectomy in patients with recurrent deformity in club foot. A long-term follow-up study.

    PubMed

    Legaspi, J; Li, Y H; Chow, W; Leong, J C

    2001-04-01

    We reviewed 24 feet in 15 patients who had undergone talectomy for recurrent equinovarus deformity; 21 were associated with arthrogryposis multiplex congenita, two with myelomeningocele and one with idiopathic congenital talipes equinovarus. The mean follow-up was 20 years. Good results were achieved in eight feet (33%) in which further surgery was not needed and walking was painless; a fair result was obtained in ten feet (42%) in which further surgery for recurrence of a hindfoot deformity had been necessary but walking was painless; the remaining six feet (25%) were poor, with pain on walking. All patients wore normal shoes and could walk independently, except one who was wheelchair-bound because of other joint problems. Recurrent deformity, the development of tibiocalcaneal arthritis and spontaneous fusion of the tibia to the calcaneum were all seen in these patients.

  6. Tendon Transfers Around the Foot: When and Where.

    PubMed

    Kuo, Ken N; Wu, Kuan-Wen; Krzak, Joseph J; Smith, Peter A

    2015-12-01

    Tendon transfers are invaluable in the treatment of severe children's foot deformities. They are often preferable to simple releases, lengthening, or fusion in surgical treatment because they provide an active motor function for deformity correction and, when properly selected, the procedures stabilize the foot against progressive deformity. The authors describe 4 commonly used tendon transfer procedures that are useful in children's foot deformity surgeries.

  7. Athlete's Foot

    MedlinePlus

    ... Room? What Happens in the Operating Room? Athlete's Foot KidsHealth > For Kids > Athlete's Foot A A A ... a public shower. Why Is It Called Athlete's Foot? Athlete's foot gets its name because athletes often ...

  8. Athlete's Foot

    MedlinePlus

    ... Surgery? A Week of Healthy Breakfasts Shyness Athlete's Foot KidsHealth > For Teens > Athlete's Foot A A A ... your skin, hair, and nails. What Is Athlete's Foot? The medical name for athlete's foot is tinea ...

  9. SKITTER foot design

    NASA Technical Reports Server (NTRS)

    Choi, Gene; Jones, David L.; Morris, James; Parham, Martin; Stephens, Jim; Yancey, Gregg

    1987-01-01

    A mechanical design team was formed to design a foot for the lunar utility vehicle SKITTER. The primary design was constrained to be a ski pole design compatible with the existing femur-tibia design legs. The lunar environment had several important effects on the foot design. Three materials were investigated for the SKITTER foot: aluminum alloys, cold worked stainless steel alloys, and titanium alloys. Thin film coatings were investigated as a method of wear reduction for the foot. The performance of the foot is dependent on the action of the legs. The range of motion for the legs was determined to be vertical to 15 degrees above horizontal. An impact analysis was performed for the foot movement, but the results were determined to be inconclusive due to unknown soil parameters. The initial foot design configuration consisted of an annulus attached to the pointed pole. The annulus was designed to prevent excess sinkage. Later designs call for a conical shaped foot with a disk at the point of the tibia attachment. The conical design was analyzed for strength and deflection by two different approaches. A deformable body analysis was performed for the foot under crane load in crane position, and also under actuator load in the vertical position. In both cases, the deflection of the foot was insignificant and the stresses well below the strength of the titanium alloy.

  10. Comparison of Efficacy and Side Effects of Oral Baclofen Versus Tizanidine Therapy with Adjuvant Botulinum Toxin Type A in Children With Cerebral Palsy and Spastic Equinus Foot Deformity.

    PubMed

    Dai, Alper I; Aksoy, Sefika N; Demiryürek, Abdullah T

    2016-02-01

    This retrospective study aimed to compare the therapeutic response, including side effects, for oral baclofen versus oral tizanidine therapy with adjuvant botulinum toxin type A in a group of 64 pediatric patients diagnosed with static encephalopathy and spastic equinus foot deformity. Following botulinum toxin A treatment, clinical improvement led to the gradual reduction of baclofen or tizanidine dosing to one-third of the former dose. Gross Motor Functional Measure and Caregiver Health Questionnaire scores were markedly elevated post-botulinum toxin A treatment, with scores for the tizanidine (Gross Motor Functional Measure: 74.45 ± 3.72; Caregiver Health Questionnaire: 72.43 ± 4.29) group significantly higher than for the baclofen group (Gross Motor Functional Measure: 68.23 ± 2.66; Caregiver Health Questionnaire: 67.53 ± 2.67, P < .001). These findings suggest that the combined use of botulinum toxin A and a low dose of tizanidine in treating children with cerebral palsy appears to be more effective and has fewer side effects versus baclofen with adjuvant botulinum toxin A.

  11. Athlete's foot

    MedlinePlus

    Tinea pedis; Fungal infection - feet; Tinea of the foot; Infection - fungal - feet; Ringworm - foot ... Athlete's foot is the most common type of tinea infection. The fungus or yeast thrives in warm, ...

  12. Foot pain

    MedlinePlus

    Pain - foot ... Foot pain may be due to: Aging Being on your feet for long periods of time Being overweight A ... sports activity Trauma The following can cause foot pain: Arthritis and gout . Common in the big toe, ...

  13. Charcot Foot

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  14. Athlete's Foot

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  15. Care of the pediatric foot in myelodysplasia.

    PubMed

    Noonan, K J; Didelot, W P; Lindseth, R E

    2000-06-01

    Foot deformity is present in almost all patients paralyzed by myelomeningocele. This article outlines the pertinent pathoanatomy resulting in differing foot deformities and their effects on normal gait. Treatment of these deformities is discussed, and the most common deformities present for the different levels of paralysis are outlined. Emphasis is placed on surgical and orthotic treatments, which result in functional improvements for the pediatric patient with spina bifida.

  16. Adult cavovarus foot.

    PubMed

    Younger, Alastair S E; Hansen, Sigvard T

    2005-09-01

    Cavovarus foot deformity, which often results from an imbalance of muscle forces, is commonly caused by hereditary motor sensory neuropathies. Other causes are cerebral palsy, cerebral injury (stroke), anterior horn cell disease (spinal root injury), talar neck injury, and residual clubfoot. In cavovarus foot deformity, the relatively strong peroneus longus and tibialis posterior muscles cause a hindfoot varus and forefoot valgus (pronated) position. Hindfoot varus causes overload of the lateral border of the foot, resulting in ankle instability, peroneal tendinitis, and stress fracture. Degenerative arthritic changes can develop in overloaded joints. Gait examination allows appropriate planning of tendon transfers to correct stance and swing-phase deficits. Inspection of the forefoot and hindfoot positions determines the need for soft-tissue release and osteotomy. The Coleman block test is invaluable for assessing the cause of hindfoot varus. Prolonged use of orthoses or supportive footwear can result in muscle imbalance, causing increasing deformity and irreversible damage to tendons and joints. Rebalancing tendons is an early priority to prevent unsalvageable deterioration of the foot. Muscle imbalance can be corrected by tendon transfer, corrective osteotomy, and fusion. Fixed bony deformity can be addressed by fusion and osteotomy.

  17. Outpatient assessment and management of the diabetic foot.

    PubMed

    DiPreta, John A

    2014-03-01

    Patients with diabetes and peripheral neuropathy are at risk for foot deformities and mechanical imbalance of the lower extremity. Peripheral neuropathy leads to an insensate foot that puts the patient at risk for injury. When combined with deformity due to neuropathic arthropathy, or Charcot foot, the risks of impending ulceration, infection, and amputation are significant to the diabetic patient. Education of proper foot care and shoe wear cannot be overemphasized. For those with significant malalignment or deformity of the foot and ankle, referral should be made immediately to an orthopedic foot and ankle specialist.

  18. Athlete's Foot

    MedlinePlus

    ... type of tinea, athlete's foot. The Basics on Tinea Infections Tinea (pronounced: TIH-nee-uh) is the medical name ... or scalp, including athlete's foot, jock itch , and ringworm (despite its name, ringworm is not a worm). ...

  19. Athlete's Foot

    MedlinePlus

    ... foot Overview By Mayo Clinic Staff Athlete's foot (tinea pedis) is a fungal infection that usually begins ... closely related to other fungal infections such as ringworm and jock itch. It can be treated with ...

  20. Foot Health

    MedlinePlus

    ... straight across and not too short Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling ... foot checks are an important part of your health care. If you have foot problems, be sure ...

  1. Diabetic neuropathy and foot complications.

    PubMed

    Boulton, Andrew J M

    2014-01-01

    Foot ulceration and Charcot neuroarthropathy (CN) are well recognized and documented late sequelae of diabetic peripheral, somatic, and sympathetic autonomic neuropathy. The neuropathic foot, however, does not ulcerate spontaneously: it is a combination of loss of sensation due to neuropathy together with other factors such as foot deformity and external trauma that results in ulceration and indeed CN. The commonest trauma leading to foot ulcers in the neuropathic foot in Western countries is from inappropriate footwear. Much of the management of the insensate foot in diabetes has been learned from leprosy which similarly gives rise to insensitive foot ulceration. No expensive equipment is required to identify the high risk foot and recently developed tests such as the Ipswich Touch Test and the Vibratip have been shown to be useful in identifying the high risk foot. A comprehensive screening program, together with education of high risk patients, should help to reduce the all too high incidence of ulceration in diabetes. More recently another very high risk group has been identified, namely patients on dialysis, who are at extremely high risk of developing foot ulceration; this should be preventable. The most important feature in management of neuropathic foot ulceration is offloading as patients can easily walk on active foot ulcers due to the loss of pain sensation. Infection should be treated aggressively and if there is any evidence of peripheral vascular disease, arteriography and appropriate surgical management is also indicated. CN often presents with a unilateral hot, swollen foot and any patient presenting with these features known to have neuropathy should be treated as a Charcot until this is proven otherwise. Most important in the management of acute CN is offloading, often in a total contact cast.

  2. [Operative treatment of diabetic foot].

    PubMed

    Hintermann, B

    1999-07-08

    The majority of diabetic foot ulcers are the results of repetitive pressure that exceeds the threshold of soft-tissue tolerance, leading to mechanical destruction of the tissue. Progression of plantar ulcers can rapidly lead to osteomyelitis that may result in loss of the foot through amputation. In order to prevent such a disaster, surgical treatment should be taken into consideration when conservative treatment remains without success. The goal of surgical treatment of an infected ulcer is debridement of the soft-tissue and removal of the underlying pressure by careful bone resection or correction of a deformity by arthrodesis. Various authors have recently reported successful surgical reconstruction of neuroarthropathic foot deformity and instability. Apparently arthrodesis is a viable alternative to amputation for patients with unstable deformity or recurrent ulceration. Proper preoperative evaluation is mandatory. The indications are not well defined yet.

  3. Foot Problems

    MedlinePlus

    ... pain begin after intense physical activity?YesNoDid your foot pain or swelling begin with an injury or accident?YesNoIs there swelling or redness on top of your foot?YesNoAre you unable to stand or walk on ...

  4. Diabetic foot ulcers: practical treatment recommendations.

    PubMed

    Edmonds, Michael

    2006-01-01

    When treating diabetic foot ulcers it is important to be aware of the natural history of the diabetic foot, which can be divided into five stages: stage 1, a normal foot; stage 2, a high risk foot; stage 3, an ulcerated foot; stage 4, an infected foot; and stage 5, a necrotic foot. This covers the entire spectrum of foot disease but emphasises the development of the foot ulcer as a pivotal event in stage 3, which demands urgent and aggressive management. Diabetic foot care in all stages needs multidisciplinary management to control mechanical, wound, microbiological, vascular, metabolic and educational aspects. Achieving good metabolic control of blood glucose, lipids and blood pressure is important in each stage, as is education to teach proper foot care appropriate for each stage. Ideally, it is important to prevent the development of ulcers in stages 1 and 2. In stage 1, the normal foot, it is important to encourage the use of suitable footwear, and to educate the patient to promote healthy foot care and footwear habits. In stage 2, the foot has developed one or more of the following risk factors for ulceration: neuropathy, ischaemia, deformity, swelling and callus. The majority of deformities can be accommodated in special footwear and as callus is an important precursor of ulceration it should be treated aggressively, especially in the neuropathic foot. In stage 3, ulcers can be divided into two distinct entities: those in the neuropathic foot and those in the neuroischaemic foot. In the neuropathic foot, ulcers commonly develop on the plantar surface of the foot and the toes, and are associated with neglected callus and high plantar pressures. In the neuroischaemic foot, ulcers are commonly seen around the edges of the foot, including the apices of the toes and back of the heel, and are associated with trauma or wearing unsuitable shoes. Ulcers in stage 3 need relief of pressure (mechanical control), sharp debridement and dressings (wound control), and

  5. [The diabetic foot].

    PubMed

    Stirnemann, P; Z'Brun, A; Brunner, D

    1998-10-01

    Problems of the diabetic foot are frequent. The magnitude of the clinical picture and morbidity mirrors the severity and complexity of the underlying pathobiology. The three pathogenetic mechanism involved are ischemia, neuropathy and infection. Seldom do these mechanisms work in isolation, rather most foot problems result from a complex interplay among all three. The clinical picture of the diabetic foot reaches from the neuropathic deformity with diminished or absent sensation of pain to limited gangrene or superficial ulcer. The polymicrobial infection leads to extensive tissue destruction (plantarphlegmone) with osteomyelitis. The patients often notes no pain and may become aware of the infection only through the presence of drainage or a foul odor. These infections are usually more extensive than would be predicted by clinical signs and symptoms. These lesions must be debrided and drained promptly and completely. This often requires amputations of one or more toes, combined with an incision along the entire course of the infected track on the plantar or dorsal aspect of the foot. Cultures should be taken from the depth of the wound. Initial treatment should be with broad-spectrum antibiotics, with subsequent adjustment based on culture results. The diabetic foot is a clinical problem that can be solved with a high degree of success when the approached by an interdisciplinary team (specialists in infectious and vascular disease, podiatry and diabetology). Arterial reconstruction should be designed to restore maximum perfusion to the foot. The most effective result can be obtained with infra-inguinal vein bypass with distal anastomosis to the most proximal artery with direct continuity to the ischemic territory. The single most important factor in the achievement of the reduction of amputation is the autologous vein bypass. The overall outcome in the diabetic patient in terms of graft patency and limb salvage is equal to that in the nondiabetic.

  6. Calcaneo-valgus deformity.

    PubMed

    Evans, D

    1975-08-01

    A discussion of the essential deformity in calcaneo-valgus feet develops a theme originally put forward in 1961 on the relapsed club foot (Evans 1961). Whereas in the normal foot the medial and lateral columns are about equal in length, in talipes equino-varus the lateral column is longer and in calcaneo-valgus shorter than the medial column. The suggestion is that in the treatment of both deformities the length of the columns be made equal. A method is described of treating calcaneo-valgus deformity by inserting cortical bone grafts taken from the tibia to elongate the anterior end of the calcaneus.

  7. Foot Surgery

    MedlinePlus

    ... be advised by a podiatrist, depending on your test results or a specific medical condition. Postoperative Care The type of foot surgery performed determines the length and kind of aftercare required ...

  8. Athlete's Foot

    MedlinePlus

    ... The fungus most commonly attacks the feet because shoes create a warm, dark, and humid environment which ... sweat mechanism, reaction to dyes or adhesives in shoes, eczema, and psoriasis, may mimic athlete's foot. Causes ...

  9. Gait Analysis before and after Gastrocnemius Fascia Lengthening for Spastic Equinus Foot Deformity in a 10-Year-Old Diplegic Child

    PubMed Central

    Galli, Manuela; Cimolin, Veronica; Santambrogio, Giorgio Cesare; Crivellini, Marcello; Albertini, Giorgio

    2010-01-01

    Purpose. This case study quantified kinematic and kinetic effects of gastrocnemius lengthening on gait in a Cerebral Palsy child with equinus foot. Methods. A 10-year-old diplegic child with Cerebral Palsy was evaluated with Gait Analysis (GA) before and after gastrocnemius fascia lengthening, investigating the lower limb joints kinematics and kinetics. Results. Kinematics improved at the level of distal joints, which are directly associated to gastrocnemius, and also at the proximal joint (like hip); improvements were found in ankle kinetics, too. Conclusions. This case study highlighted that GA was effective not only to quantify the results of the treatment but also to help preoperative decision making in dealing with CP child. PMID:20339527

  10. Surgical treatment of the Charcot foot.

    PubMed

    Pinzur, Michael S

    2016-01-01

    With the increased number of diabetics worldwide and the increased incidence of morbid obesity in more prosperous cultures, there has become an increased awareness of Charcot arthropathy of the foot and ankle. Outcome studies would suggest that patients with deformity associated with Charcot Foot arthropathy have impaired health related quality of life. This awareness has led reconstructive-minded foot and ankle surgeons to develop surgical strategies to treat these acquired deformities. This article outlines the current clinical approach to this disabling medical condition.

  11. Cavus Foot (High-Arched Foot)

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  12. Foot orthoses.

    PubMed

    Lockard, M A

    1988-12-01

    This review article describes shoe inserts and provides information to assist physical therapists to identify patients who may benefit from foot orthoses. The article discusses goals for and types of shoe inserts, in addition to the materials and methods that can be used in fabricating appliances. Clinical considerations for the use of shoe inserts and application to specific patient populations are presented.

  13. Diabetic Foot

    MedlinePlus

    ... feel a cut, a blister or a sore. Foot injuries such as these can cause ulcers and infections. Serious cases may even lead to amputation. Damage to the blood vessels can also mean that your feet do not get enough blood and oxygen. It ...

  14. Foot Problems

    MedlinePlus

    ... the best ways to exercise and keep fit. Structure of the Foot Each of your feet contains 26 bones, 33 joints, and more than 120 muscles, ligaments, tendons, and nerves. These all work together to support the weight of your body, act as shock ...

  15. [Bunion foot].

    PubMed

    Vukašinović, Zoran; Mikić, Nadan

    2012-01-01

    Hallux valgus deformity is a complex chronic progressive disease primarily characterized by a lateral great toe deviation and deformity of the first metatarsophalageal joint. Numerous etiological factors are related with the expression of this disease, and they are divided into two categories: endogenous and exogenous. Complexity of the hallux valgus deformity is reflected with the progression of the disease that gives rise to numerous forefoot deformities. The diagnosis is first of all affirmed by clinical examination and x-ray of the feet in a standing position. Treatment could be either operative or conservative. Conservative treatment has shown to be totally unsuccessful. Before decision making on the type of operative treatment, the patient's complaints, age, profession, clinical and x-ray findings must be taken into consideration. Until now, over two hundred different operative procedures have been described, which clearly supports the observation that there is no single method which could resolve all clinical varieties of this deformity. Therefore, today, when making a choice on the surgical procedure of hallux valgus deformity, the utilization of surgical algorithm is recommended.

  16. Neuropathic ulcers of the foot.

    PubMed

    Lang-Stevenson, A I; Sharrard, W J; Betts, R P; Duckworth, T

    1985-05-01

    We report a prospective study of the causes and treatment of 26 long-standing neuropathic ulcers of the foot in 21 patients. The most important causal factor, well illustrated by pressure studies, was the presence of a dynamic or static deformity leading to local areas of peak pressure on insensitive skin. All but one of the 26 ulcers had healed after an average of 10 weeks of treatment in a light, skin-tight plaster cast, with the prohibition of weight-bearing. Recurrent ulceration was prevented in all but one foot by early operation to correct the causative deformity; this was performed after the ulcer had healed and before allowing weight-bearing on the limb. Pressure studies after operation confirmed that pressure points had been relieved.

  17. Haglund's Deformity

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  18. The relationship between knee arthroplasty and foot loading.

    PubMed

    Voronov, Michael L; Pinzur, Michael S; Havey, Robert M; Carandang, Gerard; Gil, Joseph A; Hopkinson, William J

    2012-02-01

    Surgeons have questioned whether foot deformity applies abnormal loading on a knee implant. A total of 24 patients with mild knee deformity underwent a static recording of foot loading prior to and at 3 months following knee replacement. Of these patients, 13 had a preoperative varus deformity. The recorded postoperative to preoperative loading in all 6 geographic sites was decreased by an average of 10%. The largest changes were observed in the hallux and lesser toe masks, whereas the postoperative to preoperative foot pressure ratio in the metatarsal head (lateral and medial), heel, and midfoot masks was 0.94. This preliminary investigation reveals a minimal change in geographic foot loading following total knee arthroplasty in patients with mild knee deformity.

  19. Parametric study of orthopedic insole of valgus foot on partial foot amputation.

    PubMed

    Guo, Jun-Chao; Wang, Li-Zhen; Chen, Wei; Du, Cheng-Fei; Mo, Zhong-Jun; Fan, Yu-Bo

    2016-01-01

    Orthopedic insole was important for partial foot amputation (PFA) to achieve foot balance and avoid foot deformity. The inapposite insole orthosis was thought to be one of the risk factors of reamputation for foot valgus patient, but biomechanical effects of internal tissues on valgus foot had not been clearly addressed. In this study, plantar pressure on heel and metatarsal regions of PFA was measured using F-Scan. The three-dimensional finite element (FE) model of partial foot evaluated different medial wedge angles (MWAs) (0.0°-10.0°) of orthopedic insole on valgus foot. The effect of orthopedic insole on the internal bone stress, the medial ligament tension of ankle, plantar fascia tension, and plantar pressure was investigated. Plantar pressure on medial heel region was about 2.5 times higher than that of lateral region based on the F-Scan measurements. FE-predicted results showed that the tension of medial ankle ligaments was the lowest, and the plantar pressure was redistributed around the heel, the first metatarsal, and the lateral longitudinal arch regions when MWA of orthopedic insole ranged from 7.5° to 8.0°. The plantar fascias maintained about 3.5% of the total load bearing on foot. However, the internal stresses from foot bones increased. The simulation in this study would provide the suggestion of guiding optimal design of orthopedic insole and therapeutic planning to pedorthist.

  20. Work-up of the diabetic foot.

    PubMed

    Morrison, William B; Ledermann, Hans Peter

    2002-09-01

    Diabetes is a common disease with potentially devastating complications affecting the foot and ankle. A combination of vascular disease, peripheral neuropathy, and immunopathy results in a cascade of conditions including ischemia and infarction, tendinopathy, atrophy, edema, deformity, neuropathic osteoarthropathy, callus, ulceration, and infection. MRI is useful for evaluation of these complications, and assists the clinician in medical or surgical planning.

  1. [Prevention of diabetic foot].

    PubMed

    Metelko, Zeljko; Brkljacić Crkvencić, Neva

    2013-10-01

    , lipid disorders (treatment with fenofibrate reduces the incidence of DF amputations (EBM-Ib/A), hypertension, hyperuricemia, neuropathy, and angiopathy (surgical reconstructive bypass) or endovascular (percutaneous transluminar angioplasty). In the low-risk group of PwDM, no particular results can be achieved, in contrast to the high-risk groups of PwDM where patient and professional education has shown significant achievement (EBM-IV/C). In secondary prevention of DF, it is necessary to perform patient and professional education how to avoid most of external influences for DE Patient education should include all topics from primary prevention, danger of neural analgesia (no cooling or warming the foot), careful selection of shoes, daily observation of foot, early detection all foot changes or small wounds, daily hygiene of foot skin, which has to be clean and moist, regular self measurements of skin temperature between the two feet (EBM-Ib/A), prevention of self treatment of foot deformities, changing wrong habits (walking footless), medical consultation for even small foot changes (EBM-Ib/A) and consultation by multidisciplinary team (EBM-IIb/B). Tertiary DF prevention includes ulcer treatment, prevention of amputation and level of amputation. In spite of the primary and secondary prevention measures, DF ulcers develop very often. Because of different etiologic reasons as well as different principles of treatment which are at the same time prevention of the level of amputation, the approach to PwDF has to be multidisciplinary. A high place in the treatment of DF ulcers, especially neuropathic ulcers, have the off-loading principles (EBM-Ib/A), even instead of surgical treatment (EBM-Ib/A). Necrectomy, taking samples for analysis from the deep of ulcer, together with x-ray diagnostics (in particular NMR), the size of the changes can be detected, together with appropriate antibiotic use and indication for major surgical treatment. The patient has to be instructed to the

  2. Foot Health Facts for Athletes

    MedlinePlus

    ... work and the pounding their feet endure from... Foot Injuries in Olympic Athletes and Beyond Foot and ankle ... making them... Athletes Living with Diabetes Face More Foot Injuries Than Athletes Without Foot and ankle injuries are ...

  3. Prevention of foot blisters.

    PubMed

    Knapik, Joseph J

    2014-01-01

    Foot blisters are the most common medical problem faced by Soldiers during foot march operations and, if untreated, they can lead to infection. Foot blisters are caused by boots rubbing on the foot (frictional forces), which separates skin layers and allows fluid to seep in. Blisters can be prevented by wearing properly sized boots, conditioning feet through regular road marching, wearing socks that reduce reduce friction and moisture, and possibly applying antiperspirants to the feet.

  4. Cavus Foot Surgery

    MedlinePlus

    ... of the Smaller Toes How To... Foot Health Foot Injury Footwear News Videos Find a Surgeon Información en ... related problems. What are the goals of cavus foot surgery? The ... reduce other injuries such as repeated ankle sprains and broken bones. ...

  5. Foot sprain - aftercare

    MedlinePlus

    ... or weeks after your injury: Rest. Stop any physical activity that causes pain, and keep your foot still when possible. Ice your foot for 20 minutes 2 to 3 times a day. DO NOT apply ice directly to your skin. Keep your foot raised to help keep swelling ...

  6. [Foot reflex zone massage].

    PubMed

    Kesselring, A

    1994-01-01

    Foot reflexology is defined as massage of zones on the feet which correspond to different parts of the body. A medline-search yielded no literature in the field of foot reflexology. Indications for and results of foot reflexology have been extrapolated from case-descriptions and two pilot studies with small samples. One study (Lafuente et al.) found foot reflexology to be as helpful to patients with headaches as medication (flunarizine), yet foot reflexology was fraught with less side-effects than medication. In a second study (Eichelberger et al.) foot reflexology was used postoperatively on gynecological patients. The intervention group showed a lesser need for medication to enhance bladder tonus than did the control group. The literature describes foot reflexology as enhancing urination, bowel movements and relaxation.

  7. Charcot neuroarthropathy: realignment of diabetic foot by means of osteosynthesis using intramedullary screws - case report.

    PubMed

    Dos Santos, Alexandre Leme Godoy; Albino, Rômulo Ballarin; Ortiz, Rafael Trevisan; Sakaki, Marcos Hideyo; de Andrade Corsato, Marcos; Fernandes, Tulio Diniz

    2014-01-01

    Diabetes mellitus is a serious disease that affects a large portion of the population. Charcot neuroarthropathy is one of its major complications and can lead to osteoarticular deformities, functional incapacity, ulcers and ankle and foot infections. Realignment of the foot by means of arthrodesis presents a high rate of implant failure due to weight-bearing on an insensitive foot. The aim of this report was to describe successful use of intramedullary osteosynthesis with compression screws to stabilize the deformed foot, in a diabetic patient with neuroarthropathy.

  8. Search the Foot and Ankle: Interactive Foot Diagram

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  9. Surgical Correction of the Achilles Tendon for Diabetic Foot Ulcerations and Charcot Neuroarthropathy.

    PubMed

    Ramanujam, Crystal L; Zgonis, Thomas

    2017-04-01

    Achilles tendon pathologic conditions are implicated in contributing to the development of many diabetic foot complications including diabetic foot ulceration and Charcot neuroarthropathy. Surgical correction of the diabetic equinus deformity has been studied as an isolated or adjunctive treatment when dealing with difficult-to-close diabetic foot ulcerations or when surgically addressing the diabetic Charcot neuroarthropathy foot or ankle. This article reviews the most common indications, complications, and surgical procedures for equinus correction by either a tendo-Achilles lengthening or gastrocnemius recession for the management of diabetic foot conditions.

  10. Malignant Melanoma of the Foot

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  11. Foot Push-Up Test

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  12. An exploration of diabetic foot screening procedures data by a multiple correspondence analysis

    PubMed Central

    Rovan, Jože

    2017-01-01

    Abstract Aims Gangrene and amputation are among most feared complications of diabetes mellitus. Early detection of patients at high risk for foot ulceration can prevent foot complications. Regular foot screening (medical history, foot examination and classification into risk groups) was introduced at the out-patient diabetes clinic in Ljubljana in November 1996. We aimed to explore the relationships between the observed variables, check the appropriateness of the risk status classification and of the post-screening decisions. Methods The data of 11.594 patients, obtained in 18 years, were analysed by multiple correspondence analysis (MCA). Most of the observed variables were categorical. Results The majority of the screened population was free of foot complications. We demonstrated an increasing frequency and severity of foot problems with an increasing age, as well as the association between the loss of protective sensation and the history of foot ulceration, foot deformity and callus formation, the history of foot ulcer or amputation and acute foot ulceration. A new finding was that the location of foot deformity points was closer to female than male gender, indicating the possible role of fashionable high-heel footwear. The appropriateness of therapeutic decisions was confirmed: the points representing absent foot pulses and referral to vascular specialist were close together, as well as points representing foot deformity and special footwear prescription or callus formation and referral to pedicurist. Conclusions MCA was applied to the data on foot pathology in the population attending the out-patient diabetes clinic. The method proved to be a useful statistical tool for analysing the data of screening procedures. PMID:28289465

  13. Chronic laminitis: foot management.

    PubMed

    Morrison, Scott

    2010-08-01

    Laminitis is a disease of the suspensory apparatus of the distal phalanx, which can advance to the chronic stage with varying degrees of structural failure. Because the disease may ultimately lead to mechanical failure of the digit, a foot management plan is required to effectively and mechanically treat these cases. Many laminitis cases can be successfully rehabilitated back to athletic soundness, light use, breeding, or pasture soundness, whereas others suffer from permanent instability and never enjoy an acceptable level of comfort. To understand how to minimize damage in the acute laminitic foot or rehabilitate the chronic laminitic foot, the veterinarian should have an understanding of the normal supporting structures of the digit, the biomechanical forces acting on the foot, and the structural failure that results when these otherwise normal forces act on a diseased, damaged foot.

  14. Foot pressure distribution in children with cerebral palsy while standing.

    PubMed

    Galli, Manuela; Cimolin, Veronica; Pau, Massimiliano; Leban, Bruno; Brunner, Reinald; Albertini, Giorgio

    2015-01-01

    Foot deformity is a major component of impaired functioning in cerebral palsy (CP). While gait and balance issues related to CP have been studied extensively, there is little information to date on foot-ground interaction (i.e. contact area and plantar pressure distribution). This study aimed to characterize quantitatively the foot-ground contact parameters during static upright standing in hemiplegia and diplegia. We studied 64 children with hemiplegia (mean age 8.2 years; SD 2.8 years) and 43 with diplegia (mean age 8.8 years; SD 2.3 years) while standing on both legs statically on a pressure sensitive mat. We calculated pressure data for the whole foot and sub-regions (i.e. rearfoot, midfoot and forefoot) and average contact pressure. The Arch Index (AI) served for classifying the feet as flat, normal or cavus feet. The data were compared with those from a sample of age- and gender-matched participants (control group, 68 children). Most of the feet showed very high AI values, thus indicating a flat foot. This deformity was more common in diplegia (74.4%) than in hemiplegia (54.7%). In both diplegic and hemiplegic children, average plantar pressure was significantly increased in the forefoot and midfoot and decreased in the rearfoot (p<0.001). The present data indicate an increased load on the front parts of the foot, which may be due to plantarflexor overactivity or knee flexion, combined with an increased incidence of low foot arches. As a low foot arch does not necessarily increase forefoot load, this deformity can be regarded as secondary.

  15. Rear-foot, mid-foot and fore-foot motion during the stance phase of gait.

    PubMed

    Leardini, A; Benedetti, M G; Berti, L; Bettinelli, D; Nativo, R; Giannini, S

    2007-03-01

    This paper proposes a new protocol designed to track a large number of foot segments during the stance phase of gait with the smallest possible number of markers, with particular clinical focus on coronal plane alignment of the rear-foot, transverse and sagittal plane alignment of the metatarsal bones, and changes at the medial longitudinal arch. The shank, calcaneus, mid-foot and metatarsus were assumed to be 3D rigid bodies. The longitudinal axis of the first, second and fifth metatarsal bones and the proximal phalanx of the hallux were also tracked independently. Skin markers were mounted on bony prominences or joint lines, avoiding the course of main tendons. Trajectories of the 14 markers were collected by an eight-camera motion capture system at 100 Hz on a population of 10 young volunteers. Three-dimensional joint rotations and planar angles were calculated according to anatomically based reference frames. The marker set was well visible throughout the stance phase of gait, even in a camera configuration typical of gait analysis of the full body. The time-histories of the joint rotations and planar angles were well repeatable among subjects and consistent with clinical and biomechanical knowledge. Several dynamic measurements were originally taken, such as elevation/drop of the medial longitudinal arch and of three metatarsal bones, rear-foot to fore-foot rotation and transverse plane deformation of the metatarsus. The information obtained from this protocol, consistent with previous clinical knowledge, enhanced our understanding of the dynamics of the human foot during stance.

  16. Healing ulcers and preventing their recurrences in the diabetic foot

    PubMed Central

    Sabapathy, S. Raja; Periasamy, Madhu

    2016-01-01

    Fifteen percent of people with diabetes develop an ulcer in the course of their lifetime. Eighty-five percent of the major amputations in diabetes mellitus are preceded by an ulcer. Management of ulcers and preventing their recurrence is important for the quality of life of the individual and reducing the cost of care of treatment. The main causative factors of ulceration are neuropathy, vasculopathy and limited joint mobility. Altered bio-mechanics due to the deformities secondary to neuropathy and limited joint mobility leads to focal points of increased pressure, which compromises circulation leading to ulcers. Ulcer management must not only address the healing of ulcers but also should correct the altered bio-mechanics to reduce the focal pressure points and prevent recurrence. An analysis of 700 patients presenting with foot problems to the Diabetic Clinic of Ganga Hospital led to the stratification of these patients into four classes of incremental severity. Class 1 – the foot at risk, Class 2 – superficial ulcers without infection, Class 3 – the crippled foot and Class 4 – the critical foot. Almost 77.5% presented in either Class 3 or 4 with complicated foot ulcers requiring major reconstruction or amputation. Class 1 foot can be managed conservatively with foot care and appropriate foot wear. Class 2 in addition to measures for ulcer healing would need surgery to correct the altered bio-mechanics to prevent the recurrence. The procedures called surgical offloading would depend on the site of the ulcer and would need an in-depth clinical study of the foot. Class 3 would need major reconstructive procedures and Class 4 would need amputation since it may be life-threatening. As clinicians, our main efforts must be focused towards identifying patients in Class 1 and offer advice on foot care and Class 2 where appropriate surgical offloading procedure would help preserve the foot. PMID:28216809

  17. Drop foot corrective device

    NASA Technical Reports Server (NTRS)

    Deis, B. C. (Inventor)

    1986-01-01

    A light weight, economical device to alleviate a plurality of difficulties encountered in walking by a victim suffering from a drop foot condition is discussed. A legband girdles the leg below the knee and above the calf providing an anchor point for the upper end of a ligament having its lower end attached to a toe of a shoe or a toe on the foot. The ligament is of such length that the foot is supported thereby and retained in a normal position during walking.

  18. Foot anatomy specialization for postural sensation and control.

    PubMed

    Wright, W G; Ivanenko, Y P; Gurfinkel, V S

    2012-03-01

    Anthropological and biomechanical research suggests that the human foot evolved a unique design for propulsion and support. In theory, the arch and toes must play an important role, however, many postural studies tend to focus on the simple hinge action of the ankle joint. To investigate further the role of foot anatomy and sensorimotor control of posture, we quantified the deformation of the foot arch and studied the effects of local perturbations applied to the toes (TOE) or 1st/2nd metatarsals (MT) while standing. In sitting position, loading and lifting a 10-kg weight on the knee respectively lowered and raised the foot arch between 1 and 1.5 mm. Less than 50% of this change could be accounted for by plantar surface skin compression. During quiet standing, the foot arch probe and shin sway revealed a significant correlation, which shows that as the tibia tilts forward, the foot arch flattens and vice versa. During TOE and MT perturbations (a 2- to 6-mm upward shift of an appropriate part of the foot at 2.5 mm/s), electromyogram (EMG) measures of the tibialis anterior and gastrocnemius revealed notable changes, and the root-mean-square (RMS) variability of shin sway increased significantly, these increments being greater in the MT condition. The slow return of RMS to baseline level (>30 s) suggested that a very small perturbation changes the surface reference frame, which then takes time to reestablish. These findings show that rather than serving as a rigid base of support, the foot is compliant, in an active state, and sensitive to minute deformations. In conclusion, the architecture and physiology of the foot appear to contribute to the task of bipedal postural control with great sensitivity.

  19. Foot amputation - discharge

    MedlinePlus

    ... the foot. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics . 12th ed. Philadelphia, PA: Elsevier Mosby; ... of amputations. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics . 12th ed. Philadelphia, PA: Elsevier Mosby; ...

  20. Foot pain causes

    MedlinePlus

    ... 58. LeCursi N. Sports shoes and orthoses. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic ... Ligamentous Injuries of the Foot and Ankle. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic ...

  1. The Diabetic Foot

    PubMed Central

    Hunt, J.A.

    1990-01-01

    The diabetic foot presents a complex interplay of neuropathic, macrovascular, and microvascular disease on an abnormal metabolic background, complicated by an increased susceptibility to mechanical, thermal, and chemical injury and decreased healing ability. The abnormalities of diabetes, once present, are not curable. But most severe foot abnormalities in the diabetic are due to neglect of injury and are mostly preventable. The physician must ensure that the diabetic patient learns the principles of good foot care. If time for teaching is limited, this task must be delegated to a podiatrist or a diabetes nurse educator in a diabetes day centre. It is the physician's responsibility to confirm foot care by personal inspection of the feet of all diabetic patients at every visit. PMID:21234002

  2. Diabetes and Foot Problems

    MedlinePlus

    ... Infographic (English) Low Blood Glucose (Hypoglycemia) Nerve Damage (Diabetic Neuropathies) Diabetic Kidney Disease Diabetes and Foot Problems Diabetic ... time, diabetes may cause nerve damage, also called diabetic neuropathy , that can cause tingling and pain, and can ...

  3. The foot as a shock absorber.

    PubMed

    Salathé, E P; Arangio, G A; Salathé, E P

    1990-01-01

    A mathematical analysis of the deformation of the foot is developed to determine the role that stretch of ligaments and tendons plays in absorbing shock following impact. Our analysis is based on an anatomical biomechanical model that includes each of the bones of the foot. We calculate the time course of the deflection of the joints and the elongation of the ligaments and tendons and determine the ground reaction force acting on the heel. Quasi-linear viscoelastic theory is used for soft tissue constitutive relationships. With biomechanical data selected from the literature, we obtain a vertical force impact peak of 8000 N, occurring at 16 ms following heel strike. This is of higher magnitude and shorter duration than is found experimentally, as is to be expected, since we did not include the heel pad in our model and we assumed that the impact surface was ideally rigid.

  4. [The diabetic foot--state of the art from the orthopedic point of view].

    PubMed

    Schaefer, D

    1999-07-08

    A 15-30% rate of amputation of diabetic feet suggests that efforts have to be directed towards improvement of preventive measure including instruction of patients and relatives concerning foot wear. So called foot rules have been established. If surgery is indicated, an angiological and neurological assessment should be performed preoperatively. An ulcer should undergo debridement, plantar pressure release with a full contact cast and antibiotic therapy, if infected. The goal of treatment of Charcot's disease is prevention of deformity. Usually orthoses are sufficient, in irreducible deformities an arthrodesis should be considered. There is no doubt that the interdisciplinary approach improves the treatment of the diabetic foot.

  5. How to examine a foot and what to do with a bunion.

    PubMed

    Nork, S E; Coughlin, R R

    1996-06-01

    The foot is a remarkable structure that provides stable support for the body, lessens impact loading during gait, and allows for forward motion that is energy efficient. Because of the enormous loads concentrated at the joints in the foot and ankle with normal activities, frequent injuries occur and present to the primary care provider. Systemic conditions and improper footwear also contribute to the number of foot injuries that require medical attention. This article provides the clinician with the practical tools necessary for a complete examination of the foot and ankle. This article also includes a practical approach to examination and diagnosis of the bunion deformity.

  6. Circular External Fixation as a Primary or Adjunctive Therapy for the Podoplastic Approach of the Diabetic Charcot Foot.

    PubMed

    Short, Daniel J; Zgonis, Thomas

    2017-01-01

    Numerous techniques have been described for surgical management of the diabetic Charcot foot. External fixation has become a main surgical tool for the reconstructive foot and ankle surgeon when dealing with the ulcerated diabetic Charcot foot. In the presence of an open wound and/or osteomyelitis, staged reconstruction with circular external fixation becomes ideal for salvage of the diabetic lower extremity. Also, circular external fixation can provide simultaneous compression and stabilization, correct the underlying osseous or soft tissue deformities, and surgically offload the diabetic Charcot foot. This article describes a variety of circular external fixation applications for the diabetic Charcot foot.

  7. [The hyperostotic foot].

    PubMed

    Claustre, J; Simon, L

    1982-01-01

    Clinical and radiological examination of the foot in 25 cases of ankylosing verteral hyperostosis revealed signs of the disease in 16 cases: eleven patients had painful symptoms (predominantly pain in the heel, 9 cases) and and five had radiological changes in the feet which led to the discovery of the characteristic vertebral involvement. As for other extra-vertebral sites of vertebral hyperostosis, the foot warrants careful examination. The radiological lesions consist of osteophytic proliferations of the calcaneum (sometimes pathognomonic), scattered ossifications in the ligaments of the inferior and posterior aspects of this bone, the neck of the talus, the dorsum of the mid-foot, the internal aspect of the tarsal scaphoid or the external face of the styloid apophysis of the 5th metatarsal, and a bony proliferation enlarging the base of the distal phalanx of the big toe.

  8. Broken Ankle/Broken Foot

    MedlinePlus

    ... not warming up and stretching, also can cause foot and ankle injuries. Work in certain occupations. Certain work environments, such ... too little light may lead to falls and foot and ankle injuries. Have certain conditions. Having fragile bones (osteoporosis) or ...

  9. Sesamoid Injuries in the Foot

    MedlinePlus

    ... page. Please enable Javascript in your browser. Sesamoid Injuries in the Foot What Is a Sesamoid? A sesamoid is a ... also be a contributing factor. Types of Sesamoid Injuries in the Foot There are three types of sesamoid injuries in ...

  10. Hand-foot-mouth disease

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000965.htm Hand-foot-mouth disease To use the sharing features on this page, please enable JavaScript. Hand-foot-mouth disease is a common viral infection ...

  11. Hand, Foot and Mouth Disease

    MedlinePlus

    ... What's this? Submit Button Past Emails CDC Features Hand, Foot & Mouth Disease Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Hand, foot, and mouth disease is common in infants ...

  12. Neuropathy and Diabetic Foot Syndrome.

    PubMed

    Volmer-Thole, Maren; Lobmann, Ralf

    2016-06-10

    Diabetic foot ulceration is a serious complication of diabetes mellitus worldwide and the most common cause of hospitalization in diabetic patients. The etiology of diabetic foot ulcerations is complex due to their multifactorial nature; in the pathophysiology of diabetic foot ulceration polyneuropathy is important. Proper adherence to standard treatment strategies and interdisciplinary cooperation can reduce the still high rates of major amputations.

  13. X-Ray Exam: Foot

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Foot KidsHealth > For Parents > X-Ray Exam: Foot A A A What's in this ... español Radiografía: pie What It Is A foot X-ray is a safe and painless test that uses ...

  14. X-Ray Exam: Foot

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Foot KidsHealth > For Parents > X-Ray Exam: Foot Print A A A What's in ... español Radiografía: pie What It Is A foot X-ray is a safe and painless test that uses ...

  15. Neuropathy and Diabetic Foot Syndrome

    PubMed Central

    Volmer-Thole, Maren; Lobmann, Ralf

    2016-01-01

    Diabetic foot ulceration is a serious complication of diabetes mellitus worldwide and the most common cause of hospitalization in diabetic patients. The etiology of diabetic foot ulcerations is complex due to their multifactorial nature; in the pathophysiology of diabetic foot ulceration polyneuropathy is important. Proper adherence to standard treatment strategies and interdisciplinary cooperation can reduce the still high rates of major amputations. PMID:27294922

  16. Correction of neglected clubfoot deformity in children with Moebius syndrome.

    PubMed

    Purushothamdas, Sanjay; Rayan, Faizal; Gayner, Allan

    2009-03-01

    The aim of this study was to present the functional results of treatment of neglected clubfoot in children with Moebius syndrome. A prospective analysis of seven patients with Moebius syndrome who had corrective surgery for clubfoot deformity was performed. Functional result using a modified American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire at an average follow-up of 58 months was analysed. Five children were able to have their foot flat on the ground. Additional corrective surgery was required in eight feet. Our experience of treating neglected clubfoot deformity in children with Moebius syndrome shows that correction of the deformity allows them to have a reasonable independent living.

  17. Bunionette Deformity Correction

    MedlinePlus

    ... of the Smaller Toes How To... Foot Health Foot Injury Footwear News Videos Find a Surgeon Información en ... Site Map American Orthopaedic Foot & Ankle Society ® ... US) Copyright © 2017 All Rights Reserved

  18. [Rheumatic forefoot deformities].

    PubMed

    Fuhrmann, R

    2014-11-01

    The frequency and extent of rheumatic forefoot deformities have been greatly reduced since the introduction of disease-modifying antirheumatic drugs (DMARD). The accompanying reduction in arthritic destruction of joints opens up new treatment options whereby priority is given to joint preservation. This is true for the first middle foot ray as well as for the small toe rays. Whereas resection arthroplasty of the metatarsophalangeal joints II-V was previously considered the gold standard treatment, joint-preserving operative procedures (e.g. metatarsal osteotomy and periarticular soft tissue interventions) are now being increasingly more propagated. Resection arthroplasty of the first midfoot ray has major biomechanical disadvantages so that it is not surprising that reconstructive procedures are given priority. In patients with severe arthritic destruction of the first metatarsophalangeal joint, arthrodesis has substantial biomechanical advantages compared to resection arthroplasty. Nevertheless, it has not yet been confirmed that fusion leads to superior clinical results.

  19. The foot of Homo naledi

    PubMed Central

    Harcourt-Smith, W. E. H.; Throckmorton, Z.; Congdon, K. A.; Zipfel, B.; Deane, A. S.; Drapeau, M. S. M.; Churchill, S. E.; Berger, L. R.; DeSilva, J. M.

    2015-01-01

    Modern humans are characterized by a highly specialized foot that reflects our obligate bipedalism. Our understanding of hominin foot evolution is, although, hindered by a paucity of well-associated remains. Here we describe the foot of Homo naledi from Dinaledi Chamber, South Africa, using 107 pedal elements, including one nearly-complete adult foot. The H. naledi foot is predominantly modern human-like in morphology and inferred function, with an adducted hallux, an elongated tarsus, and derived ankle and calcaneocuboid joints. In combination, these features indicate a foot well adapted for striding bipedalism. However, the H. naledi foot differs from modern humans in having more curved proximal pedal phalanges, and features suggestive of a reduced medial longitudinal arch. Within the context of primitive features found elsewhere in the skeleton, these findings suggest a unique locomotor repertoire for H. naledi, thus providing further evidence of locomotor diversity within both the hominin clade and the genus Homo. PMID:26439101

  20. The foot of Homo naledi.

    PubMed

    Harcourt-Smith, W E H; Throckmorton, Z; Congdon, K A; Zipfel, B; Deane, A S; Drapeau, M S M; Churchill, S E; Berger, L R; DeSilva, J M

    2015-10-06

    Modern humans are characterized by a highly specialized foot that reflects our obligate bipedalism. Our understanding of hominin foot evolution is, although, hindered by a paucity of well-associated remains. Here we describe the foot of Homo naledi from Dinaledi Chamber, South Africa, using 107 pedal elements, including one nearly-complete adult foot. The H. naledi foot is predominantly modern human-like in morphology and inferred function, with an adducted hallux, an elongated tarsus, and derived ankle and calcaneocuboid joints. In combination, these features indicate a foot well adapted for striding bipedalism. However, the H. naledi foot differs from modern humans in having more curved proximal pedal phalanges, and features suggestive of a reduced medial longitudinal arch. Within the context of primitive features found elsewhere in the skeleton, these findings suggest a unique locomotor repertoire for H. naledi, thus providing further evidence of locomotor diversity within both the hominin clade and the genus Homo.

  1. The athlete's foot.

    PubMed

    Resnik, S S; Lewis, L A; Cohen, B H

    1977-09-01

    In general, painful feet can affect the performance of an athlete in any sport. To prevent skin diseases of the feet, the "Athlete's Foot" should be kept clean and dry with toenails trimmed. Properly fitting athletic shoes should be worn to avoid the formation of blisters. Wearing of sandals in locker and shower rooms, which prevents intimate contact with infecting organisms, can alleviate many of the problems that affect the feet.

  2. [Foot specific orthotic devices].

    PubMed

    Goldcher, Alain

    2010-03-20

    For each foot pathology, whatever its nature and aetiology, there is an orthesis, the best mechanical treatment. For toe pathologies due to or worsened by the footwear, we must recommend wearing other shoes and sometimes an orthoplasty which is not covered by health insurance. Sole orthesis are quite effective for most pathologies causing pain when walking, and involving the foot sole or starting in the foot. Realised by an approved splint technician, they are covered by health insurance for a lump sum, but patients are telling us their cost is becoming more and more difficult to bear Mass-produced shoes, therapeutic or not, deserve a special place in the therapeutic arsenal of podiatry. Temporary used shoes improve post-operation situation and some specifically located discharges. More and more shoes are available for longer use, most of them not approved but better looking, and at least as effective as and not costlier than the few models covered by health insurance.They can provide footwear that are not standard and can't be helped by bespoke shoes reserved for precise medical indications.

  3. Spinal deformity.

    PubMed

    Bunnell, W P

    1986-12-01

    Spinal deformity is a relatively common disorder, particularly in teenage girls. Early detection is possible by a simple, quick visual inspection that should be a standard part of the routine examination of all preteen and teenage patients. Follow-up observation will reveal those curvatures that are progressive and permit orthotic treatment to prevent further increase in the deformity. Spinal fusion offers correction and stabilization of more severe degrees of scoliosis.

  4. Use of talectomy in modern foot and ankle surgery.

    PubMed

    Joseph, Thomas N; Myerson, Mark S

    2004-12-01

    Talectomy is a procedure that is undertaken rarely in modern orthopedic surgery; however, it has been performed for many years. Talectomy has been used most commonly in pediatric orthopedics with some degree of success in severe clubfoot deformity, arthrogryposis multiplex congenita, myelomeningocele, tuberculosis, and tumors. In adults, talectomy has been used in salvage procedures that involve nonunion of ankle fusions, failed total ankle arthroplasty, inflammatory arthropathy, neuroarthropathy, failed talar prostheses, failed pantalar fusions, adult neglected clubfoot, posttraumatic avascular necrosis talus, and deformities that are due to sciatic nerve palsy and compartment syndrome. This article consider what place talectomy has in modern adult foot and ankle surgery.

  5. Freeman-Sheldon Syndrome with Unusual Hand and Foot Anomalies

    PubMed Central

    Estrada, Raul; Rosenfeld, Warren; Salazar, J. Delfor; Jhaveri, Ramesh

    1981-01-01

    A newborn with the characteristic facies of Freeman-Sheldon syndrome (whistling face syndrome) and unusual hand and foot anomalies is reported. Flexion contractures of fingers were so severe as to prevent their extension. Previously reported patients with similar hand anomalies had only mild to moderate limitation of extension. Over 75 percent of the 29 previous cases of this syndrome had equinovarus deformity. Not only was this deformity absent but the patient had polysyndactyly of the big toe, an anomaly not previously associated with this syndrome. ImagesFigure 1Figure 2Figure 3 PMID:7265275

  6. HSR Model Deformation Measurements from Subsonic to Supersonic Speeds

    NASA Technical Reports Server (NTRS)

    Burner, A. W.; Erickson, G. E.; Goodman, W. L.; Fleming, G. A.

    1999-01-01

    This paper describes the video model deformation technique (VMD) used at five NASA facilities and the projection moire interferometry (PMI) technique used at two NASA facilities. Comparisons between the two techniques for model deformation measurements are provided. Facilities at NASA-Ames and NASA-Langley where deformation measurements have been made are presented. Examples of HSR model deformation measurements from the Langley Unitary Wind Tunnel, Langley 16-foot Transonic Wind Tunnel, and the Ames 12-foot Pressure Tunnel are presented. A study to improve and develop new targeting schemes at the National Transonic Facility is also described. The consideration of milled targets for future HSR models is recommended when deformation measurements are expected to be required. Finally, future development work for VMD and PMI is addressed.

  7. Sta-Peg arthroereisis for treatment of the planovalgus foot in cerebral palsy.

    PubMed

    Smith, P A; Millar, E A; Sullivan, R C

    2000-07-01

    The Sta-Peg procedure is most effective in the non-rigid foot in which reasonable muscle balance can be attained. Where such balance cannot be attained or where rigid deformity exists, this procedure will not solve the problem and should not be used. The authors want to emphasize that this study pertains to the use of Sta-Peg in the valgus foot caused by cerebral palsy. The procedure is rarely needed in the flexible flatfoot of a normal child.

  8. Foot problems in middle-aged patients: keeping active people up to speed.

    PubMed

    Coady, C M; Gow, N; Stanish, W

    1998-05-01

    Most of the common foot problems that bother active middle-aged people are self-limiting and easily treated if detected early. Reviewed here are the causes, symptoms, diagnosis, and treatment of hallux valgus and rigidus, lesser-toe deformities, corns, Morton's neuroma, metatarsal stress fractures, plantar fasciitis, posterior tibialis tenosynovitis and rupture, acquired pes planus, tarsal tunnel syndrome, and foot problems related to rheumatoid arthritis and diabetes. In most cases, conservative treatment will enable patients to return to activity relatively quickly.

  9. Adding Stiffness to the Foot Modulates Soleus Force-Velocity Behaviour during Human Walking

    PubMed Central

    Takahashi, Kota Z.; Gross, Michael T.; van Werkhoven, Herman; Piazza, Stephen J.; Sawicki, Gregory S.

    2016-01-01

    Previous studies of human locomotion indicate that foot and ankle structures can interact in complex ways. The structure of the foot defines the input and output lever arms that influences the force-generating capacity of the ankle plantar flexors during push-off. At the same time, deformation of the foot may dissipate some of the mechanical energy generated by the plantar flexors during push-off. We investigated this foot-ankle interplay during walking by adding stiffness to the foot through shoes and insoles, and characterized the resulting changes in in vivo soleus muscle-tendon mechanics using ultrasonography. Added stiffness decreased energy dissipation at the foot (p < 0.001) and increased the gear ratio (i.e., ratio of ground reaction force and plantar flexor muscle lever arms) (p < 0.001). Added foot stiffness also altered soleus muscle behaviour, leading to greater peak force (p < 0.001) and reduced fascicle shortening speed (p < 0.001). Despite this shift in force-velocity behaviour, the whole-body metabolic cost during walking increased with added foot stiffness (p < 0.001). This increased metabolic cost is likely due to the added force demand on the plantar flexors, as walking on a more rigid foot/shoe surface compromises the plantar flexors’ mechanical advantage. PMID:27417976

  10. Adding Stiffness to the Foot Modulates Soleus Force-Velocity Behaviour during Human Walking

    NASA Astrophysics Data System (ADS)

    Takahashi, Kota Z.; Gross, Michael T.; van Werkhoven, Herman; Piazza, Stephen J.; Sawicki, Gregory S.

    2016-07-01

    Previous studies of human locomotion indicate that foot and ankle structures can interact in complex ways. The structure of the foot defines the input and output lever arms that influences the force-generating capacity of the ankle plantar flexors during push-off. At the same time, deformation of the foot may dissipate some of the mechanical energy generated by the plantar flexors during push-off. We investigated this foot-ankle interplay during walking by adding stiffness to the foot through shoes and insoles, and characterized the resulting changes in in vivo soleus muscle-tendon mechanics using ultrasonography. Added stiffness decreased energy dissipation at the foot (p < 0.001) and increased the gear ratio (i.e., ratio of ground reaction force and plantar flexor muscle lever arms) (p < 0.001). Added foot stiffness also altered soleus muscle behaviour, leading to greater peak force (p < 0.001) and reduced fascicle shortening speed (p < 0.001). Despite this shift in force-velocity behaviour, the whole-body metabolic cost during walking increased with added foot stiffness (p < 0.001). This increased metabolic cost is likely due to the added force demand on the plantar flexors, as walking on a more rigid foot/shoe surface compromises the plantar flexors’ mechanical advantage.

  11. [The diabetic foot].

    PubMed

    Hartemann-Heurtier, Agnès; Ha Van, Georges

    2003-05-15

    Diabetic patients are concerned with foot complications when a peripheral neuropathy is present. Screening of predisposed patients may be annually assessed using monofilament testing. Peripheral arterial disease, when associated, increases amputation risk. Ideal treatment requires a multidisciplinary approach with a first-line medical treatment including an optimal off-loading of the diabetic ulcer, ulcer dertersion, glycemic control, and if necessary antibiotic therapy. In case of associated osteomyelitis, a limited surgical resection of the infected bone may be performed. In case of associated arterial disease, a revascularization procedure precede bone resection.

  12. Bearing capacity of shell strip footing on reinforced sand

    PubMed Central

    Azzam, W.R.; Nasr, A.M.

    2014-01-01

    In this paper, the ultimate load capacities of shell foundations on unreinforced and reinforced sand were determined by laboratory model tests. A series of loading tests were carried out on model shell footing with and without single layer of reinforcement. The tests were done for shell foundation at different shell embedment depth and subgrade density. The results were compared with those for flat foundations without reinforcement. The model test results were verified using finite element analysis using program PLAXIS. The experimental studies indicated that, the ultimate load capacity of shell footing on reinforced subgrade is higher than those on unreinforced cases and the load settlement curves were significantly modified. The shell foundation over reinforced subgrade can be considered a good method to increase the effective depth of the foundation and decrease the resulting settlement. Also the rupture surface of shell reinforced system was significantly deeper than both normal footing and shell footing without reinforcement. The numerical analysis helps in understanding the deformation behavior of the studied systems and identifies the failure surface of reinforced shell footing. PMID:26425361

  13. 38 CFR 4.57 - Static foot deformities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... acquired condition. The congenital condition, with depression of the arch, but no evidence of abnormal... compensable or pensionable. In the acquired condition, it is to be remembered that depression of the longitudinal arch, or the degree of depression, is not the essential feature. The attention should be given...

  14. 38 CFR 4.57 - Static foot deformities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... acquired condition. The congenital condition, with depression of the arch, but no evidence of abnormal... compensable or pensionable. In the acquired condition, it is to be remembered that depression of the longitudinal arch, or the degree of depression, is not the essential feature. The attention should be given...

  15. 38 CFR 4.57 - Static foot deformities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... acquired condition. The congenital condition, with depression of the arch, but no evidence of abnormal... compensable or pensionable. In the acquired condition, it is to be remembered that depression of the longitudinal arch, or the degree of depression, is not the essential feature. The attention should be given...

  16. 38 CFR 4.57 - Static foot deformities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... acquired condition. The congenital condition, with depression of the arch, but no evidence of abnormal... compensable or pensionable. In the acquired condition, it is to be remembered that depression of the longitudinal arch, or the degree of depression, is not the essential feature. The attention should be given...

  17. 38 CFR 4.57 - Static foot deformities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... acquired condition. The congenital condition, with depression of the arch, but no evidence of abnormal... compensable or pensionable. In the acquired condition, it is to be remembered that depression of the longitudinal arch, or the degree of depression, is not the essential feature. The attention should be given...

  18. Ground reaction forces on the plantar surface of the foot after talectomy in the myelomeningocele.

    PubMed

    Sherk, H H; Marchinski, L J; Clancy, M; Melchonni, J

    1989-01-01

    Results of talectomies in 19 patients with severe foot deformities secondary to myelomeningocele were evaluated with an average follow-up of 12 years, 7 months. Although an apparently plantigrade foot was usually obtained, talectomy rarely succeeded in distributing weightbearing forces uniformly over the plantar surface. Photoelastic force-plate analysis incorporating three-dimensional contour mapping clearly identified areas of high ground-foot reaction forces (GFRs) and high-pressure gradients. We suggest that such high-pressure areas predispose these patients to neurotrophic ulceration.

  19. 15-Foot Spin Tunnel

    NASA Technical Reports Server (NTRS)

    1935-01-01

    A researcher is launching a model into the tunnel airstream of the 15-Foot Spin Tunnel. Charles Zimmerman wrote in NASA TR No. 557: 'After the observations have been made, the model is lowered into a net held in the air stream by one of the operators or into a large bowl-shaped net at the bottom of the test section. When lowered into the large net, the model is retrieved with a long- handled clamp.' (p. 267) 'The models used are generally 1/10 to 1/16 scale. The size of the models is limited by the wing span and the wing loading. The maximum allowable span is about 36 inches; the maximum wing loading is about 1.3 pounds per square foot.' (p. 266) 'Balsa wood is the usual structural material because of its low density. It is necessary to hollow out the after portion of the fuselage and to cut out a large portion of the wood in the wings to permit proper mass distribution. The wing cut-outs are covered with silk tissue paper. The leading and trailing edges and tips of the wings are fitted with strips of spruce, pattern pine, or bamboo inset into the edge of the balsa to prevent disfigurement from accidental blows or from striking the safety netting. Lead is used for ballast.' (p. 266)

  20. 15-Foot Spin Tunnel

    NASA Technical Reports Server (NTRS)

    1935-01-01

    Interior view of model in 15-Foot Spin Tunnel. Charles Zimmerman wrote in NASA TR No. 557: 'After the observations have been made, the model is lowered into a net held in the air stream by one of the operators or into a large bowl-shaped net at the bottom of the test section. When lowered into the large net, the model is retrieved with a long-handled clamp.' (p. 267) 'The models mused are generally 1/10 to 1/16 scale. The size of the models is limited by the wing span and the wing loading. The maximum allowable span is about 36 inches; the maximum wing loading is about 1.3 pounds per square foot.' (p. 266) 'Balsa wood is the usual structural material because of its low density. It is necessary to hollow out the after portion of the fuselage and to cut out a large portion of the wood in the wings to permit proper mass distribution. The wing cut-outs are covered with silk tissue paper. The leading and trailing edges and tips of the wings are fitted with strips of spruce, pattern pine, or bamboo inset into the edge of the balsa to prevent disfigurement from accidental blows or from striking the safety netting. Lead is used for ballast.' (p. 266)

  1. Effects of Ankle Arthrodesis on Biomechanical Performance of the Entire Foot

    PubMed Central

    Wang, Yan; Li, Zengyong; Wong, Duo Wai-Chi; Zhang, Ming

    2015-01-01

    Background/Methodology Ankle arthrodesis is one popular surgical treatment for ankle arthritis, chronic instability, and degenerative deformity. However, complications such as foot pain, joint arthritis, and bone fracture may cause patients to suffer other problems. Understanding the internal biomechanics of the foot is critical for assessing the effectiveness of ankle arthrodesis and provides a baseline for the surgical plan. This study aimed to understand the biomechanical effects of ankle arthrodesis on the entire foot and ankle using finite element analyses. A three-dimensional finite element model of the foot and ankle, involving 28 bones, 103 ligaments, the plantar fascia, major muscle groups, and encapsulated soft tissue, was developed and validated. The biomechanical performances of a normal foot and a foot with ankle arthrodesis were compared at three gait instants, first-peak, mid-stance, and second-peak. Principal Findings/Conclusions Changes in plantar pressure distribution, joint contact pressure and forces, von Mises stress on bone and foot deformation were predicted. Compared with those in the normal foot, the peak plantar pressure was increased and the center of pressure moved anteriorly in the foot with ankle arthrodesis. The talonavicular joint and joints of the first to third rays in the hind- and mid-foot bore the majority of the loading and sustained substantially increased loading after ankle arthrodesis. An average contact pressure of 2.14 MPa was predicted at the talonavicular joint after surgery and the maximum variation was shown to be 80% in joints of the first ray. The contact force and pressure of the subtalar joint decreased after surgery, indicating that arthritis at this joint was not necessarily a consequence of ankle arthrodesis but rather a progression of pre-existing degenerative changes. Von Mises stress in the second and third metatarsal bones at the second-peak instant increased to 52 MPa and 34 MPa, respectively, after

  2. What Is a Foot and Ankle Surgeon?

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  3. Osteoarthritis of the Foot and Ankle

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  4. Cosmetic Foot Surgery: Fashion's Pandora's Box

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  5. Sports Injuries to the Foot and Ankle

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  6. Clarification of the anatomic definition of the bunion deformity.

    PubMed

    Dayton, Paul; Kauwe, Merrell; Feilmeier, Mindi

    2014-01-01

    Evolution of the terminology applied to the bunion deformity has progressed in parallel with our changing understanding of the deformity itself. Along this path of progression have been multiple terms, sometimes with multiple meanings. Hallux valgus and metatarsus primus varus are 2 of the most common terms for the deformity. Although commonly used, these descriptors can have multiple meanings, and inconsistencies in interpretation can lead to confusion. We propose a more detailed terminology to provide a more accurate description of the entire bunion deformity in 3 planes and for both the hallux and the metatarsal component of the deformity. The term we propose is hallux abducto valgus with metatarsus primus adducto valgus. An accurate understanding of the multiplanar position of the deformed foot is important for planning deformity correction. The descriptors in the terminology proposed will keep in the forefront the aspects of correction required for the first ray and hallux to be returned to an anatomically correct position.

  7. Foot abnormalities of wild birds

    USGS Publications Warehouse

    Herman, C.M.; Locke, L.N.; Clark, G.M.

    1962-01-01

    The various foot abnormalities that occur in birds, including pox, scaly-leg, bumble-foot, ergotism and freezing are reviewed. In addition, our findings at the Patuxent Wildlife Research Center include pox from dove, mockingbird, cowbird, grackle and several species of sparrows. Scaly-leg has been particularly prevalent on icterids. Bumble foot has been observed in a whistling swan and in a group of captive woodcock. Ergotism is reported from a series of captive Canada geese from North Dakota. Several drug treatments recommended by others are presented.

  8. Tripod Index: Diagnostic Accuracy in Symptomatic Flatfoot and Cavovarus Foot: Part 2

    PubMed Central

    Arunakul, Marut; Amendola, Annunziato; Gao, Yubo; Goetz, Jessica E.; Femino, John E.; Phisitkul, Phinit

    2013-01-01

    Background The Tripod Index (TI) has been created to allow assessment of complex foot deformities. It utilizes tripod relationship between center of the heel, medial/lateral borders of the forefoot, and compare it to the center of the talar head. This study aimed to verify diagnostic accuracy of the TI in symptomatic flatfoot and cavovarus foot. Methods Weightbearing radiographs including foot AP with a hemispherical marker around the heel, lateral, and hindfoot alignment views were obtained on 91 patients (110 feet) presenting with medial foot and ankle pain and on 89 patients (90 feet) presenting with lateral foot and ankle pain between June 2010 and May 2011. Radiographs were evaluated blindly for the TI, AP talonavicular coverage angle, lateral talo-first metatarsal angle, calcaneal pitch angle, medial cuneiform-fifth metatarsal height, and coronal plane hindfoot alignment. The sensitivity, specificity, likelihood ratios, and predictive values were calculated. Clinically diagnosed flatfoot and cavovarus foot deformity indicated for surgical reconstruction by one of our foot and ankle orthopaedic surgeons was used as the accepted standard for diagnosis. Results In flatfoot, sensitivity of the TI was 100%, comparable with lateral talo-first metatarsal angle (100%), and medial cuneiform-fifth metatarsal height (100%). Specificity of the TI was 93%, comparable with coronal plane hindfoot alignment (98%), but superior to other parameters. Positive likelihood ratio of the TI was 14.29, which was less than coronal plane hindfoot alignment (47.5), but more than other parameters. In cavovarus foot, sensitivity of the TI was 96%, comparable with coronal plane hindfoot alignment (100%), but superior to other parameters. Specificity of the TI was 95%, comparable with lateral talo-first metatarsal angle (94%), but superior to other parameters. Positive likelihood ratio of the TI was 19.2, which was more than other parameters. Conclusion The Tripod Index showed high accuracy

  9. 8-Foot High Speed Tunnel (8-Foot HST)

    NASA Technical Reports Server (NTRS)

    1936-01-01

    Control panel below the test section of the 8-Foot High Speed Tunnel (8-Foot HST). Authorized July 17, 1933, construction of the 8-Foot HST was paid for with funds from the Federal Public Works Administration. Manly Hood and Russell Robinson designed the unusual facility which could produce a 500 mph wind stream across an 8-Foot test section. The concrete shell was not part of the original design. Like most projects funded through New Deal programs, the PWA restricted the amount of money which could be spent on materials. The majority of funds were supposed to be expended on labor. Though originally, Hood and Robinson had planned a welded steel pressure vessel around the test section, PWA officials proposed the idea of concrete. This picture shows the test section inside the igloo-like structure with walls of 1-foot thick reinforced concrete. The thick walls were needed 'because of the Bernoulli effect, [which meant that] the text chamber had to withstand powerful, inwardly directed pressure. Operating personnel located inside the igloo were subjected to pressures equivalent to 10,000-foot altitude and had to wear oxygen masks and enter through airlocks. A heat exchanger removed the large quantities of heat generated by the big fan.'

  10. 24 CFR 3285.312 - Footings.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... MODEL MANUFACTURED HOME INSTALLATION STANDARDS Foundations § 3285.312 Footings. (a) Materials approved... (incorporated by reference, see § 3285.4). (3) ABS footing pads. (i) ABS footing pads are permitted, provided... use in the soil classification at the site. (ii) ABS footing pads must be listed or labeled for...

  11. 24 CFR 3285.312 - Footings.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... MODEL MANUFACTURED HOME INSTALLATION STANDARDS Foundations § 3285.312 Footings. (a) Materials approved... (incorporated by reference, see § 3285.4). (3) ABS footing pads. (i) ABS footing pads are permitted, provided... use in the soil classification at the site. (ii) ABS footing pads must be listed or labeled for...

  12. 7 CFR 1217.4 - Board foot.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Board foot. 1217.4 Section 1217.4 Agriculture..., and Industry Information Order Definitions § 1217.4 Board foot. Board foot or BF means a unit of... cubic equivalent. A board foot calculation for softwood lumber 1 inch or more in thickness is based...

  13. 7 CFR 1217.4 - Board foot.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Board foot. 1217.4 Section 1217.4 Agriculture..., and Industry Information Order Definitions § 1217.4 Board foot. Board foot or BF means a unit of... cubic equivalent. A board foot calculation for softwood lumber 1 inch or more in thickness is based...

  14. 7 CFR 1217.4 - Board foot.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Board foot. 1217.4 Section 1217.4 Agriculture..., and Industry Information Order Definitions § 1217.4 Board foot. Board foot or BF means a unit of... cubic equivalent. A board foot calculation for softwood lumber 1 inch or more in thickness is based...

  15. Freeing the foot: integrating the foot core system into rehabilitation for lower extremity injuries.

    PubMed

    McKeon, Patrick O; Fourchet, François

    2015-04-01

    The intrinsic muscles of the foot play a critical role in the regulation of absorption and propulsion during dynamic activities. Dysfunction of these may lead to an increased demand on the remaining components within the foot core system to maintain dynamic foot control, leading to a more rapid breakdown of these contributors and those proximal to the foot. Training the intrinsic foot muscles through a systematic progression of isolation via the short foot exercise offers the opportunity to reincorporate their contribution into the foot core system. This article discusses the function of the intrinsic foot muscles, their contributions to dynamic foot control, and a progressive training paradigm.

  16. Foot, leg, and ankle swelling

    MedlinePlus

    ... feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... 51. Trayes KP, Studdiford JS, Pickle S, Tully AS. Edema: Diagnosis and management. Am Fam Phys . 2013;88( ...

  17. Mouth in Foot Disease

    PubMed Central

    DeRosa, Daniel C; Agee, Willie A; Pires, Valerie L; Yim, Duke G; Ngauy, Viseth

    2015-01-01

    Toothpicks are commonly used household items that rarely cause serious injury or infection. Toothpick-related injuries often occur due to ingestion with subsequent trauma/infection at distal sites within the gastrointestinal tract; however, cardiovascular, pleural, and soft tissue infections have been reported. Eikenella corrodens is a gram-negative, facultative anaerobic bacillus found in oral flora associated with bite wound infections. A few case reports describe E. corrodens osteomyelitis from toothpick puncture wounds. We report a case of foot cellulitis and abscess in an elderly diabetic after toothpick puncture injury that was unresponsive to empiric antibiotics. Wound cultures grew E. corrodens and rare Peptostreptococcus species. E. corrodens is resistant to first-generation cephalosporins, macrolides, aminoglycosides, clindamycin, and metronidazole. This case highlights the insidious nature of E. corrodens infections and the need to tailor empiric antibiotics for skin and soft tissue infections based on the mechanism of injury. In addition, this case stresses the importance of protective footwear in diabetics and serves as a cautionary tale regarding the use of seemingly innocuous toothpicks. PMID:26793413

  18. Homosexual foot fetishism.

    PubMed

    Weinberg, M S; Williams, C J; Calhan, C

    1994-12-01

    262 respondents from an organization for homosexual foot fetishists provide information from a broader sample than clinical cases and allow examination of the effects of sexual preference on fetishism. Data show a wide range of feet/footwear objects to be arousing. Such interests were often associated with particular types of men, yet interests were subject to change over time. Fetishistic arousal rested on both sensual and symbolic aspects of the fetish. Symbolically, it was the theme of "masculinity" that made male feet/footwear arousing, showing parallels to "femininity" evoked by female feet/footwear for male heterosexual fetishists. For many of the respondents, fetishism did not seem to be a substitute for living persons. Respondents had intimate relationships and were able to incorporate their fetish interests into stable relationships and less intimate ones. Considerable involvement in sadomasochistic practices was also found as was involvement in the gay world. Finally, nothing about a fetishistic interest seemed to preclude the development of subcultural forms around the practice.

  19. Flexible Foot Test Assembly

    SciTech Connect

    Kurita, C.H.; /Fermilab

    1987-04-27

    A test model of the flexible foot support was constructed early in the design stages to check its reactions to applied loads. The prototype was made of SS 304 and contained four vertical plates as opposed to the fourteen Inconel 718 plates which comprise the actual structure. Due to the fact that the prototype was built before the design of the support was finalized, the plate dimensions are different from those of the actual proposed design (i.e. model plate thickness is approximately one-half that of the actual plates). See DWG. 3740.210-MC-222376 for assembly details of the test model and DWG. 3740.210-MB-222377 for plate dimensions. This stanchion will be required to not only support the load of the inner vessel of the cryostat and its contents, but it must also allow for the movement of the vessel due to thermal contraction. Assuming that each vertical plate acts as a column, then the following formula from the Manual of Steel Construction (American Institute of Steel Construction, Inc., Eigth edition, 1980) can be applied to determine whether or not such columns undergoing simultaneous axial compression and transverse loading are considered safe for the given loading. The first term is representative of the axially compressive stress, and the second term, the bending stress. If the actual compressive stress is greater than 15% of the allowable compressive stress, then there are additional considerations which must be accounted for in the bending stress term.

  20. Foot and ankle surgery: considerations for the geriatric patient.

    PubMed

    Lee, Daniel K; Mulder, Gerit D

    2009-01-01

    The growing number of lower-extremity abnormalities that are seen in inpatient and outpatient settings has paralleled the increased number of elderly in the population. Foot and ankle deformities, disorders, and arthritis, which are not manifested until late in life, have become more common as more individuals attain longer lifespans. Although conservative therapies are a priority when addressing the geriatric population, surgical options may be overlooked secondary to a misunderstanding of their ability to overcome perioperative management. Advanced minimally invasive surgical procedures for the foot and ankle have decreased the complications associated with foot surgery, making surgical intervention a viable option for many of the elderly. The newer procedures do not, however, minimize strict perioperative management, including pharmacological and nutritional assessment, and cardiopulmonary precautions. Outpatient surgical intervention may effectively address many ongoing problems associated with pain, decreased ambulation, and decreased quality of life. Current techniques in joint reconstruction in the forefoot and midfoot allow weight bearing from the day of surgery. Most hindfoot and ankle surgeries now permit minimal bone resection and incision through arthroscopy, resulting in improved muscle and tendon repair and early weight bearing. The changes in surgical approaches for the geriatric foot have permitted more effective and rapid intervention in problems affecting ambulation and quality of life in our aged population.

  1. Muscle-driven finite element simulation of human foot movements.

    PubMed

    Spyrou, L A; Aravas, N

    2012-01-01

    This paper describes a finite element scheme for realistic muscle-driven simulation of human foot movements. The scheme is used to simulate human ankle plantar flexion. A three-dimensional anatomically detailed finite element model of human foot and lower leg is developed and the idea of generating natural foot movement based entirely on the contraction of the plantar flexor muscles is used. The bones, ligaments, articular cartilage, muscles, tendons, as well as the rest soft tissues of human foot and lower leg are included in the model. A realistic three-dimensional continuum constitutive model that describes the biomechanical behaviour of muscles and tendons is used. Both the active and passive properties of muscle tissue are accounted for. The materials for bones and ligaments are considered as homogeneous, isotropic and linearly elastic, whereas the articular cartilage and the rest soft tissues (mainly fat) are defined as hyperelastic materials. The model is used to estimate muscle tissue deformations as well as stresses and strains that develop in the lower leg muscles during plantar flexion of the ankle. Stresses and strains that develop in Achilles tendon during such a movement are also investigated.

  2. 8-Foot High Speed Tunnel

    NASA Technical Reports Server (NTRS)

    1936-01-01

    Control panel below the test section of the 8-Foot High Speed Tunnel (8-Foot HST). Authorized July 17, 1933, construction of the 8-Foot HST was paid for with funds from the Federal Public Works Administration. Manly Hood and Russell Robinson designed the unusual facility which could produce a 500 mph wind stream across an 8-Foot test section. The concrete shell was not part of the original design. Like most projects funded through New Deal programs, the PWA restricted the amount of money which could be spent on materials. The majority of funds were supposed to be expended on labor. Though originally, Hood and Robinson had planned a welded steel pressure vessel around the test section, PWA officials proposed the idea of concrete. This picture shows the test section inside the igloo-like structure with walls of 1-foot thick reinforced concrete. The thick walls were needed 'because of the Bernoulli effect, [which meant that] the text chamber had to withstand powerful, inwardly directed pressure. Operating personnel located inside the igloo were subjected to pressures equivalent to 10,000-foot altitude and had to wear oxygen masks and enter through airlocks. A heat exchanger removed the large quantities of heat generated by the big fan.'

  3. Correction of neglected vertical talus deformity in an adult.

    PubMed

    Lui, Tun Hing

    2015-02-18

    Congenital vertical talus is an uncommon foot deformity that is characterised by a fixed dorsal dislocation of the navicular on the talar head and neck. Left untreated, a congenital vertical talus causes significant long-term disability. We present a case of neglected vertical talus in a middle-aged woman who was successfully treated with resection of the talar head and tendon transfers.

  4. Current conservative management and classification of club foot: A review.

    PubMed

    Balasankar, Ganesan; Luximon, Ameersing; Al-Jumaily, Adel

    2016-11-30

    Clubfoot, known as congenital talipes equinovarus, is one of the complex paediatric foot deformity with the incidence of 1 in every 1000 live births. It consists of four complex foot abnormalities such as forefoot adductus, midfoot cavus, and hindfoot varus and ankle equinus. There are a number of surgical techniques (soft tissue releases, arthrodesis) used to correct clubfoot. However currently the conservative management (manipulation, serial casting, and braces) of clubfoot is considered as the best choice and it is widely accepted among orthopaedists. Clubfoot treated with surgical techniques might suffer various complications such as soft tissues contractures, neurovascular complications, infections, and shortening of the limbs. Although conservative method is generally considered as an effective method, it is still challenging to cure clubfoot in advance stages. Also, the classification of the initial severity of clubfoot is essential to evaluate the outcome of the treatment. In this review, the aim is to review the different types of conservative method and the assessment of clubfoot severity.

  5. Outcomes of subtalar arthroereisis for the planovalgus foot.

    PubMed

    Hazany, Salar; Ly, Nancy; Hazany, David; Bader, Semon; Ostuka, Norman

    2012-01-01

    Chronic pain and gait disturbance are possible complications of subtalar arthroereisis. Despite literature indicating a considerably high rate of such complications, subtalar arthroereisis continues to be commonly performed for children with pes planus. The goals of this study are to identify common presenting features and an approach to the treatment of foot pain after subtalar arthroereisis. This case report includes six feet in which subtalar implants were used to treat flatfoot deformities in children. After failing conservative management for chronic postoperative pain, all patients had their implants removed resulting in relief of pain. The expedited removal of subtalar implants in cases of chronic foot pain after arthroereisis is encouraged. The authors do not recommend the use of subtalar arthroereisis in pes planus given its potential complications and literature review indicating a paucity of cases with improved function and activity level as a result of the procedure.

  6. Bacteriology of diabetic foot lesions.

    PubMed

    Yoga, R; Khairul, A; Sunita, K; Suresh, C

    2006-02-01

    Infection plays a pivotal role in enhancing a diabetic foot at risk toward amputation. Effective antibiotic therapy against the offending pathogens is an important component of treatment of diabetic foot infections. Recognition of the pathogen is always difficult as the representative deep tissue sample for culture is surrounded by ulcer surface harbouring colonies of organisms frequently labelled as skin commensals. The emergent of resistant strains represents a compounding problem standing against efforts to prevent amputation. This study was undertaken to identify the pathogens associated with diabetic foot infection in terms of their frequency and sensitivity against certain commonly used antibiotics. Forty-four consecutive patients with open diabetic foot infections had wound swab taken for culture and sensitivity testing. Cultures positive were observed in 89% of the cases with Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeroginosa encountered in 20%, 14% and 14% of cases respectively. Mixed growths were isolated in 6% of cultures. All Staphylcoccus aureus isolates were resistant to Penicillin but 80% were sensitive to Erythromycin and Co-trimoxazole. Klebsiella pneumoniae isolates were sensitive to Methicillin and Gentamycin in 80% and 60% of cases respectively, and resistant to Ampicillin and Ceftazidime in 83% and 50% respectively. All Pseudomonas aeroginosa isolates were sensitive to Amikacin and Ciprofloxacin but 50% were resistant to Gentamycin. There was no single antibiotic possessing good coverage for all common organisms isolated from diabetic foot lesions. Staphylococcus aureus remains the predominant cause of diabetic foot infections followed by Klebsiela pneumonia and Pseudomonas aeroginosa. Most infections are monomicrobial. The emergence of multiresistant organisms is a worrying feature in diabetic foot infections.

  7. Approach to analyze a deformable moving target by using the shape deformation model and morphological operators

    NASA Astrophysics Data System (ADS)

    Wu, Weiguo; Asai, Take; Akatsuka, Takao

    1995-10-01

    The measurement of the characteristic parameters for a moving object with deformation is often an important problem. Here, an approach to analyze the shape change of a ball, when it is kicked in soccer, is proposed by using a simple shape deformation model to evaluate the shape change from the image sequence. Moreover, to determine the parameters of the model which apply to actual ball deformation, the detection of ball is necessary, and the pattern spectrum based on morphological operators is considered. Here, we assume that the deformation surface of the ball is a circular arc, when it is kicked by foot, and the arc is always convex when it is observed from the kicking side. To obtain the parameters of the arc, the preprocessing of the ball image such as local binarization, the region filling and noisy smoothing with morphological operators, is performed from actual image sequence. In order to detect the ball, the pattern spectrum with morphological operators is measured, and then circumscribed circle of the ball is extracted. So, the center and radius of the ball from circumscribed circle and the arc of the deformation surface of the model are obtained. Finally, the characteristic parameters of a moving ball such as the deformation are measured by using the shape deformation model. To demonstrate the effect of this method, we show an application to extract the deformation of the ball in football for the actual sports skill training.

  8. Bunionette deformity.

    PubMed

    Cohen, Bruce E; Nicholson, Christopher W

    2007-05-01

    The bunionette, or tailor's bunion, is a lateral prominence of the fifth metatarsal head. Most commonly, bunionettes are the result of a widened 4-5 intermetatarsal angle with associated varus of the metatarsophalangeal joint. When symptomatic, these deformities often respond to nonsurgical treatment methods, such as wider shoes and padding techniques. When these methods are unsuccessful, surgical treatment is based on preoperative radiographs and associated lesions, such as hyperkeratoses. In rare situations, a simple lateral eminence resection is appropriate; however, the risk of recurrence or overresection is high with this technique. Patients with a lateral bow to the fifth metatarsal are treated with a distal chevron-type osteotomy. A widened 4-5 intermetatarsal angle often requires a diaphyseal osteotomy for correction.

  9. The best way to reduce reulcerations: if you understand biomechanics of the diabetic foot, you can do it.

    PubMed

    Lázaro-Martínez, José Luis; Aragón-Sánchez, Javier; Alvaro-Afonso, Francisco Javier; García-Morales, Esther; García-Álvarez, Yolanda; Molines-Barroso, Raúl Juan

    2014-12-01

    Foot ulcer recurrence is still an unresolved issue. Although several therapies have been described for preventing foot ulcers, the rates of reulcerations are very high. Footwear and insoles have been recommended as effective therapies that prevent the development of new ulcers; however, the majority of studies have analyzed their effects in terms of reducing peak plantar pressure rather than ulcer relapse. Knowledge of biomechanical considerations is low, in general, in the team approach to diabetic foot because heterogeneous professionals having competence in recurrence prevention are involved. Assessment of biomechanical alterations define a foot type position; examining foot structure and recording plantar pressure could help in appropriate insole and footwear prescription and design. Patient education and compliance should be taken into consideration for better therapy success. When patients suffer from rigid deformities or have undergone an amputation, surgical offloading should be considered as an alternative.

  10. Foot Comfort for the Fashionable

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Modellista Footwear's new shoe line uses Tempur(TM) material, which conforms to each wearer's unique foot shape to absorb shock and cushion the foot. The foam's properties allow the shoe to change with the wearer's foot as it shrinks and swells throughout the day. Scientists at NASA's Ames Research Center originally developed temper foam in the early 1970s to relieve the intense pressure of G-forces experienced by astronauts during rocket launches. Tempur-Pedic, Inc., further developed the foam and granted Modellista a license to use it in footwear. The Modellista collection is the first shoe design and construction to be certified by the Space Awareness Alliance. The shoes, with designs ranging from traditional clog shapes to sling backs and open-toe sandals, are currently available nationwide at select specialty shoe stores and through catalogs. Tempur(TM) is a registered trademark of Tempur-Pedic, Inc.

  11. Talectomy for Equinovarus Deformity in Family Members with Hereditary Motor and Sensory Neuropathy Type I

    PubMed Central

    Georgiev, Hristo

    2014-01-01

    The treatment of severe rigid neurogenic clubfoot deformities still remains a challenging problem in modern paediatric orthopaedics. In those cases, in spite of being a palliative procedure, talectomy has been advocated for the correction of the deformity thus providing a stable plantigrade foot which allows pain-free walking with standard footwear. Herein, we present the results after talectomy in two patients (brother and sister) affected by a hereditary motor and sensory neuropathy type I, with rigid severe pes equinovarus deformities. PMID:25610681

  12. A 640 foot per second impact test of a two foot diameter model nuclear reactor containment system without fracture

    NASA Technical Reports Server (NTRS)

    Puthoff, R. L.

    1971-01-01

    An impact test was conducted on an 1142 pound 2 foot diameter sphere model. The purpose of this test was to determine the feasibility of containing the fission products of a mobile reactor in an impact. The model simulated the reactor core, energy absorbing gamma shielding, neutron shielding and the containment vessel. It was impacted against an 18,000 pound reinforced concrete block. The model was significantly deformed and the concrete block demolished. No leaks were detected nor cracks observed in the model after impact.

  13. Prevalence of risk factors for diabetic foot complications in a Chinese tertiary hospital

    PubMed Central

    Wu, Liaofang; Hou, Qian; Zhou, Qiuhong; Peng, Fang

    2015-01-01

    Aims: To determine the prevalency of risk factors for diabetic foot complications in diabetic patients free of active ulceration in a hospital setting and to investigate the knowledge of foot care of the patients. Methods: A retrospective study was conducted on a cohort of 296 patients with diabetes hospitalized in a tertiary hospital. A convenience sampling was adopted to recruit subjects during 2012/2013. All completed an interviewer-administered questionnaire and underwent medical assessment including foot examination and assessment of presence of peripheral sensory neuropathy (PSN) and peripheral arterial disease (PVD). The patients were assigned to a foot risk category which was developed by the International Working Group on the Diabetic Foot (IWGDF). Results: 296 inpatients were evaluated. Foot deformity was noticed in 124 patients (42%), hallux valgus was the most prevalent abnormality, found in 65% of patients. Prevalency of neuropathy hypertension, nephropathy and retinopathy were 66.2%, 57.1%, 48.3% and 44.9% respectively. 37 (12.5%) patients had a history of ulceration (n = 33) and/or toe amputation (n = 4). According to the classification system of the IWGDF, 35.1% of patients were considered as having low-risk by the modified IWGDF classification (group 0), and 49% of the study population were at high risk for pedal ulceration (group 2 and 3). There was a clear trend between the increasing severity of the staging and HbA1c, duration of diabetes, prevalence of hypertension, nephropathy and retinopathy and absent of physical activity. The mean knowledge score of foot care was 21.21±3.84. Conclusion: The risk factors for foot ulceration and lack of fool care knowledge was rather common in a hospital-based diabetic population, emphasizing the importance of implementing simple and affordable screening tools and methods to identify high-risk patients and providing foot care education for them. PMID:26064275

  14. [Reflections concerning the radiological assessment of static flat foot in the child (author's transl)].

    PubMed

    Lang, G; Kehr, P; Séjourne, P; Paternotte, H; Mathevon, H; Pointu, J

    1978-01-01

    After a precise review of the numerous parameters studied classically in AP and lateral films of the feet under load, the authors emphasis 5 measurements which are easy to determine and which they feel to objectively cover all the deformities which may be found in the static flat foot. These are: Talo-calcaneal divergence in AP and lateral views, the angle between the calcaneum and the floor, the lateral cavitation index and, finally, the angle of the axis of the talus and of the 2nd metatarsal in AP. A score of 20 is attributed to each. A score of 0 to 20 is attributed to each of these points, with a possible total, therefore, of 100. A study of 119 cases of flat foot in the child treated surgically over a period of 6 years made it possible to draw the distinction between the severe flat foot requiring operation and with a total of less than 45 points, and flat foot requiring medical orthopaedic treatment only (more than 45), the score for the normal foot being of the order of 90 points. This radiological study also makes it possible to distinguish, amongst flat feet in children, straight flat foot with collapse of the medial arch but no valgus of the forefoot and valgus flat foot where there is pronation of the calcaneum and abduction of the forefoot. This distinction is important since it determines the choice of operation. Thus in a case of valgus flat foot Judet's so-called "horseman" operation is indicated whilst in a flat foot without valgus, transposition of the tibialis anterior is preferable. In many cases, the lesion is mixed and both surgical gestures are required.

  15. Glossary of Foot and Ankle Terms

    MedlinePlus

    ... the Big Toe Ailments of the Smaller Toes Diabetic Foot Treatments Injections and other Procedures Treatments of the ... completed a four-year program in Osteopathic Medicine. Diabetic foot - Diabetes affects the feet in a profound way ...

  16. Diabetic Foot - Multiple Languages: MedlinePlus

    MedlinePlus

    ... Are Here: Home → Multiple Languages → All Health Topics → Diabetic Foot URL of this page: https://medlineplus.gov/languages/ ... V W XYZ List of All Topics All Diabetic Foot - Multiple Languages To use the sharing features on ...

  17. American Orthopaedic Foot and Ankle Society

    MedlinePlus

    ... education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of the American Orthopaedic Foot & Ankle Society. Patients Visit the official patient education site of ...

  18. American College of Foot and Ankle Surgeons

    MedlinePlus

    ... Week @ ACFAS Poll Results Arthroscopy e-Book The Journal of Foot & Ankle Surgery Read some of the latest research from the official peer-reviewed scientific journal of ACFAS, The Journal of Foot & Ankle Surgery ( ...

  19. Estimation of stature from radiographic measurement of foot dimensions: Truncated foot length may be more reliable than full foot length.

    PubMed

    Gwani, Abdullahi Suleiman; Salihu, Abubakar Tijjani; Garba, Isa Sa'idu; Rufa'i, Adamu Ahmad

    2017-02-01

    Foot length has been shown to be a reliable dimension for estimation of stature. However, phalanges of the foot are very small bones and their length may not be proportional to person's stature. Thus, we hypothesized that foot length measured excluding the phalanges, the truncated foot length, may be more reliable in stature estimation than full foot length. This study, therefore, aimed at comparing the accuracy of the regression equations derived from the truncated foot length and the full foot length. The study recruited a sample of 32 young adults (16 males and 16 females) aged from 20 to 35 years. Lateral radiographs of the right feet were obtained for each subject in a bilateral standing position while maintaining equal weight on both feet. Standing height of the participants was measured with a stadiometer. Truncated foot length and full foot length were measured on the lateral radiographs of the foot. Independent t-test was used to check for mean differences in the dimensions between genders. Linear regression analysis was used to determine the equations for stature estimation. Intra and inter-observer reliability were calculated from four precision estimates: absolute technical error of measurement (aTEM), relative technical error of measurement (rTEM), coefficient of reliability (Rr) and coefficient of variation (Cv). All the dimensions measured were significantly larger in males than females. Linear regression equations were derived for estimation of stature using both the truncated foot length and full foot length. The regression equations derived from truncated foot length have larger correlation coefficient, coefficient of determination, adjusted coefficient of determination as well as smaller standard error of estimation than those derived from full foot length. All the precision estimates showed that the measurement errors are within acceptable limits. This study suggests that even if the full foot length is available, excluding the phalanges may

  20. Mechanics of the foot Part 2: A coupled solid-fluid model to investigate blood transport in the pathologic foot.

    PubMed

    Mithraratne, K; Ho, H; Hunter, P J; Fernandez, J W

    2012-10-01

    A coupled computational model of the foot consisting of a three-dimensional soft tissue continuum and a one-dimensional (1D) transient blood flow network is presented in this article. The primary aim of the model is to investigate the blood flow in major arteries of the pathologic foot where the soft tissue stiffening occurs. It has been reported in the literature that there could be up to about five-fold increase in the mechanical stiffness of the plantar soft tissues in pathologic (e.g. diabetic) feet compared with healthy ones. The increased stiffness results in higher tissue hydrostatic pressure within the plantar area of the foot when loaded. The hydrostatic pressure acts on the external surface of blood vessels and tend to reduce the flow cross-section area and hence the blood supply. The soft tissue continuum model of the foot was modelled as a tricubic Hermite finite element mesh representing all the muscles, skin and fat of the foot and treated as incompressible with transversely isotropic properties. The details of the mechanical model of soft tissue are presented in the companion paper, Part 1. The deformed state of the soft tissue continuum because of the applied ground reaction force at three foot positions (heel-strike, midstance and toe-off) was obtained by solving the Cauchy equations based on the theory of finite elasticity using the Galerkin finite element method. The geometry of the main arterial network in the foot was represented using a 1D Hermite cubic finite element mesh. The flow model consists of 1D Navier-Stokes equations and a nonlinear constitutive equation to describe vessel radius-transmural pressure relation. The latter was defined as the difference between the fluid and soft tissue hydrostatic pressure. Transient flow governing equations were numerically solved using the two-step Lax-Wendroff finite difference method. The geometry of both the soft tissue continuum and arterial network is anatomically-based and was developed using

  1. Puncture wounds of the foot.

    PubMed

    Racz, Roger S; Ramanujam, Crystal L; Zgonis, Thomas

    2010-10-01

    Puncture wounds are common injuries of the foot. Although most puncture wounds are benign, devastating complications are possible without adequate treatment. These injuries can occur in all age groups and in various circumstances. Early diagnosis and appropriate medical and surgical management is paramount in achieving successful outcomes.

  2. Billet planting, 8-foot rows, residue updates

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Cultural practices are continually tested and upgraded to maximize sugarcane yield in Louisiana. Over the past 3 years extensive research went in to comparing the industry standard 6-foot row spacing to a wider, 8 foot row. Each 8 foot row was double drilled with seed canes that were 2-3 feet apart....

  3. 29 CFR 1915.156 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... (PPE) § 1915.156 Foot protection. (a) Use. The employer shall ensure that each affected employee wears protective footwear when working in areas where there is a danger of foot injuries due to falling or rolling... 29 Labor 7 2010-07-01 2010-07-01 false Foot protection. 1915.156 Section 1915.156...

  4. 29 CFR 1917.94 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) MARINE TERMINALS Personal Protection § 1917.94 Foot protection. (a) The employer shall ensure that each affected employee wears protective footwear when working in areas where there is a danger of foot injuries... 29 Labor 7 2010-07-01 2010-07-01 false Foot protection. 1917.94 Section 1917.94 Labor...

  5. 29 CFR 1917.94 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) MARINE TERMINALS Personal Protection § 1917.94 Foot protection. (a) The employer shall ensure that each affected employee wears protective footwear when working in areas where there is a danger of foot injuries... 29 Labor 7 2011-07-01 2011-07-01 false Foot protection. 1917.94 Section 1917.94 Labor...

  6. 29 CFR 1910.136 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... areas where there is a danger of foot injuries due to falling or rolling objects, or objects piercing... 29 Labor 5 2011-07-01 2011-07-01 false Foot protection. 1910.136 Section 1910.136 Labor... OCCUPATIONAL SAFETY AND HEALTH STANDARDS Personal Protective Equipment § 1910.136 Foot protection. (a)...

  7. 29 CFR 1910.136 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... areas where there is a danger of foot injuries due to falling or rolling objects, or objects piercing... 29 Labor 5 2010-07-01 2010-07-01 false Foot protection. 1910.136 Section 1910.136 Labor... OCCUPATIONAL SAFETY AND HEALTH STANDARDS Personal Protective Equipment § 1910.136 Foot protection. (a)...

  8. 29 CFR 1915.156 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... (PPE) § 1915.156 Foot protection. (a) Use. The employer shall ensure that each affected employee wears protective footwear when working in areas where there is a danger of foot injuries due to falling or rolling... 29 Labor 7 2011-07-01 2011-07-01 false Foot protection. 1915.156 Section 1915.156...

  9. 24 CFR 3285.312 - Footings.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... reinforcing steel in cast-in-place concrete footings. (2) Pressure-treated wood. (i) Pressure-treated wood footings must consist of a minimum of two layers of nominal 2-inch thick pressure-treated wood, a single... values listed have been reduced by the dead load of the concrete footing. 4. Concrete block piers...

  10. Why Does My Foot Fall Asleep?

    MedlinePlus

    ... Getting an X-ray Why Does My Foot Fall Asleep? KidsHealth > For Kids > Why Does My Foot Fall Asleep? Print A A A Jenna had been ... pins and needles." But why would your foot fall asleep? Many people say this is because you' ...

  11. 29 CFR 1917.94 - Foot protection.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 7 2013-07-01 2013-07-01 false Foot protection. 1917.94 Section 1917.94 Labor Regulations...) MARINE TERMINALS Personal Protection § 1917.94 Foot protection. (a) The employer shall ensure that each affected employee wears protective footwear when working in areas where there is a danger of foot...

  12. 29 CFR 1915.156 - Foot protection.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 7 2014-07-01 2014-07-01 false Foot protection. 1915.156 Section 1915.156 Labor... (PPE) § 1915.156 Foot protection. (a) Use. The employer shall ensure that each affected employee wears protective footwear when working in areas where there is a danger of foot injuries due to falling or...

  13. 33 CFR 142.33 - Foot protection.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Foot protection. 142.33 Section... CONTINENTAL SHELF ACTIVITIES WORKPLACE SAFETY AND HEALTH Personal Protective Equipment § 142.33 Foot... for foot injury to occur shall wear footwear meeting the specifications of ANSI Z41, except...

  14. 29 CFR 1918.104 - Foot protection.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 7 2014-07-01 2014-07-01 false Foot protection. 1918.104 Section 1918.104 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.104 Foot... in areas where there is a danger of foot injuries due to falling or rolling objects or...

  15. 29 CFR 1915.156 - Foot protection.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 7 2012-07-01 2012-07-01 false Foot protection. 1915.156 Section 1915.156 Labor... (PPE) § 1915.156 Foot protection. (a) Use. The employer shall ensure that each affected employee wears protective footwear when working in areas where there is a danger of foot injuries due to falling or...

  16. 33 CFR 142.33 - Foot protection.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Foot protection. 142.33 Section... CONTINENTAL SHELF ACTIVITIES WORKPLACE SAFETY AND HEALTH Personal Protective Equipment § 142.33 Foot... for foot injury to occur shall wear footwear meeting the specifications of ANSI Z41, except...

  17. 29 CFR 1918.104 - Foot protection.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 7 2013-07-01 2013-07-01 false Foot protection. 1918.104 Section 1918.104 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.104 Foot... in areas where there is a danger of foot injuries due to falling or rolling objects or...

  18. 29 CFR 1917.94 - Foot protection.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 7 2012-07-01 2012-07-01 false Foot protection. 1917.94 Section 1917.94 Labor Regulations...) MARINE TERMINALS Personal Protection § 1917.94 Foot protection. (a) The employer shall ensure that each affected employee wears protective footwear when working in areas where there is a danger of foot...

  19. Why Does My Foot Fall Asleep?

    MedlinePlus

    ... Happens in the Operating Room? Why Does My Foot Fall Asleep? KidsHealth > For Kids > Why Does My Foot Fall Asleep? A A A Jenna had been ... while you might have lost feeling in your foot, it might have felt heavy, or you might ...

  20. 33 CFR 142.33 - Foot protection.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Foot protection. 142.33 Section... CONTINENTAL SHELF ACTIVITIES WORKPLACE SAFETY AND HEALTH Personal Protective Equipment § 142.33 Foot... for foot injury to occur shall wear footwear meeting the specifications of ANSI Z41, except...

  1. 29 CFR 1910.136 - Foot protection.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 5 2013-07-01 2013-07-01 false Foot protection. 1910.136 Section 1910.136 Labor... OCCUPATIONAL SAFETY AND HEALTH STANDARDS Personal Protective Equipment § 1910.136 Foot protection. (a) General... areas where there is a danger of foot injuries due to falling or rolling objects, or objects...

  2. 29 CFR 1917.94 - Foot protection.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 7 2014-07-01 2014-07-01 false Foot protection. 1917.94 Section 1917.94 Labor Regulations...) MARINE TERMINALS Personal Protection § 1917.94 Foot protection. (a) The employer shall ensure that each affected employee wears protective footwear when working in areas where there is a danger of foot...

  3. 29 CFR 1910.136 - Foot protection.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 5 2012-07-01 2012-07-01 false Foot protection. 1910.136 Section 1910.136 Labor... OCCUPATIONAL SAFETY AND HEALTH STANDARDS Personal Protective Equipment § 1910.136 Foot protection. (a) General... areas where there is a danger of foot injuries due to falling or rolling objects, or objects...

  4. 29 CFR 1915.156 - Foot protection.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 7 2013-07-01 2013-07-01 false Foot protection. 1915.156 Section 1915.156 Labor... (PPE) § 1915.156 Foot protection. (a) Use. The employer shall ensure that each affected employee wears protective footwear when working in areas where there is a danger of foot injuries due to falling or...

  5. 29 CFR 1918.104 - Foot protection.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 7 2012-07-01 2012-07-01 false Foot protection. 1918.104 Section 1918.104 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.104 Foot... in areas where there is a danger of foot injuries due to falling or rolling objects or...

  6. Intrinsic Foot Muscle Deterioration is Associated with Metatarsophalangeal Joint Angle in People with Diabetes and Neuropathy

    PubMed Central

    Cheuy, Victor A.; Hastings, Mary K.; Commean, Paul K.; Ward, Samuel R.; Mueller, Michael J.

    2013-01-01

    Background Metatarsophalangeal joint deformity is associated with skin breakdown and amputation. The aims of this study were to compare intrinsic foot muscle deterioration ratios (ratio of adipose to muscle volume), and physical performance in subjects with diabetic neuropathy to controls, and determine their associations with 1) metatarsophalangeal joint angle and 2) history of foot ulcer. Methods 23 diabetic, neuropathic subjects [59 (SD 10) years] and 12 age-matched controls [57 (SD 14) years] were studied. Radiographs and MRI were used to measure metatarsophalangeal joint angle and intrinsic foot muscle deterioration through tissue segmentation by image signal intensity. The Foot and Ankle Ability Measure evaluated physical performance. Findings The diabetic, neuropathic group had a higher muscle deterioration ratio [1.6 (SD 1.2) vs. 0.3 (SD 0.2), P < 0.001], and lower Foot and Ankle Ability Measure scores [65.1 (SD 24.4) vs. 98.3 (SD 3.3) %, P < 0.01]. The correlation between muscle deterioration ratio and metatarsophalangeal joint angle was r = −0.51 (P = 0.01) for all diabetic, neuropathic subjects, but increased to r = −0.81 (P < 0.01) when only subjects with muscle deterioration ratios >1.0 were included. Muscle deterioration ratios in individuals with diabetic neuropathy were higher for those with a history of ulcers. Interpretation Individuals with diabetic neuropathy had increased intrinsic foot muscle deterioration, which was associated with second metatarsophalangeal joint angle and history of ulceration. Additional research is required to understand how foot muscle deterioration interacts with other impairments leading to forefoot deformity and skin breakdown. PMID:24176198

  7. Multi-joint foot kinetics during walking in people with Diabetes Mellitus and peripheral neuropathy.

    PubMed

    DiLiberto, Frank E; Tome, Josh; Baumhauer, Judith F; Quinn, Jill R; Houck, Jeff; Nawoczenski, Deborah A

    2015-10-15

    Neuropathic tissue changes can alter muscle function and are a primary reason for foot pathologies in people with Diabetes Mellitus and peripheral neuropathy (DMPN). Understanding of foot kinetics in people with DMPN is derived from single-segment foot modeling approaches. This approach, however, does not provide insight into midfoot power and work. Gaining an understanding of midfoot kinetics in people with DMPN prior to deformity or ulceration may help link foot biomechanics to anticipated pathologies in the midfoot and forefoot. The purpose of this study was to evaluate midfoot (MF) and rearfoot (RF) power and work in people with DMPN and a healthy matched control group. Thirty people participated (15 DMPN and 15 Controls). An electro-magnetic tracking system and force plate were used to record multi-segment foot kinematics and ground reaction forces during walking. MF and RF power, work, and negative work ratios were calculated and compared between groups. Findings demonstrated that the DMPN group had greater negative peak power and reduced positive peak power at the MF and RF (all p≤0.05). DMPN group negative work ratios were also greater at the MF and RF [Mean difference MF: 9.9%; p=0.24 and RF: 18.8%; p<0.01]. In people with DMPN, the greater proportion of negative work may negatively affect foot structures during forward propulsion, when positive work and foot stability should predominate. Further study is recommended to determine how both MF and RF kinetics influence the development of deformity and ulceration in people with DMPN.

  8. A rare case of unilateral postaxial duplicated foot in a developmentally normal child.

    PubMed

    Sahdi, Haniza; Hoong, Chan Wai; Rasit, Ahmad Hata; Arianto, Fredy; Siong, Lau Kiew; Abdullah, Nur Alyana Benjamin

    2017-01-01

    Diplopodia, being a rare congenital disorder, is infrequently discussed in published texts. Most reported cases have accounted the involvement of duplicated preaxial digits with other associated organ system and physical deformities. Here, we present an unusual case of isolated diplopodia involving postaxial toes in a child with no other organ and physical abnormalities. Radiological studies revealed a set of 10-digit-duplicated foot over the lateral aspect of the native foot, complete with phalanges and its corresponding metatarsals as well as tarsals, supplied by an anomalous posterior branch of the popliteal artery. Definitive surgery was performed just before the child was learning to walk.

  9. Quality of Life Impact Related to Foot Health in a Sample of Older People with Hallux Valgus

    PubMed Central

    López, Daniel López; Callejo González, Lucía; Iglesias, Marta Elena Losa; Canosa, Jesús Luis Saleta; Sanz, David Rodríguez; Lobo, Cesar Calvo; de Bengoa Vallejo, Ricardo Becerro

    2016-01-01

    Hallux Valgus (HV) is a highly prevalent forefoot deformity in older people associated with progressive subluxation and osteoarthritis of the first metatarsophalangeal (MTP) joint and it is believed to be associated with varying degrees of HV effect on the quality of life related to foot health. The aim of this study is to compare the impact of varying degrees of HV on foot health in a sample of older people. The sample consisted of 115 participants, mean age 76.7 ± 9.1, who attended an outpatient center where self-report data were recorded. The degree of HV deformity was determined in both feet using the Manchester Scale (MS) from stage 1 (mild) to 4 (very severe). Scores obtained on the Foot Health Status Questionnaire (FHSQ) were compared. This has 13 questions that assess 4 health domains of the feet, namely pain, function, general health and footwear. The stage 4 of HV shown lower scores for the footwear domain (11.23 ± 15.6); general foot health (27.62 ± 19.1); foot pain (44.65 ± 24.5); foot function (53.04 ± 27.2); vigour (42.19 ± 16.8); social capacity (44.46 ± 28.1); and general health (41.15 ± 25.5) compared with stage 1 of HV (P<0.05) and there were no differences of physical activity (62.81 ± 24.6). Often, quality of life decreases in the elderly population based in large part on their foot health. There is a progressive reduction in health in general and foot health with increasing severity of hallux valgus deformity which appears to be associated with the presence of greater degree of HV, regardless of gender. PMID:26816663

  10. Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain

    PubMed Central

    Dòria, Montserrat; Rosado, Verónica; Pacheco, Linda Roxana; Betriu, Àngels; Valls, Joan; Mauricio, Dídac

    2016-01-01

    Aim. To assess the prevalence of diabetic foot and other associated conditions in patients with diabetes mellitus under renal replacement in the region of Lleida, Spain. Methods. This was an observational, cross-sectional study of 92 dialysis-treated diabetic patients. Besides a podiatric examination, we explored the presence of cardiovascular risk factors, late diabetes complications, including peripheral neuropathy, atherosclerotic disease, and peripheral artery disease. We assessed risk factors for foot ulceration and amputation by logistic regression. Results. Prevalent diabetic foot was found in 17.4% of patients, foot deformities were found in 54.3%, previous ulcer was found in 19.6%, and amputations were found in 16.3%; and 87% of them had some risk of suffering diabetic foot in the future. We observed a high prevalence of patients with peripheral neuropathy and peripheral artery disease (89.1% and 64.2%, resp.). Multivariable analysis identified diabetic retinopathy and advanced atherosclerotic disease (stenosing carotid plaques) as independent risk factors for foot ulceration (p = 0.004 and p = 0.023, resp.) and diabetic retinopathy also as an independent risk factor for lower-limb amputations (p = 0.013). Moreover, there was a temporal association between the initiation of dialysis and the incidence of amputations. Conclusion. Diabetic patients receiving dialysis therapy are at high risk of foot complications and should receive appropriate and intensive foot care. PMID:27190996

  11. Prevalence of Diabetic Foot Disease in Patients with Diabetes Mellitus under Renal Replacement Therapy in Lleida, Spain.

    PubMed

    Dòria, Montserrat; Rosado, Verónica; Pacheco, Linda Roxana; Hernández, Marta; Betriu, Àngels; Valls, Joan; Franch-Nadal, Josep; Fernández, Elvira; Mauricio, Dídac

    2016-01-01

    Aim. To assess the prevalence of diabetic foot and other associated conditions in patients with diabetes mellitus under renal replacement in the region of Lleida, Spain. Methods. This was an observational, cross-sectional study of 92 dialysis-treated diabetic patients. Besides a podiatric examination, we explored the presence of cardiovascular risk factors, late diabetes complications, including peripheral neuropathy, atherosclerotic disease, and peripheral artery disease. We assessed risk factors for foot ulceration and amputation by logistic regression. Results. Prevalent diabetic foot was found in 17.4% of patients, foot deformities were found in 54.3%, previous ulcer was found in 19.6%, and amputations were found in 16.3%; and 87% of them had some risk of suffering diabetic foot in the future. We observed a high prevalence of patients with peripheral neuropathy and peripheral artery disease (89.1% and 64.2%, resp.). Multivariable analysis identified diabetic retinopathy and advanced atherosclerotic disease (stenosing carotid plaques) as independent risk factors for foot ulceration (p = 0.004 and p = 0.023, resp.) and diabetic retinopathy also as an independent risk factor for lower-limb amputations (p = 0.013). Moreover, there was a temporal association between the initiation of dialysis and the incidence of amputations. Conclusion. Diabetic patients receiving dialysis therapy are at high risk of foot complications and should receive appropriate and intensive foot care.

  12. Effects of custom-made insoles on idiopathic pes cavus foot during walking.

    PubMed

    Choi, Jung-Kyu; Cha, Eun-Jong; Kim, Kyung-Ah; Won, Yonggwan; Kim, Jung-Ja

    2015-01-01

    From a subject group of pes cavus, the purpose of this study was to evaluate the biomechanical characteristics of lower limbs, based on plantar foot pressure and electromyography (EMG) activities, by the effects on two kind of custom-made insoles. Ten individuals among thirty females with a clinical diagnosis of idiopathic pes cavus (mean age (SD): 22.3 (0.08) years) were selected for the study. The plantar foot pressure data and EMG activities of four lower limb muscles were collected, when subjects walked on a treadmill, under three different experimental conditions. The plantar foot pressure data was analyzed, after the bilateral foot was divided into three areas of masks and into four sections of stance phase, to compare plantar foot pressure. The EMG activities were analyzed for integrated EMG (IEMG) value. The results show that plantar foot pressure concentrated in particular parts is decreased by custom-made insoles. In the case of EMG, all the muscle activities decreased significantly. The custom-made insoles dispersed pressure concentrated by the higher medial longitudinal arch and improved the efficient use of muscles. In particular, the extension structure in the forefoot of custom-made insoles was more efficient for pes cavus. Therefore, it could help patients to walk, by offering support to prevent the disease of pes cavus deformity, and to relieve the burden and fatigue in the lower limbs on gait.

  13. The impact of foot arch height on quality of life in 6-12 year olds

    PubMed Central

    Bouza Prego, Mª de los Ángeles; Requeijo Constenla, Ana; Saleta Canosa, Jesús Luis; Bautista Casasnovas, Adolfo; Tajes, Francisco Alonso

    2014-01-01

    Objective: To determine whether arch height has an effect on the health-related quality of life of schoolchildren. Methods: One hundred and thirteen schoolchildren attended an out-patient centre where self-reported data were recorded, their feet were classified into one of three groups according to their arch index (high, normal or low) and the scores obtained from the Foot Health Status Questionnaire (FHSQ - Spanish version) were compared. Results: The groups with high, low and normal arch recorded lower scores in Section One for the general foot health and footwear domains and higher scores in foot pain and foot function. In Section Two they obtained lower scores in general health and higher scores in physical activity, social capacity and vigour. Conclusions: Comparison of the scores obtained reveals that arch height has a negative impact on quality of life. Given the limited extent of available evidence in respect of the aetiology and treatment of foot diseases and deformities, these findings reveal the need to implement programmes to promote foot health and carry out further research into this commonly occurring disabling condition. PMID:25767305

  14. Maximum force and the center of pressure trajectory length according to foot angles during stair walking

    PubMed Central

    Lee, Jeon Hyeong; Lee, Myoung Hee; Lee, Sang Yeol

    2015-01-01

    [Purpose] Walking with the feet turned inward or outward often causes issues for the people with these walking patterns. The purpose of this study was to examine the influence of in-toeing and out-toeing on maximum force and the center of pressure (COP) trajectory length during stair walking. [Subjects and Methods] The subjects were 30 female university students without orthopedic diseases of the foot. The foot angle was divided into three types: in-toeing, normal, and out-toeing. A plantar pressure measurement instrument was used, and the maximum force was obtained by dividing the foot into six regions covering the anterior medial-lateral, middle medial-lateral, and posterior medial-lateral regions. The COP trajectory length was statistically calculated by measuring the medial-lateral, anterior-posterior, and total travel distances. [Results] During stair climbing, the maximum force was significantly different in the anterior lateral region. During stair descending, the maximum force was significantly different in the anterior lateral, middle medial, middle lateral, posterior medial, and posterior lateral regions. The COP trajectory length showed a statistically significant difference in the medio-lateral travel distance. [Conclusion] Walking with abnormal foot angles causes deformed foot structures and can result in musculoskeletal disabilities in the long term. Therefore, therapeutic intervention is required to maintain normal foot angles. PMID:26504329

  15. A two-stage percutaneous approach to charcot diabetic foot reconstruction.

    PubMed

    Lamm, Bradley M; Gottlieb, H David; Paley, Dror

    2010-01-01

    The goals of Charcot deformity correction are to restore osseous alignment, regain pedal stability, and prevent ulceration. Traditional reconstructive surgical approaches involve large, open incisions to remove bone and the use of internal fixation to attempt to fuse dislocated joints. Such operations can result in shortening of the foot and/or incomplete deformity correction, fixation failure, incision healing problems, infection, and the longterm use of casts or braces. We recommend a minimally invasive surgical technique for the treatment of Charcot deformity, which we performed on 11 feet in 8 patients. Osseous realignment was achieved through gradual distraction of the joints with external fixation, after which minimally invasive arthrodesis was performed with rigid internal fixation. Feet were operated on at various stages of Charcot deformity: Eichenholtz stage I (1 foot), Eichenholtz stage II (6 feet), and Eichenholtz stage III (4 feet). When comparing the average change in preoperative and postoperative radiographic angles, the transverse plane talar-first metatarsal angle (P = .02), sagittal plane talar-first metatarsal angle (P = .008), and calcaneal pitch angle (P = .001) were all found to be statistically significant. Complications included 3 operative adjustments of external or internal fixation, 4 broken wires or half-pins, 2 broken rings, and 11 pin tract infections. Most notably, no deep infection, no screw failure, and no recurrent ulcerations occurred and no amputations were necessary during an average follow-up of 22 months. Gradual Charcot foot correction with the Taylor spatial frame plus minimally invasive arthrodesis is an effective treatment.

  16. [Orthopaedic footwear against foot ulcers in diabetes].

    PubMed

    Bus, Sicco A

    2014-01-01

    In people with diabetes mellitus, foot ulcers are a major problem because they increase the risk of a foot infection and amputation and reduce quality of life. After a foot ulcer has healed, the risk of recurrence is high. Orthopaedic shoes and orthotics are often prescribed to high risk patients and aim to reduce the mechanical pressure on the plantar surface of the foot. Orthopaedic footwear that is modified to reduce pressure is not much more effective in preventing foot ulcer recurrence than orthopaedic footwear that did not undergo such modification, unless the shoes are worn as recommended. In that case, the risk of ulcer recurrence is reduced by 46%. In patients with a history of ulceration, compliance in wearing orthopaedic shoes at home is low, while these patients walk more inside the house than outside the house. Foot pressure measurements should be part of the prescription and evaluation of orthopaedic footwear for patients at high risk for foot ulceration.

  17. Strength of Footing with Punching Shear Preventers

    PubMed Central

    Lee, Sang-Sup; Moon, Jiho; Park, Keum-Sung; Bae, Kyu-Woong

    2014-01-01

    The punching shear failure often governs the strength of the footing-to-column connection. The punching shear failure is an undesirable failure mode, since it results in a brittle failure of the footing. In this study, a new method to increase the strength and ductility of the footing was proposed by inserting the punching shear preventers (PSPs) into the footing. The validation and effectiveness of PSP were verified through a series of experimental studies. The nonlinear finite element analysis was then performed to demonstrate the failure mechanism of the footing with PSPs in depth and to investigate the key parameters that affect the behavior of the footing with PSPs. Finally, the design recommendations for the footing with PSPs were suggested. PMID:25401141

  18. Complex trauma of the foot.

    PubMed

    Zwipp, H; Dahlen, C; Randt, T; Gavlik, J M

    1997-12-01

    Following complex foot injuries (incidence up to 52 %) in the multiply-injured patient the ultimate goal remains the same as for all significant foot injuries: the restoration of a painless, stable and plantigrade foot to avoid corrective procedures with moderate results. In the case of a complex trauma of the foot (5 point-score) - e. g. a crush injury - primary amputation in the multiply-injured patient (PTS 3-4) is indicated. Limb salvage (PTS 1-2) depends on the intraoperative aspect during the second look (within 24-48 hours after injury): the debridement has to be radical, the selection of amputation level should be at the most distal point compatible with tissue viability and wound healing. A free tissue transfer should be done early if necessary. Single lesions presenting with a compartment syndrome need an immediate dorsal fasciotomy, in the case of a multiply-injured patient as soon as possible. Open fractures are reduced following radical debridement and temporarily stabilized with K-wires and/or tibiotarsal transfixation with an external fixateur until the definitive ORIF. Dislocation-fractures of the talus type 3 and 4 according to Hawkins' classification need open reduction and internal fixation by screws (titan). Open fractures of the calcaneus are stabilized temporarily by a medial external fixateur after debridement until the definitive treatment. If there is a compartment syndrome an immediate dermatofasciotomy is essential. Like closed, calcanear fractures in multiply-injured patients dislocation-fractures of the Chopart's joint need immediate open reduction only if it is an open fracture or associated with a compartment syndrome. The incidence of a compartment syndrome in the case of dislocation fractures of the Lisfranc's joint is high and therefore a dorsal dermatofasciotomy without delay is critical. Open reduction and internal fixation are achieved either by 1.8 mm K-wires or 3.5 mm cortical screws. To avoid further soft tissue damage a

  19. [Complex trauma of the foot].

    PubMed

    Zwipp, H; Dahlen, C; Randt, T; Gavlik, J M

    1997-12-01

    Following complex foot injuries (incidence up to 52%) in the multiply-injured patient the ultimate goal remains the same as for all significant foot injuries: the restoration of a painless, stable and plantigrade foot to avoid corrective procedures with moderate results. In the case of a complex trauma of the foot (5 point-score)--e.g. a crush injury--primary amputation in the multiply-injured patient (PTS 3-4) is indicated. Limb salvage (PTS 1-2) depends on the intraoperative aspect during the second look (within 24-48 hours after injury): the debridement has to be radical, the selection of amputation level should be at the most distal point compatible with tissue viability and wound healing. A free tissue transfer should be done early if necessary. Single lesions presenting with a compartment syndrome need an immediate dorsal fasciotomy, in the case of a multiply-injured patient as soon as possible. Open fractures are reduced following radical debridement and temporarily stabilized with K-wires and/or tibiotarsal transfixation with an external fixateur until the definitive ORIF. Dislocation-fractures of the talus type 3 and 4 according to Hawkins' classification need open reduction and internal fixation by screws (titan). Open fractures of the calcaneus are stabilized temporarily by a medial external fixateur after debridement until the definitive treatment. If there is a compartment syndrome an immediate dermatofasciotomy is essential. Like closed, calcanear fractures in multiply-injured patients dislocation-fractures of the Chopart's joint need immediate open reduction only if it is an open fracture or associated with a compartment syndrome. The incidence of a compartment syndrome in the case of dislocation fractures of the Lisfranc's joint is high and therefore a dorsal dermatofasciotomy without delay is critical. Open reduction and internal fixation are achieved either by 1.8 mm K-wires or 3.5 mm cortical screws. To avoid further soft tissue damage a delayed

  20. The foot core system: a new paradigm for understanding intrinsic foot muscle function.

    PubMed

    McKeon, Patrick O; Hertel, Jay; Bramble, Dennis; Davis, Irene

    2015-03-01

    The foot is a complex structure with many articulations and multiple degrees of freedom that play an important role in static posture and dynamic activities. The evolutionary development of the arch of the foot was coincident with the greater demands placed on the foot as humans began to run. The movement and stability of the arch is controlled by intrinsic and extrinsic muscles. However, the intrinsic muscles are largely ignored by clinicians and researchers. As such, these muscles are seldom addressed in rehabilitation programmes. Interventions for foot-related problems are more often directed at externally supporting the foot rather than training these muscles to function as they are designed. In this paper, we propose a novel paradigm for understanding the function of the foot. We begin with an overview of the evolution of the human foot with a focus on the development of the arch. This is followed by a description of the foot intrinsic muscles and their relationship to the extrinsic muscles. We draw the parallels between the small muscles of the trunk region that make up the lumbopelvic core and the intrinsic foot muscles, introducing the concept of the foot core. We then integrate the concept of the foot core into the assessment and treatment of the foot. Finally, we call for an increased awareness of the importance of the foot core stability to normal foot and lower extremity function.

  1. Obese older adults suffer foot pain and foot-related functional limitation.

    PubMed

    Mickle, Karen J; Steele, Julie R

    2015-10-01

    There is evidence to suggest being overweight or obese places adults at greater risk of developing foot complications such as osteoarthritis, tendonitis and plantar fasciitis. However, no research has comprehensively examined the effects of overweight or obesity on the feet of individuals older than 60 years of age. Therefore we investigated whether foot pain, foot structure, and/or foot function is affected by obesity in older adults. Three hundred and twelve Australian men and women, aged over 60 years, completed validated questionnaires to establish the presence of foot pain and health related quality of life. Foot structure (anthropometrics and soft tissue thickness) and foot function (ankle dorsiflexion strength and flexibility, toe flexor strength, plantar pressures and spatiotemporal gait parameters) were also measured. Obese participants (BMI >30) were compared to those who were overweight (BMI=25-30) and not overweight (BMI <25). Obese participants were found to have a significantly higher prevalence of foot pain and scored significantly lower on the SF-36. Obesity was also associated with foot-related functional limitation whereby ankle dorsiflexion strength, hallux and lesser toe strength, stride/step length and walking speed were significantly reduced in obese participants compared to their leaner counterparts. Therefore, disabling foot pain and altered foot structure and foot function are consequences of obesity for older adults, and impact upon their quality of life. Interventions designed to reduce excess fat mass may relieve loading of the foot structures and, in turn, improve foot pain and quality of life for older obese individuals.

  2. Weigh-in-motion scale with foot alignment features

    SciTech Connect

    Abercrombie, Robert Knox; Richardson, Gregory David; Scudiere, Matthew Bligh

    2013-03-05

    A pad is disclosed for use in a weighing system for weighing a load. The pad includes a weighing platform, load cells, and foot members. Improvements to the pad reduce or substantially eliminate rotation of one or more of the corner foot members. A flexible foot strap disposed between the corner foot members reduces rotation of the respective foot members about vertical axes through the corner foot members and couples the corner foot members such that rotation of one corner foot member results in substantially the same amount of rotation of the other corner foot member. In a strapless variant one or more fasteners prevents substantially all rotation of a foot member. In a diagonal variant, a foot strap extends between a corner foot member and the weighing platform to reduce rotation of the foot member about a vertical axis through the corner foot member.

  3. [Diabetic foot infections: microbiological aspects].

    PubMed

    Noviello, Silvana; Esposito, Isabella; Pascale, Renato; Esposito, Silvano; Zeppa, Pio

    2012-01-01

    The diagnosis of wound infection is based on clinical signs and local and/or systemic inflammation. Therefore, the examination has a major role in the diagnosis of infected lesions of the foot. Once the clinical diagnosis of infection is made, the next step is to determine the etiology with the aim to undertake a rational and appropriate treatment. The most reliable method for assessing microbiological etiology is the specimen of material from infected lesion to perform a bacterioscopic examination and culture. The microorganisms involved in the etiology of diabetic foot depends on the type of injury and on specific patient features (antibiotic therapy, previous hospitalization). The most frequently detected pathogen is Staphylococcus aureus. Mild infections are mostly caused by Gram positive cocci, with a prevalence of S. aureus. Moderate infections are mostly supported by pyogenic Gram positive cocci, but also Gram-negative bacteria can be involved. In severe infections the etiology is polymicrobial. As regards the involvement of fungi in diabetic foot infections data are few and mostly conflicting.

  4. Significant forefoot varus deformity resulting in progressive stress fractures of all lesser metatarsal bones.

    PubMed

    van der Vlies, Cornelis H; Ponsen, Kees J; Besselaar, Philip P; Goslings, J Carel

    2007-01-01

    Stress fractures may occur in any bone, but appear most frequently in the metatarsal bones. Consecutive stress fractures of all lesser metatarsals in a short period are rare, and only a few cases have been described in the literature. We report an unusual case of a young man with consecutive stress fractures of four adjacent lesser metatarsal bones. The etiology was in all probability the fixed forefoot varus deformity. This foot deformity may impose increased mechanical loads across the lateral aspect of the foot that, in turn, may result in stress fractures involving the lesser metatarsals. In our patient conservative treatment finally resulted in a satisfactory outcome.

  5. Foot Plantar Pressure Measurement System: A Review

    PubMed Central

    Razak, Abdul Hadi Abdul; Zayegh, Aladin; Begg, Rezaul K.; Wahab, Yufridin

    2012-01-01

    Foot plantar pressure is the pressure field that acts between the foot and the support surface during everyday locomotor activities. Information derived from such pressure measures is important in gait and posture research for diagnosing lower limb problems, footwear design, sport biomechanics, injury prevention and other applications. This paper reviews foot plantar sensors characteristics as reported in the literature in addition to foot plantar pressure measurement systems applied to a variety of research problems. Strengths and limitations of current systems are discussed and a wireless foot plantar pressure system is proposed suitable for measuring high pressure distributions under the foot with high accuracy and reliability. The novel system is based on highly linear pressure sensors with no hysteresis. PMID:23012576

  6. Narrative review: Diabetic foot and infrared thermography

    NASA Astrophysics Data System (ADS)

    Hernandez-Contreras, D.; Peregrina-Barreto, H.; Rangel-Magdaleno, J.; Gonzalez-Bernal, J.

    2016-09-01

    Diabetic foot is one of the major complications experienced by diabetic patients. An early identification and appropriate treatment of diabetic foot problems can prevent devastating consequences such as limb amputation. Several studies have demonstrated that temperature variations in the plantar region can be related to diabetic foot problems. Infrared thermography has been successfully used to detect complication related to diabetic foot, mainly because it is presented as a rapid, non-contact and non-invasive technique to visualize the temperature distribution of the feet. In this review, an overview of studies that relate foot temperature with diabetic foot problems through infrared thermography is presented. Through this research, it can be appreciated the potential of infrared thermography and the benefits that this technique present in this application. This paper also presents the different methods for thermogram analysis and the advantages and disadvantages of each one, being the asymmetric analysis the method most used so far.

  7. Conservative and surgical treatment of the chronic Charcot foot and ankle

    PubMed Central

    Güven, Mehmet Fatih; Karabiber, Atakan; Kaynak, Gökhan; Öğüt, Tahir

    2013-01-01

    Charcot neuroarthropathy (CN) is a severe joint disease in the foot and ankle that can result in fracture, permanent deformity, and limb loss. It is a serious and potentially limb-threatening lower-extremity late complication of diabetes mellitus. The aim of this manuscript was to evaluate modern concepts of chronic CN through a review of the available literature and to integrate a perspective of management from the authors’ extensive experience. PMID:23919114

  8. Prevention and treatment of diabetic foot ulcers.

    PubMed

    Lim, Jonathan Zhang Ming; Ng, Natasha Su Lynn; Thomas, Cecil

    2017-03-01

    The rising prevalence of diabetes estimated at 3.6 million people in the UK represents a major public health and socioeconomic burden to our National Health Service. Diabetes and its associated complications are of a growing concern. Diabetes-related foot complications have been identified as the single most common cause of morbidity among diabetic patients. The complicating factor of underlying peripheral vascular disease renders the majority of diabetic foot ulcers asymptomatic until latter evidence of non-healing ulcers become evident. Therefore, preventative strategies including annual diabetic foot screening and diabetic foot care interventions facilitated through a multidisciplinary team have been implemented to enable early identification of diabetic patients at high risk of diabetic foot complications. The National Diabetes Foot Care Audit reported significant variability and deficiencies of care throughout England and Wales, with emphasis on change in the structure of healthcare provision and commissioning, improvement of patient education and availability of healthcare access, and emphasis on preventative strategies to reduce morbidities and mortality of this debilitating disease. This review article aims to summarise major risk factors contributing to the development of diabetic foot ulcers. It also considers the key evidence-based strategies towards preventing diabetic foot ulcer. We discuss tools used in risk stratification and classifications of foot ulcer.

  9. Priorities in offloading the diabetic foot.

    PubMed

    Bus, Sicco A

    2012-02-01

    Biomechanical factors play an important role in diabetic foot disease. Reducing high foot pressures (i.e. offloading) is one of the main goals in healing and preventing foot ulceration. Evidence-based guidelines show the strong association between the efficacy to offload the foot and clinical outcome. However, several aspects related to offloading are underexposed. First, in the management of foot complications, offloading is mostly studied as a single entity, whereas it should be analysed in a broader perspective of contributing factors to better predict clinical outcome. This includes assessment of patient behavioural factors such as type and intensity of daily physical activity and adherence to prescribed treatment. Second, a large gap exists between evidence-based recommendations and clinical practice in the use of offloading for ulcer treatment, and this gap needs to be bridged. Possible ways to achieve this are discussed in this article. Third, our knowledge about the efficacy and role of offloading in treating complicated and non-plantar neuropathic foot ulcers needs to be expanded because these ulcers currently dominate presentation in multidisciplinary foot practice. Finally, foot ulcer prevention is underexposed when compared with ulcer treatment. Prevention requires a larger focus, in particular regarding the efficacy of therapeutic footwear and its relative role in comparison with other preventative strategies. These priorities need the attention of clinicians, scientists and professional societies to improve our understanding of offloading and to improve clinical outcome in the management of the diabetic foot.

  10. Complications of Pediatric Foot and Ankle Fractures.

    PubMed

    Denning, Jaime R

    2017-01-01

    Ankle fractures account for 5% and foot fractures account for approximately 8% of fractures in children. Some complications are evident early in the treatment or natural history of foot and ankle fractures. Other complications do not become apparent until weeks, months, or years after the original fracture. The incidence of long-term sequelae like posttraumatic arthritis from childhood foot and ankle fractures is poorly studied because decades or lifelong follow-up has frequently not been accomplished. This article discusses a variety of complications associated with foot and ankle fractures in children or the treatment of these injuries.

  11. Deformations in VLBI antennas

    NASA Technical Reports Server (NTRS)

    Clark, T. A.; Thomsen, P.

    1988-01-01

    A study is presented of deformations in antennas with the emphasis on their influence on VLBI measurements. The GIFTS structural analysis program has been used to model the VLBI antenna in Fairbanks (Alaska). The report identifies key deformations and studies the effect of gravity, wind, and temperature. Estimates of expected deformations are given.

  12. The role of foot morphology on foot function in diabetic subjects with or without neuropathy.

    PubMed

    Guiotto, Annamaria; Sawacha, Zimi; Guarneri, Gabriella; Cristoferi, Giuseppe; Avogaro, Angelo; Cobelli, Claudio

    2013-04-01

    The aim of this study was to investigate the role of foot morphology, related with respect to diabetes and peripheral neuropathy in altering foot kinematics and plantar pressure during gait. Healthy and diabetic subjects with or without neuropathy with different foot types were analyzed. Three dimensional multisegment foot kinematics and plantar pressures were assessed on 120 feet: 40 feet (24 cavus, 20 with valgus heel and 11 with hallux valgus) in the control group, 80 feet in the diabetic (25 cavus 13 with valgus heel and 13 with hallux valgus) and the neuropathic groups (28 cavus, 24 with valgus heel and 18 with hallux valgus). Subjects were classified according to their foot morphology allowing further comparisons among the subgroups with the same foot morphology. When comparing neuropathic subjects with cavus foot, valgus heel with controls with the same foot morphology, important differences were noticed: increased dorsiflexion and peak plantar pressure on the forefoot (P<0.05), decreased contact surface on the hindfoot (P<0.03). While results indicated the important role of foot morphology in altering both kinematics and plantar pressure in diabetic subjects, diabetes appeared to further contribute in altering foot biomechanics. Surprisingly, all the diabetic subjects with normal foot arch or with valgus hallux were no more likely to display significant differences in biomechanics parameters than controls. This data could be considered a valuable support for future research on diabetic foot function, and in planning preventive interventions.

  13. 3D Measurement of Anatomical Cross-sections of Foot while Walking

    NASA Astrophysics Data System (ADS)

    Kimura, Makoto; Mochimaru, Masaaki; Kanade, Takeo

    Recently, techniques for measuring and modeling of human body are taking attention, because human models are useful for ergonomic design in manufacturing. We aim to measure accurate shape of human foot that will be useful for the design of shoes. For such purpose, shape measurement of foot in motion is obviously important, because foot shape in the shoe is deformed while walking or running. In this paper, we propose a method to measure anatomical cross-sections of foot while walking. No one had ever measured dynamic shape of anatomical cross-sections, though they are very basic and popular in the field of biomechanics. Our proposed method is based on multi-view stereo method. The target cross-sections are painted in individual colors (red, green, yellow and blue), and the proposed method utilizes the characteristic of target shape in the camera captured images. Several nonlinear conditions are introduced in the process to find the consistent correspondence in all images. Our desired accuracy is less than 1mm error, which is similar to the existing 3D scanners for static foot measurement. In our experiments, the proposed method achieved the desired accuracy.

  14. Automatic detection of diabetic foot complications with infrared thermography by asymmetric analysis.

    PubMed

    Liu, Chanjuan; van Netten, Jaap J; van Baal, Jeff G; Bus, Sicco A; van der Heijden, Ferdi

    2015-02-01

    Early identification of diabetic foot complications and their precursors is essential in preventing their devastating consequences, such as foot infection and amputation. Frequent, automatic risk assessment by an intelligent telemedicine system might be feasible and cost effective. Infrared thermography is a promising modality for such a system. The temperature differences between corresponding areas on contralateral feet are the clinically significant parameters. This asymmetric analysis is hindered by (1) foot segmentation errors, especially when the foot temperature and the ambient temperature are comparable, and by (2) different shapes and sizes between contralateral feet due to deformities or minor amputations. To circumvent the first problem, we used a color image and a thermal image acquired synchronously. Foot regions, detected in the color image, were rigidly registered to the thermal image. This resulted in 97.8% ± 1.1% sensitivity and 98.4% ± 0.5% specificity over 76 high-risk diabetic patients with manual annotation as a reference. Nonrigid landmark-based registration with B-splines solved the second problem. Corresponding points in the two feet could be found regardless of the shapes and sizes of the feet. With that, the temperature difference of the left and right feet could be obtained.

  15. Automatic detection of diabetic foot complications with infrared thermography by asymmetric analysis

    NASA Astrophysics Data System (ADS)

    Liu, Chanjuan; van Netten, Jaap J.; van Baal, Jeff G.; Bus, Sicco A.; van der Heijden, Ferdi

    2015-02-01

    Early identification of diabetic foot complications and their precursors is essential in preventing their devastating consequences, such as foot infection and amputation. Frequent, automatic risk assessment by an intelligent telemedicine system might be feasible and cost effective. Infrared thermography is a promising modality for such a system. The temperature differences between corresponding areas on contralateral feet are the clinically significant parameters. This asymmetric analysis is hindered by (1) foot segmentation errors, especially when the foot temperature and the ambient temperature are comparable, and by (2) different shapes and sizes between contralateral feet due to deformities or minor amputations. To circumvent the first problem, we used a color image and a thermal image acquired synchronously. Foot regions, detected in the color image, were rigidly registered to the thermal image. This resulted in 97.8%±1.1% sensitivity and 98.4%±0.5% specificity over 76 high-risk diabetic patients with manual annotation as a reference. Nonrigid landmark-based registration with B-splines solved the second problem. Corresponding points in the two feet could be found regardless of the shapes and sizes of the feet. With that, the temperature difference of the left and right feet could be obtained.

  16. Diabetic foot and exercise therapy: step by step the role of rigid posture and biomechanics treatment.

    PubMed

    Francia, Piergiorgio; Gulisano, Massimo; Anichini, Roberto; Seghieri, Giuseppe

    2014-03-01

    Lower extremity ulcers represent a serious and costly complication of diabetes mellitus. Many factors contribute to the development of diabetic foot. Peripheral neuropathy and peripheral vascular disease are the main causes of foot ulceration and contribute in turn to the growth of additional risk factors such as limited joint mobility, muscular alterations and foot deformities. Moreover, a deficit of balance, posture and biomechanics can be present, in particular in patients at high risk for ulceration. The result of this process may be the development of a vicious cycle which leads to abnormal distribution of the foot's plantar pressures in static and dynamic postural conditions. This review shows that some of these risk factors significantly improve after a few weeks of exercise therapy (ET) intervention. Accordingly it has been suggested that ET can be an important weapon in the prevention of foot ulcer. The aim of ET can relate to one or more alterations typically found in diabetic patients, although greater attention should be paid to the evaluation and possible correction of body balance, rigid posture and biomechanics. Some of the most important limitations of ET are difficult access to therapy, patient compliance and the transitoriness of the results if the training stops. Many proposals have been made to overcome such limitations. In particular, it is important that specialized centers offer the opportunity to participate in ET and during the treatment the team should work to change the patient's lifestyle by improving the execution of appropriate daily physical activity.

  17. Stress distribution comparisons of foot bones in patient with tibia vara: a finite element study.

    PubMed

    Ozkan, Arif; Atmaca, Halil; Mutlu, Ibrahim; Celik, Talip; Uğur, Levent; Kişioğlu, Yasin

    2013-01-01

    Blount's disease, or tibia vara, is the most common cause of pathologic genu varum in children and adolescents. Changes in the loading of knee structures such as tibial articular cartilage, menisci and subcondral bone are well documented in case of genu varum. But the mechanical effects of this condition on foot bones are still questionable. In this study, the authors hypothesized that stress distributions on foot bones might increase in patients with tibia vara when compared with patients who had normal lower extremity mechanical axis. Three-dimensional (3D) finite element analyses of human lower limb were used to investigate and compare the loading on foot bones in normal population and patient with tibia vara. The segmentation software, MIMICS was used to generate the 3D images of the bony structures of normal and varus malalignment lower extremity. Except the spaces between the adjacent surface of the phalanges fused, metatarsals, cuneiforms, cuboid, navicular, talus and calcaneus bones were independently developed to form foot and ankle complex. Also femur, tibia and fibula were modeled utilizing mechanical axis. ANSYS version 14 was used for mechanical tests and maximum equivalent stresses (MES) were examined. As a result of the loading conditions, in varus model MES on talus, calcaneus and cuboid were found higher than in normal model. And stress distributions changed through laterally on middle and fore foot in varus deformity model.

  18. Foot Pain and Pronated Foot Type are Associated with Self-Reported Mobility Limitations in Older Adults: the Framingham Foot Study

    PubMed Central

    Menz, Hylton B.; Dufour, Alyssa B.; Katz, Patricia; Hannan, Marian T.

    2015-01-01

    Background The foot plays an important role in supporting the body when undertaking weight bearing activities. Aging is associated with an increased prevalence of foot pain and a lowering of the arch of the foot, both of which may impair mobility. Objective To examine the associations of foot pain, foot posture and dynamic foot function with self-reported mobility limitations in community-dwelling older adults. Methods Foot examinations were conducted on 1,860 members of the Framingham Study in 2002–2005. Foot posture was categorized as normal, planus or cavus using static pressure measurements, and foot function was categorized as normal, pronated or supinated using dynamic pressure measurements. Participants were asked whether they had foot pain and any difficulty performing a list of nine weight bearing tasks. Multivariate logistic regression and linear regression models were used to examine the associations of foot pain, posture, function and ability to perform these activities. Results After adjusting for age, sex, height and weight, foot pain was significantly associated with difficulty performing all nine weight bearing activities. Compared to those with normal foot posture and function, participants with planus foot posture were more likely to report difficulty remaining balanced (odds ratio [OR] = 1.40, 95% confidence interval [CI] 1.06 to 1.85; p=0.018) and individuals with pronated foot function were more likely to report difficulty walking across a small room (OR = 2.07, 95% CI 1.02 to 4.22; p=0.045). Foot pain and planus foot posture were associated with an overall mobility limitation score combining performances on each measure. Conclusion Foot pain, planus foot posture and pronated foot function are associated with self-reported difficulty undertaking common weight bearing tasks. Interventions to reduce foot pain and improve foot posture and function may therefore have a role in improving mobility in older adults. PMID:26645379

  19. A new ankle foot orthosis for running.

    PubMed

    Bishop, David; Moore, Allan; Chandrashekar, Naveen

    2009-09-01

    Traumatic knee injuries in automobile accidents and sports often lead to damage of the peroneal nerve. A lack of control of muscles innervated by the peroneal nerve due to this damage, results in the inability to dorsiflex and evert the foot and to extend the toes. This condition is commonly known as foot drop. Foot drop reduces the stability in the body while walking and running and may also cause injury due to lack of foot clearance during the swing phase of the gait. Traditionally, an ankle foot orthosis (AFO), comprised of a moulded sheet of plastic that conforms around the posterior calf and distally contains all or part of the calcaneous as well as the plantar foot, is used to treat foot drop. The intent of this orthosis is to dorsiflex the foot to provide clearance during the swing phase of walking and running. Traditional AFO results in increased pressures due to a decrease in dorsiflexion range of motion at the ankle and make the orthosis increasingly uncomfortable to wear. Several other existing designs of foot drop AFO suffer from similar inadequacies. To address these issues, a new AFO was developed. The device was successfully used by one person with foot drop without issues for more than one year. This new design conforms to the lower anterior shin and dorsum of the foot using dorsiassist Tamarack ankle joints to allow for greater plantar and dorsiflexion range of motion. While still limiting ankle inversion it does allow for more ankle eversion. This orthosis can be discretely worn inside shoes due to its smaller size, and can be worn for a longer period of time without discomfort.

  20. The madura foot: looking deep.

    PubMed

    Venkatswami, Sandhya; Sankarasubramanian, Anandan; Subramanyam, Shobana

    2012-03-01

    "Mycetoma" means a fungal tumor. Mycetoma is a chronic, granulomatous, subcutaneous tissue infection caused by both bacteria (actinomycetoma) and fungi (eumycetoma). This chronic infection was termed Madura foot and eventually mycetoma, owing to its etiology. Inoculation commonly follows minor trauma, predominantly to the foot and hence is seen more among the barefoot-walking populations, common among adult males aged 20 to 50 years. The hallmark triad of the disease includes tumefaction, fistulization of the abscess, and extrusion of colored grains. The color of these extruded grains in the active phase of the disease offers a clue to diagnosis. Radiology, ultrasonology, cytology, histology, immunodiagnosis, and culture are tools used in diagnosis. Recently, DNA sequencing has also been used successfully. Though both infections manifest with similar clinical findings, Actinomycetoma has a rapid course and can lead to amputation or death secondary to systemic spread. However, actinomycetomas are more responsive to antibiotics, whereas eumycetomas require surgical excision in addition to antifungals. Complications include secondary bacterial infections that can progress to full-blown bacteremia or septicemia, resulting in death. With extremely disfiguring sequelae, following the breakdown of the nodules and formation of discharging sinuses, it poses a therapeutic challenge.

  1. Classification of diabetic foot ulcers.

    PubMed

    Game, Frances

    2016-01-01

    It is known that the relative importance of factors involved in the development of diabetic foot problems can vary in both their presence and severity between patients and lesions. This may be one of the reasons why outcomes seem to vary centre to centre and why some treatments may seem more effective in some people than others. There is a need therefore to classify and describe lesions of the foot in patients with diabetes in a manner that is agreed across all communities but is simple to use in clinical practice. No single system is currently in widespread use, although a number have been published. Not all are well validated outside the system from which they were derived, and it has not always been made clear the clinical purposes to which such classifications should be put to use, whether that be for research, clinical description in routine clinical care or audit. Here the currently published classification systems, their validation in clinical practice, whether they were designed for research, audit or clinical care, and the strengths and weaknesses of each are explored.

  2. 13. 64 foot truss oblique view of the 64 ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. 64 foot truss - oblique view of the 64 foot pony truss showing its general configuration. The 80 foot pony trusses are similar. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  3. Cold-Weather Foot Care Key for Diabetics

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_163022.html Cold-Weather Foot Care Key for Diabetics It's important to ... potentially serious foot problems, especially during the cold weather, a foot and ankle specialist warns. "When it ...

  4. Diabetic Foot and Risk: How to Prevent Losing Your Leg

    MedlinePlus

    ... of the Smaller Toes How To... Foot Health Foot Injury Footwear News Videos Find a Surgeon Información en ... closely for any of the above-mentioned changes. Foot injuries that occur without the person's knowledge can be ...

  5. Parents: Avoid Kids Foot Problems with the Right Shoes

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  6. Back to School Foot Pain (Flip-Flops)

    MedlinePlus

    ... foot and ankle surgeons. All Fellows of the College are board certified by the American Board of Foot and Ankle Surgery. Copyright © 2017 American College of Foot and Ankle Surgeons (ACFAS), All Rights ...

  7. Salient Features of the Maasai Foot: Analysis of 1,096 Maasai Subjects

    PubMed Central

    Suh, Jin Soo; Seo, Lan

    2014-01-01

    Background The Maasai are the most widely known African ethnic group located in Kenya and northern Tanzania. Most spend their days either barefoot or in their traditional shoes made of car tires. Although they walk long distances of up to sixty kilometers a day, they do not suffer from any foot ailments. Little is known about their foot structure and gait. The goal of this investigation was to characterize various aspects of Maasai foot in standing and walking. Methods Foot length, calf circumference, hindfoot alignment, step length, cadence, and walking velocity were obtained from 1,096 adult Maasai people (545 males and 551 females; mean age, 40.28 ± 14.69 years; age range, 16 to 65 years). All included subjects were from rural areas, where the primary terrain was sandy soil, who spend most of their lifetime barefoot, walking. They all denied any medical history or previous symptoms related to foot problems. A trained clinician scanned all feet for deformities. Static (standing) and dynamic (walking) Harris mat footprints were taken to determine the distribution of forefoot pressure patterns during walking. Results The average foot length was 250.14 ± 18.12 mm (range, 210 to 295 mm) and calf circumference was 32.50 ± 3.22 cm (range, 25 to 41 cm). The mean hindfoot alignment was 6.21° ± 1.55° of valgus. Sixty-four subjects (5.84%) had bilateral flat-shaped feet with a low medial longitudinal arch that exactly matched the broad pattern of their static footprints. Step length, cadence, and walking velocity were 426.45 ± 88.73 cm (range, 200 to 690 cm), 94.35 steps/min (range, 72 to 111 steps/min), and 40.16 ± 8.36 m/min (range, 18.20 to 63.36 m/min), respectively. A total of 83.39% subjects showed unilateral or bilateral deformities of multiple toes regardless of age. The most frequent deformity was clawing (98.79%) of which the highest incidence occurred with the fifth toe (93.23%). Dynamic footprints showed even pressure patterns throughout the forefoot

  8. Robust Foot Clearance Estimation Based on the Integration of Foot-Mounted IMU Acceleration Data.

    PubMed

    Benoussaad, Mourad; Sijobert, Benoît; Mombaur, Katja; Coste, Christine Azevedo

    2015-12-23

    This paper introduces a method for the robust estimation of foot clearance during walking, using a single inertial measurement unit (IMU) placed on the subject's foot. The proposed solution is based on double integration and drift cancellation of foot acceleration signals. The method is insensitive to misalignment of IMU axes with respect to foot axes. Details are provided regarding calibration and signal processing procedures. Experimental validation was performed on 10 healthy subjects under three walking conditions: normal, fast and with obstacles. Foot clearance estimation results were compared to measurements from an optical motion capture system. The mean error between them is significantly less than 15 % under the various walking conditions.

  9. Revisiting the tailor's bunion and adductovarus deformity of the fifth digit.

    PubMed

    DiDomenico, Lawrence; Baze, Erigena; Gatalyak, Nikolay

    2013-07-01

    Correction of the fifth digit deformity and Tailor's Bunion can be rewarding as well as challenging for a foot and ankle surgeon. Immense care should be taken when performing these reconstructive surgical procedure, especially to avoid and minimize complication rates and mainly to prevent neurovascular damage. Appropriate surgical procedure selection for the fifth digit deformity and Tailor's Bunion is necessary in order to obtain a long term predictable outcome.

  10. Foot Swelling during Air Travel: A Concern?

    MedlinePlus

    Diseases and Conditions Edema What causes leg and foot swelling during air travel? Answers from Sheldon G. Sheps, M.D. Leg and foot ... 191. Sterns RH. Clinical manifestations and diagnosis of edema in adults. http://www.uptodate.com/home. Accessed ...

  11. 24 CFR 3285.312 - Footings.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... density. A footing must support every pier. Footings are to be either: (1) Concrete. (i) Four inch nominal precast concrete pads meeting or exceeding ASTM C 90-02a, Standard Specification for Loadbearing Concrete... compressive strength of 1,200 pounds per square inch (psi); or (ii) Six inch minimum poured-in-place...

  12. 24 CFR 3285.312 - Footings.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... density. A footing must support every pier. Footings are to be either: (1) Concrete. (i) Four inch nominal precast concrete pads meeting or exceeding ASTM C 90-02a, Standard Specification for Loadbearing Concrete... compressive strength of 1,200 pounds per square inch (psi); or (ii) Six inch minimum poured-in-place...

  13. 49 CFR 214.115 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... protection equipment when potential foot injury may result from impact, falling or flying objects, electrical... 49 Transportation 4 2010-10-01 2010-10-01 false Foot protection. 214.115 Section 214.115..., DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY Bridge Worker Safety Standards § 214.115...

  14. 29 CFR 1918.104 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... in areas where there is a danger of foot injuries due to falling or rolling objects or objects... 29 Labor 7 2011-07-01 2011-07-01 false Foot protection. 1918.104 Section 1918.104 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.104...

  15. 33 CFR 142.33 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... for foot injury to occur shall wear footwear meeting the specifications of ANSI Z41, except when... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Foot protection. 142.33 Section... CONTINENTAL SHELF ACTIVITIES WORKPLACE SAFETY AND HEALTH Personal Protective Equipment § 142.33...

  16. 33 CFR 142.33 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... for foot injury to occur shall wear footwear meeting the specifications of ANSI Z41, except when... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Foot protection. 142.33 Section... CONTINENTAL SHELF ACTIVITIES WORKPLACE SAFETY AND HEALTH Personal Protective Equipment § 142.33...

  17. 49 CFR 214.115 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... protection equipment when potential foot injury may result from impact, falling or flying objects, electrical... 49 Transportation 4 2011-10-01 2011-10-01 false Foot protection. 214.115 Section 214.115..., DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY Bridge Worker Safety Standards § 214.115...

  18. 29 CFR 1918.104 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... in areas where there is a danger of foot injuries due to falling or rolling objects or objects... 29 Labor 7 2010-07-01 2010-07-01 false Foot protection. 1918.104 Section 1918.104 Labor... (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR LONGSHORING Personal Protective Equipment § 1918.104...

  19. Louisiana farm discussion: 8 foot row spacing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This year several tests in growers’ fields were used to compare traditional 6-foot row spacing to 8-foot row spacing. Cane is double-drilled in the wider row spacing. The wider row spacing would accommodate John Deere 3522 harvester. Field data indicate the sugarcane yields are very comparable in 8-...

  20. 49 CFR 214.115 - Foot protection.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Foot protection. 214.115 Section 214.115..., DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY Bridge Worker Safety Standards § 214.115 Foot protection. (a) The railroad or railroad contractor shall require railroad bridge workers to wear...

  1. 49 CFR 214.115 - Foot protection.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Foot protection. 214.115 Section 214.115..., DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY Bridge Worker Safety Standards § 214.115 Foot protection. (a) The railroad or railroad contractor shall require railroad bridge workers to wear...

  2. 49 CFR 214.115 - Foot protection.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Foot protection. 214.115 Section 214.115..., DEPARTMENT OF TRANSPORTATION RAILROAD WORKPLACE SAFETY Bridge Worker Safety Standards § 214.115 Foot protection. (a) The railroad or railroad contractor shall require railroad bridge workers to wear...

  3. Tumours of the foot and ankle.

    PubMed

    Khan, Zeeshan; Hussain, Shakir; Carter, Simon R

    2015-09-01

    Sarcomas are rare tumours and particularly rarer in the foot and ankle region. The complex anatomy of the foot and ankle makes it unique and hence poses a challenge to the surgeon for limb salvage surgery. Other lesions found in the foot and ankle region are benign bone and soft tissue tumours, metastasis and infection. The purpose of this article is to discuss the relevance of the complex anatomy of the foot and ankle in relation to tumours, clinical features, their general management principles and further discussion about some of the more common bone and soft tissue lesions. Discussion of every single bone and soft tissue lesion in the foot and ankle region is beyond the scope of this article.

  4. “They just scraped off the calluses”: a mixed methods exploration of foot care access and provision for people with rheumatoid arthritis in south-western Sydney, Australia

    PubMed Central

    2013-01-01

    Background There is little indication that foot health services in Australia are meeting modern day recommendations for Rheumatoid Arthritis (RA) patients. The overall objective of this study was to explore the current state of foot health services for patients with RA with an emphasis on identifying barriers to the receipt of appropriate foot care in South-West Sydney, New South Wales, Australia. Methods A mixed (quantitative and qualitative) approach was adopted. Indications for appropriate access to foot care were determined by comparing the foot health, disease and socio-demographic characteristics of patients with unmet foot care demands, foot care users and patients with no demands for foot care. Perceptions of provision of, and access to, foot care were explored by conducting telephone-based interviews using an interpretative phenomenology approach with thematic analysis. Results Twenty-nine participants took part in the cross-sectional quantitative research study design, and 12 participants took part in the interpretative phenomenological approach (qualitative study). Foot care access appeared to be driven predominantly by the presence of rearfoot deformity, which was significantly worse amongst participants in the foot care user group (p = 0.02). Five main themes emerged from the qualitative data: 1) impact of disease-related foot symptoms, 2) footwear difficulties, 3) medical/rheumatology encounters, 4) foot and podiatry care access and experiences, and 5) financial hardship. Conclusions Foot care provision does not appear to be driven by appropriate foot health characteristics such as foot pain or foot-related disability. There may be significant shortfalls in footwear and foot care access and provision in Greater Western Sydney. Several barriers to adequate foot care access and provision were identified and further efforts are required to improve access to and the quality of foot care for people who have RA. Integration of podiatry services within

  5. Offshore Deformation Front in Miaoli Area

    NASA Astrophysics Data System (ADS)

    Chiang, P.; Gwo-shyn, S.

    2015-12-01

    Taiwan is located at the junction of the Eurasian Plate and the Philippine Sea Plate. It's because arc-continent collision occurs in the western Taiwan, resulting in the orogeny has formed a fold-and-thrust belt, developing a series of thrusts aligned in north-south direction. The thrust faults, locating in the central island, are the oldest and have almost inactive. Westward to the island, the faults become younger, dipping angles are smaller, and motions were stronger. On the west side, the foot of the Taiwan Western Foothill is considered the youngest thrust faults located along west Taiwan. Scholars recognized them as so-called the deformation front, and they also believed that the deformation front is located in between the compressive terrain uplifted area and the extensional subsidence area. Therefore, this front line is on the boundary of two different tectonic zones. This study investigates the trace of the deformation front in Miaoli area. Previous studies suggested that the west side of Miaoli collision zone should be fault-bounded, and is located in the seabed. However, in the geological map, there is no geologic evidence that appears on land and so-called active faults related with this deformation front. In the near coast seafloor, according to the reflection earthquakes data from the Institute of Oceanography of NTU, we can only see the offshore strata have been uplifted, and the data also shows that seabed is only covered by thin layer of sediments. This study indicates that in offshore place within three kilometers, shallow formations show a special layer of slime which was extruded to be corrugated transversely. Accordingly, we believe that this slime layer should be pressurized and filled with muddy water. Such features should be further investigated with other geological and geophysical survey data to check if they belong to the structural product of the deformation front.

  6. Deformations of superconformal theories

    NASA Astrophysics Data System (ADS)

    Córdova, Clay; Dumitrescu, Thomas T.; Intriligator, Kenneth

    2016-11-01

    We classify possible supersymmetry-preserving relevant, marginal, and irrelevant deformations of unitary superconformal theories in d ≥ 3 dimensions. Our method only relies on symmetries and unitarity. Hence, the results are model independent and do not require a Lagrangian description. Two unifying themes emerge: first, many theories admit deformations that reside in multiplets together with conserved currents. Such deformations can lead to modifications of the supersymmetry algebra by central and non-central charges. Second, many theories with a sufficient amount of supersymmetry do not admit relevant or marginal deformations, and some admit neither. The classification is complicated by the fact that short superconformal multiplets display a rich variety of sporadic phenomena, including supersymmetric deformations that reside in the middle of a multiplet. We illustrate our results with examples in diverse dimensions. In particular, we explain how the classification of irrelevant supersymmetric deformations can be used to derive known and new constraints on moduli-space effective actions.

  7. Ostectomy and Medial Plantar Artery Flap Reconstruction for Charcot Foot Ulceration Involving the Midfoot.

    PubMed

    Sato, Tomoya; Ichioka, Shigeru

    2016-01-01

    Charcot foot is a serious complication of diabetes, characterized by deformity and overlying ulceration. The condition most commonly affects the midfoot. However, little information is available on the use of a medial plantar artery flap to treat diabetic midfoot ulceration. The purpose of the present study was to evaluate the versatility of ostectomy and medial plantar flap reconstruction for midfoot plantar ulceration associated with rocker-bottom deformity secondary to Charcot foot. Four patients underwent ostectomy and medial plantar flap reconstruction. Before flap reconstruction, the devitalized soft tissues and bone were radically resected. After the infection had been controlled, the ulcerated portion was minimally excised, and the bony prominence underlying the ulcer was removed. A medial plantar artery flap was applied to the ulcer. The donor site was covered with a split-thickness skin graft or artificial dermis. In all patients, the ulcers healed and independent ambulation was achieved. However, 1 patient experienced ulcer recurrence, and subsequent infection necessitated a major amputation. Limb salvage is challenging in the setting of deformity and intractable plantar ulceration. The advantages of medial plantar artery flap reconstruction are that tissues with a rich blood supply are used to cover the exposed bone, and the flap can withstand the pressure and shear stress of the patient's body weight. However, a dominant artery in the foot is sacrificed. Therefore, the patency of the dorsalis pedis artery must be confirmed in every patient. The results of the present study have demonstrated that a medial plantar artery can be an effective alternative for diabetic patients with a plantar ulcer secondary to Charcot foot.

  8. Is the foot elevation the optimal position for wound healing of a diabetic foot?

    PubMed

    Park, D J; Han, S K; Kim, W K

    2010-03-01

    In managing diabetic foot ulcers, foot elevation has generally been recommended to reduce oedema and prevent other sequential problems. However, foot elevation may decrease tissue oxygenation of the foot more than the dependent position since the dependent position is known to increase blood flow within the arterial system. In addition, diabetic foot ulcers, which have peripheral vascular insufficiency, generally have less oedema than other wounds. Therefore, we argue that foot elevation may not be helpful for healing of vascularly compromised diabetic foot ulcers since adequate tissue oxygenation is an essential factor in diabetic wound healing. The purpose of this study was to evaluate the influence of foot height on tissue oxygenation and to determine the optimal foot position to accelerate wound healing of diabetic foot ulcers. This study included 122 cases (73 males and 47 females; two males had bilateral disease) of diabetic foot ulcer patients aged 40-93 years. Trans-cutaneous partial oxygen tension (TcpO(2)) values of diabetic feet were measured before and after foot elevation (n=21). Elevation was achieved by placing a foot over four cushions. We also measured foot TcpO(2) values before and after lowering the feet (n=122). Feet were lowered to the patient's tibial height, approximately 30-35 cm, beside a bed handrail. Due to the large number of lowering measurements, we divided them into five sub-groups according to initial TcpO(2.) Tissue oxygenation values were compared. Foot-elevation-lowered TcpO(2) values before and after elevation were 32.5+/-22.2 and 23.8+/-23.1 mmHg (p<0.01), respectively. Foot-lowering-augmented TcpO(2) values before and after lowering were 44.6+/-23.8 and 58.0+/-25.9 mmHg (p<0.01), respectively. The lower the initial TcpO(2) level, the more the TcpO(2) level increased. The foot lowering, rather than elevation, significantly augments TcpO(2) and may stimulate healing of diabetic foot ulcers.

  9. Foot roll-over evaluation based on 3D dynamic foot scan.

    PubMed

    Samson, William; Van Hamme, Angèle; Sanchez, Stéphane; Chèze, Laurence; Van Sint Jan, Serge; Feipel, Véronique

    2014-01-01

    Foot roll-over is commonly analyzed to evaluate gait pathologies. The current study utilized a dynamic foot scanner (DFS) to analyze foot roll-over. The right feet of ten healthy subjects were assessed during gait trials with a DFS system integrated into a walkway. A foot sole picture was computed by vertically projecting points from the 3D foot shape which were lower than a threshold height of 15 mm. A 'height' value of these projected points was determined; corresponding to the initial vertical coordinates prior to projection. Similar to pedobarographic analysis, the foot sole picture was segmented into anatomical regions of interest (ROIs) to process mean height (average of height data by ROI) and projected surface (area of the projected foot sole by ROI). Results showed that these variables evolved differently to plantar pressure data previously reported in the literature, mainly due to the specificity of each physical quantity (millimeters vs Pascals). Compared to plantar pressure data arising from surface contact by the foot, the current method takes into account the whole plantar aspect of the foot, including the parts that do not make contact with the support surface. The current approach using height data could contribute to a better understanding of specific aspects of foot motion during walking, such as plantar arch height and the windlass mechanism. Results of this study show the underlying method is reliable. Further investigation is required to validate the DFS measurements within a clinical context, prior to implementation into clinical practice.

  10. Diabetic foot ulcers. Pathophysiology, assessment, and therapy.

    PubMed Central

    Bowering, C. K.

    2001-01-01

    OBJECTIVE: To review underlying causes of diabetic foot ulceration, provide a practical assessment of patients at risk, and outline an evidence-based approach to therapy for diabetic patients with foot ulcers. QUALITY OF EVIDENCE: A MEDLINE search was conducted for the period from 1979 to 1999 for articles relating to diabetic foot ulcers. Most studies found were case series or small controlled trials. MAIN MESSAGE: Foot ulcers in diabetic patients are common and frequently lead to lower limb amputation unless a prompt, rational, multidisciplinary approach to therapy is taken. Factors that affect development and healing of diabetic patients' foot ulcers include the degree of metabolic control, the presence of ischemia or infection, and continuing trauma to feet from excessive plantar pressure or poorly fitting shoes. Appropriate wound care for diabetic patients addresses these issues and provides optimal local ulcer therapy with débridement of necrotic tissue and provision of a moist wound-healing environment. Therapies that have no known therapeutic value, such as foot soaking and topical antiseptics, can actually be harmful and should be avoided. CONCLUSION: Family physicians are often primary medical contacts for patients with diabetes. Patients should be screened regularly for diabetic foot complications, and preventive measures should be initiated for those at risk of ulceration. PMID:11398715

  11. The influence of revised high-heeled shoes on foot pressure and center of pressure during standing in young women.

    PubMed

    Bae, Young-Hyeon; Ko, Mansoo; Lee, Suk Min

    2015-12-01

    [Purpose] Revised high-heeled shoes were developed to minimize foot deformities by reducing excessive load on the forefoot during walking or standing in adult females, who frequently wear standard high-heeled shoes. Specifically, this study aimed to investigate the effects of revised high-heeled shoes on foot pressure distribution and center of pressure distance during standing in adult females. [Subjects and Methods] Twelve healthy adult females were recruited to participate in this study. Foot pressures were obtained under 3 conditions: barefoot, in revised high-heeled shoes, and in standard 7-cm high-heeled shoes. Foot pressure was measured using the Tekscan HR mat scan system. One-way repeated analysis of variance was used to compare the foot pressure distribution and center of pressure distance under these 3 conditions. [Results] The center of pressure distance between the two lower limbs and the fore-rear distribution of foot pressure were significantly different for the 3 conditions. [Conclusion] Our findings support the premise that wearing revised high-heeled shoes seems to provide enhanced physiologic standing posture compared to wearing standard high-heeled shoes.

  12. The influence of revised high-heeled shoes on foot pressure and center of pressure during standing in young women

    PubMed Central

    Bae, Young-Hyeon; Ko, Mansoo; Lee, Suk Min

    2015-01-01

    [Purpose] Revised high-heeled shoes were developed to minimize foot deformities by reducing excessive load on the forefoot during walking or standing in adult females, who frequently wear standard high-heeled shoes. Specifically, this study aimed to investigate the effects of revised high-heeled shoes on foot pressure distribution and center of pressure distance during standing in adult females. [Subjects and Methods] Twelve healthy adult females were recruited to participate in this study. Foot pressures were obtained under 3 conditions: barefoot, in revised high-heeled shoes, and in standard 7-cm high-heeled shoes. Foot pressure was measured using the Tekscan HR mat scan system. One-way repeated analysis of variance was used to compare the foot pressure distribution and center of pressure distance under these 3 conditions. [Results] The center of pressure distance between the two lower limbs and the fore-rear distribution of foot pressure were significantly different for the 3 conditions. [Conclusion] Our findings support the premise that wearing revised high-heeled shoes seems to provide enhanced physiologic standing posture compared to wearing standard high-heeled shoes. PMID:26834343

  13. Minimally invasive osteotomy for symptomatic bunionette deformity is not advisable for severe deformities: a critical retrospective analysis of the results.

    PubMed

    Waizy, Hazibullah; Olender, Gavin; Mansouri, Farhad; Floerkemeier, Thilo; Stukenborg-Colsman, Christina

    2012-04-01

    Bunionette, or tailor's bunion, is a painful protrusion on the plantar and/or lateral aspect of the fifth metatarsal head. Until recently, there have been very good results reported in literature when minimally invasive therapy is used to treat this deformity. In this study, the authors critically review the outcome of patients operated by the minimal invasive technique. A total of 31 feet were retrospectively reviewed with a mean follow-up of 52 months (range 14-106 months). The results were related to the preoperative severity of the bunionette deformity. The mean intermetatarsal angle IV/V was reduced from 12° to 7.5° postoperatively. The American Orthopaedic Foot and Ankle Society score showed good and excellent values (80-100 points) at follow-up in 16 (12 type I, 4 type III) feet. Fourteen (2 type I, 5 type II, 7 type III) feet were rated as satisfactory (60-80 points) and one (type III) foot with fair (56 points). Nine patients (5 type II and 4 type III) indicated that they would not undergo the operative procedure again. Our results show inclusive evidence that minimal invasive osteotomies have a good clinical outcome in the treatment of high-grade deformities. The best future option is to consider the classification of the deformity before a minimally invasive operation is to take place.

  14. Foot and ankle problems in dancers.

    PubMed

    Kadel, Nancy

    2014-11-01

    The dancer's foot and ankle are subjected to high forces and unusual stresses in training and performance. Injuries are common in dancers, and the foot and ankle are particularly vulnerable. Ankle sprains, ankle impingement syndromes, flexor hallucis longus tendonitis, cuboid subluxation, stress fractures, midfoot injuries, heel pain, and first metatarsophalangeal joint problems including hallux valgus, hallux rigidus, and sesamoid injuries will be reviewed. This article will discuss these common foot and ankle problems in dancers and give typical clinical presentation and diagnostic and treatment recommendations.

  15. Equinovarus deformity in arthrogryposis and myelomeningocele: evaluation of primary talectomy.

    PubMed

    Segal, L S; Mann, D C; Feiwell, E; Hoffer, M M

    1989-08-01

    As initial surgical management for rigid equinovarus deformities, 16 children with arthrogryposis (30 involved feet) and 16 myelodysplastic children (26 involved feet) underwent primary talectomies or extensive posterior-medial releases (PMR). When compared with primary PMRs in arthrogrypotic children, primary talectomies revealed a greater number of good and fair results, decreased recurrence rates, less procedures per foot, and maintenance of ambulatory status. Recurrent forefoot and cavus deformities were present after primary talectomies. Primary talectomy in arthrogrypotic children was more effective than posterior-medial releases or secondary (salvage) talectomy. Because of the small number of feet involved, the role of primary talectomy in myelomeningocele was not clarified by this study. Radical PMRs in myelodysplastic children resulted in a significant number of hindfoot valgus deformities that required secondary procedures.

  16. Elastic image registration via rigid object motion induced deformation

    NASA Astrophysics Data System (ADS)

    Zheng, Xiaofen; Udupa, Jayaram K.; Hirsch, Bruce E.

    2011-03-01

    In this paper, we estimate the deformations induced on soft tissues by the rigid independent movements of hard objects and create an admixture of rigid and elastic adaptive image registration transformations. By automatically segmenting and independently estimating the movement of rigid objects in 3D images, we can maintain rigidity in bones and hard tissues while appropriately deforming soft tissues. We tested our algorithms on 20 pairs of 3D MRI datasets pertaining to a kinematic study of the flexibility of the ankle complex of normal feet as well as ankles affected by abnormalities in foot architecture and ligament injuries. The results show that elastic image registration via rigid object-induced deformation outperforms purely rigid and purely nonrigid approaches.

  17. Reliable measurement of 3D foot bone angles based on the frame-of-reference derived from a sole of the foot

    NASA Astrophysics Data System (ADS)

    Kim, Taeho; Lee, Dong Yeon; Park, Jinah

    2016-03-01

    Clinical management of foot pathology requires accurate and robust measurement of the anatomical angles. In order to measure a 3D angle, recent approaches have adopted a landmark-based local coordinate system to establish bone angles used in orthopedics. These measurement methods mainly assess the relative angle between bones using a representative axis derived from the morphological feature of the bone and therefore, the results can be affected by bone deformities. In this study, we propose a method of deriving a global frame-of-reference to acquire consistent direction of the foot by extracting the undersurface of the foot from the CT image data. The two lowest positions of the foot skin are identified from the surface to define the base plane, and the direction from the hallux to the fourth toe is defined together to construct the global coordinate system. We performed the experiment on 10 volumes of foot CT images of healthy subjects to verify that the proposed method provides reliable measurements. We measured 3D angles for talus-calcaneus and talus-navicular using facing articular surfaces of paired bones. The angle was reported in 3 projection angles based on both coordinate systems defined by proposed global frame-of-reference and by CT image planes (saggital, frontal, and transverse). The result shows that the quantified angle using the proposed method considerably reduced the standard deviation (SD) against the angle using the conventional projection planes, and it was also comparable with the measured angles obtained from local coordinate systems of the bones. Since our method is independent from any individual local shape of a bone, unlike the measurement method using the local coordinate system, it is suitable for inter-subject comparison studies.

  18. Effects of water temperature on cardiac autonomic nervous system modulation during foot immersion (foot bath)

    NASA Astrophysics Data System (ADS)

    Nishimura, M.; Ono, K.; Onodera, S.

    2005-08-01

    The purpose of this study was to make clear the effects of water temperature during foot immersion (foot bath) on heart rate, blood pressure, rectal temperature and autonomic nervous system modulation. The subjects performed foot immersion at 25, 35, 41 and 45 degrees Celsius at random, during different days, but always at the same time. Cardiac autonomic nervous system modulation was estimated with the power spectrum analysis of heart rate variability by using the Fast Fourier Transformation. The two frequency components of HRV was measured by integrate low frequency (LF; 0.04- 0.15 Hz) and high frequency (HF; 0.15- 0.40 Hz). HF was used as an indicator of cardiac vagal modulation and was showed logarithmically (LogHF). LogHF during foot immersion at 35 and 41 degrees Celsius was significantly increased. These data indicate that cardiac vagal activity was affected by water temperature during foot immersion (foot bath).

  19. 5-foot Vertical Wind Tunnel

    NASA Technical Reports Server (NTRS)

    1932-01-01

    The researcher is sitting above the exit cone of the 5-foot Vertical Wind Tunnel and is examining the new 6-component spinning balance. This balance was developed between 1930 and 1933. It was an important advance in the technology of rotating or rolling balances. As M.J. Bamber and C.H. Zimmerman wrote in NACA TR 456: 'Data upon the aerodynamic characteristics of a spinning airplane may be obtained in several ways; namely, flight tests with full-scale airplanes, flight tests with balanced models, strip-method analysis of wind-tunnel force and moment tests, and wind-tunnel tests of rotating models.' Further, they note: 'Rolling-balance data have been of limited value because it has not been possible to measure all six force and moment components or to reproduce a true spinning condition. The spinning balance used in this investigation is a 6-component rotating balance from which it is possible to obtain wind-tunnel data for any of a wide range of possible spinning conditions.' Bamber and Zimmerman described the balance as follows: 'The spinning balance consists of a balance head that supports the model and contains the force-measuring units, a horizontal turntable supported by streamline struts in the center of the jet and, outside the tunnel, a direct-current driving motor, a liquid tachometer, an air compressor, a mercury manometer, a pair of indicating lamps, and the necessary controls. The balance head is mounted on the turntable and it may be set to give any radius of spin between 0 and 8 inches.' In an earlier report, NACA TR 387, Carl Wenzinger and Thomas Harris supply this description of the tunnel: 'The vertical open-throat wind tunnel of the National Advisory Committee for Aeronautics ... was built mainly for studying the spinning characteristics of airplane models, but may be used as well for the usual types of wind-tunnel tests. A special spinning balance is being developed to measure the desired forces and moments with the model simulating the actual

  20. Find an Orthopaedic Foot and Ankle MD/DO

    MedlinePlus

    ... of the Smaller Toes How To... Foot Health Foot Injury Footwear News Videos Find a Surgeon Información en ... all ages. They perform reconstructive procedures, treat sports injuries, and manage and treat trauma of the foot and ankle. Orthopaedic foot and ankle surgeons work ...

  1. Foot Progression Angle Walking Test

    PubMed Central

    Ranawat, Anil S.; Gaudiani, Michael A.; Slullitel, Pablo A.; Satalich, James; Rebolledo, Brian J.

    2017-01-01

    Background: Determining an accurate clinical diagnosis for nonarthritic hip pain may be challenging, as symptoms related to femoroacetabular impingement (FAI) or hip instability can be difficult to elucidate with current testing methods. In addition, commonly utilized physical examination maneuvers are static and do not include a dynamic or weightbearing assessment to reproduce activity-related symptoms. Therefore, implementing a dynamic assessment for FAI and hip instability could help to improve diagnostic accuracy for routine clinical examinations of patients with nonarthritic hip pain. Purpose: To assess the efficacy of a novel diagnostic foot progression angle walking (FPAW) test for identifying hip pathology related to FAI or hip instability. Study Design: Prospective cohort study; Level of evidence, 3. Methods: This prospective study included 199 consecutive patients who were evaluated for unilateral hip pain and who underwent FPAW testing along with standard physical examination testing. Demographic data, including age, sex and hip laterality, were collected from each patient. FPAW testing was performed with directed internal and external foot progression angles from their baseline measurements, with a positive test reproducing pain and/or discomfort. Comparisons were then made with flexion adduction internal rotation (FADIR) and flexion abduction external rotation (FABER) tests as the designated diagnostic standard examinations for FAI and hip instability, respectively. Sensitivity and specificity, along with the McNemar chi-square test for group comparison, were used to generate summary statistics. In addition, areas under the combined receiver operating characteristic curves (AUC) of test performance were calculated for both FPAW and the designated standard examination tests (FADIR, FABER). Radiographic imaging was used subsequently to confirm the diagnosis. Results: The average age of the study cohort was 35.4 ± 11.8 years, with 114 patients being

  2. Shoes, orthoses, and prostheses for partial foot amputation and diabetic foot infection.

    PubMed

    Janisse, Dennis J; Janisse, Erick J

    2010-09-01

    Amputations in patients with diabetes, while often preventable, are unfortunately a far too common outcome. The roles of the certified or licensed pedorthist, certified orthotist, and the certified prosthetist should not be undervalued in the prevention of diabetic foot complications (eg, amputations, revisions, and foot infections secondary to skin ulcerations) and in returning the patient a normal, active, and productive lifestyle in the event of an amputation. This article highlights the roles these specialists play in treating patients with partial foot amputation.

  3. Epidemiology of type 2 diabetic foot problems and predictive factors for amputation in China.

    PubMed

    Jiang, Yufeng; Ran, Xingwu; Jia, Lijing; Yang, Chuan; Wang, Penghua; Ma, Jianhua; Chen, Bing; Yu, Yanmei; Feng, Bo; Chen, Lili; Yin, Han; Cheng, Zhifeng; Yan, Zhaoli; Yang, Yuzhi; Liu, Fang; Xu, Zhangrong

    2015-03-01

    To determine incidence and clinically relevant risk factors for diabetic amputation in a large cohort study of diabetic foot ulceration patients in China, we investigated a total of 669 diabetic foot ulceration patients, who were assessed at baseline for demographic information, medical and social history, peripheral neuropathy screening, periphery artery disease screening, assessment of nutritional status and diabetic control, physical examination including foot deformity in 15 Grade III-A hospitals. Of the 669 patients, 435 were male and 201 were female, with the mean age being 64.0 years. Of all patients, 110 had neuropathic ulcers, 122 had ischemic ulcers, 276 had neuroischemic ulcers, and 12 cases were unclassified. Wagner classification showed 61 cases were grade I, 216 cases grade II, 159 cases grade III, 137 cases grade IV, and 7 cases grade V. The overall amputation rate among diabetic foot patients was 19.03%, and major and minor amputation rates were 2.14% and 16.88%, respectively. By univariate analysis, statistically significant differences were found in smoking, rest pain, ulcer history, revascularization history, amputation history, gangrene, infection, Wagner grades, duration of diabetes, and postprandial blood glucose, aldehyde, total protein, globulin, albumin, white blood cell (WBC), hemoglobin, HbA1c, ulcer property, body mass index, as well as creatinine. Binary logistic regression model showed that increased WBC (odds ratio 1.25) and ulcer history (odds ratio 6.8) were associated with increased risks from diabetic foot ulcer to major amputation; increased duration of diabetes (odds ratio 1.004), WBC (odds ratio 1.102), infection (odds ratio 2.323), foot deformity (odds ratio 1.973), revascularization history (odds ratio 2.662), and decreased postprandial blood sugar (odds ratio 0.94) were associated with increased risks from diabetic foot ulcer to minor amputation. It is of great importance to give better management to diabetic patients at

  4. Deformation mechanisms in experimentally deformed Boom Clay

    NASA Astrophysics Data System (ADS)

    Desbois, Guillaume; Schuck, Bernhard; Urai, Janos

    2016-04-01

    Bulk mechanical and transport properties of reference claystones for deep disposal of radioactive waste have been investigated since many years but little is known about microscale deformation mechanisms because accessing the relevant microstructure in these soft, very fine-grained, low permeable and low porous materials remains difficult. Recent development of ion beam polishing methods to prepare high quality damage free surfaces for scanning electron microscope (SEM) is opening new fields of microstructural investigation in claystones towards a better understanding of the deformation behavior transitional between rocks and soils. We present results of Boom Clay deformed in a triaxial cell in a consolidated - undrained test at a confining pressure of 0.375 MPa (i.e. close to natural value), with σ1 perpendicular to the bedding. Experiments stopped at 20 % strain. As a first approximation, the plasticity of the sample can be described by a Mohr-Coulomb type failure envelope with a coefficient of cohesion C = 0.117 MPa and an internal friction angle ϕ = 18.7°. After deformation test, the bulk sample shows a shear zone at an angle of about 35° from the vertical with an offset of about 5 mm. We used the "Lamipeel" method that allows producing a permanent absolutely plane and large size etched micro relief-replica in order to localize and to document the shear zone at the scale of the deformed core. High-resolution imaging of microstructures was mostly done by using the BIB-SEM method on key-regions identified after the "Lamipeel" method. Detailed BIB-SEM investigations of shear zones show the following: the boundaries between the shear zone and the host rock are sharp, clay aggregates and clastic grains are strongly reoriented parallel to the shear direction, and the porosity is significantly reduced in the shear zone and the grain size is smaller in the shear zone than in the host rock but there is no evidence for broken grains. Comparison of microstructures

  5. Diabetic foot infections: current concept review

    PubMed Central

    Hobizal, Kimberlee B.; Wukich, Dane K.

    2012-01-01

    The purpose of this manuscript is to provide a current concept review on the diagnosis and management of diabetic foot infections which are among the most serious and frequent complications encountered in patients with diabetes mellitus. A literature review on diabetic foot infections with emphasis on pathophysiology, identifiable risk factors, evaluation including physical examination, laboratory values, treatment strategies and assessing the severity of infection has been performed in detail. Diabetic foot infections are associated with high morbidity and risk factors for failure of treatment and classification systems are also described. Most diabetic foot infections begin with a wound and once an infection occurs, the risk of hospitalization and amputation increases dramatically. Early identification of infection and prompt treatment may optimize the patient's outcome and provide limb salvage. PMID:22577496

  6. 29 CFR 1910.136 - Foot protection.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... areas where there is a danger of foot injuries due to falling or rolling objects, or objects piercing... injuries due to falling or rolling objects, or objects piercing the sole, or when the use of...

  7. Foot and ankle injuries in dance.

    PubMed

    Kadel, Nancy J

    2006-11-01

    Although dancers develop overuse injuries common in other athletes, they are also susceptible to unique injuries. This article reviews common foot and ankle problems seen in dancers and provides some basic diagnosis and treatment strategies.

  8. Hand, Foot, and Mouth Disease (HFMD)

    MedlinePlus

    ... the United States. However, in some countries in Asia, outbreaks are large and occur often. Thousands of ... learn more about outbreaks occurring in countries in Asia, visit the World Health Organization . Podcast: Hand, Foot, ...

  9. Functional anatomy and imaging of the foot.

    PubMed

    Ridola, C; Palma, A

    2001-01-01

    The foot is constituted from a series of small bones making a segmented structure with multiple joints, likened to a dome, in contact with the ground in three points: posteriorly the calcanear tuberosity; anteriorly and medially the head of 1st metatarsum, and anteriorly and laterally the head of 5th metatarsum. In fact, each foot presents a semi-arch whose base is represented by the lateral border and the summit by the medial border of the foot. The foot has been likened to a half-dome, so that when the medial borders of the two feet are placed together, a complete dome is formed. In the foot are present two longitudinal arches: the medial consists of the calcaneus, the talus, the navicular, the three cuneiform bones and the first three metatarsal bones. It is more arcuated and elastic then the lateral, that consist of the calcaneus, the cuboid and the 4th and 5th metatarsus. This is flattened and in contact with the ground. We can identify two transverse arches between longitudinal arches, extending from the medial to the lateral borders of the foot: the first is a lancet dome, between midfoot and forefoot, at the tarsometatarsal joint level; it consists of the bases of the metatarsal bones and the cuboid and the three cuneiform bones; the second is at flat dome, in correspondence of forefoot, at the metatarsophalangeal joint level; it consists of the bases of the proximal phalanges of the fingers and the head of five metatarsal bones. Longitudinal and transversal arches are supported from: the shape of stones of the structure (foot bones); the long and short plantar ligaments, larger and stronger than the dorsal ligaments, tie together the lower edges of the bones; a beam (the plantar aponeurosis and the plantar muscles and tendons) connecting the ends of the bridge effectively prevents separation of the pillars and consequent sagging of the arch; the maintenance of the arch depends on multiple support (ligaments, tendons of extrinsic muscles of the foot

  10. Magnetic resonance imaging of diabetic foot complications

    PubMed Central

    Low, Keynes TA; Peh, Wilfred CG

    2015-01-01

    This pictorial review aims to illustrate the various manifestations of the diabetic foot on magnetic resonance (MR) imaging. The utility of MR imaging and its imaging features in the diagnosis of pedal osteomyelitis are illustrated. There is often difficulty encountered in distinguishing osteomyelitis from neuroarthropathy, both clinically and on imaging. By providing an accurate diagnosis based on imaging, the radiologist plays a significant role in the management of patients with complications of diabetic foot. PMID:25640096

  11. Neuropathic foot ulceration in patients with myelodysplasia.

    PubMed

    Maynard, M J; Weiner, L S; Burke, S W

    1992-01-01

    To determine if a significant relationship existed between type of operation and eventual development of pedal skin breakdown in a spina bifida patient population, 72 feet in 36 ambulatory patients with low lumbar or sacral myelomeningocele were followed for an average of 14 years 5 months. Using a clinical classification for foot suppleness and position, we determined that foot rigidity, nonplantigrade position, and performance of surgical arthrodesis were clinical indicators that had a strong statistical relationship with eventual development of neuropathic skin changes.

  12. Total ankle arthroplasty with severe preoperative varus deformity.

    PubMed

    Hanselman, Andrew E; Powell, Brian D; Santrock, Robert D

    2015-04-01

    Advancements in total ankle arthroplasty (TAA) over the past several decades have led to improved patient outcomes and implant survivorship. Despite these innovations, many implant manufacturers still consider a preoperative coronal plane deformity greater than 10° a relative contraindication to TAA. Without proper intraoperative alignment, these implants may experience abnormal wear and hardware failure. Correcting these deformities, often through the use of soft tissue procedures and/or osteotomies, not only increases the difficulty of a case, but also the intraoperative time and radiation exposure. The authors report a case in which a 54-year-old man with a severe right ankle varus deformity of 29° underwent successful TAA using the INBONE II Prophecy total ankle system (Wright Medical Technology, Inc, Memphis, Tennessee) and additional soft tissue reconstruction. Intraoperatively, the patient's coronal deformity was corrected to 1.8°. At 8 months postoperatively, the patient ambulated without restriction and had substantial improvement in validated patient outcome scores, specifically the Academy of Orthopaedic Surgeons Foot and Ankle Module and the Short Form Health Survey-12 This unique report documents the first time that this particular implant, with an exclusive preoperative computed tomography-derived patient-specific guide, has been used effectively for a severe preoperative varus deformity greater than 20° without the need for an osteotomy. Future studies should be directed toward the prospective evaluation of different total ankle implant systems and their outcomes with severe coronal plane deformity, specifically computed tomography-derived patient-specific guided implants.

  13. Foot-and-Mouth Disease

    PubMed Central

    Grubman, Marvin J.; Baxt, Barry

    2004-01-01

    Foot-and-mouth disease (FMD) is a highly contagious disease of cloven-hoofed animals. The disease was initially described in the 16th century and was the first animal pathogen identified as a virus. Recent FMD outbreaks in developed countries and their significant economic impact have increased the concern of governments worldwide. This review describes the reemergence of FMD in developed countries that had been disease free for many years and the effect that this has had on disease control strategies. The etiologic agent, FMD virus (FMDV), a member of the Picornaviridae family, is examined in detail at the genetic, structural, and biochemical levels and in terms of its antigenic diversity. The virus replication cycle, including virus-receptor interactions as well as unique aspects of virus translation and shutoff of host macromolecular synthesis, is discussed. This information has been the basis for the development of improved protocols to rapidly identify disease outbreaks, to differentiate vaccinated from infected animals, and to begin to identify and test novel vaccine candidates. Furthermore, this knowledge, coupled with the ability to manipulate FMDV genomes at the molecular level, has provided the framework for examination of disease pathogenesis and the development of a more complete understanding of the virus and host factors involved. PMID:15084510

  14. [Charcot arthropathy and diabetic foot].

    PubMed

    López-Gavito, E; Parra-Téllez, P; Vázquez-Escamilla, J

    2016-01-01

    Diabetes mellitus is a major chronic degenerative disease, which currently is taking on alarming proportions in the population of our country. Neuropathic arthropathy is one of the most interesting degenerative joint disorders and increasingly common within the orthopedic pathology. It is defined as a progressive degenerative arthropathy, chronic and affecting one or more peripheral joints, and develops as a result of the lack of sensory perception normal in the innervation of joints. As a result the joints of the feet are subjected to trauma and repetitive injury causing a neurotraumatic effect with progressive damage to the joints of the hindfoot, midfoot and forefoot. Diagnosis includes a proper medical history, careful examination of the affected limb, conventional X-ray, scintigraphy, computed tomography and magnetic resonance imaging in some cases. Conservative treatment includes: drugs, rest of the affected limb, and the use of appliances like total-contact cast, orthotics or special shoes. Surgical treatment depends on the stage of the disease, and may require one or more surgical procedures, in order to achieve a full foot plantar support to prevent ulcers. One of the surgeries performed most often is the fusion of damaged joints. Surgery must be performed only in the coalescence phase of the disease, using internal, or external fixation or both.

  15. Implementation of a foot assessment program in a regional satellite hemodialysis setting.

    PubMed

    Wilson, Barbara; Lawrence, JulieAnn

    2013-01-01

    Individuals with chronic kidney disease are at higher risk for foot problems (i.e., ulcers, deformities, amputations) than the general population. Research demonstrates that assessment and active monitoring, teaching, and timely interventions can reduce the number and severity of lower limb amputations in the hemodialysis population. This paper reports on a quality improvement project aimed at implementation of a foot assessment program in a regional satellite hemodialysis setting based on the Registered Nurses' Association of Ontario's (2005) best practice guideline (BPG), The Assessment and Management of Foot Ulcers for People with Diabetes. Elements of the program include a one-time full assessment of risk for all patients transferring to the satellite program followed by monthly foot checks for those deemed high risk (i.e., people with diabetes). Evaluation of the program has been positive from both patients and hemodialysis nursing staff. There has been a greater emphasis on self-management around the care and management of patients and their high-risk feet. At the same time, the program has resulted in prompt identification of problems and timelier referral to the appropriate services in the patient's local community.

  16. The Charcot foot: pathophysiology, diagnosis and classification.

    PubMed

    Trieb, K

    2016-09-01

    Neuropathic changes in the foot are common with a prevalence of approximately 1%. The diagnosis of neuropathic arthropathy is often delayed in diabetic patients with harmful consequences including amputation. The appropriate diagnosis and treatment can avoid an extensive programme of treatment with significant morbidity for the patient, high costs and delayed surgery. The pathogenesis of a Charcot foot involves repetitive micro-trauma in a foot with impaired sensation and neurovascular changes caused by pathological innervation of the blood vessels. In most cases, changes are due to a combination of both pathophysiological factors. The Charcot foot is triggered by a combination of mechanical, vascular and biological factors which can lead to late diagnosis and incorrect treatment and eventually to destruction of the foot. This review aims to raise awareness of the diagnosis of the Charcot foot (diabetic neuropathic osteoarthropathy and the differential diagnosis, erysipelas, peripheral arterial occlusive disease) and describe the ways in which the diagnosis may be made. The clinical diagnostic pathways based on different classifications are presented. Cite this article: Bone Joint J 2016;98-B:1155-9.

  17. 20. 80 foot pony truss an upper chord pin ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    20. 80 foot pony truss - an upper chord pin connection at a vertical post other than at the end post. Common to the five 80 foot trusses and similar to the 64 foot truss, there are two pairs per 80 foot truss and one pair on the 64 foot truss for a total of 22. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  18. Diabetic foot syndrome: Immune-inflammatory features as possible cardiovascular markers in diabetes

    PubMed Central

    Tuttolomondo, Antonino; Maida, Carlo; Pinto, Antonio

    2015-01-01

    Diabetic foot ulcerations have been extensively reported as vascular complications of diabetes mellitus associated with a high degree of morbidity and mortality. Diabetic foot syndrome (DFS), as defined by the World Health Organization, is an “ulceration of the foot (distally from the ankle and including the ankle) associated with neuropathy and different grades of ischemia and infection”. Pathogenic events able to cause diabetic foot ulcers are multifactorial. Among the commonest causes of this pathogenic pathway it’s possible to consider peripheral neuropathy, foot deformity, abnormal foot pressures, abnormal joint mobility, trauma, peripheral artery disease. Several studies reported how diabetic patients show a higher mortality rate compared to patients without diabetes and in particular these studies under filled how cardiovascular mortality and morbidity is 2-4 times higher among patients affected by type 2 diabetes mellitus. This higher degree of cardiovascular morbidity has been explained as due to the observed higher prevalence of major cardiovascular risk factor, of asymptomatic findings of cardiovascular diseases, and of prevalence and incidence of cardiovascular and cerebrovascular events in diabetic patients with foot complications. In diabetes a fundamental pathogenic pathway of most of vascular complications has been reported as linked to a complex interplay of inflammatory, metabolic and procoagulant variables. These pathogenetic aspects have a direct interplay with an insulin resistance, subsequent obesity, diabetes, hypertension, prothrombotic state and blood lipid disorder. Involvement of inflammatory markers such as IL-6 plasma levels and resistin in diabetic subjects as reported by Tuttolomondo et al confirmed the pathogenetic issue of the a “adipo-vascular” axis that may contribute to cardiovascular risk in patients with type 2 diabetes. This “adipo-vascular axis” in patients with type 2 diabetes has been reported as characterized

  19. [Ischemic origin of diabetic foot disease. Epidemiology, difficulties of diagnosis, options for prevention and revascularization].

    PubMed

    Kolossváry, Endre; Bánsághi, Zoltán; Szabó, Gábor Viktor; Járai, Zoltán; Farkas, Katalin

    2017-02-01

    "Diabetic foot" as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations. Available vascular centers with special expertise and diagnostic tools are the prerequisite for efficient diagnosis supporting timely recognition of peripheral arterial disease. In course of treatment of diabetic foot with ischemic origin, beyond effective medical treatment revascularization (open vascular surgery or endovascular procedures) has paramount importance for prevention of limb loss. Vascular teams of vascular specialists, vascular surgeons and interventional radiologist in dedicated centers in multidisciplinary cooperation with other professions represent public health issue in effective prevention. Orv. Hetil., 2017, 158(6), 203-211.

  20. Foot and ankle fractures during childhood: review of the literature and scientific evidence for appropriate treatment.

    PubMed

    Rammelt, Stefan; Godoy-Santos, Alexandre Leme; Schneiders, Wolfgang; Fitze, Guido; Zwipp, Hans

    2016-01-01

    Foot and ankle fractures represent 12% of all pediatric fractures. Malleolar fractures are the most frequent injuries of the lower limbs. Hindfoot and midfoot fractures are rare, but inadequate treatment for these fractures may results in compartment syndrome, three-dimensional deformities, avascular necrosis and early post-traumatic arthritis, which have a significant impact on overall foot and ankle function. Therefore, the challenges in treating these injuries in children are to achieve adequate diagnosis and precise treatment, while avoiding complications. The objective of the treatment is to restore normal anatomy and the correct articular relationship between the bones in this region. Moreover, the treatment needs to be planned according to articular involvement, lower-limb alignment, ligament stability and age. This article provides a review on this topic and presents the scientific evidence for appropriate treatment of these lesions.

  1. Surgical treatment of cavus foot in Charcot-Marie-tooth disease: a review of twenty-four cases: AAOS exhibit selection.

    PubMed

    Faldini, Cesare; Traina, Francesco; Nanni, Matteo; Mazzotti, Antonio; Calamelli, Carlotta; Fabbri, Daniele; Pungetti, Camilla; Giannini, Sandro

    2015-03-18

    Charcot-Marie-Tooth disease is the single most common diagnosis associated with cavus foot. The imbalance involving intrinsic and extrinsic muscles has been suggested as the main pathogenetic cause of cavus foot in this disease. The goal of surgical treatment is to correct the deformity to obtain a plantigrade foot. In the presence of a flexible deformity and the absence of degenerative arthritis, preserving as much as possible of the overall range of motion of the foot and ankle is advisable. Twenty-four cavus feet in twelve patients with Charcot-Marie-Tooth disease were included in the study. Clinical evaluation was summarized with the Maryland Foot Score. Radiographic evaluation assessed calcaneal pitch, Meary angle, Hibb angle, and absence of degenerative joint changes. Only patients who had a flexible deformity, with varus of the heel reducible in the Coleman-Andreasi test, and did not have degenerative joint arthritis were included in this study. Surgical treatment consisted in plantar fasciotomy, midtarsal osteotomy, extensor hallucis longus tendon transfer to the first metatarsal (Jones procedure), and dorsiflexion osteotomy of the first metatarsal. Mean follow-up was six years (range, two to thirteen years). The mean Maryland Foot Score was 72 preoperatively and 86 postoperatively. The postoperative result was rated as excellent in twelve feet (50%), good in ten (42%), and fair in two (8%). Mean calcaneal pitch was 34° preoperatively and 24° at the time of the latest follow-up, the mean Hibb angle was 121° preoperatively and 136° postoperatively, and the mean Meary angle was 25° preoperatively and 2° postoperatively. Plantar fasciotomy, midtarsal osteotomy, the Jones procedure, and dorsiflexion osteotomy of the first metatarsal yielded adequate correction of flexible cavus feet in patients with Charcot-Marie-Tooth disease in the absence of fixed hindfoot deformity. The fact that the improvement in the outcome score was only modest may be attributable

  2. Residual Elimination Algorithm Enhancements to Improve Foot Motion Tracking During Forward Dynamic Simulations of Gait.

    PubMed

    Jackson, Jennifer N; Hass, Chris J; Fregly, Benjamin J

    2015-11-01

    Patient-specific gait optimizations capable of predicting post-treatment changes in joint motions and loads could improve treatment design for gait-related disorders. To maximize potential clinical utility, such optimizations should utilize full-body three-dimensional patient-specific musculoskeletal models, generate dynamically consistent gait motions that reproduce pretreatment marker measurements closely, and achieve accurate foot motion tracking to permit deformable foot-ground contact modeling. This study enhances an existing residual elimination algorithm (REA) Remy, C. D., and Thelen, D. G., 2009, “Optimal Estimation of Dynamically Consistent Kinematics and Kinetics for Forward Dynamic Simulation of Gait,” ASME J. Biomech. Eng., 131(3), p. 031005) to achieve all three requirements within a single gait optimization framework. We investigated four primary enhancements to the original REA: (1) manual modification of tracked marker weights, (2) automatic modification of tracked joint acceleration curves, (3) automatic modification of algorithm feedback gains, and (4) automatic calibration of model joint and inertial parameter values. We evaluated the enhanced REA using a full-body three-dimensional dynamic skeletal model and movement data collected from a subject who performed four distinct gait patterns: walking, marching, running, and bounding. When all four enhancements were implemented together, the enhanced REA achieved dynamic consistency with lower marker tracking errors for all segments, especially the feet (mean root-mean-square (RMS) errors of 3.1 versus 18.4 mm), compared to the original REA. When the enhancements were implemented separately and in combinations, the most important one was automatic modification of tracked joint acceleration curves, while the least important enhancement was automatic modification of algorithm feedback gains. The enhanced REA provides a framework for future gait optimization studies that seek to predict subject

  3. Rock Deformation Meeting

    NASA Astrophysics Data System (ADS)

    Green, Harry

    The Third Rock Deformation Colloquium was held December 4, 1989, at the AGU Fall Meeting in San Francisco. Steve Kirby of the U.S. Geological Survey, Menlo Park, Calif., reported on actions taken by the rock deformation steering committee. Brian Wernicke of Harvard University, Cambridge, Mass., talked on the structural geology of the Great Basin.The steering committee voted for “Committee on Deformation of Earth Materials” as the name for the AGU technical committee on rock deformation, Kirby said. Considerable discussion has occurred in the steering committee over our relationship to the AGU Mineral Physics Committee. Indeed, Kirby will become chairman of that committee in 1990, underlining the overlap of the two groups. It was agreed that we will pursue closer association with Mineral Physics.

  4. Wrist deformities after fracture.

    PubMed

    Vanheest, Ann

    2006-02-01

    Wrist deformities can occur after fracture because of malunion of the fracture or injury to the growth plate leading to imbalance of growth. Prevention of malunion is paramount by early recognition with proper reduction and casting or fixation with casting. If a mal-union occurs, an osteotomy may be necessary if anticipated growth will not correct the deformity. Injury of the growth plate may lead to wrist deformity in two ways: angular growth or growth arrest. Angular growth deformities are corrected most commonly by osteotomy. Growth arrest of the radius or the ulna leads to an ulnar-positive or an ulnar-negative variance at the wrist. If the ulnar variance is symptomatic, treatment is centered on achieving a level joint. Options for joint leveling procedures include epiphysiodesis or physeal stapling of the longer bone, lengthening osteotomy of the shorter bone, or shortening osteotomy of the longer bone.

  5. Robust Foot Clearance Estimation Based on the Integration of Foot-Mounted IMU Acceleration Data

    PubMed Central

    Benoussaad, Mourad; Sijobert, Benoît; Mombaur, Katja; Azevedo Coste, Christine

    2015-01-01

    This paper introduces a method for the robust estimation of foot clearance during walking, using a single inertial measurement unit (IMU) placed on the subject’s foot. The proposed solution is based on double integration and drift cancellation of foot acceleration signals. The method is insensitive to misalignment of IMU axes with respect to foot axes. Details are provided regarding calibration and signal processing procedures. Experimental validation was performed on 10 healthy subjects under three walking conditions: normal, fast and with obstacles. Foot clearance estimation results were compared to measurements from an optical motion capture system. The mean error between them is significantly less than 15% under the various walking conditions. PMID:26703622

  6. Diagnostic considerations of lateral column foot pain in athletes.

    PubMed

    Traister, Eric; Simons, Stephen

    2014-01-01

    Foot maladies are often classified descriptively by general foot locations, i.e., forefoot, midfoot, and rearfoot. However, common vernacular verbiage, implicating a common biomechanical purpose, also applies pathology to the medial or lateral foot column. Although imprecisely defined, lateral column injuries to the foot encompass conditions that affect any of the lateral side of the foot from the calcaneus to the toes. The lateral column of the foot includes the calcaneus, the cuboid, the fourth and fifth metatarsals as well as the calcaneocuboid, cuboido-metatarsal, and intermetatarsal joints. It may be helpful to think in a "lateral column" fashion when evaluating and treating certain lateral foot injuries, load patterns, and biomechanical or anatomical faults. Misdiagnosed injuries in this area of the foot can be a source of great morbidity to the athlete. It is important for the clinician to be aware of common conditions presenting as pain to the lateral side of the foot.

  7. Principles of rock deformation

    SciTech Connect

    Nicolas, A.

    1987-01-01

    This text focuses on the recent achievements in the analysis of rock deformation. It gives an analytical presentation of the essential structures in terms of kinetic and dynamic interpretation. The physical properties underlying the interpretation of rock structures are exposed in simple terms. Emphasized in the book are: the role of fluids in rock fracturing; the kinematic analysis of magnetic flow structures; the application of crystalline plasticity to the kinematic and dynamic analysis of the large deformation imprinted in many metamorphic rocks.

  8. Polygonal deformation bands

    NASA Astrophysics Data System (ADS)

    Antonellini, Marco; Mollema, Pauline Nella

    2015-12-01

    We report for the first time the occurrence of polygonal faults in sandstone, which is compelling given that layer-bound polygonal fault systems have been observed so far only in fine-grained sediments such as clay and chalk. The polygonal faults are shear deformation bands that developed under shallow burial conditions via strain hardening in dm-wide zones. The edges of the polygons are 1-5 m long. The shear deformation bands are organized as conjugate faults along each edge of the polygon and form characteristic horst-like structures. The individual deformation bands have slip magnitudes ranging from a few mm to 1.5 cm; the cumulative average slip magnitude in a zone is up to 10 cm. The deformation bands heaves, in aggregate form, accommodate a small isotropic horizontal extension (strain <0.005). The individual shear deformation bands show abutting T-junctions, veering, curving, and merging where they mechanically interact. Crosscutting relationships are rare. The interactions of the deformation bands are similar to those of mode I opening fractures. The documented fault networks have important implications for evaluating the geometry of km-scale polygonal fault systems in the subsurface, top seal integrity, as well as constraining paleo-tectonic stress regimes.

  9. Nursing care of the aging foot.

    PubMed

    Mitty, Ethel

    2009-01-01

    Feet are not necessarily the most attractive part of the body as it ages, and given the choice, most older adults would rather ignore them. In fact, many older adults cannot even see them, reach them, or care for them properly. And when they ache or look misshapen and oddly colored; well, that's just part of growing old, isn't it? The feet are important for weight bearing, balance, and mobility. Over an average life span, the feet are subject to considerable stress and trauma. Age-related changes of the foot predispose the older adult to discomfort if not pain, fungal infection, reduced range of motion, and itchy dry skin. More than three fourths of older adults (i.e., those age over 65 years) complain of foot pain that is associated with a significant foot problem and have evidence of arthritic changes on x-ray. Impaired ambulation can make the difference between independence versus dependency on others, engagement versus isolation. Assisted living is about choices. Being unable to get where one wants to go or do what one wants to do because of foot problems is a barrier to full enjoyment of the opportunities in assisted living communities. This article describes foot problems associated with aging, diabetes, nursing assessment of the feet, and nursing interventions in the service of accessing and optimizing choices for quality of life.

  10. 8-Foot High Speed Tunnel (HST)

    NASA Technical Reports Server (NTRS)

    1953-01-01

    Semi-automatic readout equipment installed in the 1950s used for data recording and reduction in the 8-Foot High Speed Tunnel (HST). A 1957 NACA report on wind tunnel facilities at Langley included these comments on the data recording and reduction equipment for the 8-foot HST: 'The data recording and reduction equipment used for handling steady force and pressure information at the Langley 8-foot transonic tunnel is similar to that described for the Langley 16-foot transonic tunnel. Very little dynamic data recording equipment, however, is available.' The description of the 16-foot transonic tunnel equipment is as follows: 'A semiautomatic force data readout system provides tabulated raw data and punch card storage of raw data concurrent with the operation of the wind tunnel. Provision is made for 12 automatic channels of strain gage-data output, and eight channels of four-digit manually operated inputs are available for tabulating and punching constants, configuration codes, and other information necessary for data reduction and identification. The data are then processed on electronic computing machines to obtain the desired coefficients. These coefficients and their proper identification are then machine tabulated to provide a printed record of the results. The punched cards may also be fed into an automatic plotting device for the preparation of plots necessary for data analysis.'

  11. How visual perceptual grouping influences foot placement

    PubMed Central

    Fennell, John; Goodwin, Charlotte; Burn, Jeremy F.; Leonards, Ute

    2015-01-01

    Everybody would agree that vision guides locomotion; but how does vision influence choice when there are different solutions for possible foot placement? We addressed this question by investigating the impact of perceptual grouping on foot placement in humans. Participants performed a stepping stone task in which pathways consisted of target stones in a spatially regular path of foot falls and visual distractor stones in their proximity. Target and distractor stones differed in shape and colour so that each subset of stones could be easily grouped perceptually. In half of the trials, one target stone swapped shape and colour with a distractor in its close proximity. We show that in these ‘swapped’ conditions, participants chose the perceptually groupable, instead of the spatially regular, stepping location in over 40% of trials, even if the distance between perceptually groupable steps was substantially larger than normal step width/length. This reveals that the existence of a pathway that could be traversed without spatial disruption to periodic stepping is not sufficient to guarantee participants will select it and suggests competition between different types of visual input when choosing foot placement. We propose that a bias in foot placement choice in favour of visual grouping exists as, in nature, sudden changes in visual characteristics of the ground increase the uncertainty for stability. PMID:26587273

  12. Opto-electronic system for detection of flat foot by using estimation techniques: study and approach of design.

    PubMed

    Navarro, Luis A; García, Daniel O; Villavicencio, Emilio A; Torres, Miguel A; Nakamura, Orlando K; Huamani, Robinson; Yabar, Leopoldo F

    2010-01-01

    Distribution of Foot Pressure reflects the deformations of body biomechanical design. They are caused by different reasons: degenerative, by trauma, etc., being flat foots a common pathology in Peru with high incidence. However there isn't the properly technology to detect properly this disease because is detected by a non-reliable visual way using pedoscopes. Flat foot is the degree of internal plantar arch lack and is well observed in foot pressure distribution. This distribution can be obtained by optical or electronic systems. The most required, by their accuracy, are the electronic ones but sensor manufacturing process increases its price, meanwhile optics provides an indirect optical solution whose price depends on scanners resolution. Therefore, this paper takes advantage of both systems: a direct pressure value from electronics and no problems calibration from optical systems. In regard of these reasons, prototype will use a webcam and twelve FSR (Force sensing resistor) sensors including estimation techniques, and thus obtain the foot pressure distribution. Accordingly, the present study is looking for providing to the specialist with an efficient tool to generate better diagnostics in Perú.

  13. A case series to describe the clinical characteristics of foot ulceration in patients with rheumatoid arthritis.

    PubMed

    Siddle, Heidi J; Firth, Jill; Waxman, Robin; Nelson, E Andrea; Helliwell, Philip S

    2012-03-01

    The aim of this study was to describe the clinical characteristics of foot ulceration in patients with rheumatoid arthritis (RA). Adults with RA and current foot ulceration but without diabetes were recruited. Clinical examination included assessment of RA disease activity, foot deformity, peripheral vascular disease, neuropathy and plantar pressures. Location, wound characteristics and time to healing were recorded for each ulcer. Participants completed the Health Assessment Questionnaire and Leeds Foot Impact Scale. Thirty-two cases with 52 current ulcers were recruited. Thirteen patients (41%) experienced more than one current ulcer: 5 (16%) had bilateral ulceration, 15 (47%) had previous ulceration at a current ulcer site. The majority (n = 33) of open ulcers were located over the dorsal aspect of the interphalangeal joints (n = 12), plantar aspect of the metatarsophalangeal joints (MTPJs) (n = 12) and medial aspect of first MTPJs (n = 9). In ulcerated limbs (n = 37), ankle brachial pressure index (ABPI) was <0.8 in 2 (5%); protective sensation was reduced in 25 (68%) and peak plantar pressures were >6 kg/cm(2) in 6 (16%). Mean ulcer size was 4.84 by 3.29 mm. Most ulcers (n = 42, 81%) were superficial; five (9.6%) were infected. Time to healing was available for 41 ulcers: mean duration was 28 weeks. Three ulcers remained open. In conclusion, foot ulceration in RA is recurrent and multiple ulcers are common. Whilst ulcers are small and shallow, time to achieve healing is slow, posing infection risk. Reduced protective sensation is common in affected patients. The prevalence of arterial disease is low but may be under estimated due to high intolerance of ABPI.

  14. A finite element model of the foot and ankle for automotive impact applications.

    PubMed

    Shin, Jaeho; Yue, Neng; Untaroiu, Costin D

    2012-12-01

    A finite element (FE) model of the foot and leg was developed to improve understanding of injury mechanisms of the ankle and subtalar joints during vehicle collisions and to aid in the design of injury countermeasures. The FE model was developed based on the reconstructed geometry of a male volunteer close to the anthropometry of a 50th percentile male and a commercial anatomical database. While the forefoot bones were defined as rigid bodies connected by ligament models, the surrounding bones of the ankle and subtalar joints and the leg bones were modeled as deformable structures. The material and structural properties were selected based on a synthesis of current knowledge of the constitutive models for each tissue. The whole foot and leg model was validated in different loading conditions including forefoot impact, axial rotation, dorsiflexion, and combined loadings. Overall results obtained in the model validation indicated improved biofidelity relative to previous FE models. The developed model was used to investigate the injury tolerance of the ankle joint under brake pedal loading for internally and externally rotated feet. Ligament failures were predicted as the main source of injury in this loading condition. A 12% variation of failure moment was observed in the range of axial foot rotations (±15°). The most vulnerable position was the internally rotated (15°) posture among three different foot positions. Furthermore, the present foot and ankle model will be coupled together with other body region FE models into the state-of-art human FE model to be used in the field of automotive safety.

  15. Experimental Deformation of Magnetite

    NASA Astrophysics Data System (ADS)

    Till, J. L.; Rybacki, E.; Morales, L. F. G.

    2015-12-01

    Magnetite is an important iron ore mineral and the most prominent Fe-oxide phase in the Earth's crust. The systematic occurrence of magnetite in zones of intense deformation in oceanic core complexes suggests that it may play a role in strain localization in some silicate rocks. We performed a series of high-temperature deformation experiments on synthetic magnetite aggregates and natural single crystals to characterize the rheological behavior of magnetite. As starting material, we used fine-grained magnetite powder that was hot isostatically pressed at 1100°C for several hours, resulting in polycrystalline material with a mean grain size of around 40 μm and containing 3-5% porosity. Samples were deformed to 15-20% axial strain under constant load (approximating constant stress) conditions in a Paterson-type gas apparatus for triaxial deformation at temperatures between 900 and 1100°C and 300 MPa confining pressure. The aggregates exhibit typical power-law creep behavior. At high stresses, samples deformed by dislocation creep exhibit stress exponents close to 3, revealing a transition to near-Newtonian creep with stress exponents around 1.3 at lower stresses. Natural magnetite single crystals deformed at 1 atm pressure and temperatures between 950°C and 1150 °C also exhibit stress exponents close to 3, but with lower flow stresses and a lower apparent activation energy than the aggregates. Such behavior may result from the different oxygen fugacity buffers used. Crystallographic-preferred orientations in all polycrystalline samples are very weak and corroborate numerical models of CPO development, suggesting that texture development in magnetite may be inherently slow compared with lower symmetry phases. Comparison of our results with experimental deformation data for various silicate minerals suggests that magnetite should be weaker than most silicates during ductile creep in dry igneous rocks.

  16. An unusual case of postaxial polydactyly of the foot treated by metatarsal transfer.

    PubMed

    Han, Seung Hwan; Cho, Jae Ho; Lee, Yu Sang

    2014-01-01

    Postaxial polydactyly is a relatively rare congenital deformity. We present a unique unusual fourth metatarsal type polydactyly in which the extra bone from the fourth metatarsal bone articulated with the most lateral ray proximal phalanx. We discuss the surgical management of this problem using a bone transfer from the extra metatarsal bone within the midfoot. This is the first reported case of fourth metatarsal-type polydactyly treated by bone transfer of the extra metatarsal bone and internal plate fixation to recover normal articulation. The normal orientation of the metatarsophalangeal joint, alignment, and cosmesis are important determinants when selecting the bone to be excised in cases of lateral ray foot polydactyly.

  17. Minimally invasive–percutaneous surgery – recent developments of the foot surgery techniques

    PubMed Central

    Botezatu, I; Marinescu, R; Laptoiu, D

    2015-01-01

    Percutaneous techniques are currently more and more used in many surgical procedures on the soft tissues and bones of the foot. Practical advantages include lower complication rates and faster recovery times. Potential disadvantages are related to the need for specific equipment and extensive learning curve. One of the most frequent techniques involves a combination of chevron osteotomy of the first metatarsal with osteotomy of the first phalanx, both internally fixated. Lateral metatarsal misalignment and toe deformities can also be addressed by percutaneous treatment, with lower morbidity rates than open techniques. The most commonly performed percutaneous procedures are described, with their current indications, outcomes, and recent developments. PMID:26361518

  18. Radiologic evaluation of chronic foot pain.

    PubMed

    Joong, Mo Ahn; El-Khoury, Georges Y

    2007-10-01

    Chronic foot pain is a common and often disabling clinical complaint that can interfere with a patient's routine activities. Despite careful and detailed clinical history and physical examination, providing an accurate diagnosis is often difficult because chronic foot pain has a broad spectrum of potential causes. Therefore, imaging studies play a key role in diagnosis and management. Initial assessment is typically done by plain radiography; however, magnetic resonance imaging has superior soft-tissue contrast resolution and multiplanar capability, which makes it important in the early diagnosis of ambiguous or clinically equivocal cases when initial radiographic findings are inconclusive. Computed tomography displays bony detail in stress fractures, as well as in arthritides and tarsal coalition. Bone scanning and ultrasonography also are useful tools for diagnosing specific conditions that produce chronic foot pain.

  19. [Mycetoma of the foot: a case report].

    PubMed

    Iniesta, A; Baptista, C; Guinard, D; Legré, R; Gay, A

    2015-04-01

    Mycetoma is a chronic inflammatory cutaneous and subcutaneous pathology caused by either a fongic (eumycetoma) or bacterial (actinomycetoma) infection, which lead to a granulomatous tumefaction with multiple sinuses. When localized in the foot this infection is named "Madura foot". This infection is endemic to tropical and subtropical regions and rarely occurs in western countries. A historical case in Europe of a foot mycetoma evolving since 20 years without any treatment is presented. A histopathologic diagnosis of actinomycetoma has been done in 1987. The patient presented a severe Staphylococcus aureus chronic osteitis leading to a trans-tibial amputation. This case allows to present this infection which, even if rarely presented in France, can be meet especially among a migrant's population.

  20. Approach to managing diabetic foot ulcers.

    PubMed Central

    Nesbitt, John A. A.

    2004-01-01

    INTRODUCTION: Of an estimated 1.7 to 2 million Canadians with diabetes, approximately 10% will present each year to their family doctors with plantar ulcers. Nearly 3500 will require major lower extremity amputations. SOURCES OF INFORMATION: Most of the recommendations outlined in this paper are based on level I evidence from excellent bench research and epidemiologic studies. MAIN MESSAGE: Both insulin-dependent and non-insulin-dependent diabetics develop foot infections. These patients are on average 60 years old and have had diabetes for more than 10 years. Physicians who insist on excellent blood sugar control, provide ongoing patient education on diabetic foot care, prescribe appropriate shoes, and practise an aggressive multidisciplinary approach to wound care can reduce the rate of lower extremity amputations by more than 50%. CONCLUSION: Foot problems remain one of the main challenges associated with diabetes, but family physicians can manage them successfully. PMID:15116801

  1. Foot Conditions among Homeless Persons: A Systematic Review

    PubMed Central

    To, Matthew J.; Brothers, Thomas D.; Van Zoost, Colin

    2016-01-01

    Introduction Foot problems are common among homeless persons, but are often overlooked. The objectives of this systematic review are to summarize what is known about foot conditions and associated interventions among homeless persons. Methods A literature search was conducted on MEDLINE (1966–2016), EMBASE (1947–2016), and CINAHL (1982–2016) and complemented by manual searches of reference lists. Articles that described foot conditions in homeless persons or associated interventions were included. Data were independently extracted on: general study characteristics; participants; foot assessment methods; foot conditions and associated interventions; study findings; quality score assessed using the Downs and Black checklist. Results Of 333 articles screened, 17 articles met criteria and were included in the study. Prevalence of any foot problem ranged from 9% to 65% across study populations. Common foot-related concerns were corns and calluses, nail pathologies, and infections. Foot pathologies related to chronic diseases such as diabetes were identified. Compared to housed individuals across studies, homeless individuals were more likely to have foot problems including tinea pedis, foot pain, functional limitations with walking, and improperly-fitting shoes. Discussion Foot conditions were highly prevalent among homeless individuals with up to two thirds reporting a foot health concern, approximately one quarter of individuals visiting a health professional, and one fifth of individuals requiring further follow-up due to the severity of their condition. Homeless individuals often had inadequate foot hygiene practices and improperly-fitting shoes. These findings have service provision and public health implications, highlighting the need for evidence-based interventions to improve foot health in this population. An effective interventional approach could include optimization of foot hygiene and footwear, provision of comprehensive medical treatment, and

  2. Assessing foot care knowledge in a rural population with diabetes.

    PubMed

    Neil, Janice A

    2002-01-01

    In people with insensate extremities, such as those with diabetes mellitus, daily foot care and inspection can prevent the development of foot ulcers and the subsequent complications that may lead to amputation--one of the biggest threats to adults with diabetes. Preventive behaviors focus on not going barefoot, performing/receiving proper foot care, and wearing properly fitting shoes. This descriptive study of footcare practices involved a convenience sample of 61 adult men and women with type 1 or type 2 diabetes, 24 with existing foot ulcers and 37 without foot ulcers, who resided in a rural area of a southeastern state. The questionnaire was divided into four categories: foot inspection, foot cleaning, nail care, and use of footwear. Out of a possible score of 20, those with foot ulcers scored an average of 13.88 and those without ulcers averaged 13.57. These results reveal that those without foot ulcers have similar foot care practices to those with foot ulcers. This instrument is useful in assessing current foot care practices on a point-in-time basis. Preventive practices must be stressed and reinforced so those without foot ulcers do not develop ulcers.

  3. The role of ring external fixation in Charcot foot arthropathy.

    PubMed

    Pinzur, Michael S

    2006-12-01

    These two morbidly obese patients with severe Charcot foot arthropathy were treated successfully with percutaneous correction of their deformity followed by a stepwise application of a pre-assembled neutrally aligned multiplane ring external fixator. This technique transfers well to the trauma environment in which alignment can be maintained without further violation within the zone of injury. The application of the fine wire ring external fixation has been used for many years to accomplished leg lengthening and correction of deformity. Historically it has required a great deal of experience to apply to complex frames and implement the required daily adjustments. The patient experience often has been an unpleasant ordeal with a high potential for associated morbidity. This negative exposure has prompted practicing orthopedic surgeons to avoid this technique, feeling that it best be left to those in tertiary care setting who are equipped to handle the morbidity and complications. Taking this technology from the domain of the deformity surgeon to the general orthopedic community will require the suppression of bad memories from residency. Using the device solely as a method of maintaining alignment eliminates many of the dynamic attributes that contributes to pain and morbidity. The bone and soft tissues are not stretched, eliminating much of the pain and decreasing the rate of traction-associated pin tract morbidity. Because there is no dynamic of the treatment, the simplified frame can be pre-assembled and have no adjustable components. The experience derived from this application has the potential of expanding the role of ring external fixation. Where the ring has been used previously as method of both obtaining and maintaining alignment, this application uses a simplified neutral version of a complex device to simply maintain alignment in a high risk patient population. Correction of deformity and achieving alignment/reduction of fractures is well within the

  4. Plantar Pressure as a Risk Assessment Tool for Diabetic Foot Ulceration in Egyptian Patients with Diabetes

    PubMed Central

    Fawzy, Olfat A; Arafa, Asmaa I; El Wakeel, Mervat A; Abdul Kareem, Shaimaa H

    2014-01-01

    groups compared to the DC group (P < 0.05) with no significant difference between the DN and DU groups (P > 0.05). FFPPP, F/R ratio, FFPPG, and FFPPG/RFPPG correlated significantly with the severity of neuropathy according to MNDS (P < 0.05). These same variables as well as MNDS were also significantly higher in patients with foot deformity compared to those without deformity (P < 0.05). Using the receiver operating characteristic analysis, the optimal cut-point of PPP for ulceration risk, as determined by a balance of sensitivity, specificity, and accuracy was 335 kPa and was found at the forefoot. Multivariate logistical regression analysis for ulceration risk was statistically significant for duration of diabetes (odds ratio [OR] = 0.8), smoking (OR = 9.7), foot deformity (OR = 8.7), MNDS (OR = 1.5), 2-h postprandial plasma glucose (2 h-PPG) (OR = 0.9), glycated hemoglobin (HbA1c) (OR = 2.1), FFPPP (OR = 1.0), and FFPPG (OR = 1.0). CONCLUSION In conclusion, persons with diabetes having neuropathy and/or ulcers have elevated PPP. Risk of ulceration was highly associated with duration of diabetes, smoking, severity of neuropathy, glycemic control, and high PP variables especially the FFPPP, F/R, and FFPPG. We suggest a cut-point of 355 kPa for FFPPP to denote high risk for ulceration that would be more valid when used in conjunction with other contributory risk factors, namely, duration of diabetes, smoking, glycemic load, foot deformity, and severity of neuropathy. PMID:25520564

  5. Development of a Composite Antenna Foot

    NASA Astrophysics Data System (ADS)

    Bonnes, Lionel

    2012-07-01

    MECANO ID develops and produces composite parts using RTM (Resin Transfer Molding) and LRI (Liquid Resin Infusion) processes. In collaboration with THALES ALENIA SPACE and ONERA, this project aims at replacing titanium antenna feet, which interface the Earth deck antenna of a telecommunication satellite to its support panel, with composite feet. The objectives of the presentation are to detail: - The methodology applied to develop the composite antenna foot - The experimental validation of the foot sizing This project was granted by the French state and the region Midi-Pyrénées.

  6. Foot and Ankle Injuries in American Football.

    PubMed

    Hsu, Andrew R; Anderson, Robert B

    Physicians need to be aware of a variety of foot and ankle injuries that commonly occur in American football, including turf toe, Jones fractures, Lisfranc injuries, syndesmotic and deltoid disruption, and Achilles ruptures. These injuries are often complex and require early individual tailoring of treatment and rehabilitation protocols. Successful management and return to play requires early diagnosis, a thorough work-up, and prompt surgical intervention when warranted with meticulous attention to restoration of normal foot and ankle anatomy. Physicians should have a high suspicion for subtle injuries and variants that can occur via both contact and noncontact mechanisms.

  7. Foot and ankle injuries in theatrical dancers.

    PubMed

    Hardaker, W T; Margello, S; Goldner, J L

    1985-10-01

    The theatrical dancer is a unique combination of athlete and artist. The physical demands of dance class, rehearsal, and performance can lead to injury, particularly to the foot and ankle. Ankle sprains are the most common acute injury. Chronic injuries predominate and relate primarily to the repeated impact loading of the foot and ankle on the dance floor. Contributing factors include anatomic variation, improper technique, and fatigue. Early and aggressive conservative management is usually successful and surgery is rarely indicated. Orthotics play a limited but potentially useful role in treatment. Following treatment, a structured rehabilitation program is fundamental to the successful return to dance.

  8. Diabetic foot ulcers: Part II. Management.

    PubMed

    Alavi, Afsaneh; Sibbald, R Gary; Mayer, Dieter; Goodman, Laurie; Botros, Mariam; Armstrong, David G; Woo, Kevin; Boeni, Thomas; Ayello, Elizabeth A; Kirsner, Robert S

    2014-01-01

    The management of diabetic foot ulcers can be optimized by using an interdisciplinary team approach addressing the correctable risk factors (ie, poor vascular supply, infection control and treatment, and plantar pressure redistribution) along with optimizing local wound care. Dermatologists can initiate diabetic foot care. The first step is recognizing that a loss of skin integrity (ie, a callus, blister, or ulcer) considerably increases the risk of preventable amputations. A holistic approach to wound assessment is required. Early detection and effective management of these ulcers can reduce complications, including preventable amputations and possible mortality.

  9. Foot Pedals for Spacecraft Manual Control

    NASA Technical Reports Server (NTRS)

    Love, Stanley G.; Morin, Lee M.; McCabe, Mary

    2010-01-01

    Fifty years ago, NASA decided that the cockpit controls in spacecraft should be like the ones in airplanes. But controls based on the stick and rudder may not be best way to manually control a vehicle in space. A different method is based on submersible vehicles controlled with foot pedals. A new pilot can learn the sub's control scheme in minutes and drive it hands-free. We are building a pair of foot pedals for spacecraft control, and will test them in a spacecraft flight simulator.

  10. Long-Term Results of Reconstruction for Treatment of a Flexible Cavovarus Foot in Charcot-Marie-Tooth Disease

    PubMed Central

    Ward, Christina M.; Dolan, Lori A.; Bennett, D. Lee; Morcuende, Jose A.; Cooper, Reginald R.

    2008-01-01

    Background: Cavovarus foot deformity is common in patients with Charcot-Marie-Tooth disease. Multiple surgical reconstructive procedures have been described, but few authors have reported long-term results. The purpose of this study was to evaluate the long-term results of an algorithmic approach to reconstruction for the treatment of a cavovarus foot in these patients. Methods: We evaluated twenty-five consecutive patients with Charcot-Marie-Tooth disease and cavovarus foot deformity (forty-one feet) who had undergone, between 1970 and 1994, a reconstruction consisting of dorsiflexion osteotomy of the first metatarsal, transfer of the peroneus longus to the peroneus brevis, plantar fascia release, transfer of the extensor hallucis longus to the neck of the first metatarsal, and in selected cases transfer of the tibialis anterior tendon to the lateral cuneiform. Each patient completed standardized outcome questionnaires (the Short Form-36 [SF-36] and Foot Function Index [FFI]). Radiographs were evaluated to assess alignment and degenerative arthritis, and gait analysis was performed. The mean age at the time of follow-up was 41.5 years, and the mean duration of follow-up was 26.1 years. Results: Correction of the cavus deformity was well maintained, although most patients had some recurrence of hindfoot varus as seen on radiographic examination. The patients had a lower mean SF-36 physical component score than age-matched norms, and the women had a lower mean SF-36 physical component score than the men, although this difference was not significant. Smokers had lower mean SF-36 scores and significantly higher mean FFI pain, disability, and activity limitation subscores (p < 0.0001). Seven patients (eight feet) underwent a total of eleven subsequent foot or ankle operations, but no patient required a triple arthrodesis. Moderate-to-severe osteoarthritis was observed in eleven feet. With the numbers studied, the age at surgery, age at the time of follow-up, and body

  11. Genetics Home Reference: hand-foot-genital syndrome

    MedlinePlus

    ... Encyclopedia: Hypospadias Encyclopedia: Urinary Tract Infection Health Topic: Foot Injuries and Disorders Health Topic: Hand Injuries and Disorders Genetic and Rare Diseases Information Center (1 link) Hand foot uterus syndrome Educational Resources (5 links) American Society ...

  12. 1. VIEW SHOWING REMAINS OF CAMOUFLAGE COVERING CONCRETE FOOTING FOR ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. VIEW SHOWING REMAINS OF CAMOUFLAGE COVERING CONCRETE FOOTING FOR A GENERATOR PAD - Fort Cronkhite, Anti-Aircraft Battery No. 1, Concrete Footing-Generator Pad, Wolf Road, Sausalito, Marin County, CA

  13. 20. LOCK GATES, 3 FOOT WALKWAY, ADJUSTMENT AT GUDGEON PIN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    20. LOCK GATES, 3 FOOT WALKWAY, ADJUSTMENT AT GUDGEON PIN AND QUOIN SHOE. May 1933 - Mississippi River 9-Foot Channel Project, Lock & Dam No. 17, Upper Mississippi River, New Boston, Mercer County, IL

  14. APPROACH BRIDGE PORTION OF VALVE TOWER FOOT BRIDGE, AS SEEN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    APPROACH BRIDGE PORTION OF VALVE TOWER FOOT BRIDGE, AS SEEN FROM ENTRY. VIEW FACING NORTHWEST - Schofield Barracks Military Reservation, Ku Tree Reservoir, Valve Tower Foot Bridge, Kalakoa Stream, East Range, Wahiawa, Honolulu County, HI

  15. APPROACH BRIDGE PORTION OF VALVE TOWER FOOT BRIDGE, AS SEEN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    APPROACH BRIDGE PORTION OF VALVE TOWER FOOT BRIDGE, AS SEEN FROM BELOW, SHOWING VALVE TOWER TO RIGHT. VIEW FACING NORTH - Schofield Barracks Military Reservation, Ku Tree Reservoir, Valve Tower Foot Bridge, Kalakoa Stream, East Range, Wahiawa, Honolulu County, HI

  16. [The gold standard in diabetic foot treatment: total contact cast].

    PubMed

    Lozano-Platonoff, Adriana; Florida Mejía-Mendoza, Melissa Desireé; Ibáñez-Doria, Mónica; Contreras-Ruiz, José

    2014-01-01

    In patients with diabetes, foot complications remain one of the main health issues, with ulcers representing one of the most common. These ulcerations originate from repetitive trauma on a foot with neuropathy. Inadequate care of the diabetic foot may lead to one of the gravest complications of the diabetic foot: amputation. The key to the treatment of the diabetic foot is the control of comorbidities (glucose levels and vascular disease), debridement, exudate control with the available modern dressings, treatment of infection, and offloading the affected foot. A common error in this basic treatment is the method used for offloading, leading to delayed healing as a result, and maybe even amputation. For this purpose we propose the total contact cast considered the "gold standard" in diabetic foot offloading. The objective of the present review is to present the existing evidence in the medical literature on the effectiveness of its use for healing diabetic foot ulcers and hence preventing amputations.

  17. Crustal deformation and earthquakes

    NASA Technical Reports Server (NTRS)

    Cohen, S. C.

    1984-01-01

    The manner in which the Earth's surface deforms during the cycle of stress accumulation and release along major faults is investigated. In an investigation of the crustal deformation associated with a thin channel asthenosphere displacements are reduced from those computed for a half space asthenosphere. A previous finding by other workers that displacements are enhanced when flow is confined to a thin channel is based on several invalid approximations. The major predictions of the finite element model are that the near field postseismic displacements and strain rates are less than those for a half space asthenosphere and that the postseismic strain rates at intermediate distances are greater (in magnitude). The finite width of the asthenosphere ceases to have a significant impact on the crustal deformation pattern when its magnitude exceeds about three lithosphere thicknesses.

  18. Interfacial Bubble Deformations

    NASA Astrophysics Data System (ADS)

    Seymour, Brian; Shabane, Parvis; Cypull, Olivia; Cheng, Shengfeng; Feitosa, Klebert

    Soap bubbles floating at an air-water experience deformations as a result of surface tension and hydrostatic forces. In this experiment, we investigate the nature of such deformations by taking cross-sectional images of bubbles of different volumes. The results show that as their volume increases, bubbles transition from spherical to hemispherical shape. The deformation of the interface also changes with bubble volume with the capillary rise converging to the capillary length as volume increases. The profile of the top and bottom of the bubble and the capillary rise are completely determined by the volume and pressure differences. James Madison University Department of Physics and Astronomy, 4VA Consortium, Research Corporation for Advancement of Science.

  19. Plate motion and deformation

    SciTech Connect

    Minster, B.; Prescott, W.; Royden, L.

    1991-02-01

    Our goal is to understand the motions of the plates, the deformation along their boundaries and within their interiors, and the processes that control these tectonic phenomena. In the broadest terms, we must strive to understand the relationships of regional and local deformation to flow in the upper mantle and the rheological, thermal and density structure of the lithosphere. The essential data sets which we require to reach our goal consist of maps of current strain rates at the earth's surface and the distribution of integrated deformation through time as recorded in the geologic record. Our success will depend on the effective synthesis of crustal kinematics with a variety of other geological and geophysical data, within a quantitative theoretical framework describing processes in the earth's interior. Only in this way can we relate the snapshot of current motions and earth structure provided by geodetic and geophysical data with long-term processes operating on the time scales relevant to most geological processes. The wide-spread use of space-based techniques, coupled with traditional geological and geophysical data, promises a revolution in our understanding of the kinematics and dynamics of plate motions over a broad range of spatial and temporal scales and in a variety of geologic settings. The space-based techniques that best address problems in plate motion and deformation are precise space-geodetic positioning -- on land and on the seafloor -- and satellite acquisition of detailed altimetric and remote sensing data in oceanic and continental areas. The overall science objectives for the NASA Solid Earth Science plan for the 1990's, are to Understand the motion and deformation of the lithosphere within and across plate boundaries'', and to understand the dynamics of the mantle, the structure and evolution of the lithosphere, and the landforms that result from local and regional deformation. 57 refs., 7 figs., 2 tabs.

  20. A pictorial review of reconstructive foot and ankle surgery: hallux abductovalgus

    PubMed Central

    Meyr, Andrew J; Singh, Salil; Chen, Oliver; Ali, Sayed

    2015-01-01

    This pictorial review focuses on basic procedures performed within the field of podiatric surgery, specifically for the hallux abductovalgus or “bunion” deformity. Our goal is to define objective radiographic parameters that surgeons utilize to initially define deformity, lead to procedure selection and judge post-operative outcomes. We hope that radiologists will employ this information to improve their assessment of post-operative radiographs following reconstructive foot surgeries. First, relevant radiographic measurements are defined and their role in procedure selection explained. Second, the specific surgical procedures of the distal metatarsal, metatarsal shaft, metatarsal base, and phalangeal osteotomies are described in detail. Additional explanations of arthrodesis of the first metatarsal-phalangeal and metatarsal-cuneiform joints are also provided. Finally, specific plain film radiographic findings that judge post-operative outcomes for each procedure are detailed. PMID:26622935

  1. Nanolaminate deformable mirrors

    DOEpatents

    Papavasiliou, Alexandros P.; Olivier, Scot S.

    2009-04-14

    A deformable mirror formed out of two layers of a nanolaminate foil attached to a stiff substrate is introduced. Deformation is provided by an electrostatic force between two of the layers. The internal stiffness of the structure allows for high-spatial-frequency shapes. The nanolaminate foil of the present invention allows for a high-quality mirror surface. The device achieves high precision in the vertical direction by using foils with accurately controlled thicknesses, but does not require high precision in the lateral dimensions, allowing such mirrors to be fabricated using crude lithography techniques. Such techniques allow structures up to about the meter scale to be fabricated.

  2. Nanolaminate deformable mirrors

    DOEpatents

    Papavasiliou, Alexandros P.; Olivier, Scot S.

    2010-04-06

    A deformable mirror formed out of two layers of a nanolaminate foil attached to a stiff substrate is introduced. Deformation is provided by an electrostatic force between two of the layers. The internal stiffness of the structure allows for high-spatial-frequency shapes. The nanolaminate foil of the present invention allows for a high-quality mirror surface. The device achieves high precision in the vertical direction by using foils with accurately controlled thicknesses, but does not require high precision in the lateral dimensions, allowing such mirrors to be fabricated using crude lithography techniques. Such techniques allow structures up to about the meter scale to be fabricated.

  3. Micromachined, Electrostatically Deformable Reflectors

    NASA Technical Reports Server (NTRS)

    Bartman, Randall K.; Wang, Paul K. C.; Miller, Linda M.; Kenny, Thomas W.; Kaiser, William J.; Hadaegh, Fred Y.; Agronin, Michael L.

    1995-01-01

    Micromachined, closed-loop, electrostatically actuated reflectors (microCLEARs) provide relatively simple and inexpensive alternatives to large, complex, expensive adaptive optics used to control wavefronts of beams of light in astronomy and in experimental laser weapons. Micromachining used to make deformable mirror, supporting structure, and actuation circuitry. Development of microCLEARs may not only overcome some of disadvantages and limitations of older adaptive optics but may also satisfy demands of potential market for small, inexpensive deformable mirrors in electronically controlled film cameras, video cameras, and other commercial optoelectronic instruments.

  4. Disorder-Driven Metal-Insulator Transitions in Deformable Lattices

    NASA Astrophysics Data System (ADS)

    Di Sante, Domenico; Fratini, Simone; Dobrosavljević, Vladimir; Ciuchi, Sergio

    2017-01-01

    We show that, in the presence of a deformable lattice potential, the nature of the disorder-driven metal-insulator transition is fundamentally changed with respect to the noninteracting (Anderson) scenario. For strong disorder, even a modest electron-phonon interaction is found to dramatically renormalize the random potential, opening a mobility gap at the Fermi energy. This process, which reflects disorder-enhanced polaron formation, is here given a microscopic basis by treating the lattice deformations and Anderson localization effects on the same footing. We identify an intermediate "bad insulator" transport regime which displays resistivity values exceeding the Mott-Ioffe-Regel limit and with a negative temperature coefficient, as often observed in strongly disordered metals. Our calculations reveal that this behavior originates from significant temperature-induced rearrangements of electronic states due to enhanced interaction effects close to the disorder-driven metal-insulator transition.

  5. Safety Pedal for Foot-Operated Machinery

    NASA Technical Reports Server (NTRS)

    Garcia, G. D.

    1985-01-01

    Ninged structure prevents inadvertent use. Forward motion of foot on yoke plate necessary to operate brake pedal. Downward force on yoke plate turns locking/releasing laver, which then pushes locking pin into indexing hole. New pedal improves both productivity and safety of power brakes and such other machines as metal shearers and punch presses.

  6. Animal health: foot-and-mouth disease

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foot-and-mouth disease (FMD) is one of the most contagious viral diseases that can affect cloven-hoofed livestock and wild animals. Outbreaks of FMD have caused devastating economic losses and the slaughter of millions of animals in many regions of the world affecting the food chain and global devel...

  7. Intravascular papillary endothelial hyperplasia of the foot.

    PubMed

    Cisco, R W; McCormac, R M

    1994-01-01

    Intravascular papillary endothelial hyperplasia is a rare benign reactive lesion usually found in thrombosed subcutaneous blood vessels. The lesion resembles malignant angiosarcoma clinically and histopathologically, and must be diagnosed correctly to avoid inappropriate treatment. The following is a case presentation involving the foot.

  8. Malignant melanoma of the foot and ankle.

    PubMed

    John, K J; Hayes, D W; Green, D R; Dickerson, J

    2000-04-01

    Malignant melanoma is a serious and devastating skin disease that podiatrists may be called upon to treat. It is pertinent that delays in diagnosis and treatment of malignant melanoma be avoided. Some of the topics discussed in this article are causes, clinical features, classification, and treatment of malignant melanoma, focusing on the foot and ankle.

  9. Gas Gangrene of the Diabetic Foot.

    PubMed

    Kuy, SreyRam; Romero, Ramon A L; Kuy, SreyReath

    2015-01-01

    A 67-year old man presented with a painful left foot and a putrid odor. His past medical history was significant for poorly controlled diabetes mellitus, coronary artery disease, and peripheral vascular disease. His surgical history included a prior right below-knee amputation for a diabetic foot infection three years prior, and a left third toe amputation for osteomyelitis one month ago. He was an active smoker. His laboratory data revealed a white blood count of 22 k/uL and a blood glucose of 381 mg/dL. Physical exam demonstrated an erythematous and edematous left foot with subcutaneous crepitus along the plantar surface. Plain film x-rays of the left foot demonstrated gas pockets in the soft tissue and acute osteomyelitis (Figure 1). The patient was diagnosed with gas gangrene and was taken emergently to the operating room. In order to obtain source control of this life threatening infection, a left below-knee amputation was performed and broad spectrum empiric antibiotics were initiated immediately with vancomycin and piperacillin/tazobactam. Cultures were not obtained at the time of surgery and the organisms causing this infection are unknown. The patient survived and was discharged to a rehabilitation facility.

  10. Lightweight, Economical Device Alleviates Drop Foot

    NASA Technical Reports Server (NTRS)

    Deis, B. C.

    1983-01-01

    Corrective apparatus alleviates difficulties in walking for victims of drop foot. Elastic line attached to legband provides flexible support to toe of shoe. Device used with flat (heelless) shoes, sneakers, crepe-soled shoes, canvas shoes, and many other types of shoes not usable with short leg brace.

  11. Rare presentation of foot postaxial polydactyly.

    PubMed

    Rafique, Atif; Arshad, Ambreen; Abu-Zaid, Ahmed

    2014-01-01

    Polydactyly is a prevalent birth anomaly observed in the foot, and a number of classification systems have been suggested for this condition. Postaxial (fifth or little toe) polydactyly is the most common type. We encountered an exceedingly rare presentation of foot postaxial polydactyly that, to our inspection, had neither been previously classified nor described in published studies. In the present report, we have described an otherwise healthy 2-year-old female who had presented to our clinic with an isolated, extra little toe on her left foot. Foot radiographs revealed the presence of all 5 metatarsals; however, the fifth metatarsal was blocked and did not give rise to the fifth toe. Instead, the fifth (medial normal) and sixth (lateral extra) toes had originated from a single, separate accessory bud from the fourth metatarsal, and the main fourth metatarsal had given rise to the normal fourth toe. The lateral sixth toe was excised, and a periosteal sleeve of the excised extra toe was used for reconstruction of the lateral collateral ligament. We propose that this heretofore unmentioned presentation of postaxial polydactyly be added to the existing systems of classification of pedal polydactyly. A review of the published data pertaining to pedal polydactyly has also been presented.

  12. Assessment of acute foot and ankle sprains.

    PubMed

    Lynam, Louise

    2006-07-01

    Acute ankle and foot trauma is a regular emergency presentation and prompt strategic assessment skills are required to enable nurses to categorise and prioritise these injuries appropriately. This article provides background information on the anatomy and physiology of the lower limb to help nurses to identify various grades of ankle sprain as well as injuries that are limb threatening

  13. The foot and ankle of Australopithecus sediba.

    PubMed

    Zipfel, Bernhard; DeSilva, Jeremy M; Kidd, Robert S; Carlson, Kristian J; Churchill, Steven E; Berger, Lee R

    2011-09-09

    A well-preserved and articulated partial foot and ankle of Australopithecus sediba, including an associated complete adult distal tibia, talus, and calcaneus, have been discovered at the Malapa site, South Africa, and reported in direct association with the female paratype Malapa Hominin 2. These fossils reveal a mosaic of primitive and derived features that are distinct from those seen in other hominins. The ankle (talocrural) joint is mostly humanlike in form and inferred function, and there is some evidence for a humanlike arch and Achilles tendon. However, Au. sediba is apelike in possessing a more gracile calcaneal body and a more robust medial malleolus than expected. These observations suggest, if present models of foot function are correct, that Au. sediba may have practiced a unique form of bipedalism and some degree of arboreality. Given the combination of features in the Au. sediba foot, as well as comparisons between Au. sediba and older hominins, homoplasy is implied in the acquisition of bipedal adaptations in the hominin foot.

  14. Diabetes: Good Diabetes Management and Regular Foot Care Help Prevent Severe Foot Sores

    MedlinePlus

    ... often fit poorly and irritate your skin. Buy shoes that fit properly. Buy comfortable shoes that provide support and cushioning for the heel, arch and ball of the foot. Avoid tightfitting shoes and high heels or narrow shoes that crowd ...

  15. The Athletic Foot and Its Import to Performance during Running.

    ERIC Educational Resources Information Center

    Bogdan, Richard

    In this paper, problems and conditions of the foot, including flat feet, achilles tendon problems, heel spur syndrome, digital problems, shin splints, and leg stress fractures, are examined. Ways to examine the athlete's foot and leg are described, including the one-foot test and the off weight-bearing examination. (CJ)

  16. The Diabetic Foot: The Importance of Coordinated Care

    PubMed Central

    Huang, Dean Y.; Wilkins, C. Jason; Evans, David R.; Ammar, Thoraya; Deane, Colin; Vas, Prashanth R.; Rashid, Hisham; Sidhu, Paul S.; Edmonds, Michael E.

    2014-01-01

    Because of the severe morbidity and mortality associated with diabetes, diabetic foot care is an essential component of a peripheral vascular service. The goal of this article is to describe the vascular diabetic foot care pathway and how the coordinated foot care service for diabetic patients is delivered at King's College Hospital, London. PMID:25435655

  17. 8-Foot High Speed Tunnel (HST

    NASA Technical Reports Server (NTRS)

    1957-01-01

    Interior view of the slotted throat test section installed in the 8-Foot High Speed Tunnel (HST) in 1950. The slotted region is about 160 inches in length. In this photograph, the sting-type model support is seen straight on. In a NASA report, the test section is described as follows: 'The test section of the Langley 8-foot transonic tunnel is dodecagonal in cross section and has a cross-sectional area of about 43 square feet. Longitudinal slots are located between each of the 12 wall panels to allow continuous operation through the transonic speed range. The slots contain about 11 percent of the total periphery of the test section. Six of the twelve panels have windows in them to allow for schlieren observations. The entire test section is enclosed in a hemispherical shaped chamber.' John Becker noted that the tunnel's 'final achievement was the development and use in routine operations of the first transonic slotted throat. The investigations of wing-body shapes in this tunnel led to Whitcomb's discovery of the transonic area rule.' James Hansen described the origins of the the slotted throat as follows: 'In 1946 Langley physicist Ray H. Wright conceived a way to do transonic research effectively in a wind tunnel by placing slots in the throat of the test section. The concept for what became known as the slotted-throat or slotted-wall tunnel came to Wright not as a solution to the chronic transonic problem, but as a way to get rid of wall interference (i.e., the mutual effect of two or more meeting waves or vibrations of any kind caused by solid boundaries) at subsonic speeds. For most of the year before Wright came up with this idea, he had been trying to develop a theoretical understanding of wall interference in the 8-Foot HST, which was then being repowered for Mach 1 capability.' When Wright presented these ideas to John Stack, the response was enthusiastic but neither Wright nor Stack thought of slotted-throats as a solution to the transonic problem, only

  18. Assessment of Diabetic Polyneuropathy and Plantar Pressure in Patients with Diabetes Mellitus in Prevention of Diabetic Foot

    PubMed Central

    Skopljak, Amira; Sukalo, Aziz; Batic-Mujanovic, Olivera; Muftic, Mirsad; Tiric-Campara, Merita; Zunic, Lejla

    2014-01-01

    Introduction: Risk assessment for development foot ulcer in diabetics is a key aspect in any plan and program for prevention of non-traumatic amputation of lower extremities. Material and methods: In the prospective research to assessed diabetic neuropathy in diabetic patients, to determined the dynamic function of the foot (plantar pressure), by using pedobarography (Group I), and after the use of orthopedic insoles with help of pedobarography, to determined the connection between the risk factors: deformity of the foot, limited joint movements, diabetic polyneuropathy, plantar pressure in effort preventing changes in the diabetic foot. Results: Out of 1806 patients, who are registered in one Team of family medicine examined 100 patients with diabetes mellitus Type 2. The average age of subjects was 59.4, SD11.38. The average HbA1c was 7.78% SD1.58. Combining monofilament and tuning fork tests, the diagnosis of polyneuropathy have 65% of patients. Comparing Test Symptom Score individual parameters between the first and second measurement, using pedobarography, in Group I, statistically significant difference was found for all of the assessed parameters: pain, burning sensation, paresthesia and insensitivity (p<0,05). The measurements of peak pressure, both first and the second measurement, for all of the subjects in Group I(45) show values above 200kPa. That’s a level of pressure that needs to be corrected. The study finds correlation between the foot deformation, diabetic polyneuropathy and plantar pressure (p>0,05). Conclusion: A detail clinical exam of diabetic food in a family doctor office equipped with pedobarography (plantar pressure measurements), use of orthopedic insoles, significantly reduces clinical symptoms of diabetic polyneuropathy in patients with diabetes. PMID:25650237

  19. Normative values for the Foot Posture Index

    PubMed Central

    Redmond, Anthony C; Crane, Yvonne Z; Menz, Hylton B

    2008-01-01

    Background The Foot Posture Index (FPI) is a validated method for quantifying standing foot posture, and is being used in a variety of clinical settings. There have however, been no normative data available to date for comparison and reference. This study aimed to establish normative FPI reference values. Methods Studies reporting FPI data were identified by searching online databases. Nine authors contributed anonymised versions of their original datasets comprising 1648 individual observations. The datasets included information relating to centre, age, gender, pathology (if relevant), FPI scores and body mass index (BMI) where available. FPI total scores were transformed to interval logit scores as per the Rasch model and normal ranges were defined. Comparisons between groups employed t-tests or ANOVA models as appropriate and data were explored descriptively and graphically. Results The main analysis based on a normal healthy population (n = 619) confirmed that a slightly pronated foot posture is the normal position at rest (mean back transformed FPI raw score = +4). A 'U' shaped relationship existed for age, with minors and older adults exhibiting significantly higher FPI scores than the general adult population (F = 51.07, p < 0.001). There was no difference between the FPI scores of males and females (2.3 versus 2.5; t = -1.44, p = 0.149). No relationship was found between the FPI and BMI. Systematic differences from the adult normals were confirmed in patients with neurogenic and idiopathic cavus (F = 216.981, p < 0.001), indicating some sensitivity of the instrument to detect a posturally pathological population. Conclusion A set of population norms for children, adults and older people have been derived from a large sample. Foot posture is related to age and the presence of pathology, but not influenced by gender or BMI. The normative values identified may assist in classifying foot type for the purpose of research and clinical decision making. PMID

  20. Foot Syndactyly: A Clinical and Demographic Analysis

    PubMed Central

    Kim, Jong Ho; Kim, Byung Jun

    2016-01-01

    Background Syndactyly of the foot is the second most common congenital foot anomaly. In East Asia, however, no large case study has been reported regarding the clinical features of isolated foot syndactyly. In this study, we report a review of 118 patients during the last 25 years. Methods We conducted a chart review of patients who underwent surgical correction for foot syndactyly between January 1990 and December 2014. Operations were performed with a dorsal triangular flap and a full-thickness skin graft. The demographics of included patients and their clinical features were evaluated. Surgical outcomes and complications were analyzed. Results Among 118 patients with 194 webs (155 feet), 111 patients showed nonsyndromic cases and 7 patients showed syndromic cases. In 80 unilateral cases (72.1%), the second web was the most frequently involved (37.5%), followed by the fourth (30%), the first (15%), the third (15%), the first and second in combination (1.3%), and the second and third in combination (1.3%). Among 31 bilateral cases, 2 cases were asymmetric. Among the remaining 29 symmetric bilateral cases, the second web was the most frequently involved (45.2%), followed by the first (22.6%), and the fourth (6.5%). No specific postoperative complications were observed, except in the case of 1 patient (0.51%) who required a secondary operation to correct web creep. Conclusions This retrospective clinical study of 118 patients with both unilateral and bilateral foot syndactyly revealed that the second web was the most frequently involved. In addition, complete division and tension-free wound closure with a full-thickness skin graft of sufficient size showed good postoperative results. PMID:27896188

  1. Concordance in diabetic foot ulcer infection

    PubMed Central

    Nelson, E Andrea; Backhouse, Michael Ross; Bhogal, Moninder S; Wright-Hughes, Alexandra; Lipsky, Benjamin A; Nixon, Jane; Brown, Sarah; Gray, Janine

    2013-01-01

    Introduction Accurate identification of pathogens, rather than colonising bacteria, is a prerequisite for targeted antibiotic therapy to ensure optimal patient outcome in wounds, such as diabetic foot ulcers. Wound swabs are the easiest and most commonly used sampling technique but most published guidelines recommend instead removal of a tissue sample from the wound bed, which is a more complex process. The aim of this study was to assess the concordance between culture results from wound swabs and tissue samples in patients with suspected diabetic foot infection. Methods and analysis Patients with a diabetic foot ulcer that is thought to be infected are being recruited from 25 sites across England in a cross-sectional study. The coprimary endpoints for the study are agreement between the two sampling techniques for three microbiological parameters: reported presence of likely isolates identified by the UK Health Protection Agency; resistance of isolates to usual antibiotic agents; and, the number of isolates reported per specimen. Secondary endpoints include appropriateness of the empiric antibiotic therapy prescribed and adverse events. Enrolling 400 patients will provide 80% power to detect a difference of 3% in the reported presence of an organism, assuming organism prevalence of 10%, discordance of 5% and a two-sided test at the 5% level of significance. Assumed overall prevalence is based on relatively uncommon organisms such as Pseudomonas. We will define acceptable agreement as κ>0.6. Ethics and dissemination Concordance in diabetic foot ulcer infection (CODIFI) will produce robust data to evaluate the two most commonly used sampling techniques employed for patients with a diabetic foot infection. This will help determine whether or not it is important that clinicians take tissue samples rather than swabs in infected ulcers. This study has been approved by the Sheffield NRES Committee (Ref: 11/YH/0078) and all sites have obtained local approvals prior

  2. Factors influencing accuracy and reproducibility of body resistance measurements by foot-to-foot impedancemeters.

    PubMed

    Bousbiat, Sana; Jaffrin, Michel; Assadi, Imen

    2015-01-01

    The electronics of a BodySignal V2 (Tefal, France) foot-to-foot impedancemeter (FFI) was modified to display the foot-to-foot resistance instead of body fat. This device was connected to electrodes of different sizes mounted on a podoscope permitting photographs of subjects feet soles and electrodes in order to calculate the contact area between feet and electrodes. The foot-to-foot resistance was found to decrease when the contact area of feet with current and voltage electrodes increased. It was also sensitive to feet displacement and a backward move of 5 cm increased the mean resistance by 37 Ω. The resistance reproducibility was tested by asking the subject to repeat measurements 10-times by stepping up and down from the podoscope. The mean SD of these tests was 0.88% of mean resistance, but it fell to 0.47% when feet position was guided and to 0.29% with transverse voltage electrodes. For good reproducibility, it is important that voltage electrodes be small and that the scale design facilitates a correct position of heels on these electrodes.

  3. Functional Assessment of the Foot Undergoing Percutaneous Achilles Tenotomy in Term of Gait Analysis

    PubMed Central

    Jiang, Shu-Yun; Tao, Xu-Chen; Zhao, Da-Hang

    2016-01-01

    Background. This study was designed to evaluate the function of the foot undergoing the procedure of percutaneous Achilles tenotomy (PAT) in case of clubfoot management in terms of gait analysis. Methods. Nineteen patients with unilateral clubfeet were retrospectively reviewed from our database from July 2012 to June 2016. The result in all the cases was rated as excellent according to the scale of International Clubfoot Study Group (ICSG). The affected sides were taken as Group CF and the contralateral sides as Group CL. Three-dimensional gait analysis was applied for the functional evaluation of the involved foot. Results. Statistical difference was found in physical parameters of passive ankle dorsiflexion and plantar-flexion. No statistical difference was found in temporal-spatial parameters. There was statistical difference in kinematic parameters of total ankle rotation, ankle range of motion, and internal foot progression angle and in kinetic parameters of peak ankle power. No statistical difference was found in other kinematic and kinetic parameters. Conclusions. It is demonstrated that the procedure of PAT is safe and efficient for correcting the equinus deformity in case of clubfoot management and preserving the main function of Achilles tendon at the minimum of four-year follow-up. PMID:27652259

  4. The Relationship with Balance, Foot Posture, and Foot Size in School of Physical Education and Sports Students

    ERIC Educational Resources Information Center

    Irez, Gonul Babayigit

    2014-01-01

    The aim of this study is to investigate the relationship of foot posture and foot size with balance. A hundred and thirteen healthy volunteers were recruited from undergraduate students (Male = 74, Female = 37, age range 18-22). The Foot Posture Index (FPI-6), anthropometric measurements, dynamic balance and static balance measurements were done…

  5. Plantar measurements to determine success of surgical correction of Stage IIb adult acquired flatfoot deformity.

    PubMed

    Matheis, Erika A; Spratley, E Meade; Hayes, Curtis W; Adelaar, Robert S; Wayne, Jennifer S

    2014-01-01

    Adult acquired flatfoot deformity is a degenerative disease causing medial arch dysfunction. Surgical correction has typically involved tendon reconstruction with calcaneal osteotomy; however, the postoperative changes have not been fully characterized. The present study assessed the success of surgical correction of Stage IIb adult acquired flatfoot deformity through changes in plantar pressures and patient-generated outcome scores. With Institutional Review Board approval, 6 participants were evaluated before and after surgery using pedobarography, the Foot and Ankle Outcome Score, and the Medical Outcomes Study 36-item short-form questionnaire. The plantar pressures were recorded using a TekScan HRMat(®) during walking and in a 1- and 2-foot stance. The resulting contour maps were segmented into 9 regions, with the peak pressure, normalized force, and arch index calculated. Surgical effects were analyzed using paired t tests. Postoperatively, the Foot and Ankle Outcome Score and Medical Outcomes Study 36-item short-form questionnaire scores increased significantly from 180 ± 78 to 360 ± 136 (p < .03) and 47 ± 18 to 71 ± 19 (p = .06), respectively. During the 2-foot stance, the normalized force had increased significantly in the lateral midfoot (p < .03), although no significant differences were found in peak pressures. No significant differences were observed in the 1-foot stance. During walking, the normalized force increased significantly in the lateral mid- and forefoot (p < .05). The peak pressure increased significantly in the lateral forefoot (p < .01). The arch index values demonstrated no significant changes. The increased questionnaire scores indicated that surgical correction improved the self-perceived health of the participants. Lateral shifts in the peak pressure and normalized force suggest that forefoot and midfoot loading is altered postoperatively, consistent with the goal of offloading the dysfunctional arch. Thus, the present study has

  6. 18. 80 foot pony truss detail of the lower ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    18. 80 foot pony truss - detail of the lower cord pin connection, typical of the 80 foot trusses and similar to the 64 foot truss, where the vertical lace post joins the upper and lower chords. There are two pair of each 80 foot truss and a single pair on the 64 foot truss for a total of 22. The view also shows the chord eye bar and eye rod along with the diagonal bar and rod members. The rod hanging diagonally to the left is a broken lateral member. A four inch conduit is also in view. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  7. Acute bilateral isolated foot drop: Report of two cases

    PubMed Central

    Kertmen, H.; Gürer, B.; Yimaz, E. R.; Sekerci, Z.

    2015-01-01

    Foot drop is defined as the weakness of the foot and ankle dorsiflexion. Acute unilateral foot drop is a well-documented entity, whereas bilateral foot drop is rarely documented. Slowly progressing bilateral foot drop may occur with various metabolic causes, parasagittal intracranial pathologies, and cauda equina syndrome. Acute onset of bilateral foot drop due to disc herniation is extremely rare. Here we present two cases of acute bilateral foot drop due to disc herniation. The first patient was a 45-year-old man presented with acute bilateral foot drop, without any sign of the cauda equina syndrome. Lumbar magnetic resonance imaging of the patient revealed L4-5 disc herniation. To our knowledge, this is the first presented case of acute bilateral foot drop without any signs of cauda equina syndrome caused by L4-5 disc herniation. The second patient was a 50-year-old man who was also presented with acute bilateral foot drop, and had T12-L1 disc herniation with intradural extension. Also this is the first presented case of T12-L1 disc herniation with intradural extension causing acute bilateral foot drop. We performed emergent decompressive laminectomy to both of the patients and extrude disc materials were excised. Both of the patients were recovered with favorable outcome. PMID:25972945

  8. Foot Disorders Associated with Over-Pronated and Over-Supinated Foot Function:The Johnston County Osteoarthritis Project

    PubMed Central

    Golightly, Yvonne M.; Hannan, Marian T.; Dufour, Alyssa B.; Hillstrom, Howard J.; Jordan, Joanne M.

    2015-01-01

    Background The occurrence of musculoskeletal foot disorders differs by race and obesity, and these disorders may be related to pronated (low arch) or supinated (high arch) foot function. This cross-sectional analysis examined relationships of foot disorders and foot function by race and obesity in a community-based observational study of adults 50+ years old with and without osteoarthritis. Methods Members of a prospective cohort study in North Carolina were included in this analysis (N=1466, 67.2% women, 29.5% African American, mean age 68.5 years). Foot disorders were identified with a validated assessment tool, and each foot was categorized as over-pronated, over-supinated, and referent using the center of pressure excursion index from foot pressure scans during normal-paced walking. Logistic regression models estimated associations between foot function and each foot disorder with age, body mass index (BMI), gender, and race as covariates. Results Compared to referent, an over-pronated foot was associated with hallux valgus (adjusted odds ratio [aOR] 1.36, 95% confidence interval [CI] 1.13-1.65) and overlapping toes (aOR 1.36, 95% CI 1.12-1.64), especially in the obese. An over-supinated foot was inversely associated with hallux valgus (aOR 0.85, 95% CI 0.74-0.97). An over-supinated foot was less likely to be associated with Tailor’s bunions among the obese and was more likely to be associated with plantar fasciitis in Caucasians. Conclusion Foot function was related to hallux valgus and overlapping toes, especially among the obese. In clinical patients as well as in the community of older adults, treatments for both the foot disorder and the pronated/supinated foot are needed. Level of Evidence Level II-2: Evidence obtained from well-designed cohort study. PMID:25037712

  9. Foot placement during error and pedal applications in naturalistic driving.

    PubMed

    Wu, Yuqing; Boyle, Linda Ng; McGehee, Daniel; Roe, Cheryl A; Ebe, Kazutoshi; Foley, James

    2017-02-01

    Data from a naturalistic driving study was used to examine foot placement during routine foot pedal movements and possible pedal misapplications. The study included four weeks of observations from 30 drivers, where pedal responses were recorded and categorized. The foot movements associated with pedal misapplications and errors were the focus of the analyses. A random forest algorithm was used to predict the pedal application types based the video observations, foot placements, drivers' characteristics, drivers' cognitive function levels and anthropometric measurements. A repeated multinomial logit model was then used to estimate the likelihood of the foot placement given various driver characteristics and driving scenarios. The findings showed that prior foot location, the drivers' seat position, and the drive sequence were all associated with incorrect foot placement during an event. The study showed that there is a potential to develop a driver assistance system that can reduce the likelihood of a pedal error.

  10. Nanoscale deformation mechanisms in bone.

    PubMed

    Gupta, Himadri S; Wagermaier, Wolfgang; Zickler, Gerald A; Raz-Ben Aroush, D; Funari, Sérgio S; Roschger, Paul; Wagner, H Daniel; Fratzl, Peter

    2005-10-01

    Deformation mechanisms in bone matrix at the nanoscale control its exceptional mechanical properties, but the detailed nature of these processes is as yet unknown. In situ tensile testing with synchrotron X-ray scattering allowed us to study directly and quantitatively the deformation mechanisms at the nanometer level. We find that bone deformation is not homogeneous but distributed between a tensile deformation of the fibrils and a shearing in the interfibrillar matrix between them.

  11. Behaviors predicting foot lesions in patients with non-insulin-dependent diabetes mellitus.

    PubMed

    Suico, J G; Marriott, D J; Vinicor, F; Litzelman, D K

    1998-07-01

    Associations between specific foot-care behaviors and foot lesions in patients with non-insulin-dependent diabetes mellitus were prospectively investigated. Data from a randomized controlled trial for preventing diabetic foot lesions were analyzed as a prospective cohort using logistic regression. Independent variables included foot-care behaviors, patient self-foot examination, going barefoot, availability of foot-care assistance, and visits to health-care providers. The dependent variable was a foot wound on each foot at follow-up. In the final multivariate model, patients who rarely lubricated their feet had an increased risk of foot lesions. Increasing patient use of emollients may be key to preventing foot lesions.

  12. ACCURACY OF SELF-REPORTED FOOT STRIKE PATTERN IN INTERCOLLEGIATE AND RECREATIONAL RUNNERS DURING SHOD RUNNING

    PubMed Central

    Bade, Michael B.; Aaron, Katie

    2016-01-01

    ABSTRACT Background Clinicians are interested in the foot strike pattern (FSP) in runners because of the suggested relationship between the strike pattern and lower extremity injury. Purpose The purpose of this study was to assess the ability of collegiate cross-country runners and recreational runners to self-report their foot strike pattern during running. Study Design Cross-sectional Study Methods Twenty-three collegiate cross-country and 23 recreational runners voluntarily consented to participate. Inclusion criteria included running at least 18 miles per week, experience running on a treadmill, no history of lower extremity congenital or traumatic deformity, or acute injury three months prior to the start of the study. All participants completed a pre-test survey to indicate their typical foot strike pattern during a training run (FSPSurvey). Prior to running, reflective markers were placed on the posterior midsole and the vamp of the running shoe. A high-speed camera was used to film each runner in standing and while running at his or her preferred speed on a treadmill. The angle between the vector formed by the two reflective markers and the superior surface of the treadmill was used to calculate the foot strike angle (FSA). To determine the foot strike pattern from the video data (FSPVideo), the static standing angle was subtracted from the FSA at initial contact of the shoe on the treadmill. In addition to descriptive statistics, percent agreement and Chi square analysis was used to determine distribution differences between the video analysis results and the survey. Results The results of the chi-square analysis on the distribution of the FSPSurvey in comparison to the FSPVideo were significantly different for both the XCRunners (p < .01; Chi-square = 8.77) and the REC Runners (p < .0002; Chi-square = 16.70). The cross-country and recreational runners could correctly self-identified their foot strike pattern 56.5% and 43.5% of the time

  13. Probing deformed quantum commutators

    NASA Astrophysics Data System (ADS)

    Rossi, Matteo A. C.; Giani, Tommaso; Paris, Matteo G. A.

    2016-07-01

    Several quantum gravity theories predict a minimal length at the order of magnitude of the Planck length, under which the concepts of space and time lose their physical meaning. In quantum mechanics, the insurgence of such a minimal length can be described by introducing a modified position-momentum commutator, which in turn yields a generalized uncertainty principle, where the uncertainty on position measurements has a lower bound. The value of the minimal length is not predicted by theories and must be estimated experimentally. In this paper, we address the quantum bound to the estimability of the minimal uncertainty length by performing measurements on a harmonic oscillator, which is analytically solvable in the deformed algebra induced by the deformed commutation relations.

  14. [Babies with cranial deformity].

    PubMed

    Feijen, Michelle M W; Claessens, Edith A W M Habets; Dovens, Anke J Leenders; Vles, Johannes S; van der Hulst, Rene R W J

    2009-01-01

    Plagiocephaly was diagnosed in a baby aged 4 months and brachycephaly in a baby aged 5 months. Positional or deformational plagio- or brachycephaly is characterized by changes in shape and symmetry of the cranial vault. Treatment options are conservative and may include physiotherapy and helmet therapy. During the last two decades the incidence of positional plagiocephaly has increased in the Netherlands. This increase is due to the recommendation that babies be laid on their backs in order to reduce the risk of sudden infant death syndrome. We suggest the following: in cases of positional preference of the infant, referral to a physiotherapist is indicated. In cases of unacceptable deformity of the cranium at the age 5 months, moulding helmet therapy is a possible treatment option.

  15. Partially segmented deformable mirror

    DOEpatents

    Bliss, Erlan S.; Smith, James R.; Salmon, J. Thaddeus; Monjes, Julio A.

    1991-01-01

    A partially segmented deformable mirror is formed with a mirror plate having a smooth and continuous front surface and a plurality of actuators to its back surface. The back surface is divided into triangular areas which are mutually separated by grooves. The grooves are deep enough to make the plate deformable and the actuators for displacing the mirror plate in the direction normal to its surface are inserted in the grooves at the vertices of the triangular areas. Each actuator includes a transducer supported by a receptacle with outer shells having outer surfaces. The vertices have inner walls which are approximately perpendicular to the mirror surface and make planar contacts with the outer surfaces of the outer shells. The adhesive which is used on these contact surfaces tends to contract when it dries but the outer shells can bend and serve to minimize the tendency of the mirror to warp.

  16. Partially segmented deformable mirror

    DOEpatents

    Bliss, E.S.; Smith, J.R.; Salmon, J.T.; Monjes, J.A.

    1991-05-21

    A partially segmented deformable mirror is formed with a mirror plate having a smooth and continuous front surface and a plurality of actuators to its back surface. The back surface is divided into triangular areas which are mutually separated by grooves. The grooves are deep enough to make the plate deformable and the actuators for displacing the mirror plate in the direction normal to its surface are inserted in the grooves at the vertices of the triangular areas. Each actuator includes a transducer supported by a receptacle with outer shells having outer surfaces. The vertices have inner walls which are approximately perpendicular to the mirror surface and make planar contacts with the outer surfaces of the outer shells. The adhesive which is used on these contact surfaces tends to contract when it dries but the outer shells can bend and serve to minimize the tendency of the mirror to warp. 5 figures.

  17. Determining the maximum diameter for holes in the shoe without compromising shoe integrity when using a multi-segment foot model.

    PubMed

    Shultz, Rebecca; Jenkyn, Thomas

    2012-01-01

    Measuring individual foot joint motions requires a multi-segment foot model, even when the subject is wearing a shoe. Each foot segment must be tracked with at least three skin-mounted markers, but for these markers to be visible to an optical motion capture system holes or 'windows' must be cut into the structure of the shoe. The holes must be sufficiently large avoiding interfering with the markers, but small enough that they do not compromise the shoe's structural integrity. The objective of this study was to determine the maximum size of hole that could be cut into a running shoe upper without significantly compromising its structural integrity or changing the kinematics of the foot within the shoe. Three shoe designs were tested: (1) neutral cushioning, (2) motion control and (3) stability shoes. Holes were cut progressively larger, with four sizes tested in all. Foot joint motions were measured: (1) hindfoot with respect to midfoot in the frontal plane, (2) forefoot twist with respect to midfoot in the frontal plane, (3) the height-to-length ratio of the medial longitudinal arch and (4) the hallux angle with respect to first metatarsal in the sagittal plane. A single subject performed level walking at her preferred pace in each of the three shoes with ten repetitions for each hole size. The largest hole that did not disrupt shoe integrity was an oval of 1.7cm×2.5cm. The smallest shoe deformations were seen with the motion control shoe. The least change in foot joint motion was forefoot twist in both the neutral shoe and stability shoe for any size hole. This study demonstrates that for a hole smaller than this size, optical motion capture with a cluster-based multi-segment foot model is feasible for measure foot in shoe kinematics in vivo.

  18. Osteotomies for bunionette deformity.

    PubMed

    Weil, Lowell; Weil, Lowell Scott

    2011-12-01

    A variety of surgical osteotomy procedures have been described for the bunionette deformity.Metatarsal osteotomies narrow the forefoot, maintain the length of the metatarsal, and preserve function of the metatarsophalangeal joint. Distal metatarsal osteotomies produce less correction and reduce postoperative disability; however, they pose a risk of inadequate correction because of the small width of the fifth metatarsal head and transfer lesions if shortened or dorsiflexed excessively. The sliding oblique metaphyseal osteotomy described by Smith and Weil (without fixation) and later by Steinke (with fixation) is easy to perform and provides good cancellous bone contact. Fixation is sometimes difficult and bone healing can take a few months owing to the unstable construct of this osteotomy. Kitaoka described a distal chevron osteotomy, which provides lateral pressure relief and reduced plantar pressure. This osteotomy is currently the most common procedure used; however, it may prove difficult to perform if the deformity is large and the bone is narrow. Diaphyseal osteotomies are indicated when greater correction is needed; however, they require more dissection and there is greater postoperative convalescence with non–weight bearing for several weeks. Proximal base osteotomies may be used to address significantly increased 4–5 IMAs or when a large degree of sagittal plane correction is required. Approaches that have been described include opening and closing base wedges and basal chevrons. Advantages to this approach are the ability to avoid epiphyseal plates in pediatric patients and maintain function of the MTPJ, while disadvantages include inherent instability of the location of the osteotomy, embarrassment of intraosseous and extraosseus blood supply of the metatarsal, and technical demand. Non–weight bearing is essential for several weeks. The Scarfette procedure is a combination head–shaft procedure, which is indicated to treat mild to moderate

  19. Covariant deformed oscillator algebras

    NASA Technical Reports Server (NTRS)

    Quesne, Christiane

    1995-01-01

    The general form and associativity conditions of deformed oscillator algebras are reviewed. It is shown how the latter can be fulfilled in terms of a solution of the Yang-Baxter equation when this solution has three distinct eigenvalues and satisfies a Birman-Wenzl-Murakami condition. As an example, an SU(sub q)(n) x SU(sub q)(m)-covariant q-bosonic algebra is discussed in some detail.

  20. Advanced Curvature Deformable Mirrors

    DTIC Science & Technology

    2010-09-01

    designs using just a glass wafer and a wafer of Carbon Fiber Reinforced Polymer ( CFRP ). In both cases minimum bend radius decreases and the resonant... matrix is consequently nearly diagonal. The long actuators at the outer edge of the deformable mirror are largely outside the working pupil so their...formal reconstruction of the wave front either explicitly or implicitly in the control matrix . The WFS-DM combination is acting like an analog computer

  1. Innovations in diabetic foot reconstruction using supermicrosurgery.

    PubMed

    Suh, Hyun Suk; Oh, Tae Suk; Hong, Joon Pio

    2016-01-01

    The treatment of diabetic foot ulceration is complex with multiple factors involved, and it may often lead to limb amputation. Hence, a multidisciplinary approach is warranted to cover the spectrum of treatment for diabetic foot, but in complex wounds, surgical treatment is inevitable. Surgery may involve the decision to preserve the limb by reconstruction or to amputate it. Reconstruction involves preserving the limb with secure coverage. Local flaps usually are able to provide sufficient coverage for small or moderate sized wound, but for larger wounds, soft tissue coverage involves flaps that are distantly located from the wound. Reconstruction of distant flap usually involves microsurgery, and now, further innovative methods such as supermicrosurgery have further given complex wounds a better chance to be reconstructed and limbs salvaged. This article reviews the microsurgery involved in reconstruction and introduces the new method of supermicrosurgery.

  2. Foot and ankle injuries in dance.

    PubMed

    Brown, Treg D; Micheli, Lyle J

    2004-06-01

    This review focuses on many of the foot and ankle injuries commonly seen among dancers. These unique athletes place extreme demands on their musculoskeletal system and thereby face a variety of acute and overuse injuries. Conservative treatment is successful in the majority of cases, but these patients often continue to dance while healing--commonly prolonging and at times complicating treatment. When surgery is being contemplated, the dancer's performance level and expectations about returning to dance after surgery should be thoroughly explored. Foot and ankle surgeries that routinely yield good to excellent results in the general population can prematurely end a dancer's otherwise promising career. The physician must consider all these factors when designing an appropriate treatment plan for a dancer.

  3. Location of foot arteries using infrared images

    NASA Astrophysics Data System (ADS)

    Villasenor-Mora, Carlos; González-Vega, Arturo; Martín Osmany Falcón, Antonio; Benítez Ferro, Jesús Francisco Guillemo; Córdova Fraga, Teodoro

    2014-11-01

    In this work are presented the results of localization of foot arteries, in a young group of participants by using infrared thermal images, these are the dorsal, posterior tibial and anterior tibial arteries. No inclusion criteria were considered, that causes that no strong statistical data about the influence of the age in the arterial localization. It was achieved to solve the confusion when veins present a heat distribution similar to the artery and in the position of this. it contributes to enhance the rate of location of arteries. In general it is possible to say that the use of infrared thermal images is a good technique to find the foot arteries and can be applied in its characterization in a future. The procedure proposed is a non-invasive technique, and in certain fashion does not requires specialized personnel to achieve locate the arteries. It is portable, safe, and relatively economical.

  4. Underground coal miners' foot and boot problems.

    PubMed

    Wood, G; Marr, S; Berry, G; Nubé, V; Cole, J

    1999-11-01

    The New South Wales (NSW) Joint Coal Board Health and Safety Trust funded an investigation into foot problems reported by 400 randomly selected underground coal miners from 15 mines in NSW. Miners were interviewed and their responses were entered directly into laptop computers. Digital cameras were also used to take pictures of skin conditions and miners' posture. Observations of the skin results indicate that miners find gumboots to be hot, sweaty and uncomfortable. Skin breakdown and tinea, is frequent and disabling and responsible for absences from the workforce that are costly for both miner and employer. A more comfortable and better designed boot is needed, fabricated in waterproof leather together with socks that 'wick' the moisture away from the foot. Socks worn were of varying components and washed at irregular intervals, indicating a need for regular changes of socks and improved hygiene.

  5. Deformation of Wrinkled Graphene

    PubMed Central

    2015-01-01

    The deformation of monolayer graphene, produced by chemical vapor deposition (CVD), on a polyester film substrate has been investigated through the use of Raman spectroscopy. It has been found that the microstructure of the CVD graphene consists of a hexagonal array of islands of flat monolayer graphene separated by wrinkled material. During deformation, it was found that the rate of shift of the Raman 2D band wavenumber per unit strain was less than 25% of that of flat flakes of mechanically exfoliated graphene, whereas the rate of band broadening per unit strain was about 75% of that of the exfoliated material. This unusual deformation behavior has been modeled in terms of mechanically isolated graphene islands separated by the graphene wrinkles, with the strain distribution in each graphene island determined using shear lag analysis. The effect of the size and position of the Raman laser beam spot has also been incorporated in the model. The predictions fit well with the behavior observed experimentally for the Raman band shifts and broadening of the wrinkled CVD graphene. The effect of wrinkles upon the efficiency of graphene to reinforce nanocomposites is also discussed. PMID:25765609

  6. Deformable micro torque swimmer

    NASA Astrophysics Data System (ADS)

    Ishikawa, Takuji; Tanaka, Tomoyuki; Omori, Toshihiro; Imai, Yohsuke

    2015-11-01

    We investigated the deformation of a ciliate swimming freely in a fluid otherwise at rest. The cell body was modeled as a capsule with a hyper elastic membrane enclosing Newtonian fluid. Thrust forces due to the ciliary beat were modeled as torques distributed above the cell body. Effects of the membrane elasticity, the aspect ratio of cell's reference shape and the density difference between the cell and the surrounding fluid were investigated. The results showed that the cell deformed like heart shape when Capillary number (Ca) was sufficiently large, and the swimming velocity decreased as Ca was increased. The gravity effect on the membrane tension suggested that the upwards and downwards swimming velocities of Paramecium might be reglated by the calcium ion channels distributed locally around the anterior end. Moreover, the gravity induced deformation made a cell directed vertically downwards, which resulted in a positive geotaxis like behavior with physical origin. These results are important to understand physiology of ciliate's biological responses to mechanical stimuli.

  7. Nonlinear MHD Waves in a Prominence Foot

    NASA Astrophysics Data System (ADS)

    Ofman, L.; Knizhnik, K.; Kucera, T.; Schmieder, B.

    2015-11-01

    We study nonlinear waves in a prominence foot using a 2.5D MHD model motivated by recent high-resolution observations with Hinode/Solar Optical Telescope in Ca ii emission of a prominence on 2012 October 10 showing highly dynamic small-scale motions in the prominence material. Observations of Hα intensities and of Doppler shifts show similar propagating fluctuations. However, the optically thick nature of the emission lines inhibits a unique quantitative interpretation in terms of density. Nevertheless, we find evidence of nonlinear wave activity in the prominence foot by examining the relative magnitude of the fluctuation intensity (δI/I ˜ δn/n). The waves are evident as significant density fluctuations that vary with height and apparently travel upward from the chromosphere into the prominence material with quasi-periodic fluctuations with a typical period in the range of 5-11 minutes and wavelengths <2000 km. Recent Doppler shift observations show the transverse displacement of the propagating waves. The magnetic field was measured with the THEMIS instrument and was found to be 5-14 G. For the typical prominence density the corresponding fast magnetosonic speed is ˜20 km s-1, in qualitative agreement with the propagation speed of the detected waves. The 2.5D MHD numerical model is constrained with the typical parameters of the prominence waves seen in observations. Our numerical results reproduce the nonlinear fast magnetosonic waves and provide strong support for the presence of these waves in the prominence foot. We also explore gravitational MHD oscillations of the heavy prominence foot material supported by dipped magnetic field structure.

  8. NONLINEAR MHD WAVES IN A PROMINENCE FOOT

    SciTech Connect

    Ofman, L.; Knizhnik, K.; Kucera, T.; Schmieder, B.

    2015-11-10

    We study nonlinear waves in a prominence foot using a 2.5D MHD model motivated by recent high-resolution observations with Hinode/Solar Optical Telescope in Ca ii emission of a prominence on 2012 October 10 showing highly dynamic small-scale motions in the prominence material. Observations of Hα intensities and of Doppler shifts show similar propagating fluctuations. However, the optically thick nature of the emission lines inhibits a unique quantitative interpretation in terms of density. Nevertheless, we find evidence of nonlinear wave activity in the prominence foot by examining the relative magnitude of the fluctuation intensity (δI/I ∼ δn/n). The waves are evident as significant density fluctuations that vary with height and apparently travel upward from the chromosphere into the prominence material with quasi-periodic fluctuations with a typical period in the range of 5–11 minutes and wavelengths <2000 km. Recent Doppler shift observations show the transverse displacement of the propagating waves. The magnetic field was measured with the THEMIS instrument and was found to be 5–14 G. For the typical prominence density the corresponding fast magnetosonic speed is ∼20 km s{sup −1}, in qualitative agreement with the propagation speed of the detected waves. The 2.5D MHD numerical model is constrained with the typical parameters of the prominence waves seen in observations. Our numerical results reproduce the nonlinear fast magnetosonic waves and provide strong support for the presence of these waves in the prominence foot. We also explore gravitational MHD oscillations of the heavy prominence foot material supported by dipped magnetic field structure.

  9. Nuclear medicine applications for the diabetic foot

    SciTech Connect

    Hartshorne, M.F.; Peters, V.

    1987-04-01

    Although not frequently described in the podiatric literature, nuclear medicine imaging may be of great assistance to the clinical podiatrist. This report reviews in detail the use of modern nuclear medicine approaches to the diagnosis and management of the diabetic foot. Nuclear medicine techniques are helpful in evaluating possible osteomyelitis, in determining appropriate amputation levels, and in predicting response to conservative ulcer management. Specific indications for bone, gallium, and perfusion imaging are described.

  10. Foot Marching, Load Carriage, and Injury Risk

    DTIC Science & Technology

    2016-05-01

    marches,” “loaded marches,” and “road marches.” Other operational and training -related lifting activities may also be included. During these... training .1-4 Soldiers’ exposures to foot marching and load-carriage activities, therefore, include both training and deployment scenarios...be a factor of load weight or speed. Variations to these factors depend on mission; unit training ; and fitness levels, equipment, and terrain

  11. Epidermodysplasia Verruciformis with severe hand and foot deformity successfully treated with surgical excision.

    PubMed

    Fang, Fang; Zhao, Liang; Jiang, Ming-jun; Wang, Yan; Wang, Qian-qiu

    2008-01-01

    Epidermodysplasia Verruciformis is a rare skin disease due to human papillomavirus (HPV) infection. We report here a male patient of 39 years with severe giant lesion of hands and feet leading to disability for 20 years. The function of the hands was almost lost. We treated the case with the shaving technique and a satisfactory result without recrudescence in the following two years. No apparent scarring resulted.

  12. Diabetic foot infection treatment and care.

    PubMed

    Cigna, Emanuele; Fino, Pasquale; Onesti, Maria G; Amorosi, Vittoria; Scuderi, Nicolò

    2016-04-01

    Foot infections in diabetic patients are a common, complex and costly problem. They are potentially adverse with progression to deeper spaces and tissues and are associated with severe complications. The management of diabetic foot infection (DFI) requires a prompt and systematic approach to achieve more successful outcomes and to ultimately avoid amputations. This study reviews a multi-step treatment for DFIs. Between September 2010 and September 2012, a total of about 37 patients were consulted for DFI. The treatment algorithm included four steps, that is, several types of debridement according to the type of wound, the application of negative pressure therapy (NPT), other advanced dressings, a targeted antibiotic therapy local or systemic as the case may, and, if necessary, reconstructive surgery. This treatment protocol showed excellent outcomes, allowing us to avoid amputation in most difficult cases. Only about 8% of patients require amputation. This treatment protocol and a multidisciplinary approach with a specialised team produced excellent results in the treatment of DFI and in the management of diabetic foot in general, allowing us to improve the quality of life of diabetic patients and also to ensure cost savings.

  13. Computed tomographic anatomy of the equine foot.

    PubMed

    Claerhoudt, S; Bergman, E H J; Saunders, J H

    2014-10-01

    This study describes a detailed computed tomographic reference of the normal equine foot. Ten forefeet of five adult cadavers, without evidence of orthopaedic disease, were used. Computed tomography (CT) was performed on all feet. Two-millimetre thick transverse slices were obtained, and sagittal and dorsal planes were reformatted. The CT images were matched with the corresponding anatomic slices. The phalanges and the distal sesamoid bone showed excellent detail. The extensor and flexor tendons (including their attachments) could be clearly evaluated. The collateral (sesamoidean) ligaments could be readily located, but were difficult to delineate at their proximal attachment. The distal digital annular ligament could only be distinguished from the deep digital flexor tendon proximal to the distal sesamoid bone, and its proximal attachment could be identified, but not its distal insertion. Small ligaments (impar ligament, chondrosesamoidean, chondrocoronal and chondrocompedal ligaments, axial and abaxial palmar ligaments of the proximal inter-phalangeal joint) were seen with difficulty and not at all slices. The joint capsules could not be delineated from the surrounding soft tissue structures. The lateral and medial proprius palmar digital artery and vein could be visualized occasionally on some slices. The ungular cartilages, corium and hoof wall layering were seen. The nerves, the articular and fibrocartilage of the distal sesamoid bone and the chondroungular ligament could not be assessed. Computed tomography of the equine foot can be of great value when results of radiography and ultrasonography are inconclusive. Images obtained in this study may serve as reference for CT of the equine foot.

  14. End effector with astronaut foot restraint

    NASA Technical Reports Server (NTRS)

    Monford, Leo G., Jr. (Inventor)

    1991-01-01

    The combination of a foot restraint platform designed primarily for use by an astronaut being rigidly and permanently attached to an end effector which is suitable for attachment to the manipulator arm of a remote manipulating system is described. The foot restraint platform is attached by a brace to the end effector at a location away from the grappling interface of the end effector. The platform comprises a support plate provided with a pair of stirrups for receiving the toe portion of an astronaut's boots when standing on the platform and a pair of heel retainers in the form of raised members which are fixed to the surface of the platform and located to provide abutment surfaces for abutting engagement with the heels of the astronaut's boots when his toes are in the stirrups. The heel retainers preclude a backward sliding movement of the feet on the platform and instead require a lifting of the heels in order to extract the feet. The brace for attaching the foot restraint platform to the end effector may include a pivot or swivel joint to permit various orientations of the platform with respect to the end effector.

  15. Diabetic Foot Biomechanics and Gait Dysfunction

    PubMed Central

    Wrobel, James S.; Najafi, Bijan

    2010-01-01

    Background Diabetic foot complications represent significant morbidity and precede most of the lower extremity amputations performed. Peripheral neuropathy is a frequent complication of diabetes shown to affect gait. Glycosylation of soft tissues can also affect gait. The purpose of this review article is to highlight the changes in gait for persons with diabetes and highlight the effects of glycosylation on soft tissues at the foot–ground interface. Methods PubMed, the Cochrane Library, and EBSCOhost® on-line databases were searched for articles pertaining to diabetes and gait. Bibliographies from relevant manuscripts were also searched. Findings Patients with diabetes frequently exhibit a conservative gait strategy where there is slower walking speed, wider base of gait, and prolonged double support time. Glycosylation affects are observed in the lower extremities. Initially, skin thickness decreases and skin hardness increases; tendons thicken; muscles atrophy and exhibit activation delays; bones become less dense; joints have limited mobility; and fat pads are less thick, demonstrate fibrotic atrophy, migrate distally, and may be stiffer. Interpretation In conclusion, there do appear to be gait changes in patients with diabetes. These changes, coupled with local soft tissue changes from advanced glycosylated end products, also alter a patient’s gait, putting them at risk of foot ulceration. Better elucidation of these changes throughout the entire spectrum of diabetes disease can help design better treatments and potentially reduce the unnecessarily high prevalence of foot ulcers and amputation. PMID:20663446

  16. Improving Hohlraums for High Foot Implosions

    NASA Astrophysics Data System (ADS)

    Hinkel, D. E.; Berzak Hopkins, L. F.; Ma, T.; Ralph, J. E.; Albert, F.; Benedetti, L. R.; Celliers, P. M.; Doeppner, T.; Goyon, C. S.; Izumi, N.; Jarrott, L. C.; Khan, S. F.; Kline, J. L.; Kritcher, A. L.; Kyrala, G. A.; Nagel, S. R.; Pak, A. E.; Patel, P.; Rosen, M. D.; Rygg, J. R.; Schneider, M. B.; Turnbull, D. P.; Yeamans, C. B.; Callahan, D. A.; Hurricane, O. A.

    2016-10-01

    Analysis of High Foot implosions show that performance has been limited by the radiation drive environment, i.e., the hohlraum. Demonstrated here is that improvements in the radiation environment result in an enhancement in implosion performance. This is accomplished by using a longer, larger case-to-capsule ratio hohlraum at lower gas fill density. At fixed laser energy, High Foot implosions driven with this hohlraum have achieved a 1.4 x increase in stagnation pressure, with an accompanying relative increase in fusion yield of 50%. Low mode asymmetries are still present, however, and are most likely a consequence of poor inner beam propagation through the hohlraum to the wall. Presented here are results from these High Foot implosions, as well as analyses of inner beam propagation, and additional hohlraum improvements that further ameliorate the implosion. This work performed under the auspices of U.S. Department of Energy by Lawrence Livermore National Laboratory under Contract DE-AC52-07NA27344.

  17. Foot posture is associated with kinematics of the foot during gait: A comparison of normal, planus and cavus feet.

    PubMed

    Buldt, Andrew K; Levinger, Pazit; Murley, George S; Menz, Hylton B; Nester, Christopher J; Landorf, Karl B

    2015-06-01

    Variations in foot posture are associated with the development of some lower limb injuries. However, the mechanisms underlying this relationship are unclear. The objective of this study was to compare foot kinematics between normal, pes cavus and pes planus foot posture groups using a multi-segment foot model. Ninety-seven healthy adults, aged 18-47 were classified as either normal (n=37), pes cavus (n=30) or pes planus (n=30) based on normative data for the Foot Posture Index, Arch Index and normalised navicular height. A five segment foot model was used to measure tri-planar motion of the rearfoot, midfoot, medial forefoot, lateral forefoot and hallux during barefoot walking at a self-selected speed. Angle at heel contact, peak angle, time to peak angle and range of motion was measured for each segment. One way ANOVAs with post-hoc analyses of mean differences were used to compare foot posture groups. The pes cavus group demonstrated a distinctive pattern of motion compared to the normal and pes planus foot posture groups. Effect sizes of significant mean differences were large and comparable to similar studies. Three key differences in overall foot function were observed between the groups: (i) altered frontal and transverse plane angles of the rearfoot in the pes cavus foot; (ii) Less midfoot motion in the pes cavus foot during initial contact and midstance; and (iii) reduced midfoot frontal plane ROM in the pes planus foot during pre-swing. These findings indicate that foot posture does influence motion of the foot.

  18. Nanoscale Deformable Optics

    NASA Technical Reports Server (NTRS)

    Strauss, Karl F.; Sheldon, Douglas J.

    2011-01-01

    Several missions and instruments in the conceptual design phase rely on the technique of interferometry to create detectable fringe patterns. The intimate emplacement of reflective material upon electron device cells based upon chalcogenide material technology permits high-speed, predictable deformation of the reflective surface to a subnanometer or finer resolution with a very high degree of accuracy. In this innovation, a layer of reflective material is deposited upon a wafer containing (perhaps in the millions) chalcogenic memory cells with the reflective material becoming the front surface of a mirror and the chalcogenic material becoming a means of selectively deforming the mirror by the application of heat to the chalcogenic material. By doing so, the mirror surface can deform anywhere from nil to nanometers in spots the size of a modern day memory cell, thereby permitting realtime tuning of mirror focus and reflectivity to mitigate aberrations caused elsewhere in the optical system. Modern foundry methods permit the design and manufacture of individual memory cells having an area of or equal to the Feature (F) size of the design (assume 65 nm). Fabrication rules and restraints generally require the instantiation of one memory cell to another no closer than 1.5 F, or, for this innovation, 90 nm from its neighbor in any direction. Chalcogenide is a semiconducting glass compound consisting of a combination of chalcogen ions, the ratios of which vary according to properties desired. It has been shown that the application of heat to cells of chalcogenic material cause a large alteration in resistance to the range of 4 orders of magnitude. It is this effect upon which chalcogenidebased commercial memories rely. Upon removal of the heat source, the chalcogenide rapidly cools and remains frozen in the excited state. It has also been shown that the chalcogenide expands in volume because of the applied heat, meaning that the coefficient of expansion of chalcogenic

  19. Single-event multilevel acute total correction of complex equinocavovarus deformity in skeletally mature patients with spastic cerebral palsy hemiparesis.

    PubMed

    Bishay, Sherif N G

    2013-01-01

    Complex multiplanar ankle/foot deformity as equinocavovarus is a common problem in patients with spastic cerebral palsy hemiparesis. The data from 30 consecutive patients (30 feet), treated between March 2009 and March 2010, with equinocavovarus and toe clawing secondary to spastic cerebral palsy hemiparesis, aged 16 to 18 years, were analyzed clinically and radiographically. All the patients had received conservative physiotherapy treatment and ankle/foot orthoses before undergoing combined soft tissue and bony surgical procedures performed in a single session to correct the complex toe clawing, cavus, varus, and equinus deformities. Preoperative measurements of certain foot angles were compared with their corresponding postoperative values. A grading system for evaluation of the results using a point scoring system was used to accurately evaluate both the clinical and the radiographic results after an average follow-up period of 2.5 years. Of the 30 patients (30 feet), 18 (60%) had excellent, 9 (30%) good, 3 (10%) fair, and 0 had poor outcomes. Neither vascular problems nor nonunion occurred. Significant improvement was seen postoperatively (p < .0333). Neither staged surgical procedures nor gradual distraction techniques using external fixators are ideal modalities to correct complex ankle/foot equinocavovarus deformity in patients with spastic cerebral palsy. Single-event, multilevel surgery with complete soft tissue and bony correction appears to be the treatment of choice in such cases. It shortens the treatment period and avoids patient dissatisfaction associated with multiple procedures, without major complications.

  20. Assessment of foot perfusion in patients with a diabetic foot ulcer.

    PubMed

    Forsythe, Rachael O; Hinchliffe, Robert J

    2016-01-01

    Assessment of foot perfusion is a vital step in the management of patients with diabetic foot ulceration, in order to understand the risk of amputation and likelihood of wound healing. Underlying peripheral artery disease is a common finding in patients with foot ulceration and is associated with poor outcomes. Assessment of foot perfusion should therefore focus on identifying the presence of peripheral artery disease and to subsequently estimate the effect this may have on wound healing. Assessment of perfusion can be difficult because of the often complex, diffuse and distal nature of peripheral artery disease in patients with diabetes, as well as poor collateralisation and heavy vascular calcification. Conventional methods of assessing tissue perfusion in the peripheral circulation may be unreliable in patients with diabetes, and it may therefore be difficult to determine the extent to which poor perfusion contributes to foot ulceration. Anatomical data obtained on cross-sectional imaging is important but must be combined with measurements of tissue perfusion (such as transcutaneous oxygen tension) in order to understand the global and regional perfusion deficit present in a patient with diabetic foot ulceration. Ankle-brachial pressure index is routinely used to screen for peripheral artery disease, but its use in patients with diabetes is limited in the presence of neuropathy and medial arterial calcification. Toe pressure index may be more useful because of the relative sparing of pedal arteries from medial calcification but may not always be possible in patients with ulceration. Fluorescence angiography is a non-invasive technique that can provide rapid quantitative information about regional tissue perfusion; capillaroscopy, iontophoresis and hyperspectral imaging may also be useful in assessing physiological perfusion but are not widely available. There may be a future role for specialized perfusion imaging of these patients, including magnetic resonance

  1. Diabetic foot disease: From the evaluation of the "foot at risk" to the novel diabetic ulcer treatment modalities.

    PubMed

    Amin, Noha; Doupis, John

    2016-04-10

    The burden of diabetic foot disease (DFD) is expected to increase in the future. The incidence of DFD is still rising due to the high prevalence of DFD predisposing factors. DFD is multifactorial in nature; however most of the diabetic foot amputations are preceded by foot ulceration. Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulceration. DPN leads to loss of protective sensation resulting in continuous unconscious traumas. Patient education and detection of high risk foot are essential for the prevention of foot ulceration and amputation. Proper assessment of the diabetic foot ulceration and appropriate management ensure better prognosis. Management is based on revascularization procedures, wound debridement, treatment of infection and ulcer offloading. Management and type of dressing applied are tailored according to the type of wound and the foot condition. The scope of this review paper is to describe the diabetic foot syndrome starting from the evaluation of the foot at risk for ulceration, up to the new treatment modalities.

  2. Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatment modalities

    PubMed Central

    Amin, Noha; Doupis, John

    2016-01-01

    The burden of diabetic foot disease (DFD) is expected to increase in the future. The incidence of DFD is still rising due to the high prevalence of DFD predisposing factors. DFD is multifactorial in nature; however most of the diabetic foot amputations are preceded by foot ulceration. Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulceration. DPN leads to loss of protective sensation resulting in continuous unconscious traumas. Patient education and detection of high risk foot are essential for the prevention of foot ulceration and amputation. Proper assessment of the diabetic foot ulceration and appropriate management ensure better prognosis. Management is based on revascularization procedures, wound debridement, treatment of infection and ulcer offloading. Management and type of dressing applied are tailored according to the type of wound and the foot condition. The scope of this review paper is to describe the diabetic foot syndrome starting from the evaluation of the foot at risk for ulceration, up to the new treatment modalities. PMID:27076876

  3. Three-dimensional optical high-resolution profiler with a large observation field: foot arch behavior under low static charge studies.

    PubMed

    Meneses, Jaime; Gharbi, Tijani; Cornu, Jean Yves

    2002-09-01

    Our aim is to describe a method for detecting small deformations from a three-dimensional (3D) shape of large lateral dimensions. For this purpose the measurement method is based on the simultaneous utilization of several 3D optical systems and the phase-shifting technique. In this way, the following problems appear: optical distortion due to the large field observed, nonlinear phase-to-height conversion, conversion of image coordinates into object coordinates for each 3D optical system, and coordinate unification of all optical systems. The resolution is 50 microm with a field of view of 320 mm x 150 mm. We used this system to study the 3D human foot arch deformation under low loads in vivo. First results indicate the hysteresis behavior of the human foot under a low load (50 to 450 N).

  4. Smoothly deformed light

    NASA Technical Reports Server (NTRS)

    Stenholm, Stig

    1993-01-01

    A single mode cavity is deformed smoothly to change its electromagnetic eigenfrequency. The system is modeled as a simple harmonic oscillator with a varying period. The Wigner function of the problem is obtained exactly by starting with a squeezed initial state. The result is evaluated for a linear change of the cavity length. The approach to the adiabatic limit is investigated. The maximum squeezing is found to occur for smooth change lasting only a fraction of the oscillational period. However, only a factor of two improvement over the adiabatic result proves to be possible. The sudden limit cannot be investigated meaningfully within the model.

  5. Care of Patients with Diabetic Foot Disease in Oman

    PubMed Central

    Al-Busaidi, Ibrahim S.; Abdulhadi, Nadia N.; Coppell, Kirsten J.

    2016-01-01

    Diabetes mellitus is a major public health challenge and causes substantial morbidity and mortality worldwide. Diabetic foot disease is one of the most debilitating and costly complications of diabetes. While simple preventative foot care measures can reduce the risk of lower limb ulcerations and subsequent amputations by up to 85%, they are not always implemented. In Oman, foot care for patients with diabetes is mainly provided in primary and secondary care settings. Among all lower limb amputations performed in public hospitals in Oman between 2002–2013, 47.3% were performed on patients with diabetes. The quality of foot care among patients with diabetes in Oman has not been evaluated and unidentified gaps in care may exist. This article highlights challenges in the provision of adequate foot care to Omani patients with diabetes. It concludes with suggested strategies for an integrated national diabetic foot care programme in Oman. PMID:27606104

  6. Pain and rehabilitation problems after single-event multilevel surgery including bony foot surgery in cerebral palsy

    PubMed Central

    Høiness, Per Reidar; Capjon, Hilde; Lofterød, Bjørn

    2014-01-01

    Background and purpose — Surgical correction of foot deformities as part of single-event multilevel surgery (SEMLS) to optimize postoperative training is sometimes indicated in ambulatory children with cerebral palsy. We have, however, experienced excessive postoperative pain and rehabilitation problems in a number of these patients. We therefore investigated children who underwent such procedures regarding postoperative rehabilitation and pain, gait parameters 1 year after surgery, and mobility 5 years after surgery. Patients and methods — 9 children with diplegic cerebral palsy who had also undergone bony foot surgery were identified from a cohort of 70 children treated with SEMLS according to a standardized protocol. 2 children were excluded due to mental retardation and atypical surgery, and 7 patients (4 of them boys) were included. The children and their parents underwent a semi-structured interview on average 5 (3–7) years after the surgery. Gait parameters preoperatively and 1 year postoperatively were compared. Results — 5 children had experienced regional pain syndrome and considerable sociopsychological problems during the first postoperative year. 5 years after surgery, 4 of the 5 children still had hypersensitive and painful feet, 2 had lost their ability to walk, 1 child was no longer self-reliant in daily care, and 3 were wheelchair bound. There were, however, no clinically significant differences in functional mobility scale (FMS) or gait parameters preoperatively and 1 year postoperatively. Interpretation — We found troublesome postoperative rehabilitation and poor outcomes in this series of children who had undergone simultaneous multilevel surgeries and bony foot corrections. Caution is warranted when treating marginally ambulatory children with bilateral spastic cerebral palsy and foot deformities. PMID:25191930

  7. 19. 80 foot pony truss view of upper chord ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    19. 80 foot pony truss - view of upper chord pin connection at the end post, typical of the five 80 foot trusses and similar to the 64 foot tress. There are two pair per pony truss for a total of 24. Shown are the vertical lace post, end post, top chord member, and a diagonal member. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  8. Impact of Foot Type on Cost of Lower Extremity Injury

    DTIC Science & Technology

    2013-01-25

    were at higher risk for injury. Additionally, researchers have found relationships between chronic heel pain and osteoarthritis of the knee and hip...study. BMC Musculoskelet Disord, 2007. 8: p. 41. 48. Reilly, K., et al., The role of foot and ankle assessment of patients with lower limb osteoarthritis ... Physiotherapy , 2009. 95(3): p. 164-9. 49. Redmond, A.C., Y.Z. Crane, and H.B. Menz, Normative values for the Foot Posture Index. J Foot Ankle Res

  9. Outcomes of a Nurse-Managed Diabetes Foot Clinic

    DTIC Science & Technology

    2016-06-07

    Managed Diabetes Foot Clinic 5b. GRANT NUMBER HU0001-04-1-TS10 5c. PROGRAM ELEMENT NUMBER N/A 6. AUTHOR(S) 5d. PROJECT NUMBER N04-017...measured outcomes of a nurse-managed diabetes foot clinic on foot wound rates, health care costs, and changes in health status in adults with... diabetes . Design: This study reflects results of a two-group randomized, controlled trial. Sample: Participants were 126 adults with diabetes for more

  10. Deformity correction using supramalleolar gigli saw osteotomy and Taylor spatial frame: how to perform this osteotomy safely?

    PubMed

    Eidelman, Mark; Katzman, Alexander; Zaidman, Michael; Keren, Yaniv

    2011-09-01

    Supramalleolar osteotomy (SMO) is useful for the correction of various deformities around the ankle joint,especially deformities of the distal tibia secondary to partial growth arrest, foot equinus, and hind foot deformities. By definition, this osteotomy cuts through the tibia and fibula approximately 2–3 cm above the ankle joint.It can be performed by various techniques, each of them have advantages and disadvantages. Gigli saw SMO can be performed percutaneously with minimal soft tissue dissection, leaving a very smooth bone surface, which is especially useful for the correction of rotational deformities. Over a period of 6 years we performed eight gigli saw SMO in seven male patients and one female patient with a mean age of 13.6 years. All patients had multiplanar deformities with some shortening (range 15–40 mm) and underwent correction and lengthening by Taylor spatial frame. Treatment goal was achieved in all patients with minimal complications. On the basis of our experience, we believe that gigli saw SMO can be performed safely. This osteotomy, in conjunction with the Taylor spatial frame, became our treatment of choice for the correction of ankle and hindfoot deformities.The evidence is level 4, case series.

  11. Role of industries in the care of diabetic foot.

    PubMed

    Ramachandran, A; Lakshmi, S; Arun, Nanditha; Samith Shetty, A; Snehalatha, C

    2010-09-01

    Diabetic foot disease is a dreaded complication causing severe economic and social burden, mental and physical agony, and severe morbidity and mortality. This complication is largely preventable if the risk factors such as peripheral neuropathy and peripheral arterial disease are detected early and appropriate measures are taken to control glycemia, foot pressure, and chances of foot injury. In the case of ulceration, proper microbial control, pressure offloading by debridement, and use of appropriate footwear are mandatory to save the foot. This article focuses on the need for preventive care for diabetic complications demonstrating potentially helpful roles for industry in India.

  12. 16. CONSTRUCTION DETAIL (NORTHWEST LOWER FOOT OF CRANE), LOOKING NORTHWEST ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    16. CONSTRUCTION DETAIL (NORTHWEST LOWER FOOT OF CRANE), LOOKING NORTHWEST - Cabot Station Electric Generating Plant, Gantry Crane, Montague City Road, Turners Falls vicinity, Montague, Franklin County, MA

  13. Congenital hypertrophy of multiple intrinsic muscles of the foot.

    PubMed

    Shiraishi, Tomohiro; Park, Susam; Niu, Atushi; Hasegawa, Hiromi

    2014-12-01

    Congenital hypertrophy of a single intrinsic muscle of the foot is rare, and as far as we know, only six cases have been reported. We describe a case of congenital anomaly that showed hypertrophy of multiple intrinsic muscles of the foot; the affected muscles were all the intrinsic muscles of the foot except the extensor digitorum brevis or extensor hallucis. Other tissues such as adipose tissue, nervous tissue, or osseous tissue showed no abnormalities. To reduce the volume of the foot we removed parts of the enlarged muscles.

  14. The reliability and validity of the Korean version of the foot function index for patients with foot complaints.

    PubMed

    In, Tae-Sung; Jung, Jin-Hwa; Kim, Keunjo; Jung, Kyoung-Sim; Cho, Hwi-Young

    2017-01-01

    [Purpose] The purpose of this study was to establish the reliability and validity of the Foot Function Index translated into Korean for use in patients with plantar fasciitis and foot/ankle fracture. [Subjects and Methods] Thirty-six subjects with foot complaints, 14 males and 22 females, participated in the study. Reliability was determined by using the intra-class correlation coefficient and Cronbach's alpha for internal consistency. Validity was examined by correlating Foot Function Index scores with the Short Form-36 and the Visual Analog Scale scores. [Results] Test-retest reliability was 0.90 for the pain subscale, and 0.94 and 0.91 for the disability and activity limitation subscales, respectively. The criterion-related validity was established by comparison with the Korean version of the Short Form-36 and Visual Analog Scale. [Conclusion] The Korean version of the Foot Function Index was shown to be a reliable and valid instrument for assessing foot complaints.

  15. Algorithmic deformation of matrix factorisations

    NASA Astrophysics Data System (ADS)

    Carqueville, Nils; Dowdy, Laura; Recknagel, Andreas

    2012-04-01

    Branes and defects in topological Landau-Ginzburg models are described by matrix factorisations. We revisit the problem of deforming them and discuss various deformation methods as well as their relations. We have implemented these algorithms and apply them to several examples. Apart from explicit results in concrete cases, this leads to a novel way to generate new matrix factorisations via nilpotent substitutions, and to criteria whether boundary obstructions can be lifted by bulk deformations.

  16. [Experience of treatment of diabetic foot syndrome].

    PubMed

    Pertsov, V I; Ponomarenko, O V

    2014-07-01

    In The Clinic of Cathedra of The Catastrophes Medicine, Military Medicine, Anesthesiology and Reanimatology in 2010 - 2013 yrs 53 patients, ageing 23-65 yrs, were treated for diabetic foot syndrome (DFS) of neuropathic and mixed forms. Diagnostic-treatment algorithm was proposed for determination of level and degree of a circulation and neuropathic disorders, introduction of which have promoted optimization of surgical and local treatment, improvement of the complex treatment results in patients, suffering DFS. A new method of treatment application, using combined preparation of hyaluronic acid with the sodium succinic, have permitted to achieve a complete healing of the ulcer defect.

  17. Sagittal alignment of the first metatarsophalangeal joint after arthrodesis for rheumatoid forefoot deformity.

    PubMed

    Tanabe, Akihiko; Majima, Tokifumi; Onodera, Tomohiro; Sawaguchi, Naohiro; Watanabe, Takuya; Kasahara, Yasuhiko; Takahashi, Daisuke

    2013-01-01

    The present study assessed the midterm results of reconstruction for rheumatoid forefoot deformity with arthrodesis of the first metatarsophalangeal (MTP) joint, scarf osteotomy, resection arthroplasty of the metatarsal head of the lesser toes, and surgical repair of hammertoe deformity (arthrodesis of the proximal interphalangeal joint). Special focus was placed on the sagittal alignment of the first metatarsophalangeal joint after arthrodesis. We retrospectively evaluated the postoperative clinical outcomes and radiographic findings for 16 consecutive female patients (20 feet) with symptomatic rheumatoid forefoot deformities. The mean duration of follow-up was 7.9 (range 4 to 13) years. All first MTP joints and first metatarsal bones were fused successfully. The mean value of the American Orthopaedic Foot and Ankle Society and Japanese Society for Foot Surgery clinical scores significantly improved overall, except for 2 patients (10%), who complained of first toe pain at the final follow-up visit owing to sagittal misalignment of the fused first MTP joint. Sagittal alignment of the first metatarsal varies greatly because of the rheumatoid midfoot and hindfoot deformities. Therefore, inclination of the first metatarsal should be considered when determining the first MTP joint sagittal fusion angle.

  18. A kinematic method to detect foot contact during running for all foot strike patterns.

    PubMed

    Milner, Clare E; Paquette, Max R

    2015-09-18

    The biomechanics of distance running are studied in relation to both understanding injury mechanisms and improving performance. Kinematic methods must be used to identify the stance phase of running when data are recorded during running on a standard treadmill or outside the laboratory. Recently, a focus on foot strike patterns has emerged in the field. Thus, there is a need for a kinematic method to identify foot contact that is equally effective for both rearfoot and non-rearfoot strike patterns. The purpose of this study was to determine whether a new kinematic method could accurately determine foot contact during running in both rearfoot and non-rearfoot strikers. Overground gait data were collected at on 22 runners, 11 with a rearfoot strike pattern and 11 with a non-rearfoot strike pattern. Data were processed to identify foot contact from: vertical ground reaction force, two previously published kinematic methods, and our new kinematic method. Limits of agreement were used to determine bias and random error of each kinematic method compared to ground reaction force onset. The new method had comparable random error at 200 Hz sampling frequency (5 ms per frame) to the previous methods (7 frames vs 6-9 frames) and produced the same offset for both strike patterns (3 frames), while the existing methods had different offsets for different strike patterns (4 or 7 frames). Study findings support use of this new method, as it can be applied to all running strike patterns without adjusting the frame offset, simplifying data processing.

  19. Mechanism and Design Analysis of Articulated Ankle Foot Orthoses for Drop-Foot

    PubMed Central

    Choudhury, Imtiaz Ahmed; Mamat, Azuddin Bin

    2014-01-01

    Robotic technologies are being employed increasingly in the treatment of lower limb disabilities. Individuals suffering from stroke and other neurological disorders often experience inadequate dorsiflexion during swing phase of the gait cycle due to dorsiflexor muscle weakness. This type of pathological gait, mostly known as drop-foot gait, has two major complications, foot-slap during loading response and toe-drag during swing. Ankle foot orthotic (AFO) devices are mostly prescribed to resolve these complications. Existing AFOs are designed with or without articulated joint with various motion control elements like springs, dampers, four-bar mechanism, series elastic actuator, and so forth. This paper examines various AFO designs for drop-foot, discusses the mechanism, and identifies limitations and remaining design challenges. Along with two commercially available AFOs some designs possess promising prospective to be used as daily-wear device. However, the design and mechanism of AFO must ensure compactness, light weight, low noise, and high efficiency. These entailments present significant engineering challenges to develop a new design with wide consumer adoption. PMID:24892102

  20. The reliability and validity of a three-camera foot image system for obtaining foot anthropometrics.

    PubMed

    O'Meara, Damien; Vanwanseele, Benedicte; Hunt, Adrienne; Smith, Richard

    2010-08-01

    The purpose was to develop a foot image capture and measurement system with web cameras (the 3-FIS) to provide reliable and valid foot anthropometric measures with efficiency comparable to that of the conventional method of using a handheld anthropometer. Eleven foot measures were obtained from 10 subjects using both methods. Reliability of each method was determined over 3 consecutive days using the intraclass correlation coefficient and root mean square error (RMSE). Reliability was excellent for both the 3-FIS and the handheld anthropometer for the same 10 variables, and good for the fifth metatarsophalangeal joint height. The RMSE values over 3 days ranged from 0.9 to 2.2 mm for the handheld anthropometer, and from 0.8 to 3.6 mm for the 3-FIS. The RMSE values between the 3-FIS and the handheld anthropometer were between 2.3 and 7.4 mm. The 3-FIS required less time to collect and obtain the final variables than the handheld anthropometer. The 3-FIS provided accurate and reproducible results for each of the foot variables and in less time than the conventional approach of a handheld anthropometer.

  1. A review of the foot function index and the foot function index – revised

    PubMed Central

    2013-01-01

    Background The Foot Function Index (FFI) is a self-report, foot-specific instrument measuring pain and disability and has been widely used to measure foot health for over twenty years. A revised FFI (FFI-R) was developed in response to criticism of the FFI. The purpose of this review was to assess the uses of FFI and FFI-R as were reported in medical and surgical literature and address the suggestions found in the literature to improve the metrics of FFI-R. Methods A systematic literature search of PubMed/Medline and Embase databases from October 1991 through December 2010 comprised the main sources of literature. To enrich the bibliography, the search was extended to BioMedLib and Scopus search engines and manual search methods. Search terms included FFI, FFI scores, FFI-R. Requirements included abstracts/full length articles, English-language publications, and articles containing the term "foot complaints/problems." Articles selected were scrutinized; EBM abstracted data from literature and collected into tables designed for this review. EBM analyzed tables, KJC, JM, RMS reviewed and confirmed table contents. KJC and JM reanalyzed the original database of FFI-R to improve metrics. Results Seventy-eight articles qualified for this review, abstracts were compiled into 12 tables. FFI and FFI-R were used in studies of foot and ankle disorders in 4700 people worldwide. FFI Full scale or the Subscales and FFI-R were used as outcome measures in various studies; new instruments were developed based on FFI subscales. FFI Full scale was adapted/translated into other cultures. FFI and FFI-R psychometric properties are reported in this review. Reanalysis of FFI-R subscales' confirmed unidimensionality, and the FFI-R questionnaires' response categories were edited into four responses for ease of use. Conclusion This review was limited to articles published in English in the past twenty years. FFI is used extensively worldwide; this instrument pioneered a quantifiable measure

  2. Model Deformation Measurements at NASA Langley Research Center

    NASA Technical Reports Server (NTRS)

    Burner, A. W.

    1998-01-01

    Only recently have large amounts of model deformation data been acquired in NASA wind tunnels. This acquisition of model deformation data was made possible by the development of an automated video photogrammetric system to measure the changes in wing twist and bending under aerodynamic load. The measurement technique is based upon a single view photogrammetric determination of two dimensional coordinates of wing targets with a fixed third dimensional coordinate, namely the spanwise location. A major consideration in the development of the measurement system was that use of the technique must not appreciably reduce wind tunnel productivity. The measurement technique has been used successfully for a number of tests at four large production wind tunnels at NASA and a dedicated system is nearing completion for a fifth facility. These facilities are the National Transonic Facility, the Transonic Dynamics Tunnel, and the Unitary Plan Wind Tunnel at NASA Langley, and the 12-FT Pressure Tunnel at NASA Ames. A dedicated system for the Langley 16-Foot Transonic Tunnel is scheduled to be used for the first time for a test in September. The advantages, limitations, and strategy of the technique as currently used in NASA wind tunnels are presented. Model deformation data are presented which illustrate the value of these measurements. Plans for further enhancements to the technique are presented.

  3. Update on the diabetic foot 2012: the 14th biennial Malvern Diabetic Foot Conference, May 9-11, 2012.

    PubMed

    Lamont, Peter; Franklyn, Kerryn; Rayman, Gerry; Boulton, Andrew J M

    2013-03-01

    The 14th biennial Malvern Diabetic Foot Conference was held in May 2012. Physicians, podiatrists, nurses, orthotists, surgeons, radiologists, and other professionals attended to reflect on the diabetic foot. The conference comprised interactive workshops, oral presentations of new research findings, and lectures from leading figures in the world of the diabetic foot. Over the 3 days, topics such as epidemiology, neuropathy, screening, vascular disease, prevention, and management among others were discussed. The conference has been an excellent platform from which to share new and ongoing research and it will without a doubt improve the treatment of the diabetic foot across the world.

  4. Altering prosthetic foot stiffness influences foot and muscle function during below-knee amputee walking: a modeling and simulation analysis.

    PubMed

    Fey, Nicholas P; Klute, Glenn K; Neptune, Richard R

    2013-02-22

    Most prosthetic feet are designed to improve amputee gait by storing and releasing elastic energy during stance. However, how prosthetic foot stiffness influences muscle and foot function is unclear. Identifying these relationships would provide quantitative rationale for prosthetic foot prescription that may lead to improved amputee gait. The purpose of this study was to identify the influence of altered prosthetic foot stiffness on muscle and foot function using forward dynamics simulations of amputee walking. Three 2D muscle-actuated forward dynamics simulations of unilateral below-knee amputee walking with a range of foot stiffness levels were generated, and muscle and prosthetic foot contributions to body support and propulsion and residual leg swing were quantified. As stiffness decreased, the prosthetic keel provided increased support and braking (negative propulsion) during the first half of stance while the heel contribution to support decreased. During the second half of stance, the keel provided decreased propulsion and increased support. In addition, the keel absorbed less power from the leg, contributing more to swing initiation. Thus, several muscle compensations were necessary. During the first half of stance, the residual leg hamstrings provided decreased support and increased propulsion. During the second half of stance, the intact leg vasti provided increased support and the residual leg rectus femoris transferred increased energy from the leg to the trunk for propulsion. These results highlight the influence prosthetic foot stiffness has on muscle and foot function throughout the gait cycle and may aid in prescribing feet of appropriate stiffness.

  5. A pneumatic power harvesting ankle-foot orthosis to prevent foot-drop

    PubMed Central

    Chin, Robin; Hsiao-Wecksler, Elizabeth T; Loth, Eric; Kogler, Géza; Manwaring, Scott D; Tyson, Serena N; Shorter, K Alex; Gilmer, Joel N

    2009-01-01

    Background A self-contained, self-controlled, pneumatic power harvesting ankle-foot orthosis (PhAFO) to manage foot-drop was developed and tested. Foot-drop is due to a disruption of the motor control pathway and may occur in numerous pathologies such as stroke, spinal cord injury, multiple sclerosis, and cerebral palsy. The objectives for the prototype PhAFO are to provide toe clearance during swing, permit free ankle motion during stance, and harvest the needed power with an underfoot bellow pump pressurized during the stance phase of walking. Methods The PhAFO was constructed from a two-part (tibia and foot) carbon composite structure with an articulating ankle joint. Ankle motion control was accomplished through a cam-follower locking mechanism actuated via a pneumatic circuit connected to the bellow pump and embedded in the foam sole. Biomechanical performance of the prototype orthosis was assessed during multiple trials of treadmill walking of an able-bodied control subject (n = 1). Motion capture and pressure measurements were used to investigate the effect of the PhAFO on lower limb joint behavior and the capacity of the bellow pump to repeatedly generate the required pneumatic pressure for toe clearance. Results Toe clearance during swing was successfully achieved during all trials; average clearance 44 ± 5 mm. Free ankle motion was observed during stance and plantarflexion was blocked during swing. In addition, the bellow component repeatedly generated an average of 169 kPa per step of pressure during ten minutes of walking. Conclusion This study demonstrated that fluid power could be harvested with a pneumatic circuit built into an AFO, and used to operate an actuated cam-lock mechanism that controls ankle-foot motion at specific periods of the gait cycle. PMID:19527526

  6. The German and Belgian accreditation models for diabetic foot services.

    PubMed

    Morbach, Stephan; Kersken, Joachim; Lobmann, Ralf; Nobels, Frank; Doggen, Kris; Van Acker, Kristien

    2016-01-01

    The International Working Group on the Diabetic Foot recommends that auditing should be part of the organization of diabetic foot care, the efforts required for data collection and analysis being balanced by the expected benefits. In Germany legislature demands measures of quality management for in- and out-patient facilities, and, in 2003, the Germany Working Group on the Diabetic Foot defined and developed a certification procedure for diabetic foot centres to be recognized as 'specialized'. This includes a description of management facilities, treatment procedures and outcomes, as well as the organization of mutual auditing visits between the centres. Outcome data is collected at baseline and 6 months on 30 consecutive patients. By 2014 almost 24,000 cases had been collected and analysed. Since 2005 Belgian multidisciplinary diabetic foot clinics could apply for recognition by health authorities. For continued recognition diabetic foot clinics need to treat at least 52 patients with a new foot problem (Wagner 2 or more or active Charcot foot) per annum. Baseline and 6-month outcome data of these patients are included in an audit-feedback initiative. Although originally fully independent of each other, the common goal of these two initiatives is quality improvement of national diabetic foot care, and hence exchanges between systems has commenced. In future, the German and Belgian accreditation models might serve as templates for comparable initiatives in other countries. Just recently the International Working Group on the Diabetic Foot initiated a working group for further discussion of accreditation and auditing models (International Working Group on the Diabetic Foot AB(B)A Working Group).

  7. Analysis, design and development of a carbon fibre reinforced plastic knee-ankle-foot orthosis prototype for myopathic patients.

    PubMed

    Granata, C; De Lollis, A; Campo, G; Piancastelli, L; Merlini, L

    1990-01-01

    A traditional knee-ankle-foot orthosis (KAFO) for myopathic patients has been studied for the assessment of loads and fatigue resistance. Starting from this basis a thermoplastic matrix carbon fibre reinforced plastic composite (CFRP) KAFO has been developed in order to reduce the weight. A finite-element simulation programme for deformation analysis was used to compare the behaviour of conventional and CFRP orthosis. There were no breakages either of the prototype or of its parts. The CFRP orthosis allows a weight reduction of more than 40 per cent.

  8. Deformed chiral nucleons

    NASA Astrophysics Data System (ADS)

    Price, C. E.; Shepard, J. R.

    1991-04-01

    We compute properties of the nucleon in a hybrid chiral model based on the linear σ-model with quark degrees of freedom treated explicity. In contrast to previous calculations, we do not use the hedgehog ansatz. Instead we solve self-consistently for a state with well defined spin and isospin projections. We allow this state to be deformed and find that, although d- and g-state admixtures in the predominantly s-state single quark wave functions are not large, they have profound effects on many nucleon properties including magnetic moments and gA. Our best fit parameters provide excellent agreement with experiment but are much different from those determined in hedgehog calculations.

  9. Autonomic neuropathy and diabetic foot ulceration.

    PubMed

    Edmonds, M E; Nicolaides, K H; Watkins, P J

    1986-01-01

    Autonomic function was studied in three groups of insulin-dependent diabetic patients. Heart rate changes during deep breathing and on standing were significantly less in 28 patients with a recent history of foot ulceration compared with 40 patients with peripheral neuropathy but without ulceration (p less than 0.001) and 54 patients without neuropathy (p less than 0.001). Sympathetic function was assessed in 36 of these patients from peripheral arterial diastolic flow patterns obtained by Doppler ultrasound measurements and expressed as the pulsatility index (PI). Patients with a history of ulceration (n = 10) showed considerably increased diastolic flow (PI = 4.28 +/- 0.53, mean +/- S.E.M.) compared with 12 neuropathic patients with no history of ulceration (PI = 7.80 +/- 0.68, p less than 0.002) and 14 patients without neuropathy (PI = 9.55 +/- 0.89, p less than 0.002). Severely abnormal autonomic function occurs in association with neuropathic foot ulceration, but patients without ulcers have lesser degrees of autonomic neuropathy, thus a causal relationship has not been established.

  10. Diabetic foot syndrome--dermatological point of view.

    PubMed

    Troskot, Nina; Duvancić, Tomislav; Kolić, Maja

    2013-03-01

    Patients with diabetes mellitus often suffer from diabetic foot syndrome, a condition leading to foot ulceration or even amputation of lower extremity. Peripheral neuropathy combined with repetitive trauma to the foot and peripheral vascular disease are the main etiological factors in the development of foot ulcers. Other major contributive factors include the effects of callus, increased plantar pressures, and local infections. Patient education concerning their disease has a central role in the prevention of foot ulcers. Ordinary preventive measures taken by the patient include regular self-inspections, appropriate daily hygiene of the feet, appropriate footwear to reduce plantar pressures, and medical pedicure performed by a pedicurist experienced in diabetic foot patients. The importance of callus in diabetic patients has been shown in several studies by high predictability of subsequent ulcer development in patients with plantar calluses. For removing callus, urea based preparations are considered to be the treatment of choice. In case of local bacterial and fungal diabetic foot infections, systemic antibiotic and systemic antimycotic therapy is indicated, respectively. Wound dressings of various types are the mainstay in the treatment of chronic foot ulcers with avoidance of occlusive dressings in infected ulcers. Since the vast majority of ulcers and amputations can be prevented in diabetic patients, proper diagnosis and multidisciplinary approach are essential.

  11. Efficient foot motor control by Neymar’s brain

    PubMed Central

    Naito, Eiichi; Hirose, Satoshi

    2014-01-01

    How very long-term (over many years) motor skill training shapes internal motor representation remains poorly understood. We provide valuable evidence that the football brain of Neymar da Silva Santos Júnior (the Brasilian footballer) recruits very limited neural resources in the motor-cortical foot regions during foot movements. We scanned his brain activity with a 3-tesla functional magnetic resonance imaging (fMRI) while he rotated his right ankle at 1 Hz. We also scanned brain activity when three other age-controlled professional footballers, two top-athlete swimmers and one amateur footballer performed the identical task. A comparison was made between Neymar’s brain activity with that obtained from the others. We found activations in the left medial-wall foot motor regions during the foot movements consistently across all participants. However, the size and intensity of medial-wall activity was smaller in the four professional footballers than in the three other participants, despite no difference in amount of foot movement. Surprisingly, the reduced recruitment of medial-wall foot motor regions became apparent in Neymar. His medial-wall activity was smallest among all participants with absolutely no difference in amount of foot movement. Neymar may efficiently control given foot movements probably by largely conserving motor-cortical neural resources. We discuss this possibility in terms of over-years motor skill training effect, use-dependent plasticity, and efficient motor control. PMID:25136312

  12. 17. 80 foot pony truss detail of the lower ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    17. 80 foot pony truss - detail of the lower pin connection located where an end post joins the first and the last vertical post. There are two pair on each of the five 80 foot trusses for a total of 20. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  13. How to Eat Right for Your Foot Health

    MedlinePlus

    ... the Big Toe Ailments of the Smaller Toes Diabetic Foot Treatments Injections and other Procedures Treatments of the ... Feet Flexible How to Eat Right for Your Foot Health Currently selected How to Care for Your Diabetic Feet How to Assess Changes in Feet: Normal ...

  14. Treatment for Common Running/Walking Foot Injuries

    ERIC Educational Resources Information Center

    McDaniel, Larry W.; Haar, Calin; Ihlers, Matt; Jackson, Allen; Gaudet, Laura

    2009-01-01

    Whether you are a weekend warrior or a serious athlete, most runners fear the possibility of being injured. For those who are physically active or stand on their feet all day, healthy feet are important Highly conditioned runners spend many hours performing foot maintenance to prevent unnecessary injuries. Some of the common foot injuries are:…

  15. Functional limitations due to foot involvement in spondyloarthritis

    PubMed Central

    Ozaras, Nihal; Havan, Nuri; Poyraz, Emine; Rezvanı, Aylin; Aydın, Teoman

    2016-01-01

    [Purpose] Spondyloarthritis is a major inflammatory disease followed-up in the rheumatology clinics, foot involvement in spodyloarthritis is common. The functional states of patients with spondyloarthritis are usually evaluated globally. The aim of this study was to assess the foot involvement-related functional limitations in patients with spondyloarthritis. [Subjects and Methods] Patients with ankylosing spondylitis and psoriatic arthritis with foot pain more than 4 weeks who underwent anteroposterior and lateral feet radiography were enrolled into the study. A “clinical findings score” was calculated by assigning 1 point for every finding of swelling, redness, and tenderness. C-reactive protein and erythrocyte sedimentation rate were used as serum markers for disease activity. Foot radiograms were evaluated using the spondyloarthropathy tarsal radiographic index and the foot-related functional state of patients was determined by the Turkish version of the Foot and Ankle Outcome Score. [Results] There were no relationships between Foot and Ankle Outcome Score subscales and clinical findings score, serum markers, or radiologic score. Pain and symptoms subscale scores were result positively correlated with activity of daily living, sport and recreation, and quality of life subscale scores. [Conclusion] Pain and symptoms are the main determinants of foot-related functional limitations in spondyloarthritis. PMID:27512252

  16. Classification and prevalence of foot lesions in captive flamingos (Phoenicopteridae).

    PubMed

    Nielsen, Adriana M W; Nielsen, Søren S; King, Catherine E; Bertelsen, Mads F

    2010-03-01

    Foot lesions can compromise the health and welfare of captive birds. In this study, we estimated the prevalence of foot lesions in captive flamingos (Phoenicopteridae). The study was based on photos of 1,495 pairs of foot soles from 854 flamingos in 18 European and two Texan (USA) zoological collections. Methodology for evaluating flamingo feet lesions was developed for this project because no suitable method had been reported in the literature. Four types of foot lesions were identified: hyperkeratoses, fissures, nodular lesions, and papillomatous growths. Seven areas on each foot received a severity score from 0 to 2 for each type of lesion (0 = no lesion, 1 = mild to moderate lesion, 2 = severe lesion). The prevalence of birds with lesions (scores 1 or 2) were 100%, 87%, 17%, and 46% for hyperkeratosis, fissures, nodular lesions, and papillomatous growths, respectively. Birds with severe lesions (score 2) constituted 67%, 46%, 4%, and 12% for hyperkeratosis, fissures, nodular lesions, and papillomatous growths, respectively. Hyperkeratosis and nodular lesions were most prevalent on the base of the foot and the proximal portion of the digits, likely reflecting those areas bearing the most weight. The second and fourth digits were most affected with fissures and papillomatous lesions; these areas of the foot appear to be where the most flexion occurs during ambulation. The study demonstrates that foot lesions are highly prevalent and widely distributed in the study population, indicating that they are an extensive problem in captive flamingos.

  17. [Discrimination on diseases originated from Foot-Taiyin meridian].

    PubMed

    Wang, Bao-Hua; Zhao, Jing-Sheng

    2011-08-01

    Through the analysis on the form, origin and evolution of diseases originated from Foot-Taiyin Meridian, and the investigation on clinical practice, it is held that diseases originated from Foot-Taiyin meridian were developed on the base of supplement and adaption of the ancient medical classics. And it is also held that great respect on clinical practice was attached by the compiler.

  18. Tibialis posterior tendon rupture: a cause of rheumatoid flat foot.

    PubMed

    Downey, D J; Simkin, P A; Mack, L A; Richardson, M L; Kilcoyne, R F; Hansen, S T

    1988-03-01

    Flat foot, a major cause of foot pain and disability, may result from rupture of the tibialis posterior tendon. We describe 2 patients with rheumatoid arthritis who developed flat feet secondary to surgically confirmed tendon rupture, and we discuss the anatomy and diagnosis of this condition. In the second patient, we also present the results of tendon imaging with both magnetic resonance and ultrasound.

  19. Risk and prevention of reulceration after partial foot amputation.

    PubMed

    Sage, Ronald A

    2010-09-01

    Partial foot amputations are frequently performed to salvage significant portions of the lower extremity affected by limb-threatening infection. Once healed, the residual foot is at high risk for reulceration. Careful long-term follow-up and appropriate interventions can lower this risk.

  20. Compartment syndrome of the foot in a child.

    PubMed

    Sharma, A K; Sharaf, I; Ajay, S

    2001-06-01

    We report a case of a 12-year-old boy with acute compartment syndrome of the foot following a road-traffic accident. Due to the rarity of the injury, there was a delay in diagnosing the injury. An emergency fasciotomy was performed 19 hours after the injury. The foot healed with a mild extension contracture of the second toe.

  1. Inpatient Management of Diabetic Foot Disorders: A Clinical Guide

    PubMed Central

    Wukich, Dane K.; Armstrong, David G.; Attinger, Christopher E.; Boulton, Andrew J.M.; Burns, Patrick R.; Frykberg, Robert G.; Hellman, Richard; Kim, Paul J.; Lipsky, Benjamin A.; Pile, James C.; Pinzur, Michael S.; Siminerio, Linda

    2013-01-01

    The implementation of an inpatient diabetic foot service should be the goal of all institutions that care for patients with diabetes. The objectives of this team are to prevent problems in patients while hospitalized, provide curative measures for patients admitted with diabetic foot disorders, and optimize the transition from inpatient to outpatient care. Essential skills that are required for an inpatient team include the ability to stage a foot wound, assess for peripheral vascular disease, neuropathy, wound infection, and the need for debridement; appropriately culture a wound and select antibiotic therapy; provide, directly or indirectly, for optimal metabolic control; and implement effective discharge planning to prevent a recurrence. Diabetic foot ulcers may be present in patients who are admitted for nonfoot problems, and these ulcers should be evaluated by the diabetic foot team during the hospitalization. Pathways should be in place for urgent or emergent treatment of diabetic foot infections and neuropathic fractures/dislocations. Surgeons involved with these patients should have knowledge and interest in limb preservation techniques. Prevention of iatrogenic foot complications, such as pressure sores of the heel, should be a priority in patients with diabetes who are admitted for any reason: all hospitalized diabetic patients require a clinical foot exam on admission to identify risk factors such as loss of sensation or ischemia. Appropriate posthospitalization monitoring to reduce the risk of reulceration and infection should be available, which should include optimal glycemic control and correction of any fluid and electrolyte disturbances. PMID:23970716

  2. 7 CFR 3201.82 - Foot care products.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 15 2013-01-01 2013-01-01 false Foot care products. 3201.82 Section 3201.82... Designated Items § 3201.82 Foot care products. (a) Definition. Products formulated to be used in the soothing or cleaning of feet. (b) Minimum biobased content. The Federal preferred procurement product...

  3. 7 CFR 3201.82 - Foot care products.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 15 2014-01-01 2014-01-01 false Foot care products. 3201.82 Section 3201.82... Designated Items § 3201.82 Foot care products. (a) Definition. Products formulated to be used in the soothing or cleaning of feet. (b) Minimum biobased content. The Federal preferred procurement product...

  4. 29 CFR 1926.96 - Occupational foot protection.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 8 2014-07-01 2014-07-01 false Occupational foot protection. 1926.96 Section 1926.96 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... § 1926.96 Occupational foot protection. Safety-toe footwear for employees shall meet the requirements...

  5. 29 CFR 1926.96 - Occupational foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 8 2011-07-01 2011-07-01 false Occupational foot protection. 1926.96 Section 1926.96 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... § 1926.96 Occupational foot protection. Safety-toe footwear for employees shall meet the requirements...

  6. 29 CFR 1926.96 - Occupational foot protection.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 8 2013-07-01 2013-07-01 false Occupational foot protection. 1926.96 Section 1926.96 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... § 1926.96 Occupational foot protection. Safety-toe footwear for employees shall meet the requirements...

  7. 29 CFR 1926.96 - Occupational foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Occupational foot protection. 1926.96 Section 1926.96 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... § 1926.96 Occupational foot protection. Safety-toe footwear for employees shall meet the requirements...

  8. Understanding the nature and mechanism of foot pain

    PubMed Central

    Hawke, Fiona; Burns, Joshua

    2009-01-01

    Approximately one-quarter of the population are affected by foot pain at any given time. It is often disabling and can impair mood, behaviour, self-care ability and overall quality of life. Currently, the nature and mechanism underlying many types of foot pain is not clearly understood. Here we comprehensively review the literature on foot pain, with specific reference to its definition, prevalence, aetiology and predictors, classification, measurement and impact. We also discuss the complexities of foot pain as a sensory, emotional and psychosocial experience in the context of clinical practice, therapeutic trials and the placebo effect. A deeper understanding of foot pain is needed to identify causal pathways, classify diagnoses, quantify severity, evaluate long term implications and better target clinical intervention. PMID:19144200

  9. Development of an artificial multifunctional foot: A project review

    NASA Astrophysics Data System (ADS)

    Almeida, João; Ferreira, Maria José; Lobarinhas, Pedro; Silva, Luís F.; Leite, Abílio; Araújo, Alfredo; Sousa, Fernando

    2013-10-01

    The main purpose of this project is the development of a multifunctional artificial foot, capable of duplicate a human foot in a laboratory environment, in order to evaluate and simulate footwear's performance under certain conditions. This foot is used as a laboratory prototype and is multisegmented, in order that each section is controlled independently in terms of heat generation and sweating rate, therefore it is possible to simulate more accurately the real behaviour of a human foot. The device produces thermal insulation values that will help to design footwear with better ability in terms of thermal comfort, replacing human volunteers in thermal comfort perception tests, which are very subjective. The prototype was already tested, and preliminary results indicated that thermal insulation values are within the range of expected values produced by other foot thermal manikins and by human volunteers' tests. This fact suggests that this lab prototype can be used infuture thermal comfort evaluations.

  10. Long-term follow-up results of foot and ankle tuberculosis in Turkey.

    PubMed

    Gursu, Sarper; Yildirim, Timur; Ucpinar, Hanifi; Sofu, Hakan; Camurcu, Yalkin; Sahin, Vedat; Sahin, Nursu

    2014-01-01

    The incidence of tuberculosis has been increasing, especially in the past 2 decades. Skeletal tuberculosis is very rare compared with the frequency of the pulmonary form. In the present study, we have shared our long-term experience with foot and ankle tuberculosis, providing information about the different aspects of the disease. A total of 70 patients with foot and ankle tuberculosis, treated from 1983 to 2005, were evaluated. The mean patient age was 34.4 (range 7 to 85) years at the diagnosis. The mean interval between the first symptoms and the diagnosis was 26.4 months (range 1 month to 15 years). The mean follow-up period was 21.7 (range 8 to 30) years. The infection affected both the joint and the bones in 29 patients, only the joints in 13, only the bones in 22, and the soft tissues alone in the remaining 6 patients. The most common joint location was the tibiotalar joint. The talus was the most commonly infiltrated bone. All patients underwent biopsy, and 28 patients underwent additional surgical procedures. In 18 patients (25.7%), 1 to 4 recurrences developed during the follow-up period. In the last follow-up visits, either severe destruction of the bones or end-stage arthrosis was evident in 39 patients (55.7%), especially in those with osseous tuberculosis. Foot and ankle tuberculosis is very rare. The diagnosis of the disease will often be late owing to the lack of pathognomonic findings. A histopathologic evaluation should not be omitted in cases with suspicion. The incidence of residual deformity or end-stage arthrosis has been high in the long term; however, the patients will usually be without any symptoms.

  11. [Spectrum research on metamorphic and deformation of tectonically deformed coals].

    PubMed

    Li, Xiao-Shi; Ju, Yi-Wen; Hou, Quan-Lin; Lin, Hong

    2011-08-01

    The structural and compositive evolution of tectonically deformed coals (TDCs) and their influencing factors were investigated and analyzed in detail through Fourier transform infrared spectroscopy (FTIR) and laser Raman spectra analysis. The TDC samples (0.7% < Ro,max <3.1%) were collected from Huaibei coalfield with different deformation mechanisms and intensity. The FTIR of TDCs shows that the metamorphism and the deformation affect the degradation and polycondensation process of macromolecular structure to different degree. The Raman spectra analysis indicates that secondary structure defects can be produced mainly by structural deformation, also the metamorphism influences the secondary structure defects and aromatic structure. Through comprehensive analysis, it was discussed that the ductile deformation could change to strain energy through the increase and accumulation of dislocation in molecular structure units of TDC, and it could make an obvious influence on degradation and polycondensation. While the brittle deformation could change to frictional heat energy and promote the metamorphism and degradation of TDC structure, but has less effect on polycondensation. Furthermore, degradation is the main reason for affecting the structural evolution of coal in lower metamorphic stage, and polycondensation is the most important controlling factor in higher metamorphic stage. Under metamorphism and deformation, the small molecules which break and fall off from the macromolecular tructure of TDC are preferentially replenished and embedded into the secondary structure defects or the residual aromatic rings were formed into aromatic structure by polycondensation. This process improved the stability of coal structure. It is easier for ductile deformation of coal to induce the secondary structure defects than brittle deformation.

  12. The effects of foot position and orientation on inter- and intra-foot coordination in standing postures: a frequency domain PCA analysis.

    PubMed

    Wang, Zheng; Molenaar, Peter C M; Molenaar, Peter M C; Newell, Karl M

    2013-09-01

    We investigated the effect of foot position and foot orientation on asymmetrical body weight loading and the inter- and intra-foot coordination dynamics of standing postures. The participants were instructed to stand with the feet side-by-side and in staggered and tandem positions with the right foot oriented at different angles (30, 60 and 90°). The results showed that the participants naturally loaded more on their left foot when positioned with their right foot forward. As the orientation of the right foot was changed from 90 to 30°, they loaded a significantly large proportion of their body weight on their left foot and the degree of coordination of the 4 COP time series increased. Foot position, constrains both the area of the base of support and the loading of the feet, played an important role differentiating the contribution of each COP to the postural control system. In particular, when postural stance was challenged by the limitation of the base of support, the COPs in the unstable plane (inter-foot coordination) showed larger factor weightings. In contrast, when standing posture was not challenged by the base of support boundary, the COPs of the more loaded foot (intra-foot coordination) dominated foot coordination in postural control. These findings show that the mechanical constraints of foot position and orientation interact to channel different patterns of inter- and intra-foot coordination dynamics of standing postures.

  13. Starting off on the right foot: strong right-footers respond faster with the right foot to positive words and with the left foot to negative words

    PubMed Central

    de la Vega, Irmgard; Graebe, Julia; Härtner, Leonie; Dudschig, Carolin; Kaup, Barbara

    2015-01-01

    Recent studies have provided evidence for an association between valence and left/right modulated by handedness, which is predicted by the body-specificity hypothesis (Casasanto, 2009) and also reflected in response times. We investigated whether such a response facilitation can also be observed with foot responses. Right-footed participants classified positive and negative words according to their valence by pressing a key with their left or right foot. A significant interaction between valence and foot only emerged in the by-items analysis. However, when dividing participants into two groups depending on the strength of their footedness, an interaction between valence and left/right was observed for strong right-footers, who responded faster with the right foot to positive words, and with the left foot to negative words. No interaction emerged for weak right-footers. The results strongly support the assumption that fluency lies at the core of the association between valence and left/right. PMID:25852609

  14. From flat foot to fat foot: structure, ontogeny, function, and evolution of elephant "sixth toes".

    PubMed

    Hutchinson, John R; Delmer, Cyrille; Miller, Charlotte E; Hildebrandt, Thomas; Pitsillides, Andrew A; Boyde, Alan

    2011-12-23

    Several groups of tetrapods have expanded sesamoid (small, tendon-anchoring) bones into digit-like structures ("predigits"), such as pandas' "thumbs." Elephants similarly have expanded structures in the fat pads of their fore- and hindfeet, but for three centuries these have been overlooked as mere cartilaginous curiosities. We show that these are indeed massive sesamoids that employ a patchy mode of ossification of a massive cartilaginous precursor and that the predigits act functionally like digits. Further, we reveal clear osteological correlates of predigit joint articulation with the carpals/tarsals that are visible in fossils. Our survey shows that basal proboscideans were relatively "flat-footed" (plantigrade), whereas early elephantiforms evolved the more derived "tip-toed" (subunguligrade) morphology, including the predigits and fat pad, of extant elephants. Thus, elephants co-opted sesamoid bones into a role as false digits and used them for support as they changed their foot posture.

  15. Replantation of an avulsive amputation of a foot after recovering the foot from the sea.

    PubMed

    Yüksel, F; Karacaoğlu, E; Ulkür, E; Güler, M M

    2000-04-01

    A foot avulsion case, with the dismembered body part submerged in sea water for 1 hour, is presented. This report is unique in that it is the first to document the reattachment of a body part that had been submerged in sea water. It was not known how salt-water exposure would affect wound management. Differences in osmolarity and bacterial flora between the sea water and foot tissues have not caused any problems, and the patient has not suffered any vascular or infectious complications after replantation. Neurotization of the plantar surface by the tibial nerve, which was stripped off during amputation and replaced in its original traces, was the most critical part of convalescence. After management of such an interesting case, we conclude that exposure to sea water of the dismembered part should not be a contraindication for replantation surgery.

  16. Welcome to Journal of Foot and Ankle Research: a new open access journal for foot health professionals.

    PubMed

    Menz, Hylton B; Potter, Mike J; Borthwick, Alan M; Landorf, Karl B

    2008-07-28

    Journal of Foot and Ankle Research (JFAR) is a new, open access, peer-reviewed online journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders. JFAR will cover a wide range of clinical subject areas, including diabetology, paediatrics, sports medicine, gerontology and geriatrics, foot surgery, physical therapy, dermatology, wound management, radiology, biomechanics and bioengineering, orthotics and prosthetics, as well the broad areas of epidemiology, policy, organisation and delivery of services related to foot and ankle care. The journal encourages submission from all health professionals who manage lower limb conditions, including podiatrists, nurses, physical therapists and physiotherapists, orthopaedists, manual therapists, medical specialists and general medical practitioners, as well as health service researchers concerned with foot and ankle care. All manuscripts will undergo open peer review, and all accepted manuscripts will be freely available on-line using the open access platform of BioMed Central.

  17. Genomics and outbreaks: foot and mouth disease.

    PubMed

    Freimanis, G L; Di Nardo, A; Bankowska, K; King, D J; Wadsworth, J; Knowles, N J; King, D P

    2016-04-01

    Foot and mouth disease virus (FMDV) is an animal pathogen of global economic significance. Identifying the sources of outbreaks plays an important role in disease control; however, this can be confounded by the ease with which FMDV can spread via movement of infected livestock and animal products, aerosols or fomites, e.g. contaminated persons and objects. As sequencing technologies have advanced, this review highlights the uses of viral genomic data in helping to understand the global distribution and transboundary movements of FMDV, and the role that these approaches have played in control and surveillance programmes. The recent application of next-generation sequencing platforms to address important epidemiological and evolutionary challenges is discussed with particular reference to the advent of 'omics' technologies.

  18. Perceptual transparency from image deformation

    PubMed Central

    Kawabe, Takahiro; Maruya, Kazushi; Nishida, Shin’ya

    2015-01-01

    Human vision has a remarkable ability to perceive two layers at the same retinal locations, a transparent layer in front of a background surface. Critical image cues to perceptual transparency, studied extensively in the past, are changes in luminance or color that could be caused by light absorptions and reflections by the front layer, but such image changes may not be clearly visible when the front layer consists of a pure transparent material such as water. Our daily experiences with transparent materials of this kind suggest that an alternative potential cue of visual transparency is image deformations of a background pattern caused by light refraction. Although previous studies have indicated that these image deformations, at least static ones, play little role in perceptual transparency, here we show that dynamic image deformations of the background pattern, which could be produced by light refraction on a moving liquid’s surface, can produce a vivid impression of a transparent liquid layer without the aid of any other visual cues as to the presence of a transparent layer. Furthermore, a transparent liquid layer perceptually emerges even from a randomly generated dynamic image deformation as long as it is similar to real liquid deformations in its spatiotemporal frequency profile. Our findings indicate that the brain can perceptually infer the presence of “invisible” transparent liquids by analyzing the spatiotemporal structure of dynamic image deformation, for which it uses a relatively simple computation that does not require high-level knowledge about the detailed physics of liquid deformation. PMID:26240313

  19. Recognizing the prevalence of changing adult foot size: an opportunity to prevent diabetic foot ulcers?

    PubMed

    Connolly, John E; Wrobel, James S

    2014-01-01

    Ill-fitting shoes may precipitate up to half of all diabetes-related amputations and are often cited as a leading cause of diabetic foot ulcers (DFU), with those patients being 5 to 10 times more likely to present wearing improperly fitting shoes. Among patients with prior DFU, those who self-select their shoe wear are at a three-fold risk for reulceration at 3 years versus those patients wearing prescribed shoes. Properly designed and fitted shoes should then address much of this problem, but evidence supporting the benefit of therapeutic shoe programs is inconclusive. The current study, performed in a male veteran population, is the first such effort to examine the prevalence and extent of change in foot length affecting individuals following skeletal maturity. Nearly half of all participants in our study experienced a ≥1 shoe size change in foot length during adulthood. We suggest that these often unrecognized changes may explain the broad use of improperly sized shoe wear, and its associated sequelae such as DFU and amputation. Regular clinical assessment of shoe fit in at-risk populations is therefore also strongly recommended as part of a comprehensive amputation prevention program.

  20. Intrauterine structure of foot muscles in talipes equinovarus due to high-level myelomeningocele: a light microscopic study in fetal cadavers.

    PubMed

    Omeroğlu, Suna; Peker, Tuncay; Omeroğlu, Hakan; Gülekon, Nadir; Mungan, Tamer; Danişman, Nuri

    2004-07-01

    The purpose of this study was to investigate the light microscopic structure of extrinsic foot muscles in talipes equinovarus (TEV) deformity that developed during intrauterine life due to high-level myelomeningocele. Ten feet of five fetal cadavers ranging in age from 18 to 20 weeks were dissected. Five feet had typical TEV deformity and the other five feet did not have any deformity (control group). Under light microscopic examination quantitative measurement of both muscle fiber sizes and fibrosis in the muscle tissue were performed to investigate the denervation muscle atrophy. Mean muscle fiber size of the TEV group was found to be significantly lower than that of the control group in all foot muscles except the gastrocnemius muscle. The proportion of fibrosis due to denervation atrophy was significantly higher in the TEV group than in the control group in all muscles. This situation was most evident in the peroneus longus muscle. It was concluded that muscular imbalance due to significant muscular atrophy might be the cause of TEV deformity that developed during intrauterine life due to high-level myelomeningocele.

  1. A simulation study of planar swaging deformation

    NASA Astrophysics Data System (ADS)

    Zhang, Cheng-Gen; Jen, Gwang-Shen; Su, Gwang-Huei

    1992-08-01

    Planar swaging deformation was studied with a photoplastic method. The domestic polycarbonate was used as a simulation material. The full-field strain distribution for planar swaging deformation was obtained. The average error of the calculated strain was less than 7 percent. The deformation area and the effect of friction on deformation area were studied with the characteristics of photoplasticity. This paper points out the special features of planar swaging deformation and the effect of lubrication on deformation flow.

  2. Femoral deformity planning: intentional placement of the apex of deformity.

    PubMed

    Fabricant, Peter D; Camara, James M; Rozbruch, S Robert

    2013-05-01

    Traditionally, correction of femoral deformity has been performed with osteotomies through the center of rotation of angulation (CORA), but the CORA location is not always practical. If the osteotomy is created at a site adjacent to the CORA, an additional translation must be performed to accurately correct the deformity. However, at times, the ideal osteotomy site may require an unfeasible amount of translation. Multiple osteotomies may also be problematic, and when overcorrection of the mechanical axis is planned, the CORA method is not practical.This article describes a novel method by which the surgeon may choose the location of the osteotomy regardless of the location of the CORA and may consolidate a multiapical deformity into a single corrective osteotomy. Furthermore, intentional mechanical axis overcorrection may be performed to unload knee joint arthritis. Simple, complex, and multiapical deformities may now be corrected via a single familiar surgical procedure, such as a distal femoral osteotomy, and the need for translation is eliminated.

  3. Videogrammetric Model Deformation Measurement Technique

    NASA Technical Reports Server (NTRS)

    Burner, A. W.; Liu, Tian-Shu

    2001-01-01

    The theory, methods, and applications of the videogrammetric model deformation (VMD) measurement technique used at NASA for wind tunnel testing are presented. The VMD technique, based on non-topographic photogrammetry, can determine static and dynamic aeroelastic deformation and attitude of a wind-tunnel model. Hardware of the system includes a video-rate CCD camera, a computer with an image acquisition frame grabber board, illumination lights, and retroreflective or painted targets on a wind tunnel model. Custom software includes routines for image acquisition, target-tracking/identification, target centroid calculation, camera calibration, and deformation calculations. Applications of the VMD technique at five large NASA wind tunnels are discussed.

  4. Control of micromachined deformable mirrors

    NASA Technical Reports Server (NTRS)

    Agronin, M. L.; Bartman, R.; Hadaegh, F. Y.; Kaiser, W.; Wang, P. K. C.

    1993-01-01

    A micromachined deformable mirror with pixelated electrostatic actuators is proposed. The paper begins with a physical description of the proposed mirror. Then a mathematical model in the form of a nonlinear partial differential equation describing the mirror surface deformations is derived. This model is used to derive the required voltages for the actuators to achieve a specified static deformation of the mirror surface. This is followed by the derivation of a static nonlinear feedback controller for achieving noninteracting actuation. Then the structure for a complete control system for wavefront correction is proposed. The paper concludes with a discussion of the physical implementation of the proposed control system.

  5. Metrological analysis of the human foot: 3D multisensor exploration

    NASA Astrophysics Data System (ADS)

    Muñoz Potosi, A.; Meneses Fonseca, J.; León Téllez, J.

    2011-08-01

    In the podiatry field, many of the foot dysfunctions are mainly generated due to: Congenital malformations, accidents or misuse of footwear. For the treatment or prevention of foot disorders, the podiatrist diagnoses prosthesis or specific adapted footwear, according to the real dimension of foot. Therefore, it is necessary to acquire 3D information of foot with 360 degrees of observation. As alternative solution, it was developed and implemented an optical system of threedimensional reconstruction based in the principle of laser triangulation. The system is constituted by an illumination unit that project a laser plane into the foot surface, an acquisition unit with 4 CCD cameras placed around of axial foot axis, an axial moving unit that displaces the illumination and acquisition units in the axial axis direction and a processing and exploration unit. The exploration software allows the extraction of distances on three-dimensional image, taking into account the topography of foot. The optical system was tested and their metrological performances were evaluated in experimental conditions. The optical system was developed to acquire 3D information in order to design and make more appropriate footwear.

  6. Minimally invasive surgery of diabetic foot - review of current techniques.

    PubMed

    I, Botezatu; D, Laptoiu

    2016-01-01

    The term diabetic foot is usually used to indicate advanced foot pathology (complex clinical situations correlating diabetic foot ulcers, diabetic foot infections, Charcot foot, and critical limb ischemia). The early recognition of the etiology of these foot lesions is essential for the therapeutic decision in order to achieve a good functional result. Several surgical procedures involving the foot have been developed in order to promote healing and avoid complications. Traditionally, surgery has been performed in an open way. The literature regarding the performance and efficacy of classical osteotomies and arthrodesis is inconsistent. This can be attributed to several variables, such as differences in patient clinical aspects and the panel of surgical techniques utilized. As with other surgical specialties, fluoroscopic imaging and minimally invasive tools are now being incorporated in these procedures. The use of high speed burrs associated with specialized osteosynthesis implants, offers several advantages over classical techniques. The ability to associate these gestures to complex protocols is beginning to be currently developed. The respect for the soft tissues is considered one of the first advantages. Despite the limited time since they were introduced in clinical practice, functional results seemed to be consistent, supporting the use of this technology.

  7. The influence of body mass on foot dimensions during pregnancy.

    PubMed

    Chiou, Wen-Ko; Chiu, Hsin-Tzu; Chao, An-Shine; Wang, Ming-Hsu; Chen, Yi-Lang

    2015-01-01

    In this study, a time-series approach was used to measure women's feet to accurately analyze changes in foot size and body mass during pregnancy. One-hundred women who were pregnant for the first time were asked to respond to questions on subjective complaints of foot discomfort listed in a questionnaire. Among these 100 women, a sample of 30 was obtained and used to measure the women's feet from the twentieth week of the gestation period until labor. The data (from 5 of the 30 women) were used to establish a prediction model for the influence of body mass on changes in foot size during pregnancy. The results indicate that the women subjectively complained that their shoes were too tight, resulting in foot discomfort. From the twentieth to the thirty-eighth week of pregnancy, the average increase in foot length, width, and back foot surface was 0.86 cm (3.6%), 0.25 cm (2.6%), and 18.36 cm(2) (11.9%), respectively. The height of the arch decreased by an average of 0.52 cm (-24.2%). Body mass accounted for more than 90% of the variation (R(2)) in foot dimensions during pregnancy and, thus indicated satisfactory predictive ability. The prediction model developed in this study can serve as a reference for clinical applications and shoe design to prevent women from experiencing extreme discomfort in their feet during pregnancy.

  8. Foot Morphological Difference between Habitually Shod and Unshod Runners

    PubMed Central

    Shu, Yang; Mei, Qichang; Fernandez, Justin; Li, Zhiyong; Feng, Neng; Gu, Yaodong

    2015-01-01

    Foot morphology and function has received increasing attention from both biomechanics researchers and footwear manufacturers. In this study, 168 habitually unshod runners (90 males whose age, weight & height were 23±2.4years, 66±7.1kg & 1.68±0.13m and 78 females whose age, weight & height were 22±1.8years, 55±4.7kg & 1.6±0.11m) (Indians) and 196 shod runners (130 males whose age, weight & height were 24±2.6years, 66±8.2kg & 1.72±0.18m and 66 females whose age, weight & height were 23±1.5years, 54±5.6kg & 1.62±0.15m)(Chinese) participated in a foot scanning test using the easy-foot-scan (a three-dimensional foot scanning system) to obtain 3D foot surface data and 2D footprint imaging. Foot length, foot width, hallux angle and minimal distance from hallux to second toe were calculated to analyze foot morphological differences. This study found that significant differences exist between groups (shod Chinese and unshod Indians) for foot length (female p = 0.001), width (female p = 0.001), hallux angle (male and female p = 0.001) and the minimal distance (male and female p = 0.001) from hallux to second toe. This study suggests that significant differences in morphology between different ethnicities could be considered for future investigation of locomotion biomechanics characteristics between ethnicities and inform last shape and design so as to reduce injury risks and poor performance from mal-fit shoes. PMID:26148059

  9. Automated, foot-bone registration using subdivision-embedded atlases for spatial mapping of bone mineral density.

    PubMed

    Liu, Lu; Commean, Paul K; Hildebolt, Charles; Sinacore, Dave; Prior, Fred; Carson, James P; Kakadiaris, Ioannis; Ju, Tao

    2013-06-01

    We present an atlas-based registration method for bones segmented from quantitative computed tomography (QCT) scans, with the goal of mapping their interior bone mineral densities (BMDs) volumetrically. We introduce a new type of deformable atlas, called subdivision-embedded atlas, which consists of a control grid represented as a tetrahedral subdivision mesh and a template bone surface embedded within the grid. Compared to a typical lattice-based deformation grid, the subdivision control grid possesses a relatively small degree of freedom tailored to the shape of the bone, which allows efficient fitting onto subjects. Compared with previous subdivision atlases, the novelty of our atlas lies in the addition of the embedded template surface, which further increases the accuracy of the fitting. Using this new atlas representation, we developed an efficient and fully automated pipeline for registering atlases of 12 tarsal and metatarsal bones to a segmented QCT scan of a human foot. Our evaluation shows that the mapping of BMD enabled by the registration is consistent for bones in repeated scans, and the regional BMD automatically computed from the mapping is not significantly different from expert annotations. The results suggest that our improved subdivision-based registration method is a reliable, efficient way to replace manual labor for measuring regional BMD in foot bones in QCT scans.

  10. Update in diagnosis and treatment of diabetic foot infections.

    PubMed

    Miller, Andy O; Henry, Michael

    2009-11-01

    Foot infections are a major cause of morbidity and mortality in diabetics. Evaluation of diabetic foot infections often requires clinical, radiologic, laboratory, and microbiologic assessment. Osteomyelitis has a profound impact on the prognosis and management of these infections, and diagnosis can be difficult; the gold standard remains bone biopsy. Despite a panoply of studies, the optimal management of diabetic foot infections remains poorly understood. Antibiotics, surgery, rehabilitation and/or off-loading, and glycemic control remain the cornerstones of treatment; alternative therapies remain largely unproven.

  11. Diabetic charcot neuroarthropathy of the foot and ankle with osteomyelitis.

    PubMed

    Ramanujam, Crystal L; Stapleton, John J; Zgonis, Thomas

    2014-10-01

    One of the most devastating foot and/or ankle complications in the diabetic population with peripheral neuropathy is the presence of Charcot neuroarthropathy (CN). In recent years, diabetic limb salvage has been attempted more frequently as opposed to major lower extremity amputation for CN of the foot and ankle with ulceration and/or deep infection. Treatment strategies for osteomyelitis in the diabetic population have evolved. This article reviews some of the most common surgical strategies recommended for the diabetic patient with CN of the foot and/or ankle and concomitant osteomyelitis.

  12. The diagnosis of flat foot in the child.

    PubMed

    Rose, G K; Welton, E A; Marshall, T

    1985-01-01

    The term flat foot is surrounded by confusion and there is little to help the clinician to identify cases which require treatment and to avoid treating many children unnecessarily. Research for 25 years has been aimed at elucidating this problem by identifying and evaluating a series of signs and tests. These tests allow the recognition of the abnormal foot as early as possible, when efficient treatment is likely to be most effective. The results indicate that evaluation of the flat foot should be based on a combination of signs, with most emphasis on the result of the great toe extension test.

  13. Clinical characteristics of foot ulceration in people with chronic gout.

    PubMed

    Rome, Keith; Erikson, Kathryn; Otene, Cynthia; Sahid, Hazra; Sangster, Karyn; Gow, Peter

    2016-04-01

    Gout is the most common form of inflammatory arthritis and it has an affliction to the foot. Foot involvement in gout has been linked to foot pain, impairment and disability. There has been limited research on the effect of ulceration on foot pain, impairment, disability and health-related quality of life in patients already living with gout. The aim of the study was to describe the wound characteristics and the effect on foot pain, disability and health-related quality of life in patients with foot ulceration associated with gout. Participants were recruited from rheumatology clinics in Auckland, New Zealand. All the current foot ulceration sites and wound characteristics were recorded using the TIME wound assessment tool. The outcome measures included general pain, patient global assessment scale, foot pain, disability and impairment. Participants completed the Cardiff Wound Impact Schedule to assess the effect of ulcers on health-related quality of life. Sensory loss, vibrational thresholds and ankle brachial pressure index were collated to assess for lower limb arterial disease. Six participants were predominantly older men with a long duration of gout, high rates of obesity and co-morbidities such as hypertension, hyperlipidaemia, diabetes and cardiovascular disease. The mean (SD) duration of the foot ulcers was 4 (2) months. The majority of foot ulcers observed were 0·5 cm(2) or smaller superficial thickness with surrounding callus. Partial thickness and full-thickness ulcers were also observed. Two patients presented with ulcers on multiple sites. There was only one case of infection. Gouty tophi were evident in most of the wounds. The dorsal aspect of the third toe was found to ulcerate in most cases. Moderate scores of foot pain, disability, impairment and health-related quality of life were observed. Most participants wore shoes deemed as poor. Foot ulceration in gout is chronic and multiple ulcers can occur with the potential of leading to delayed

  14. Variable focal length deformable mirror

    DOEpatents

    Headley, Daniel; Ramsey, Marc; Schwarz, Jens

    2007-06-12

    A variable focal length deformable mirror has an inner ring and an outer ring that simply support and push axially on opposite sides of a mirror plate. The resulting variable clamping force deforms the mirror plate to provide a parabolic mirror shape. The rings are parallel planar sections of a single paraboloid and can provide an on-axis focus, if the rings are circular, or an off-axis focus, if the rings are elliptical. The focal length of the deformable mirror can be varied by changing the variable clamping force. The deformable mirror can generally be used in any application requiring the focusing or defocusing of light, including with both coherent and incoherent light sources.

  15. ROCK DEFORMATION. Final Progress Report

    SciTech Connect

    2002-05-24

    The Gordon Research Conference (GRC) on ROCK DEFORMATION was held at II Ciocco from 5/19/02 thru 5/24/02. Emphasis was placed on current unpublished research and discussion of the future target areas in this field.

  16. Deformity of Ears and Kidneys

    PubMed Central

    Taylor, W. C.

    1965-01-01

    Ten children with gross deformity of the external ear were observed. In six the facial bones were underdeveloped on the same side as the deformed ear. In all six there was a congenital abnormality of the kidney or upper urinary tract, usually on the same side as the deformed ear. In addition there were usually other associated congenital defects in each case. In the remaining four children the facial bones appeared normal, and pyelography showed no abnormality of the urinary tract. In these four children there were no other associated defects. These observations emphasize the importance of investigating the urinary tract in children with gross deformity of the external ear, especially where there is an associated underdevelopment of the facial bones. PMID:14317453

  17. Anisotropic ripple deformation in phosphorene

    DOE PAGES

    Kou, Liangzhi; Ma, Yandong; Smith, Sean C.; ...

    2015-04-07

    Here, two-dimensional materials tend to become crumpled according to the Mermin-Wagner theorem, and the resulting ripple deformation may significantly influence electronic properties as observed in graphene and MoS2. Here, we unveil by first-principles calculations a new, highly anisotropic ripple pattern in phosphorene, a monolayer black phosphorus, where compression-induced ripple deformation occurs only along the zigzag direction in the strain range up to 10%, but not the armchair direction. This direction-selective ripple deformation mode in phosphorene stems from its puckered structure with coupled hinge-like bonding configurations and the resulting anisotropic Poisson ratio. We also construct an analytical model using classical elasticitymore » theory for ripple deformation in phosphorene under arbitrary strain. The present results offer new insights into the mechanisms governing the structural and electronic properties of phosphorene crucial to its device applications.« less

  18. Anisotropic ripple deformation in phosphorene

    SciTech Connect

    Kou, Liangzhi; Ma, Yandong; Smith, Sean C.; Chen, Changfeng

    2015-04-07

    Here, two-dimensional materials tend to become crumpled according to the Mermin-Wagner theorem, and the resulting ripple deformation may significantly influence electronic properties as observed in graphene and MoS2. Here, we unveil by first-principles calculations a new, highly anisotropic ripple pattern in phosphorene, a monolayer black phosphorus, where compression-induced ripple deformation occurs only along the zigzag direction in the strain range up to 10%, but not the armchair direction. This direction-selective ripple deformation mode in phosphorene stems from its puckered structure with coupled hinge-like bonding configurations and the resulting anisotropic Poisson ratio. We also construct an analytical model using classical elasticity theory for ripple deformation in phosphorene under arbitrary strain. The present results offer new insights into the mechanisms governing the structural and electronic properties of phosphorene crucial to its device applications.

  19. Anisotropic Ripple Deformation in Phosphorene.

    PubMed

    Kou, Liangzhi; Ma, Yandong; Smith, Sean C; Chen, Changfeng

    2015-05-07

    Two-dimensional materials tend to become crumpled according to the Mermin-Wagner theorem, and the resulting ripple deformation may significantly influence electronic properties as observed in graphene and MoS2. Here, we unveil by first-principles calculations a new, highly anisotropic ripple pattern in phosphorene, a monolayer black phosphorus, where compression-induced ripple deformation occurs only along the zigzag direction in the strain range up to 10%, but not the armchair direction. This direction-selective ripple deformation mode in phosphorene stems from its puckered structure with coupled hinge-like bonding configurations and the resulting anisotropic Poisson ratio. We also construct an analytical model using classical elasticity theory for ripple deformation in phosphorene under arbitrary strain. The present results offer new insights into the mechanisms governing the structural and electronic properties of phosphorene crucial to its device applications.

  20. Metatarsophalangeal Hyperextension Movement Pattern Related to Diabetic Forefoot Deformity

    PubMed Central

    Hastings, Mary K.; Mueller, Michael J.

    2016-01-01

    Background Metatarsophalangeal joint (MTPJ) hyperextension deformity is common in people with diabetic neuropathy and a known risk factor for ulceration and amputation. An MTPJ hyperextension movement pattern may contribute to the development of this acquired deformity. Objective The purpose of this study was to determine, in people with diabetes mellitus and peripheral neuropathy (DM+PN), the ankle and MTPJ ranges of motion that characterize an MTPJ hyperextension movement pattern and its relationship to MTPJ deformity severity. It was hypothesized that severity of MTPJ deformity would be related to limitations in maximum ankle dorsiflexion and increased MTPJ extension during active ankle dorsiflexion movement tasks. Design A cross-sectional study design was used that included 34 people with DM+PN (mean age=59 years, SD=9). Methods Computed tomography and 3-dimensional motion capture analysis were used to measure resting MTPJ angle and intersegmental foot motion during the tasks of ankle dorsiflexion and plantar flexion with the knee extended and flexed to 90 degrees, walking, and sit-to/from-stand. Results The MTPJ extension movement pattern during all tasks was directly correlated with severity of MTPJ deformity: maximum ankle dorsiflexion with knee extended (r=.35; 95% confidence interval [CI]=.02, .62), with knee flexed (r=.35; 95% CI=0.01, 0.61), during the swing phase of gait (r=.47; 95% CI=0.16, 0.70), during standing up (r=.48; 95% CI=0.17, 0.71), and during sitting down (r=.38; 95% CI=0.05, 0.64). All correlations were statistically significant. Limitations This study was cross-sectional, and causal relationships cannot be made. Conclusions A hyperextension MTPJ movement pattern associated with limited ankle dorsiflexion has been characterized in people with diabetic neuropathy. Increased MTPJ extension during movement and functional tasks was correlated with severity of resting MTPJ alignment. Repetition of this movement pattern could be an important

  1. Plastic Deformation of Granular Materials

    DTIC Science & Technology

    1993-01-25

    discontinuities. These result will be important in our granular flow work, when considering viscoplastic constitutive relations (i.e. relaxation systems...5 CUNDN( NUMRES Plastic Deformation of Granular Materials (U) 61102F 6. AUTHOR(S) 2304/A4 Dr. E. Bruce Pitman 7 PERFORMING ORGANIZATION NA .h • 8...lose hyperbolicity. 98 3 81 061! SUBJECT TERMS 15. NUMBER OF PAGES granular material ; plastic deformation; hyperbolic 12 equations 16. PRICE CODE 17

  2. Cleft Nasal Deformity and Rhinoplasty

    PubMed Central

    Kaufman, Yoav; Buchanan, Edward P.; Wolfswinkel, Erik M.; Weathers, William M.; Stal, Samuel

    2012-01-01

    The cleft nasal deformity is a complex challenge in plastic surgery involving the skin, cartilage, mucosa, and skeletal platform. Ever since Blair and Brown first described the intricacies of the cleft pathology in 1931, the appropriate approach has been extensively debated in the literature with respect to timing, technique, and extent of surgical intervention. In this article, the authors review the literature and summarize the various modalities for achieving a successful rhinoplasty in the patient with a cleft nasal deformity. PMID:24179452

  3. The adaptive drop foot stimulator - Multivariable learning control of foot pitch and roll motion in paretic gait.

    PubMed

    Seel, Thomas; Werner, Cordula; Schauer, Thomas

    2016-11-01

    Many stroke patients suffer from the drop foot syndrome, which is characterized by a limited ability to lift (the lateral and/or medial edge of) the foot and leads to a pathological gait. In this contribution, we consider the treatment of this syndrome via functional electrical stimulation (FES) of the peroneal nerve during the swing phase of the paretic foot. A novel three-electrodes setup allows us to manipulate the recruitment of m. tibialis anterior and m. fibularis longus via two independent FES channels without violating the zero-net-current requirement of FES. We characterize the domain of admissible stimulation intensities that results from the nonlinearities in patients' stimulation intensity tolerance. To compensate most of the cross-couplings between the FES intensities and the foot motion, we apply a nonlinear controller output mapping. Gait phase transitions as well as foot pitch and roll angles are assessed in realtime by means of an Inertial Measurement Unit (IMU). A decentralized Iterative Learning Control (ILC) scheme is used to adjust the stimulation to the current needs of the individual patient. We evaluate the effectiveness of this approach in experimental trials with drop foot patients walking on a treadmill and on level ground. Starting from conventional stimulation parameters, the controller automatically determines individual stimulation parameters and thus achieves physiological foot pitch and roll angle trajectories within at most two strides.

  4. Adaptive control of a variable-impedance ankle-foot orthosis to assist drop-foot gait.

    PubMed

    Blaya, Joaquin A; Herr, Hugh

    2004-03-01

    An active ankle-foot orthoses (AAFO) is presented where the impedance of the orthotic joint is modulated throughout the walking cycle to treat drop-foot gait. During controlled plantar flexion, a biomimetic torsional spring control is applied where orthotic joint stiffness is actively adjusted to minimize forefoot collisions with the ground. Throughout late stance, joint impedance is minimized so as not to impede powered plantar flexion movements, and during the swing phase, a torsional spring-damper control lifts the foot to provide toe clearance. To assess the clinical effects of variable-impedance control, kinetic and kinematic gait data were collected on two drop-foot participants wearing the AAFO. For each participant, zero, constant, and variable impedance control strategies were evaluated and the results were compared to the mechanics of three age, weight, and height matched normals. We find that actively adjusting joint impedance reduces the occurrence of slap foot allows greater powered plantar flexion and provides for less kinematic difference during swing when compared to normals. These results indicate that a variable-impedance orthosis may have certain clinical benefits for the treatment of drop-foot gait compared to conventional ankle-foot orthoses having zero or constant stiffness joint behaviors.

  5. Acquired midfoot deformity and function in individuals with diabetes and peripheral neuropathy

    PubMed Central

    Hastings, Mary K.; Mueller, Michael J.; Woodburn, James; Strube, Michael J; Commean, Paul; Johnson, Jeffrey E.; Cheuy, Victor; Sinacore, David R.

    2015-01-01

    Background Diabetes mellitus related medial column foot deformity is a major contributor to ulceration and amputation. However, little is known about the relationship between medial column alignment and function and the integrity of the soft tissues that support and move the medial column. The purposes of this study were to determine the predictors of medial column alignment and function in people with diabetes and peripheral neuropathy. Methods 23 participants with diabetes and neuropathy had radiographs, heel rise kinematics, magnetic resonance imaging and isokinetic muscle testing to measure: 1) medial column alignment (Meary’s angle- the angle between the 1st metatarsal longitudinal axis and the talar head and neck), 2) medial column function (forefoot relative to hindfoot plantarflexion during heel rise), 3) intrinsic foot muscle and fat volume, ratio of posterior tibialis to flexor digitorum tendon volume, 4) plantar fascia function (Meary’s angle change from toes flat to extended) and 5) plantarflexor peak torque. Predictors of medial column alignment and function were determined using simultaneous entry multiple regression. Findings Posterior tibialis to flexor digitorum tendon volume ratio and intrinsic foot muscle volume were significant predictors of medial column alignment (p<.05), accounting for 44% of the variance. Intrinsic foot fat volume and plantarflexor peak torque were significant predictors of medial column function (p<.05), accounting for 37% of the variance. Interpretation Deterioration of medial column supporting structures predicted alignment and function. Prospective research is required to monitor alignment, structure, and function over time to inform early intervention strategies to prevent deformity, ulceration, and amputation. PMID:26588885

  6. Impaired Foot Plantar Flexor Muscle Performance in Individuals With Plantar Heel Pain and Association With Foot Orthosis Use.

    PubMed

    McClinton, Shane; Collazo, Christopher; Vincent, Ebonie; Vardaxis, Vassilios

    2016-08-01

    Study Design Controlled laboratory study. Background Plantar heel pain is one of the most common foot and ankle conditions seen in clinical practice, and many individuals continue to have persisting or recurrent pain after treatment. Impaired foot plantar flexor muscle performance is a factor that may contribute to limited treatment success, but reliable methods to identify impairments in individuals with plantar heel pain are needed. In addition, foot orthoses are commonly used to treat this condition, but the implications of orthosis use on muscle performance have not been assessed. Objectives To assess ankle plantar flexor and toe flexor muscle performance in individuals with plantar heel pain using clinically feasible measures and to examine the relationship between muscle performance and duration of foot orthosis use. Methods The rocker-board plantar flexion test (RBPFT) and modified paper grip test for the great toe (mPGTGT) and lesser toes (mPGTLT) were used to assess foot plantar flexor muscle performance in 27 individuals with plantar heel pain and compared to 27 individuals without foot pain who were matched according to age, sex, and body mass. Pain ratings were obtained before and during testing, and self-reported duration of foot orthosis use was recorded. Results Compared to the control group, individuals with plantar heel pain demonstrated lower performance on the RBPFT (P = .001), the mPGTGT (P = .022), and the mPGTLT (P = .037). Longer duration of foot orthosis use was moderately correlated to lower performance on the RBPFT (r = -0.52, P = .02), the mPGTGT (r = -0.54, P = .01), and the mPGTLT (r = -0.43, P = .03). Conclusion Ankle plantar flexor and toe flexor muscle performance was impaired in individuals with plantar heel pain and associated with longer duration of self-reported foot orthosis use. J Orthop Sports Phys Ther 2016;46(8):681-688. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6482.

  7. Functional Foot Symmetry and Its Relation to Lower Extremity Physical Performance in Older Adults: The Framingham Foot Study

    PubMed Central

    Riskowski, J.L.; Hagedorn, TJ; Dufour, AB; Hannan, MT

    2012-01-01

    Background While many studies use gait symmetry as a marker of healthy gait, the evidence that gait symmetry exists is limited. Because gait symmetry is thought to arise through laterality (i.e., limb preference) and affects gait retraining efforts, it is important to understand if symmetry exists during gait in older adults. Therefore, the purpose of this study was to evaluate foot and gait symmetry in the population-based Framingham Foot Study as well as to determine the effects of vertical force symmetry on physical performance measures. Methods Members of the Framingham Foot Study were included in this analysis (N=1333). Foot function and force data were collected using the Tekscan Matscan during self-selected gait, with symmetry evaluated using the symmetry index. The short physical performance battery (SPPB) measures of balance, chair stands and gait speed assessed lower extremity physical function. Participants were evaluated using quartiles of gait speed and foot symmetry to determine the effects of symmetry on lower extremity physical function. Results Individuals with faster gait speed displayed greater foot function asymmetry; individuals with −3.0% to −9.5% asymmetry in foot function performed better on the short physical performance battery (SPPB). Further, with aging, the degree of asymmetry was reduced. Conclusions While this research suggests that a moderate degree of foot asymmetry is associated with better lower extremity function, the causes of vertical force asymmetry are unknown. Future studies should evaluate the causes of foot asymmetry and should track the changes in symmetry that occur with aging. PMID:22560642

  8. A Comparison of Two Injection Locations in Obese Patients Having Lower Leg/Foot Surgery

    ClinicalTrials.gov

    2015-10-13

    Strain of Muscle and/or Tendon of Lower Leg; Fracture of Lower Leg; Crushing Injury of Lower Leg; Fracture Malunion - Ankle and/ or Foot; Complete Tear, Ankle and/or Foot Ligament; Pathological Fracture - Ankle and/or Foot; Loose Body in Joint of Ankle and/or Foot

  9. [Lower extremity deformities as an obstacle in rehabilitation of meningomyelocele patients--pathogenesis and principles of treatment].

    PubMed

    Szulc, A; Głowacki, M

    1998-01-01

    The fate of 89 patients with meningomyelocele operated at the Institute of Orthopedics and Rehabilitation in Poznań between 1970 and 1989 due to paretic deformities of lower extremities has been traced by the authors. Deformities prevented nursing, standing or ambulating; their type and results of treatment have been related to the level of neurosegmental lesion. Modified Sharrard's classification served to group the patients. The level of lesion established during lower extremities muscles testing has been verified after neurological examination supplemented with electrophysiological tests: sensory response within L3-S2 dermatomes, afferent conduction velocity of the peroneal nerve and selected muscles of lower extremity electromyogram. Deformities due to inadequate nursing (hip and knee contractures and equinus foot) were the main obstacle in the rehabilitation in patients with spinal Th12-L2 lesion. In patients with L3-L5 lesion hip contractures were accompanied by dislocation or subluxation of the hip due to muscular imbalance. Knee contracture was less frequent in this group and foot deformities were diverse. Surgical correction of paretic deformity of the hip was the last stage of management designed to promote rehabilitation, following previous foot and knee surgery. In patients with Th12-L2 lesion recurrence of contractures made standing and walking impossible. In patients with L3-L5 neurosegmental lesion surgery for paretic dislocation or subluxation of the hip inclusive of open reduction, varus-derotation osteotomy of the proximal femur, transiliac osteotomy and iliopsoas transfer to the greater trochanter according to Mustard resulted in stable hip. Seventy percent of patients with L3-L4 lesion and all patients with L5 lesion profited from hip surgery with reduced orthotic use and effective gait.

  10. Simulation and analysis of the plutonium shipping container subject to 30-foot drops

    SciTech Connect

    Gong, C.; Gupta, N.K.; Gromada, R.J.

    1995-12-31

    The shipping container 5320 is a shipping package for radioactive materials. In order to maintain the component in this packaging within the sub-critical state when subjected to any kind of Hypothetical Accident conditions (HAC), this Type B packaging is designed with various impact limiters. The present study is to examine the energy absorbing capacity of the impact limiter design of this container subjected to a 30-foot drop onto a flat unyielding horizontal surface in each of the three critical dropping orientations. This paper presents the results of a three dimensional nonlinear dynamic impact analysis. This analysis shows the deformed configuration of the container caused by the impact and also determines the effects of different stress wave paths in three distinct drops on the stress states in the critical component. The solution to the problem was obtained using the ABAQUS (explicit) finite element computer code. The nonlinearity of this analysis involves large structural deformation, elasto-plastic materials with strain hardening as well as multiple contact interfaces. Three drop orientations were studied, namely, top down impact, bottom down impact and side impact. Results will be compared against actual drop test data.

  11. Analysis of Mining Terrain Deformation Characteristics with Deformation Information System

    NASA Astrophysics Data System (ADS)

    Blachowski, Jan; Milczarek, Wojciech; Grzempowski, Piotr

    2014-05-01

    Mapping and prediction of mining related deformations of the earth surface is an important measure for minimising threat to surface infrastructure, human population, the environment and safety of the mining operation itself arising from underground extraction of useful minerals. The number of methods and techniques used for monitoring and analysis of mining terrain deformations is wide and increasing with the development of geographical information technologies. These include for example: terrestrial geodetic measurements, global positioning systems, remote sensing, spatial interpolation, finite element method modelling, GIS based modelling, geological modelling, empirical modelling using the Knothe theory, artificial neural networks, fuzzy logic calculations and other. The aim of this paper is to introduce the concept of an integrated Deformation Information System (DIS) developed in geographic information systems environment for analysis and modelling of various spatial data related to mining activity and demonstrate its applications for mapping and visualising, as well as identifying possible mining terrain deformation areas with various spatial modelling methods. The DIS concept is based on connected modules that include: the spatial database - the core of the system, the spatial data collection module formed by: terrestrial, satellite and remote sensing measurements of the ground changes, the spatial data mining module for data discovery and extraction, the geological modelling module, the spatial data modeling module with data processing algorithms for spatio-temporal analysis and mapping of mining deformations and their characteristics (e.g. deformation parameters: tilt, curvature and horizontal strain), the multivariate spatial data classification module and the visualization module allowing two-dimensional interactive and static mapping and three-dimensional visualizations of mining ground characteristics. The Systems's functionality has been presented on

  12. 8. 320 FOOT LEVEL, SWING ARM NINE SHOWING BACK SIDE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. 320 FOOT LEVEL, SWING ARM NINE SHOWING BACK SIDE OF ENVIRONMENTAL CHAMBER (WHITE ROOM). WHITE ROOM MADE CONNECTION WITH CAPSULE ON LAUNCH VEHICLE. - Mobile Launcher One, Kennedy Space Center, Titusville, Brevard County, FL

  13. 13. View South, showing the remaining pier footings for the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. View South, showing the remaining pier footings for the steam engine water tower for the Chesapeake and Ohio Railroad. - Cotton Hill Station Bridge, Spanning New River at State Route 16, Cotton Hill, Fayette County, WV

  14. 23. 100 foot through truss looking west from the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    23. 100 foot through truss - looking west from the downstream side, view of a single through truss showing its general arrangement on extended column piers. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  15. 34. 100 foot through truss looking north from the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    34. 100 foot through truss - looking north from the deck up to an internal top strut, showing the general configuration. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  16. 38. 100 foot through truss bridge original identification plaque ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    38. 100 foot through truss - bridge original identification plaque located on the top of the north portal entrance. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  17. 9. 64 foot pony truss south west bearing abutment ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. 64 foot pony truss - south west bearing abutment of the first pony, truss, showing the sheet piling and the added 'I' beam support. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  18. 12. 80 foot pony truss looking east from the ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    12. 80 foot pony truss - looking east from the upstream side, view of a single pony truss showing its general arrangement on replacement piers, circa 1966. - Weidemeyer Bridge, Spanning Thomes Creek at Rawson Road, Corning, Tehama County, CA

  19. The lives of Mary Foote: painter and Jungian.

    PubMed

    Trousdell, Richard

    2016-11-01

    Mary Foote (1872-1968) was a successful early twentieth century American artist who suddenly closed her New York studio in 1926 to go to Zurich to study with Jung. There she joined his 'Interpretation of Visions' seminars (1930-1934), which she recorded and edited. This work won Jung's praise and his friendship, but all too often Foote was seen merely as a secretary or background figure. Deirdre Bair's biography of Jung suggested that Foote's life and work deserved fuller study, if only to rebalance our view of Jung's early women followers. This paper takes up that work to ask how Foote's early life and career led to her important work in preserving and describing Jung's earliest attempts to apply his theories to clinical practice.

  20. Current challenges in imaging of the diabetic foot

    PubMed Central

    Sanverdi, S. Eser; Ergen, F. Bilge; Oznur, Ali

    2012-01-01

    Although a variety of diagnostic imaging modalities are available for the evaluation of diabetes-related foot complications, the distinction between neuroarthropathy and osteomyelitis is still challenging. The early and accurate diagnosis of diabetic foot complications can help reduce the incidence of infection-related morbidities, the need for and duration of hospitalization, and the incidence of major limb amputation. Conventional radiography, computed tomography, nuclear medicine scintigraphy, magnetic resonance imaging, ultrasonography, and positron emission tomography are the main procedures currently in use for the evaluation of diabetes-related foot complications. However, each of these modalities does not provide enough information alone and a multimodal approach should be used for an accurate diagnosis. The present study is a review of the current concepts in imaging of diabetes-related foot complications and an analysis of the advantages and disadvantages of each method. PMID:23050068

  1. 9. VIEW OF BASEMENT, NORTH SECTION, SHOWING TYPICAL PIER, FOOTINGS, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    9. VIEW OF BASEMENT, NORTH SECTION, SHOWING TYPICAL PIER, FOOTINGS, AND STRUCTURAL MEMBERS FOR FIRST FLOOR ABOVE, LOOKING WEST - Massachusetts Mills, Cloth Room-Section 15, 95 Bridge Street, Lowell, Middlesex County, MA

  2. Foot-and-mouth disease virus L peptidase

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Foot-and-mouth disease virus (FMDV), equine rhinitis A virus (ERAV) and bovine rhinitis B virus (BRBV) comprise the genus Aphthovirus of the Picornaviridae family. Seven genera within this family, Aphthoviruses, Cardioviruses, Erboviruses (ERBV), Kobuviruses, Senecaviruses, Sapeloviruses, and Tescho...

  3. 13. GROOVED FOOTING (CONSTRUCTION KEY) EXTENDING ABOVE CEMENT FLOOR IN ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    13. GROOVED FOOTING (CONSTRUCTION KEY) EXTENDING ABOVE CEMENT FLOOR IN FIRST UNLINED SECTION BEYOND SOUTH PORTAL. - Salinas River Project, Cuesta Tunnel, Southeast of U.S. 101, San Luis Obispo, San Luis Obispo County, CA

  4. Ascending infection of foot tendons in diabetic patients.

    PubMed

    Mismar, Ayman; Yousef, Mohammad; Badran, Darwish; Younes, Nidal

    2013-12-01

    Bone and soft tissue infection in the foot of diabetic patients is a well-described issue in the literature. A sound anatomical knowledge of the foot anatomy and compartments is mandatory to understand the mechanisms of infection spread. We describe four cases of diabetic foot infection complicated by long ascending infection. All did not respond initially to antibiotic treatment and the usual surgical debridement and were cured only after excision of the infected tendons. We highlight a rare but serious complication of the diabetic foot disease not commonly seen by the surgical community. We hope that this report raises the awareness of this condition so that a prompt diagnosis is made and appropriate treatment started, thereby reducing the risk of major lower limb amputations.

  5. Pilot Overmyer completes hygiene activities / demostrates IVA foot restraint

    NASA Technical Reports Server (NTRS)

    1982-01-01

    On middeck, Pilot Overmyer, drying his face with a towel from forward single tray personal item stowage locker, completes personal hygiene activities (shaving) and demostrates use of intravehicular activity (IVA) foot restraint on floor.

  6. 38. DETAIL OF TIMBER, STONE, AND CONCRETE FOOTINGS FOR APRON ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    38. DETAIL OF TIMBER, STONE, AND CONCRETE FOOTINGS FOR APRON SUSPENSION STRUCTURE AT BRIDGE NO. 11. LOOKING NORTHWEST. - Greenville Yard, Transfer Bridge System, Port of New York/New Jersey, Upper New York Bay, Jersey City, Hudson County, NJ

  7. 6. VIEW FROM SOUTHERN FOOT BRIDGE ABOVE INTAKE STRUCTURE EASTERLY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. VIEW FROM SOUTHERN FOOT BRIDGE ABOVE INTAKE STRUCTURE EASTERLY TOWARD UPSTREAM SIDE OF SPILLWAY - Upper Doughty Dam, 200 feet west of Garden State Parkway, 1.7 miles west of Absecon, Egg Harbor City, Atlantic County, NJ

  8. Ultrasound of ankle and foot: overuse and sports injuries.

    PubMed

    Khoury, Viviane; Guillin, Raphaël; Dhanju, Jag; Cardinal, Etienne

    2007-06-01

    Sports and overuse injuries of the ankle and foot are commonly encountered in clinical practice. Ultrasound (US) has been established as an excellent diagnostic modality for foot and ankle injuries, providing a rapid noninvasive, economical, and readily available tool that is well tolerated by the patient with acute or chronic pain. The opportunity for dynamic examination is another advantage of US in evaluating ankle and foot pathology, where maneuvers such as muscle contraction and stressing of the joint may be particularly helpful. In many cases, US can be used as a first-line and only imaging modality for diagnosis. This article focuses on ankle disorders related to sports or overuse that affect tendons, including tendinosis, tenosynovitis, paratendinitis, rupture, dislocation, and ligaments that are commonly torn. The sonographic features of certain common foot disorders related to physical activity and overuse are also discussed, including plantar fasciitis, Morton's neuroma, stress fractures, and plantar plate injury.

  9. 33. Steampowered pile driver working on footings for Pier 3, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    33. Steam-powered pile driver working on footings for Pier 3, with south abutment visible at right; view to south. - Parks Bar Bridge, Spanning Yuba River at State Highway 20, Smartville, Yuba County, CA

  10. 14. Photocopy of c. 1906 photograph of 70 foot boom ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. Photocopy of c. 1906 photograph of 70 foot boom crane that unloaded the sugar cane. - Laurel Valley Sugar Plantation, Sugar Mill, 2 miles South of Thibodaux on State Route 308, Thibodaux, Lafourche Parish, LA

  11. 50. FOOT OF WEST STAIRS & CLOCK OVER DOORWAY FROM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    50. FOOT OF WEST STAIRS & CLOCK OVER DOORWAY FROM NORTH VESTIBULE, LOOKING NORTHEAST - Smithsonian Institution Building, 1000 Jefferson Drive, between Ninth & Twelfth Streets, Southwest, Washington, District of Columbia, DC

  12. Human Behavior Recognition Using Foot Pressure Sensing Shoes

    NASA Astrophysics Data System (ADS)

    Sugimoto, Chika; Ozaki, Kenji; Ezoe, Ryosuke; Hosaka, Hiroshi; Yamato, Hiroyuki

    To recognize human behavior in unlimited environments, sensing shoes for measuring foot pressure distribution were developed. Seven pressure sensors were installed on an insole, and a measurement module was embedded in the shoe. An analysis for discriminating the user's movements from the foot pressure distribution was examined, considering the movements, walking, running, standing, sitting, going upstairs and downstairs, and cycling. These seven actions were discriminated using feature quantities such as the average, standard deviation, maximum, and difference deviation extracted from the data of three sensors by discriminant analysis. The evaluation results showed highly accurate behavior recognition based on foot pressure at some points. In addition, by canonical discriminant analysis, six discriminant functions which classify the seven actions with an accuracy of 100% were derived by using feature quantities extracted from five sensors. The results confirmed that discriminant analysis can be used for automatically recognizing human behaviors based on foot pressure data.

  13. Flood damaged foot bridge at Tamarack Creek on alignment of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Flood damaged foot bridge at Tamarack Creek on alignment of Old Big Oak Flat Road. Looking northeast - Big Oak Flat Road, Between Big Oak Flat Entrance & Merced River, Yosemite Village, Mariposa County, CA

  14. 28. VIEW OF OCTAGONAL SPREAD FOOTING AND HOLDDOWN RODS 1929, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    28. VIEW OF OCTAGONAL SPREAD FOOTING AND HOLD-DOWN RODS 1929, SUBMARINE ESCAPE TRAINING TANK - U.S. Naval Submarine Base, New London Submarine Escape Training Tank, Albacore & Darter Roads, Groton, New London County, CT

  15. Typical Mid Tower Elevation & Section, Typical Mid Tower Footing ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Typical Mid Tower Elevation & Section, Typical Mid Tower Footing Section & Elevation, South Tower Section & Elevation, and North Tower Sections & Elevation - Cape Arago Light Station Footbridge, Gregory Point, Charleston, Coos County, OR

  16. 3. DETAIL OF WOODSTAVE PIPE (Tenths of a foot scale ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. DETAIL OF WOODSTAVE PIPE (Tenths of a foot scale in photograph) - Outlook Irrigation District, Pumping Plant & Woodstave Pipe, Hudson Road & Snipes Lateral Road vicinity, Outlook, Yakima County, WA

  17. A technique for evaluating black-footed ferret habitat

    USGS Publications Warehouse

    Biggins, Dean E.; Miller, Brian J.; Hanebury, Louis R.; Oakleaf, Bob; Farmer, Adrian H.; Crete, Ron; Dood, Arnold

    1993-01-01

    In this paper, we provide a model and step-by-step procedures for rating a prairie dog (Cynomys sp.) complex for the reintroduction of black-footed ferrets (Mustela nigripes). An important factor in the model is an estimate of the number of black-footed ferret families a prairie dog complex can support for a year; thus, the procedures prescribe how to estimate the size of a prairie dog complex and the density of prairie dogs. Other attributes of the model are qualitative: arrangement of colonies, potential for plague and canine distemper, potential for prairie dog expansion, abundance of predators, future resource conflicts and ownership stability, and public and landowner attitudes about prairie dogs and black-footed ferrets. Because of the qualitative attributes in the model, a team approach is recommended for ranking complexes of prairie dogs for black-footed ferret reintroduction.

  18. Corner footing and structural connections of southwest tower leg, looking ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Corner footing and structural connections of southwest tower leg, looking southwest. - Western Union Telegraph Company, Jennerstown Relay, Laurel Summit Road off U.S. 30, Laughlintown, Westmoreland County, PA

  19. Preferred orientation in experimentally deformed stishovite: implications for deformation mechanisms

    NASA Astrophysics Data System (ADS)

    Kaercher, P. M.; Zepeda-Alarcon, E.; Prakapenka, V.; Kanitpanyacharoen, W.; Smith, J.; Sinogeikin, S. V.; Wenk, H. R.

    2014-12-01

    The crystal structure of the high pressure SiO2 polymorph stishovite has been studied in detail, yet little is known about its deformation mechanisms. Information about how stishovite deforms under stress is important for understanding subduction of quartz-bearing crustal rocks into the mantle. Particularly, stishovite is elastically anisotropic and thus development of crystallographic preferred orientation (CPO) during deformation may contribute to seismic anomalies in the mantle. We converted a natural sample of flint to stishovite in a laser heated diamond anvil cell and compressed the stishovite aggregate up to 38 GPa. Diffraction patterns were collected in situ in radial geometry at the Advanced Light Source (ALS) and the Advanced Photon Source (APS) to examine development of CPO during deformation. We find that (001) poles preferentially align with the compression direction and infer deformation mechanisms leading to the observed CPO with visco-plastic self consistent (VPSC) polycrystal plasticity models. Our results show pyramidal and basal slip are most likely active at high pressure and ambient temperature, in agreement with transmission electron microscopy (TEM) studies of rutile (TiO2) and paratellurite (TeO2), which are isostructural to stishovite. Conversely other TEM studies of stishovite done at higher temperature suggest dominant prismatic slip. This indicates that a variety of slip systems may be active in stishovite, depending on conditions. As a result, stishovite's contribution to the seismic signature in the mantle may vary as a function of pressure and temperature and thus depth.

  20. Diabetic foot infections: stepwise medical and surgical management.

    PubMed

    Armstrong, David G; Lipsky, Benjamin A

    2004-06-01

    Foot complications are common among diabetic patients; foot ulcers are among the more serious consequences. These ulcers frequently become infected, with potentially disastrous progression to deeper spaces and tissues. If not treated promptly and appropriately, diabetic foot infections can become incurable or even lead to septic gangrene, which may require foot amputation. Diagnosing infection in a diabetic foot ulcer is based on clinical signs and symptoms of inflammation. Properly culturing an infected lesion can disclose the pathogens and provide their antibiotic susceptibilities. Specimens for culture should be obtained after wound debridement to avoid contamination and optimise identification of pathogens. Staphylococcus aureus is the most common isolate in these infections; the increasing incidence of methicillin-resistant S. aureus over the past two decades has further complicated antibiotic treatment. While chronic infections are often polymicrobial, many acute infections in patients not previously treated with antibiotics are caused by a single pathogen, usually a gram-positive coccus. We offer a stepwise approach to treating diabetic foot infections. Most patients must first be medically stabilised and any metabolic aberrations should be addressed. Antibiotic therapy is not required for uninfected wounds but should be carefully selected for all infected lesions. Initial therapy is usually empirical but may be modified according to the culture and sensitivity results and the patient's clinical response. Surgical intervention is usually required in cases of retained purulence or advancing infection despite optimal medical therapy. Possible additional indications for surgical procedures include incision and drainage of an abscess, debridement of necrotic material, removal of any foreign bodies, arterial revascularisation and, when needed, amputation. Most foot ulcers occur on the plantar surface of the foot, thus requiring a plantar incision for any drainage