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Sample records for foot deformities

  1. 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.

  2. Surgical correction of foot deformities after stroke.

    PubMed

    Yamamoto, H; Okumura, S; Morita, S; Obata, K; Furuya, K

    1992-09-01

    Of 104 patients with corrective surgery for foot deformities subsequent to a cerebrovascular accident from 1980 until 1983, 53 patients returned for clinical examination and 22 patients were evaluated by questionnaire and telephone interview. The average follow-up period was 6.4 years. The operative techniques were tenotomy of the toe flexors for hammer-toe deformity, lengthening of the aponeurosis of the gastrocnemius for equinus deformity, and transfer of the anterior tibial tendon or the posterior tibial tendon or the long toe flexors for varus deformity. In 74% of patients, correction was maintained; 79% did not use an orthosis; 51% could bathe unassisted; and 76% were satisfied with the results. The ability to walk was related to the degree of paralysis, the age of the patient at surgery, and the walking speed at discharge.

  3. Zellweger syndrome: an older child with progressive foot deformity.

    PubMed

    Westberry, David; Pugh, Linda

    2013-12-01

    Zellweger spectrum disorders result from defects in the assembly of the peroxisome and are sometimes referred to as peroxisome biogenesis disorders. Orthopedic manifestations of this condition are variable. This case report illustrates an ambulatory child with Zellweger syndrome and progressive foot deformity. The course of treatment consisted of initial soft tissue surgery, early recurrence of the deformity, followed by successful arthrodesis. PMID:27625860

  4. Zellweger syndrome: an older child with progressive foot deformity

    PubMed Central

    Westberry, David; Pugh, Linda

    2013-01-01

    Zellweger spectrum disorders result from defects in the assembly of the peroxisome and are sometimes referred to as peroxisome biogenesis disorders. Orthopedic manifestations of this condition are variable. This case report illustrates an ambulatory child with Zellweger syndrome and progressive foot deformity. The course of treatment consisted of initial soft tissue surgery, early recurrence of the deformity, followed by successful arthrodesis. PMID:27625860

  5. Posterior Tibial Tendon Dysfunction: An Overlooked Cause of Foot Deformity

    PubMed Central

    Bubra, Preet Singh; Keighley, Geffrey; Rateesh, Shruti; Carmody, David

    2015-01-01

    Posterior tibial tendon dysfunction is the most common cause of adult acquired flatfoot. Degenerative changes in this tendon, lead to pain and weakness and if not identified and treated will progress to deformity of the foot and degenerative changes in the surrounding joints. Patients will complain of medial foot pain, weakness, and a slowly progressive foot deformity. A “too many toes” sign may be present and patients will be unable to perform a single heal raise test. Investigations such X-ray, ultrasound and magnetic resonance imaging will help stage the disease and decide on management. The optimal manage may change based on the progression of deformity and stage of disease. Early identification and prompt initiation of treatment can halt progression of the disease. The purpose of this article is to examine the causes, signs, symptoms, examinations, investigations and treatment options for posterior tibial tendon dysfunction. PMID:25810985

  6. Deformity or dysfunction? Osteopathic manipulation of the idiopathic cavus foot: A clinical suggestion.

    PubMed Central

    Gidali, Adi; Harris, Valerie

    2010-01-01

    Observed gait abnormalities are often related to a variety of foot deformities such as the cavus foot, also known as pes cavus, cavovarus, uncompensated varus, and the high arched foot. When gait abnormalities related to cavus foot deformities produce symptoms or contribute to dysfunctional movement of the lower extremity, foot orthotics are commonly used to accommodate the deformity and optimize the function of the lower extremity. In more severe cases, surgical intervention is common. Hypomobility of the many joints of the foot and ankle may be mistaken as an idiopathic cavus foot deformity. As for any other limb segment suspected of musculoskeletal dysfunction, it is suggested that joint mobility testing and mobilization, if indicated, be attempted on the foot and ankle joints before assuming the presence of a bony cavus deformity. The purpose of this clinical suggestion is to describe the use of osteopathic manipulations of the foot and ankle in the context of an illustrative case of bilateral idiopathic cavus feet to demonstrate that apparent foot deformities may actually be joint hypomobility dysfunctions. PMID:21509155

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

    PubMed

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

    2014-04-01

    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.

  8. 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

  9. Kinematics and Kinetics of Single-Limb Heel Rise in Diabetes Related Medial Column Foot Deformity

    PubMed Central

    Hastings, Mary K.; Woodburn, James; Mueller, Michael J.; Strube, Michael J; Johnson, Jeffrey E.; Sinacore, David R.

    2014-01-01

    Background Diabetes-related medial column foot deformities contribute to high plantar pressure, joint instability, ulceration and amputation. Impaired foot function may be an early indicator of foot structural incompetence and contribute to deformity progression. This study examines the ability of single-limb heel rise multi-segmental kinematics and kinetics to identify midfoot and hindfoot dysfunction in those with diabetes-related medial column foot deformity. Methods Single-limb heel rise foot kinematics and kinetics were examined in adults with diabetes mellitus and peripheral neuropathy with and without medial column foot deformity and age-, weight-matched controls. Findings Hindfoot relative to shank plantarflexion, peak and excursion, were reduced in bothdiabetes groups compared to controls (P<0.017). Controls' initial forefoot relative to hindfoot position was plantarflexed 31 degrees and plantarflexed an additional 13 degrees during heel rise. The initial forefoot relative to hindfoot position for the diabetes group without deformity was similarly plantarflexed as controls (34 degrees) while the diabetes deformity group was less plantarflexed (lower arch position: 23 degrees, P<0.017). During the heel rise task both diabetes groups demonstrated less ability to plantarflex the forefoot relative to the hindfoot compared to controls (2 and 5 degrees respectively, P<0.017). Ankle plantarflexion power was reduced in the diabetes deformity group compared to controls (P<0.017). Interpretation The single-limb heel rise task identified movement dysfunction in those with diabetes mellitus and peripheral neuropathy. Failure to plantarflex the forefoot relative to hindfoot may compromise midfoot joint stability and increase the risk of injury and arch collapse. PMID:25218437

  10. 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.

  11. 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.

  12. Application of plantography examination to the assessment of foot deformity in patients with rheumatoid arthritis

    PubMed Central

    Dzięcioł, Zofia; Dzięcioł, Janusz

    2015-01-01

    Introduction Rheumatoid arthritis (RA) is a chronic, inflammatory and multiple-system disorder of connective tissue. It frequently affects joints and periarticular structures of feet that constitute a significant supporting element underlying normal gait and motion of the body centre of gravity. The aim of the study was to evaluate foot deformities on the basis of plantography examination in RA patients according to the severity of the disease. Material and methods The study was performed on 54 RA patients. The control group consisted of 34 volunteers free of any disorders. Plantography examination was carried out by means of a CQ ST2K podoscope. The following parameters were applied to the assessment of the disturbances of foot statics: hallux valgus angle (α), Sztriter-Godunow index (KY), Wejsflog's index (Wwp) and Clarke's angle (CL). Results Markedly higher values of the α angle were noted in RA patients, reflecting the presence of hallux valgus. Moreover, values of the α angle were higher in patients in the third stage of radiological changes than those in the second one. On the other hand, values of Clarke's angle for the right foot were significantly higher in men in the second and third stage of RA compared to the control group. The most common deformities in RA patients include HV and transverse flat foot, more explicit in women in the third stage of RA. Conclusions Plantography examination has been shown to constitute a useful diagnostic tool for assessment and monitoring of foot deformities in RA patients. PMID:26528345

  13. Development of cave foot deformity in failed repair of the Achilles tendon.

    PubMed

    Fortems, Y; Victor, J

    1993-01-01

    Two cases of failed primary repair of the Achilles tendon are reported. Cave foot deformity as an additional clinical sign of this condition is described. A possible biomechanical hypothesis is formulated, and a surgical procedure for correction of the symptoms is described. PMID:8323838

  14. 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

  15. Plantar Loading Reflects Ulceration Risks of Diabetic Foot with Toe Deformation

    PubMed Central

    Lu, Y. C.; Mei, Q. C.; Gu, Y. D.

    2015-01-01

    Diabetes has been one of the most common chronic diseases all over the world. The purpose of this study was to quantitatively assess the foot loading characteristics of diabetic patients with fifth-toe deformity through a comparative analysis with diabetic patients with healthy and normal feet. Six neuropathic diabetic female subjects with the fifth-toe deformation and six age-matched neuropathic diabetic controls without any feet deformities participated in the walking test. Dynamic barefoot plantar pressure was measured with Novel EMED force plate. Peak pressure and pressure-time integral for all 7 foot regions (rearfoot, midfoot, lateral forefoot, central forefoot, medial forefoot, great toe, and other toes) were collected. Peak pressure was significantly higher in the patients with toe deformity in rearfoot, central forefoot, and great toe regions compared with the control group. Meanwhile, loading sustaining period extended longer in great toe region of deformed group than in that of the control group, and the center of pressure was nearly in the big toe region during toe offstage. Diabetic patients with fifth-toe deformity could have plantar contact area reduction in the other toes part and increased loading to the great toe part. The result showed that fifth-toe deformity was associated with potential ulceration risk especially in hallux region. PMID:25861622

  16. 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.

  17. Split tendon transfers for the correction of spastic varus foot deformity: a case series study

    PubMed Central

    2010-01-01

    Background Overactivity of anterior and/or posterior tibial tendon may be a causative factor of spastic varus foot deformity. The prevalence of their dysfunction has been reported with not well defined results. Although gait analysis and dynamic electromyography provide useful information for the assessment of the patients, they are not available in every hospital. The purpose of the current study is to identify the causative muscle producing the deformity and apply the most suitable technique for its correction. Methods We retrospectively evaluated 48 consecutive ambulant patients (52 feet) with spastic paralysis due to cerebral palsy. The average age at the time of the operation was 12,4 yrs (9-18) and the mean follow-up 7,8 yrs (4-14). Eigtheen feet presented equinus hind foot deformity due to gastrocnemius and soleus shortening. According to the deformity, the feet were divided in two groups (Group I with forefoot and midfoot inversion and Group II with hindfoot varus). The deformities were flexible in all cases in both groups. Split anterior tibial tendon transfer (SPLATT) was performed in Group I (11 feet), while split posterior tibial tendon transfer (SPOTT) was performed in Group II (38 feet). In 3 feet both procedures were performed. Achilles tendon sliding lengthening (Hoke procedure) was done in 18 feet either preoperatively or concomitantly with the index procedure. Results The results in Group I, were rated according to Hoffer's clinical criteria as excellent in 8 feet and satisfactory in 3, while in Group II according to Kling's clinical criteria were rated as excellent in 20 feet, good in 14 and poor in 4. The feet with poor results presented residual varus deformity due to intraoperative technical errors. Conclusion Overactivity of the anterior tibial tendon produces inversion most prominent in the forefoot and midfoot and similarly overactivity of the posterior tibial tendon produces hindfoot varus. The deformity can be clinically unidentifiable in

  18. Crouch gait changes after planovalgus foot deformity correction in ambulatory children with cerebral palsy.

    PubMed

    Kadhim, Muayad; Miller, Freeman

    2014-02-01

    Ambulatory children with cerebral palsy (CP) may present with several gait patterns due to muscular spasticity, commonly with crouch gait. Several factors may contribute to continuous knee flexion during gait, including hamstring and gastrocnemius contracture. In planovalgus foot deformity, the combination of heel equinus, talonavicular joint dislocation, midfoot break and external tibial torsion also contribute to crouch gait as part of lever arm dysfunction. In this retrospective cohort study, we assessed 21 children with CP (34 feet) who underwent planovalgus foot correction as a single level surgery. Fifteen feet underwent subtalar fusion and 19 feet had lateral calcaneal lengthening. Patients who underwent knee, hip or pelvis surgeries were excluded from the study. The aim was to examine the changes in gait pattern and the correlation between the changes of knee flexion at stance phase with the other kinematic and kinetic parameters after foot surgery. Post surgery change of Maximum knee extension at stance (MKE-dif) was the outcome of interest. The magnitude of change in MKE after surgery increased (less crouch after surgery) in patients who had milder preoperative planovalgus feet and higher preoperative ankle maximum dorsiflexion at stance and ankle power. The gain of knee extension after surgery correlated with correction of ankle hyperdorsiflexion and with increase of knee extension at initial contact and knee power. Patients with high preoperative ankle maximum dorsiflexion may benefit from surgical foot deformity correction to achieve decreased ankle dorsiflexion with no knee surgical intervention.

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

    PubMed

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

    2016-03-01

    [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. 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

  1. [The inborn flat-valgus deformity of the foot in children].

    PubMed

    Solov'ev, A E; Shchekin, O V; Shchekin, A O

    2013-07-01

    To optimize the diagnosis and treatment for the inborn flat-valgus deformity of the foot (IFVDF), the results of treatment of 78 children, ageing from 1 mo to 12 yrs old, were analyzed. Algorithms of diagnosis and treatment were elaborated. Operative treatment on soft tissues for IFVDF was indicated in the cases of inefficacy or insufficient efficacy of conservative therapy in the age after 1 year old, when a child starts to walk by himself. The proposed method of operative treatment permits to achieve good results and it is less traumatic in comparison with the existing methods. Better results are noted while application of the method in children, ageing from 1 to 4 yrs old.

  2. 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.

  3. Prenatal diagnosis of Wolf-Hirschhorn syndrome (4p-) in association with congenital hypospadias and foot deformity

    PubMed Central

    Aslan, Halil; Karaca, Nilay; Basaran, Seher; Ermis, Hayri; Ceylan, Yavuz

    2003-01-01

    Background Wolf-Hirschhorn syndrome is caused by distal deletion of the short arm of chromosome 4 (4p-). We report a case in which intrauterine growth restriction, hypospadias and foot deformity were detected by prenatal ultrasound examination at 29 weeks of gestation. Case Presentation A 31-year-old gravida 2 partus 1 woman was referred at 29 weeks' gestation with suspicion of intrauterine growth restriction. Sonographic examination revealed deformity of the right lower limb and undescended testes with an irregular distal penis. A cordocentesis was performed and chromosome analysis revealed a 46,XY,del(4)(p14) karyotype. Conclusion The prenatal detection of intrauterine growth restriction, hypospadias and foot deformity should lead doctors to suspect the presence of Wolf-Hirschhorn syndrome. PMID:12546710

  4. 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.

  5. Does excessive flatfoot deformity affect function? A comparison between symptomatic and asymptomatic flatfeet using the Oxford Foot Model.

    PubMed

    Hösl, Matthias; Böhm, Harald; Multerer, Christel; Döderlein, Leonhard

    2014-01-01

    Treatment of asymptomatic flexible flatfeet is a subject of great controversy. The purpose of this study was to examine foot function during walking in symptomatic (SFF) and asymptomatic (ASFF) flexible flatfeet. Thirty-five paediatric and juvenile patients with idiopathic flexible flatfeet were recruited from an orthopaedic outpatient department (14 SFF and 21 ASFF). Eleven age-matched participants with typically developing feet served as controls (TDF). To study foot function, 3D multi-segment foot kinematics and ankle joint kinetics were captured during barefoot gait analysis. Overall, alterations in foot kinematics in flatfeet were pronounced but differences between SFF and ASFF were not observed. Largest discriminatory effects between flatfeet and TDF were noticed in reduced hindfoot dorsiflexion as well as in increased forefoot supination and abduction. Upon clinical examination, restrictions in passive dorsiflexion in ASFF and SFF were significant. During gait, the hindfoot in flatfeet (both ASFF and SFF) was more everted, but less flexible. In sagittal plane, limited hindfoot dorsiflexion of ASFF and SFF was compensated for by increased forefoot mobility and a hypermobile hallux. Concerning ankle kinetics, SFF lacked positive joint energy for propulsion while ASFF needed to absorb more negative ankle joint energy during loading response. This may risk fatigue and overuse syndrome of anterior shank muscles in ASFF. Hence, despite a lack of symptoms flatfoot deformity in ASFF affected function. Yet, contrary to what was expected, SFF did not show greater deviations in 3D foot kinematics than ASFF. Symptoms may rather depend on tissue wear and subjective pain thresholds.

  6. Foot pressure and radiographic outcome measures of lateral column lengthening for pes planovalgus deformity.

    PubMed

    Oeffinger, D J; Pectol, R W; Tylkowski, C M

    2000-12-01

    The purpose of this study was to establish and characterize the relationship between foot pressure analysis and radiographic measurements in children that underwent a lateral column lengthening procedure for pes planovalgus (PPV). Eight children (13 feet) with PPV that had failed non-operative treatment underwent a lateral column lengthening procedure. Pre-operative and post-operative standing AP and lateral radiographs and foot pressure data were obtained. The relationships between the radiographic and foot pressure measurements were investigated. The findings from this study demonstrated strong relationships between these parameters. The relationships seen in this study indicate that the addition of foot pressure analysis provides objective documentation of the improvement in foot pressure distribution following a lateral column lengthening. Also, there is a direct, positive relationship between the key radiographic and foot pressure measurements.

  7. Club foot, an adverse outcome of early amniocentesis: disruption or deformation?

    PubMed Central

    Farrell, S; Summers, A; Dallaire, L; Singer, J; Johnson, J.; Wilson, R

    1999-01-01

    An association between the occurrence of club foot and early amniocentesis has been reported. The largest of these randomised studies was the Canadian Early and Mid-Trimester Amniocentesis Trial. Data describing the neonatal outcome, focusing on this association, are presented. Possible mechanisms for the association and the implications for the development of club foot are discussed.


Keywords: amniocentesis; early amniocentesis; club foot PMID:10544229

  8. Management of the recurrent deformity in a flexible foot following failure of tendon transfer: is arthrodesis necessary?

    PubMed

    Hatic, Safet O; Philbin, Terrence M

    2012-06-01

    Recurrent deformity in the adult flatfoot following previous tendon transfer represents a challenging treatment dilemma for even the most experienced foot and ankle surgeon. The evaluation must be comprehensive, resulting in a clear understanding of the extent to which previous surgical procedures either failed to address the deformity initially or led to progressive recurrence. Particularly in younger, more high-demand patients, every effort to preserve normal joint mechanics while alleviating pain and restoring functional alignment must be made. LCL coupled with MDCO and a comprehensive medial soft tissue reconstruction represents a joint-sparing modality for approaching even the most challenging flexible flatfoot deformities. Care to avoid overcorrection, particularly with a double calcaneal osteotomy, must be taken. In the presence of progressive degenerative changes or patient factors such as morbid obesity and advanced age, hindfoot arthrodesis, particularly realignment subtalar joint arthrodesis, provides a technically straightforward, predictable means of achieving a pain-free plantigrade foot. Talonavicular arthrodesis and double arthrodesis, although reliable means of achieving pain relief and functional alignment, do sacrifice considerably more hindfoot motion and are likely more appropriately reserved for elderly, low-demand patients or those with more severe fixed deformities. PMID:22541527

  9. Foot Surgery

    MedlinePlus

    ... About Feet » Foot Health Information Surgery When is Foot Surgery Necessary? Many foot problems do not respond ... restore the function of your foot. Types of Foot Surgery Fusions: Fusions are usually performed to treat ...

  10. 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.

  11. Athlete's Foot

    MedlinePlus

    ... Homework? Here's Help White House Lunch Recipes Athlete's Foot KidsHealth > For Kids > Athlete's Foot Print A A ... a public shower. Why Is It Called Athlete's Foot? Athlete's foot gets its name because athletes often ...

  12. 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.

  13. Athlete's Foot

    MedlinePlus

    ... Home » Learn About Feet » Foot Health Information Athlete's Foot What is Athlete's Foot? Athlete's foot is a skin disease caused by a fungus, ... fungus growth. Not all fungus conditions are athlete's foot. Other conditions, such as disturbances of the sweat ...

  14. 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, ...

  15. 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, ...

  16. Foot Drop

    MedlinePlus

    ... Awards Enhancing Diversity Find People About NINDS NINDS Foot Drop Information Page Table of Contents (click to ... research is being done? Clinical Trials What is Foot Drop? Foot drop describes the inability to raise ...

  17. 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. PMID:26589081

  18. Athlete's Foot

    MedlinePlus

    Athlete's foot is a common infection caused by a fungus. It most often affects the space between the toes. ... skin between your toes. You can get athlete's foot from damp surfaces, such as showers, swimming pools, ...

  19. Foot Problems

    MedlinePlus

    ... the foot and take an over-the-counter anti-inflammatory medicine to relieve pain. See your doctor if ... foot. Use ice and an over-the-counter anti-inflammatory medicine. See your doctor if the pain doesn' ...

  20. 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). ...

  1. 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 ...

  2. Involvement of valgus hindfoot deformity in hallux valgus deformity in rheumatoid arthritis.

    PubMed

    Yamada, Shutaro; Hirao, Makoto; Tsuboi, Hideki; Akita, Shosuke; Matsushita, Masato; Ohshima, Shiro; Saeki, Yukihiko; Hashimoto, Jun

    2014-09-01

    The involvement of valgus hindfoot deformity in hallux valgus deformity was confirmed in a rheumatoid arthritis case with a destructive valgus hindfoot deformity. Correction of severe valgus, calcaneal lateral offset, and pronated foot deformity instantly normalized hallux valgus deformities postoperatively. Thus, careful hindfoot status evaluation is important when assessing forefoot deformity, including hallux valgus, in rheumatoid arthritis cases.

  3. Complications of the diabetic foot.

    PubMed

    Kim, Paul J; Steinberg, John S

    2013-12-01

    The diabetic foot is at high risk for complications because of its role in ambulation. Peripheral neuropathy and peripheral vascular disease can lead to chronic foot ulcers, which are at high risk for infection, in part attributable to areas of high pressure caused by lack of tolerance of the soft tissue and bone and joint deformity. If left untreated, infection and ischemia lead to tissue death, culminating in amputation. Treatment strategies include antibiosis, topical therapies, offloading, debridement, and surgery. A multidisciplinary team approach is necessary in the prevention and treatment of complications of the diabetic foot.

  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. [Congenital foot abnormalities].

    PubMed

    Delpont, M; Lafosse, T; Bachy, M; Mary, P; Alves, A; Vialle, R

    2015-03-01

    The foot may be the site of birth defects. These abnormalities are sometimes suspected prenatally. Final diagnosis depends on clinical examination at birth. These deformations can be simple malpositions: metatarsus adductus, talipes calcaneovalgus and pes supinatus. The prognosis is excellent spontaneously or with a simple orthopedic treatment. Surgery remains outstanding. The use of a pediatric orthopedist will be considered if malposition does not relax after several weeks. Malformations (clubfoot, vertical talus and skew foot) require specialized care early. Clubfoot is characterized by an equine and varus hindfoot, an adducted and supine forefoot, not reducible. Vertical talus combines equine hindfoot and dorsiflexion of the forefoot, which is performed in the midfoot instead of the ankle. Skew foot is suspected when a metatarsus adductus is resistant to conservative treatment. Early treatment is primarily orthopedic at birth. Surgical treatment begins to be considered after walking age. Keep in mind that an abnormality of the foot may be associated with other conditions: malposition with congenital hip, malformations with syndromes, neurological and genetic abnormalities. PMID:25524290

  6. Green foot.

    PubMed

    LeFeber, W P; Golitz, L E

    1984-07-01

    Pseudomonas aeruginosa may infect the skin surface, nails, hair follicles, or deeper tissues. We report a 13-year-old male with an asymptomatic green discoloration of the toenails and sole of the right foot. Pseudomonas aeruginosa was cultured from the shoe, but not from the discolored skin. We suspect that constant wearing of occlusive, rubber-soled, basketball shoes associated with hyperhidrosis allowed colonization of his shoe with pseudomonas. This case is unique in that colonization resulted in a green color of the foot not associated with infection of the skin.

  7. Lobster claw deformity.

    PubMed

    Agrawal, Ashish; Agrawal, Rahul; Singh, Rajat; Agrawal, Romi; Agrawal, Seema

    2014-01-01

    Endogenous erythroid colony (EEC) syndrome comprise of three cardinal features, i.e. ectrodactyly, ectodermal dysplasia and cleft lip. EEC itself has three different forms. Ectrodactyly (absence of one or more digits) can be present with clefting in the proximal portion of hand or foot known as split hand foot malformation (SHFM) or lobster claw deformity. SHFM can be of four types depending upon the different responsible chromosomal loci. SHFM-4 can be present as pure limb malformation (non-syndromic form). In this article, describes a rare case report of lobster claw deformity patient.

  8. Lobster claw deformity.

    PubMed

    Agrawal, Ashish; Agrawal, Rahul; Singh, Rajat; Agrawal, Romi; Agrawal, Seema

    2014-01-01

    Endogenous erythroid colony (EEC) syndrome comprise of three cardinal features, i.e. ectrodactyly, ectodermal dysplasia and cleft lip. EEC itself has three different forms. Ectrodactyly (absence of one or more digits) can be present with clefting in the proximal portion of hand or foot known as split hand foot malformation (SHFM) or lobster claw deformity. SHFM can be of four types depending upon the different responsible chromosomal loci. SHFM-4 can be present as pure limb malformation (non-syndromic form). In this article, describes a rare case report of lobster claw deformity patient. PMID:24992861

  9. Diabetic Foot

    MedlinePlus

    ... can cause you to lose feeling in your feet. You may not feel a cut, a blister or a sore. Foot injuries such as these can cause ulcers and ... the blood vessels can also mean that your feet do not get enough blood and oxygen. It ...

  10. Foot Problems

    MedlinePlus

    ... bend abnormally toward the small toes. Calluses and corns. Dead, yellowish, thickened skin on toes. Hammertoes. Toe ... In older people, pain most often comes from corns, calluses and toe deformities, of which 75% are ...

  11. [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

  12. Diabetic foot ulcers: Part I. Pathophysiology and prevention.

    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

    Diabetes mellitus is a serious, life-long condition that is the sixth leading cause of death in North America. Dermatologists frequently encounter patients with diabetes mellitus. Up to 25% of patients with diabetes mellitus will develop diabetic foot ulcers. Foot ulcer patients have an increased risk of amputation and increased mortality rate. The high-risk diabetic foot can be identified with a simplified screening, and subsequent foot ulcers can be prevented. Early recognition of the high-risk foot and timely treatment will save legs and improve patients' quality of life. Peripheral arterial disease, neuropathy, deformity, previous amputation, and infection are the main factors contributing to the development of diabetic foot ulcers. Early recognition of the high-risk foot is imperative to decrease the rates of mortality and morbidity. An interprofessional approach (ie, physicians, nurses, and foot care specialists) is often needed to support patients' needs.

  13. Cavus Foot Surgery

    MedlinePlus

    ... Toes All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A cavus or high-arched foot may have ... related problems. What are the goals of cavus foot surgery? The main goal of surgery is to ...

  14. Reconstruction of Mirror Foot with Dysplastic Tibia

    PubMed Central

    Deshmukh, Ranjit; Shyam, Ashok K

    2015-01-01

    Introduction: The Mirror foot is a rare congenital anomaly associated with duplication of the structures of the foot. Verghese et al have classified these feet into three types. Type three is associated with a Dysplastic tibia of which only 5 have been reported. Surgical management has been reported in only two of these five cases which are in the form of amputation. Case Report: We would like to present the reconstruction of a Mirror foot associated with a dysplastic tibia. Our case which is only the sixth reported case attempts to present a surgical reconstruction to a plantigrade foot. Reconstruction was attempted in this case since the child showed a good quadriceps function at the knee. Reconstruction consisted of excision of the preaxial polydactyly to achieve a more cosmetic appearance to the foot as well as improve the ability to wear foot wear. The dysplastic tibia was osteotomized to correct the varus deformity and achieve a plantigtade foot. This helped the child to ambulate more easily with a shoe raise and a brace to maintain the correction achieved. At a five year follow up the child was walking and running with a shoe raise for a 9 cm limb length discrepancy. There was however recurrence of the deformity due to fibular overgrowth. The child’s parents refused further reconstruction and were satisfied with the present function and appearance of the child. Conclusion: Reconstruction can therefore be attempted in these limbs associated with good quadriceps function. PMID:27299070

  15. What's New in Severe Deformity Correction: The German Perspective.

    PubMed

    Schmitt, Sebastian; Peak, Anna C; Berrsche, Gregor; Wenz, Wolfram

    2016-06-01

    Foot deformities are found in several neurologic conditions, most typically, but not exclusively, Charcot-Marie-Tooth disease. Posttraumatic deformities and undercorrection or overcorrection of congenital talipes equinovarus are also encountered. A severely deformed foot that cannot fit into normal shoes presents a significant day-to-day challenge to the young and active patient. This article presents some basic principles for evaluating the deformity and a toolkit of procedures to deal with these complex cases. PMID:27261803

  16. Planus Foot Posture and Pronated Foot Function are Associated with Foot Pain: The Framingham Foot Study

    PubMed Central

    Menz, Hylton B.; Dufour, Alyssa B.; Riskowski, Jody L.; Hillstrom, Howard J.; Hannan, Marian T.

    2014-01-01

    Objective To examine the associations of foot posture and foot function to foot pain. Methods Data were collected on 3,378 members of the Framingham Study who completed foot examinations in 2002–2008. Foot pain (generalized and at six locations) was based on the response to the question “On most days, do you have pain, aching or stiffness in either foot?” Foot posture was categorized as normal, planus or cavus using static pressure measurements of the arch index. Foot function was categorized as normal, pronated or supinated using the center of pressure excursion index from dynamic pressure measurements. Sex-specific multivariate logistic regression models were used to examine the effect of foot posture and function on generalized and location-specific foot pain, adjusting for age and weight. Results Planus foot posture was significantly associated with an increased likelihood of arch pain in men (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.01 – 1.90), while cavus foot posture was protective against ball of foot pain (OR 0.74, 95% CI 0.55 – 1.00) and arch pain (OR 0.64, 95% CI 0.48 – 0.85) in women. Pronated foot function was significantly associated with an increased likelihood of generalized foot pain (OR 1.28, 95% CI 1.04 – 1.56) and heel pain (OR 1.54, 95% CI 1.04 – 2.27) in men, while supinated foot function was protective against hindfoot pain in women (OR 0.74, 95% CI 0.55 – 1.00). Conclusion Planus foot posture and pronated foot function are associated with foot symptoms. Interventions that modify abnormal foot posture and function may therefore have a role in the prevention and treatment of foot pain. PMID:23861176

  17. [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

  18. Congenital idiopathic clubfoot deformities.

    PubMed

    Kyzer, S P; Stark, S L

    1995-03-01

    Clubfoot is a birth defect that is marked primarily by a deformed talus (ie, ankle) and calcaneous (ie, heel) that give the foot a characteristic "club-like" appearance. In congenital idiopathic clubfoot (ie, talipes equinovarus), the infant's foot points downward (ie, equinus) and turns inward (ie, varus), while the forefoot curls toward the heel (ie, adduction). This congenital disorder has an incidence of 1 in 400 live births, with boys affected twice as often as girls. Unilateral clubfoot is somewhat more common than bilateral clubfoot and may occur as an isolated defect or in association with other disorders (eg, chromosomal aberrations, cerebral palsy, spina bifida, arthrogryposis). Infantile clubfoot deformity is painless and is correctable with early diagnosis and prompt treatment. PMID:7778903

  19. Procedure selection for the flexible adult acquired flatfoot deformity.

    PubMed

    Hentges, Matthew J; Moore, Kyle R; Catanzariti, Alan R; Derner, Richard

    2014-07-01

    Adult acquired flatfoot represents a spectrum of deformities affecting the foot and the ankle. The flexible, or nonfixed, deformity must be treated appropriately to decrease the morbidity that accompanies the fixed flatfoot deformity or when deformity occurs in the ankle joint. A comprehensive approach must be taken, including addressing equinus deformity, hindfoot valgus, forefoot supinatus, and medial column instability. A combination of osteotomies, limited arthrodesis, and medial column stabilization procedures are required to completely address the deformity.

  20. Procedure selection for the flexible adult acquired flatfoot deformity.

    PubMed

    Hentges, Matthew J; Moore, Kyle R; Catanzariti, Alan R; Derner, Richard

    2014-07-01

    Adult acquired flatfoot represents a spectrum of deformities affecting the foot and the ankle. The flexible, or nonfixed, deformity must be treated appropriately to decrease the morbidity that accompanies the fixed flatfoot deformity or when deformity occurs in the ankle joint. A comprehensive approach must be taken, including addressing equinus deformity, hindfoot valgus, forefoot supinatus, and medial column instability. A combination of osteotomies, limited arthrodesis, and medial column stabilization procedures are required to completely address the deformity. PMID:24980927

  1. Foot structure and footwear prescription in diabetes mellitus.

    PubMed

    Bus, Sicco A

    2008-01-01

    Foot structure abnormalities such as foot deformity and limited joint mobility are common and well established components of the diabetic foot which are associated with increased levels of mechanical stress on the foot and the development of ulcers. Our understanding of foot structure abnormality in diabetes has improved recently, mainly through the findings from in vivo imaging studies. Several examples will be discussed in this review. A limited understanding, however, still exists about several aspects related to the assessment, etiology, and consequences of change in foot structure in diabetes. Knowledge on these matters is needed if we are to better deal with the implications of foot structure change in diabetes. Diabetic patients with neuropathy and foot deformity are commonly prescribed with custom footwear, in particular after ulcer healing. The goal of this footwear is to redistribute and reduce plantar foot pressures, and to prevent ulcer recurrence. However, the available evidence for the effectiveness of custom footwear in secondary ulcer prevention is not yet strong. This may be associated with several factors, including a lack of standardized or systematic approach (a set of guidelines) in footwear prescription and evaluation or with the significant variability that exists across patients in the offloading effect of different footwear interventions, which increases the difficulty of predicting what works for a given patient. Objective evaluation tools such as in-shoe plantar pressure analysis can be helpful in this regard in order to ensure efficacy of an intervention. This provides a more optimal footwear solution that may lower the risk for ulceration.

  2. Athlete's Foot (Tinea Pedis)

    MedlinePlus

    ... The most common locations for athlete's foot include: Spaces (webs) between the toes, especially between the 4th ... no worm involved.) Between the toes (the interdigital spaces), athlete's foot may appear as inflamed, scaly, and ...

  3. Etiology, pathophysiology and classifications of the diabetic Charcot foot

    PubMed Central

    Papanas, Nikolaos; Maltezos, Efstratios

    2013-01-01

    In people with diabetes mellitus, the Charcot foot is a specific manifestation of peripheral neuropathy that may involve autonomic neuropathy with high blood flow to the foot, leading to increased bone resorption. It may also involve peripheral somatic polyneuropathy with loss of protective sensation and high risk of unrecognized acute or chronic minor trauma. In both cases, there is excess local inflammatory response to foot injury, resulting in local osteoporosis. In the Charcot foot, the acute and chronic phases have been described. The former is characterized by local erythema, edema, and marked temperature elevation, while pain is not a prominent symptom. In the latter, signs of inflammation gradually recede and deformities may develop, increasing the risk of foot ulceration. The most common anatomical classification describes five patterns, according to the localization of bone and joint pathology. This review article aims to provide a brief overview of the diabetic Charcot foot in terms of etiology, pathophysiology, and classification. PMID:23705058

  4. Management of Foot Pain

    PubMed Central

    Godfrey, Charles M.

    1987-01-01

    This paper deals chiefly with the young adult foot, the older adult foot, and pain of mechanical origin. It does not discuss treatment by surgical methods, but rather by the use of exercises, foot supports and shoe corrections. Foot pain resulting from mechanical disorders can be treated effectively by determination of the biomechanical causative factors, usually by simple physical examination. Relief can often be gained with simple mechanical devices, provided at low cost. ImagesFigure 1Figure 2Figure 4 PMID:21263862

  5. 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. PMID:24952049

  6. A dynamic 3D foot reconstruction system.

    PubMed

    Thabet, Ali K; Trucco, Emanuele; Salvi, Joaquim; Wang, Weijie; Abboud, Rami J

    2011-01-01

    Foot problems are varied and range from simple disorders through to complex diseases and joint deformities. Wherever possible, the use of insoles, or orthoses, is preferred over surgery. Current insole design techniques are based on static measurements of the foot, despite the fact that orthoses are prevalently used in dynamic conditions while walking or running. This paper presents the design and implementation of a structured-light prototype system providing dense three dimensional (3D) measurements of the foot in motion, and its use to show that foot measurements in dynamic conditions differ significantly from their static counterparts. The input to the system is a video sequence of a foot during a single step; the output is a 3D reconstruction of the plantar surface of the foot for each frame of the input. Engineering and clinical tests were carried out for the validation of the system. The accuracy of the system was found to be 0.34 mm with planar test objects. In tests with real feet, the system proved repeatable, with reconstruction differences between trials one week apart averaging 2.44 mm (static case) and 2.81 mm (dynamic case). Furthermore, a study was performed to compare the effective length of the foot between static and dynamic reconstructions using the 4D system. Results showed an average increase of 9 mm for the dynamic case. This increase is substantial for orthotics design, cannot be captured by a static system, and its subject-specific measurement is crucial for the design of effective foot orthoses.

  7. Pediatric foot fractures.

    PubMed

    Ribbans, William J; Natarajan, Ramanathan; Alavala, Sairam

    2005-03-01

    Fractures of the foot in children usually have a good prognosis and generally are treated nonoperatively. Displaced fractures of the talus and calcaneus and tarsometatarsal dislocations are rare in children and their outcome is generally good in the younger child. Older adolescents with these injuries need treatment similar to how an adult would be treated for the same injury in order to achieve a good result. Foot fractures in children may pose a diagnostic challenge particularly in the absence of obvious radiographic changes. Repeated clinical examination and judicious use of imaging techniques such as isotope bone scans and magnetic resonance imaging are needed to establish a diagnosis. Knowledge of the anatomy and significance of accessory bones of the foot and disorders of the growing foot skeleton are helpful in managing injuries of child's foot. In this study, we review common injuries of a child's foot and include a discussion on differential diagnosis.

  8. Clinical workflow for personalized foot pressure ulcer prevention.

    PubMed

    Bucki, M; Luboz, V; Perrier, A; Champion, E; Diot, B; Vuillerme, N; Payan, Y

    2016-09-01

    Foot pressure ulcers are a common complication of diabetes because of patient's lack of sensitivity due to neuropathy. Deep pressure ulcers appear internally when pressures applied on the foot create high internal strains nearby bony structures. Monitoring tissue strains in persons with diabetes is therefore important for an efficient prevention. We propose to use personalized biomechanical foot models to assess strains within the foot and to determine the risk of ulcer formation. Our workflow generates a foot model adapted to a patient's morphology by deforming an atlas model to conform it to the contours of segmented medical images of the patient's foot. Our biomechanical model is composed of rigid bodies for the bones, joined by ligaments and muscles, and a finite element mesh representing the soft tissues. Using our registration algorithm to conform three datasets, three new patient models were created. After applying a pressure load below these foot models, the Von Mises equivalent strains and "cluster volumes" (i.e. volumes of contiguous elements with strains above a given threshold) were measured within eight functionally meaningful foot regions. The results show the variability of both location and strain values among the three considered patients. This study also confirms that the anatomy of the foot has an influence on the risk of pressure ulcer. PMID:27212210

  9. The diabetic foot--an update.

    PubMed

    Boulton, Andrew J M

    2008-01-01

    Despite an improvement in our understanding of the aetiopathogenesis of diabetic foot problems in the last 2 decades, the 21st Century epidemic of type 2 diabetes will ensure that the incidence of foot problems will continue to increase in the diabetic population. In the aetiopathogenesis it is important to understand that a number of factors working together usually result in foot ulceration: the commonest trio is neuropathy, deformity and trauma. In Western countries, the incidence of neuroischaemic ulcers is now increasing making early detection of those at risk even more important. In the pathogenesis of Charcot neuroarthropathy, recent advances in our understanding of the mechanisms underlying the development of osteopenia and osteoporosis include the central role of the RANK-L OPG signalling system. Finally, in terms of wound healing, the most frequently neglected aspect of care is appropriate offloading of neuropathic or neuroischaemic foot ulcers. The next decades will undoubtedly see the application of stem cell therapy in the management of diabetic foot ulceration.

  10. Foot Health Facts for Athletes

    MedlinePlus

    ... pounding their feet endure from... Foot Injuries in Olympic Athletes and Beyond Foot and ankle surgeons offer ... for athletes of all levels. The 2012 Summer Olympics have arrived, and according to foot and ankle ...

  11. Malignant Melanoma of the Foot

    MedlinePlus

    ... Javascript in your browser. Malignant Melanoma of the Foot What is Malignant Melanoma? Melanoma is a cancer ... age groups, even the young. Melanoma in the Foot Melanoma that occurs in the foot or ankle ...

  12. Arthrodesis for the cavus foot: when, where, and how?

    PubMed

    Zide, Jacob R; Myerson, Mark S

    2013-12-01

    When the cavus foot has become rigid, midfoot and triple arthrodesis may be the only reasonable surgical options left. The apex of the deformity is multiplanar and some deformities may have more than one apex. The best outcomes are achieved with minimal shortening of the foot, so correction should be by rotation and translation and with minimal wedge resection wherever possible. Posterior tibial tendon transfer and peroneus longus transfer are nearly always required for correction. If the principles of soft tissue balancing are followed, arthrodesis is an excellent procedure despite the literature that states to the contrary. PMID:24215838

  13. Diabetic foot infections.

    PubMed

    Gemechu, Fassil W; Seemant, Fnu; Curley, Catherine A

    2013-08-01

    Diabetic foot infection, defined as soft tissue or bone infection below the malleoli, is the most common complication of diabetes mellitus leading to hospitalization and the most frequent cause of nontraumatic lower extremity amputation. Diabetic foot infections are diagnosed clinically based on the presence of at least two classic findings of inflammation or purulence. Infections are classified as mild, moderate, or severe. Most diabetic foot infections are polymicrobial. The most common pathogens are aerobic gram-positive cocci, mainly Staphylococcus species. Osteomyelitis is a serious complication of diabetic foot infection that increases the likelihood of surgical intervention. Treatment is based on the extent and severity of the infection and comorbid conditions. Mild infections are treated with oral antibiotics, wound care, and pressure off-loading in the outpatient setting. Selected patients with moderate infections and all patients with severe infections should be hospitalized, given intravenous antibiotics, and evaluated for possible surgical intervention. Peripheral arterial disease is present in up to 40% of patients with diabetic foot infections, making evaluation of the vascular supply critical. All patients with diabetes should undergo a systematic foot examination at least once a year, and more frequently if risk factors for diabetic foot ulcers exist. Preventive measures include patient education on proper foot care, glycemic and blood pressure control, smoking cessation, use of prescription footwear, intensive care from a podiatrist, and evaluation for surgical interventions as indicated.

  14. Diabetes - foot ulcers

    MedlinePlus

    ... 33. Kim PJ, Steinberg JS. Complications of the diabetic foot. Endocrinol Metab Clin N Am. 2013;42:833-847. PMID: 24286952 www.ncbi.nlm.nih.gov/pubmed/24286952 . Read More Diabetes Diabetes and nerve damage Leg or foot amputation Type 1 diabetes Type 2 diabetes Patient Instructions Diabetes and ...

  15. 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.

  16. Foot anatomy specialization for postural sensation and control

    PubMed Central

    Ivanenko, Y. P.; Gurfinkel, V. S.

    2012-01-01

    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. PMID:22157121

  17. Haglund's Deformity

    MedlinePlus

    ... Is Haglund’s Deformity? Haglund’s deformity is a bony enlargement on the back of the heel. The soft ... the Achilles tendon becomes irritated when the bony enlargement rubs against shoes. This often leads to painful ...

  18. 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.

  19. Foot amputation - discharge

    MedlinePlus

    ... 2016. Richardson DR. Amputations of the foot. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics . 12th ... 15. Toy PC. General principles of amputations. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics . 12th ...

  20. Diabetes and Foot Problems

    MedlinePlus

    ... Disease, and Other Dental Problems Diabetic Eye Disease Diabetes and Foot Problems How can diabetes affect my feet? Too much glucose, also called ... you have any of these signs. How can diabetes change the shape of my feet? Nerve damage ...

  1. Fancy Foot Work!

    ERIC Educational Resources Information Center

    Blattner, Bunny; And Others

    1979-01-01

    Seventy-six Fort Lauderdale third, fourth, and fifth graders spent an entire day researching, measuring, comparing, and creating fantasies about feet. This article describes "Foot Day" and presents the activity sheets used by the students. (Author/SJL)

  2. Predictive factors for diabetic foot ulceration: a systematic review.

    PubMed

    Monteiro-Soares, M; Boyko, E J; Ribeiro, J; Ribeiro, I; Dinis-Ribeiro, M

    2012-10-01

    Improving ability to predict and prevent diabetic foot ulceration is imperative because of the high personal and financial costs of this complication. We therefore conducted a systematic review in order to identify all studies of factors associated with DFU and assess whether available DFU risk stratification systems incorporate those factors of highest potential value. We performed a search in PubMed for studies published through April 2011 that analysed the association between independent variables and DFU. Articles were selected by two investigators-independently and blind to each other. Divergences were solved by a third investigator. A total of 71 studies were included that evaluated the association between diabetic foot ulceration and more than 100 independent variables. The variables most frequently assessed were age, gender, diabetes duration, BMI, HbA(1c) and neuropathy. Diabetic foot ulceration prevalence varied greatly among studies. The majority of the identified variables were assessed by only two or fewer studies. Diabetic neuropathy, peripheral vascular disease, foot deformity and previous diabetic foot ulceration or lower extremity amputation - which are the most common variables included in risk stratification systems - were consistently associated with diabetic foot ulceration development. Existing diabetic foot ulceration risk stratification systems often include variables shown repeatedly in the literature to be strongly predictive of this outcome. Improvement of these risk classification systems though is impaired because of deficiencies noted, including a great lack of standardization in outcome definition and variable selection and measurement.

  3. Risk factors for ulceration and amputation in diabetic foot: study in a cohort of 496 patients.

    PubMed

    Moura Neto, Arnaldo; Zantut-Wittmann, Denise Engelbrecht; Fernandes, Tulio Diniz; Nery, Marcia; Parisi, Maria Candida Ribeiro

    2013-08-01

    Treatment strategies for foot at risk and diabetic foot are mainly preventive. Studies describing demographic data, clinical and impacting factors continue to be, however, scarce. Our objective was to determine the epidemiological presentation of diabetic foot and understand whether there were easily assessable variables capable of predicting the development of diabetic foot. This was a retrospective study of 496 patients with established foot at risk or diabetic foot, who were evaluated based on age, gender, type and duration of diabetes, foot at risk classification, and the presence of deformities, ulceration, and amputation. The presence of deformities, ulceration, and amputation was recorded in 45.9, 25.3, and 12.9 % of patients, respectively. As for diabetic foot classification, the great majority of our cohort had diabetic neuropathy (92.9 %). Approximately 30 % had neuro-ischemic disease and only 7.1 % had ischemic disease alone. Sixty-two percent of patients presented neuropathy with no signs of arteriopathy. Foot classification was as a significant predictor for the presence of ulcer (p = 0.009; OR = 3.2; 95 % CI = 1.18-7.3). Only male gender was a significant predictor for ulceration (p < 0.001). Predictors of amputation were male gender (p < 0.001; OR = 3.44 95 % CI = 1.81-6.56) and neuro-ischemic diabetic foot (p < 0.049; OR = 4.6; 95 % CI = 1.01-20.9). The predictors for diabetic foot were male gender and the presence of neuropathy. The combination of neuropathy and peripheral vascular disease adds significantly to the risk for amputation among patients with the diabetic foot syndrome. Men, presenting combined risk factors, should be a group receiving special attention and in the foot clinic, due to their potentially worse evolution.

  4. Charcot foot syndrome.

    PubMed

    Jeffcoate, W J

    2015-06-01

    Charcot foot syndrome is an uncommon complication of diabetes but is potentially devastating in its consequences. Outcome is made worse by widespread professional ignorance leading to delayed diagnosis, but it is also hampered by lack of understanding of its causes and lack of treatments with proven effectiveness, other than offloading. There remains a desperate need for studies into its causes as well as comparative audit and trials designed to determine the best treatment for this difficult condition. Such work can probably only be effectively carried out through the establishment of multicentre networks. Nevertheless, improved understanding in recent years of the likely role of inflammatory pathways has raised awareness of the multiple ways in which the effects of neuropathy may be manifest in the development of the Charcot foot. This awareness is also leading to the realization that similar processes may conceivably contribute to the refractoriness of other foot diseases in diabetes, including both chronic unhealing ulcers and osteomyelitis.

  5. Deep foot burns: effects of early excision and grafting.

    PubMed

    Shakirov, Babur M

    2011-12-01

    Few on the problem of foot burns can be found in the available scientific literature. It is necessary to mention that often deep foot burns occur in Central Asia since many natives still use the ancient means of heating called 'Sandal' during the winter months. Eighty-four patients with severe foot burns were treated in the Burn department of RCSUMA and the Inter-regional Burn Center, Uzbekistan. The patients were subdivided into two groups, depending upon the terms of performing operative intervention. There was no special allocation of patients to groups. Criteria for selection were isolated deep burns of the foot. As for the character of the injury, area of deep burn and the severity of injury, patients of the control and basic groups were not different. The first group included 34 patients on whom early excision was done using skin graft 4-5 days after resuscitation, and the second group consisted of 50 patients who were treated in the traditional way. Methods used on the first group, described in this article, helped to improve the general condition of patients, contributed to the restoration of their foot function, lessened joint deformities and post-burn contracture deformities, shortened their stay in hospital and also reduced expenses.

  6. 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

  7. Stereophotogrammetry and relief photography in the assessment of foot disorders.

    PubMed Central

    Craxford, A D; Rutherford, A; Evans, M S; Park, C

    1981-01-01

    Expanded polyethylene foam (Plastazote) is used in the treatment of rheumatoid, diabetic, and leprotic foot disorders. This paper describes a diagnostic use for this material. Two photographic techniques combine to give vivid and quantitative representations of foot deformities which are easily applicable to clinical use. Relief photography uses illumination to create an illusion of solidity in a 2-dimensional photography. Stereophotogrammetry produces contour plots from stereopairs of photographs of the Plastazote footprint. After use the impressions are trimmed and slipped into the patient's shoes in the same way as any other foam insole. Images PMID:7469529

  8. [Mycetoma pedis (Madura foot)].

    PubMed

    Vogel, H; Gonzales Echazarreta, R; Kniha, H; Vogel-Karl, B

    1983-01-01

    Mycetoma pedis or Madura foot is rare in central Europe but has a wide distribution in the tropics. In roentgendiagnostic there are a destruction of the cortical margin and lytic zones in the spongiosa. Older bone manifestations show sclerosis. Periosteal reaction provokes spicules and only seldom "onion peel" patterns. PMID:6666256

  9. Charcot foot in diabetes: farewell to the neurotrophic theory.

    PubMed

    Chantelau, E; Onvlee, G J

    2006-06-01

    Neuropathic osteoarthropathy is characterised by relatively painless swelling together with extensive damage in bones and joints, predominantly in the feet and ankles. The uncontrolled natural course of the condition leads to gross foot deformity, skin pressure ulceration, spreading infections, and sometimes amputation. Jean-Martin Charcot in 1883 described "Charcot foot" named after him in patients with tabes dorsalis insensitivity. Charcot believed that intrinsic bone weakness was the underlying condition, and was caused by neurogenic deficiencies in bone nutrition. His followers believed such dystrophy to be mediated by sympathetic denervation of the bone vasculature (neurotrophic, or neurovascular theory). Attempts to prove this theory were futile. A neurogenic circulatory disorder potentially relevant to bone nutrition could not be identified. Nowadays, Charcot foot is mostly seen in diabetic neuropathy, which has replaced syphilis as a frequent cause of peripheral nerve dysfunction. Recent studies in the diabetic Charcot foot and bone turnover indicate that the neurotrophic theory is a myth. The assumption of bone resorption due to sympathetic denervation proved to be false--sympathetic activity increases osteoclastic activity and thereby bone loss (sympathomimetic bone resorption). Except for the transient, inflammatory stage of the diabetic Charcot foot, there is no evidence of relevant osteoporosis or demineralisation of the foot skeleton in diabetes.

  10. Minimally invasive soft tissue release of foot and ankle contracture secondary to stroke.

    PubMed

    Boffeli, Troy J; Collier, Rachel C

    2014-01-01

    Lower extremity contracture associated with stroke commonly results in a nonreducible, spastic equinovarus deformity of the foot and ankle. Rigid contracture deformity leads to gait instability, pain, bracing difficulties, and ulcerations. The classic surgical approach for stroke-related contracture of the foot and ankle has been combinations of tendon lengthening, tendon transfer, osteotomy, and joint fusion procedures. Recovery after traditional foot and ankle reconstructive surgery requires a period of non-weightbearing that is not typically practical for these patients. Little focus has been given in published studies on minimally invasive soft tissue release of contracture. We present the case of a 61-year-old female with an equinovarus foot contracture deformity secondary to stroke. The patient underwent Achilles tendon lengthening, posterior tibial tendon Z lengthening, and digital flexor tenotomy of each toe with immediate weightbearing in a walking boot, followed by transition to an ankle-foot orthosis. The surgical principles and technique tips are presented to demonstrate our minimally invasive approach to release of foot and ankle contracture secondary to stroke. The main goal of this approach is to improve foot and ankle alignment for ease of bracing, which, in turn, will improve gait, reduce the risk of falls, decrease pain, and avoid the development of pressure sores. PMID:23890795

  11. Foot posture, foot function and low back pain: the Framingham Foot Study

    PubMed Central

    Menz, Hylton B.; Dufour, Alyssa B.; Riskowski, Jody L.; Hillstrom, Howard J.

    2013-01-01

    Objective. Abnormal foot posture and function have been proposed as possible risk factors for low back pain, but this has not been examined in detail. The objective of this study was to explore the associations of foot posture and foot function with low back pain in 1930 members of the Framingham Study (2002–05). Methods. Low back pain, aching or stiffness on most days was documented on a body chart. Foot posture was categorized as normal, planus or cavus using static weight-bearing measurements of the arch index. Foot function was categorized as normal, pronated or supinated using the centre of pressure excursion index derived from dynamic foot pressure measurements. Sex-specific multivariate logistic regression models were used to examine the associations of foot posture, foot function and asymmetry with low back pain, adjusting for confounding variables. Results. Foot posture showed no association with low back pain. However, pronated foot function was associated with low back pain in women [odds ratio (OR) = 1.51, 95% CI 1.1, 2.07, P = 0.011] and this remained significant after adjusting for age, weight, smoking and depressive symptoms (OR = 1.48, 95% CI 1.07, 2.05, P = 0.018). Conclusion. These findings suggest that pronated foot function may contribute to low back symptoms in women. Interventions that modify foot function, such as orthoses, may therefore have a role in the prevention and treatment of low back pain. PMID:24049103

  12. 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. PMID:3786010

  13. 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

    2015-01-01

    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

  14. 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.

  15. 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

  16. Chondroblastoma of the foot.

    PubMed

    Fink, B R; Temple, H T; Chiricosta, F M; Mizel, M S; Murphey, M D

    1997-04-01

    A total of 322 cases of chondroblastoma were referred to the Armed Forces Institute of Pathology between 1960 and 1990. Ten additional cases of chondroblastoma were treated at Walter Reed Army Medical Center between 1985 and 1993. Forty-two of these involved the foot, two of which were treated at Walter Reed Army Medical Center. Patients with chondroblastoma of the foot were male in 35 (81%) cases, with a mean age of 25.5 years, which was significantly different from the mean age of 17.3 years in patients with chondroblastoma of the long bones (P < 0.0001). Chondroblastoma of the foot is most commonly found in the posterior subchondral areas of the talus and calcaneus as well as in the calcaneal apophysis. Radiographically, the lesion was associated with an articular surface or apophyseal area in all cases and appeared radiolucent, with little to no matrix production. The margins were generally well defined. Cystic features were noted grossly and histologically in 24 (57%) specimens, a feature seen in only 21% of all chondroblastomas overall. Treatment consists of thorough curetting and bone grafting with good oncologic and functional results.

  17. The neuropathic diabetic foot.

    PubMed

    Rathur, Haris M; Boulton, Andrew J M

    2007-01-01

    Diabetic foot problems are common throughout the world, and result in major medical, social and economic consequences for the patients, their families, and society. Foot ulcers are likely to be of neuropathic origin and, therefore, are eminently preventable. Individuals with the greatest risk of ulceration can easily be identified by careful clinical examination of their feet: education and frequent follow-up is indicated for these patients. When infection complicates a foot ulcer, the combination can be limb-threatening, or life-threatening. Infection is defined clinically, but wound cultures assist in identification of causative pathogens. Tissue specimens are strongly preferred to wound swabs for wound cultures. Antimicrobial therapy should be guided by culture results, and although such therapy may cure the infection, it does not heal the wound. Alleviation of the mechanical load on ulcers (offloading) should always be a part of treatment. Plantar neuropathic ulcers typically heal in 6 weeks with nonremovable casts, because pressure at the ulcer site is mitigated and compliance is enforced. The success of other approaches to offloading similarly depends on the patient's adherence to the strategy used for pressure relief.

  18. The diabetic foot.

    PubMed

    Rathur, Haris M; Boulton, Andrew J M

    2007-01-01

    Diabetic foot problems are common throughout the world, resulting in major medical, social and economic consequences for the patients, their families, and society. Foot ulcers are more likely to be of neuropathic origin, and therefore eminently preventable. People at greatest risk of ulceration can easily be identified by careful clinical examination of the feet: education and frequent follow-up is indicated for these patients. When infection complicates a foot ulcer, the combination can be limb or life-threatening. Infection is defined clinically, but wound cultures assist in identifying the causative pathogens. Tissue specimens are strongly preferred to wound swabs for wound cultures. Antimicrobial therapy should be guided by culture results, and although such therapy may cure the infection, it does not heal the wound. Alleviation of the mechanical load on ulcers (offloading) should always be a part of treatment. Plantar neuropathic ulcers typically heal in 6 weeks with irremovable casting, because pressure at the ulcer site is mitigated and compliance is enforced. The success of other approaches to offloading similarly depends on the patients' adherence to the effectiveness of pressure relief.

  19. Quaternary deformation

    SciTech Connect

    Brown, R.D. Jr.

    1990-01-01

    Displaced or deformed rock units and landforms record the past 2 m.y. of faulting, folding, uplift, and subsidence in California. Properly interpreted, such evidence provides a quantitative basis for predicting future earthquake activity and for relating many diverse structures and landforms to the 5 cm/yr of horizontal motion at the boundary between the North American and Pacific plates. Modern techniques of geologic dating and expanded research on earthquake hazards have greatly improved our knowledge of the San Andreas fault system. Much of this new knowledge has been gained since 1965, and that part which concerns crustal deformation during the past 2 m.y. is briefly summarized here.

  20. 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

  1. 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.

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

    PubMed

    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

  3. Bearing capacity of shell strip footing on reinforced sand.

    PubMed

    Azzam, W R; Nasr, A M

    2015-09-01

    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.

  4. Bearing capacity of shell strip footing on reinforced sand.

    PubMed

    Azzam, W R; Nasr, A M

    2015-09-01

    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

  5. 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

  6. Pressure and the diabetic foot: clinical science and offloading techniques.

    PubMed

    Boulton, Andrew J M

    2004-05-01

    Diabetic foot ulceration is a common, yet in many cases an eminently preventable, complication that affects 1 in 20 patients with diabetes. Risk factors for ulceration include insensitivity (secondary to somatic neuropathy), high foot pressures, callus formation (a consequence of sympathetic neuropathy and high foot pressures), deformities (such as claw feet, prominent metatarsal heads, etc.), peripheral vascular disease, and most importantly, a past history of ulceration. None of these factors alone causes ulceration; thus, early identification and amelioration of these factors is a primary aim in foot ulcer prevention. A number of therapeutic approaches may help reduce ulcer incidence: these include therapeutic footwear, hosiery, and, potentially, liquid silicone injected under high-pressure areas. In the management of neuropathic ulcers, pressure relief is of the utmost importance, and total contact casting remains the "gold standard" means of achieving such pressure redistribution. The successful management of diabetic foot ulceration depends on a team approach, remembering that ulcers should heal if (1) the arterial circulation is intact, (2) pressure relief is achieved and maintained over the ulcer, and (3) infection is appropriately treated.

  7. 38 CFR 4.57 - Static foot deformities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Achilles tendon, the medial tilting of the upper border of the astragalus. This is an unfavorable... Achilles tendon, peroneal spasm due to adhesion about the peroneal sheaths, and other evidence of pain...

  8. 38 CFR 4.57 - Static foot deformities.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Achilles tendon, the medial tilting of the upper border of the astragalus. This is an unfavorable... Achilles tendon, peroneal spasm due to adhesion about the peroneal sheaths, and other evidence of pain...

  9. 38 CFR 4.57 - Static foot deformities.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Achilles tendon, the medial tilting of the upper border of the astragalus. This is an unfavorable... Achilles tendon, peroneal spasm due to adhesion about the peroneal sheaths, and other evidence of pain...

  10. 38 CFR 4.57 - Static foot deformities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Achilles tendon, the medial tilting of the upper border of the astragalus. This is an unfavorable... Achilles tendon, peroneal spasm due to adhesion about the peroneal sheaths, and other evidence of pain...

  11. 38 CFR 4.57 - Static foot deformities.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Achilles tendon, the medial tilting of the upper border of the astragalus. This is an unfavorable... Achilles tendon, peroneal spasm due to adhesion about the peroneal sheaths, and other evidence of pain...

  12. Importance and challenges of measuring intrinsic foot muscle strength

    PubMed Central

    2012-01-01

    Background Intrinsic foot muscle weakness has been implicated in a range of foot deformities and disorders. However, to establish a relationship between intrinsic muscle weakness and foot pathology, an objective measure of intrinsic muscle strength is needed. The aim of this review was to provide an overview of the anatomy and role of intrinsic foot muscles, implications of intrinsic weakness and evaluate the different methods used to measure intrinsic foot muscle strength. Method Literature was sourced from database searches of MEDLINE, PubMed, SCOPUS, Cochrane Library, PEDro and CINAHL up to June 2012. Results There is no widely accepted method of measuring intrinsic foot muscle strength. Methods to estimate toe flexor muscle strength include the paper grip test, plantar pressure, toe dynamometry, and the intrinsic positive test. Hand-held dynamometry has excellent interrater and intrarater reliability and limits toe curling, which is an action hypothesised to activate extrinsic toe flexor muscles. However, it is unclear whether any method can actually isolate intrinsic muscle strength. Also most methods measure only toe flexor strength and other actions such as toe extension and abduction have not been adequately assessed. Indirect methods to investigate intrinsic muscle structure and performance include CT, ultrasonography, MRI, EMG, and muscle biopsy. Indirect methods often discriminate between intrinsic and extrinsic muscles, but lack the ability to measure muscle force. Conclusions There are many challenges to accurately measure intrinsic muscle strength in isolation. Most studies have measured toe flexor strength as a surrogate measure of intrinsic muscle strength. Hand-held dynamometry appears to be a promising method of estimating intrinsic muscle strength. However, the contribution of extrinsic muscles cannot be excluded from toe flexor strength measurement. Future research should clarify the relative contribution of intrinsic and extrinsic muscles

  13. Neuropathic Minimally Invasive Surgeries (NEMESIS):: Percutaneous Diabetic Foot Surgery and Reconstruction.

    PubMed

    Miller, Roslyn J

    2016-09-01

    Patients with peripheral neuropathy associated with ulceration are the nemesis of the orthopedic foot and ankle surgeon. Diabetic foot syndrome is the leading cause of peripheral neuropathy, and its prevalence continues to increase at an alarming rate. Poor wound healing, nonunion, infection, and risk of amputation contribute to the understandable caution toward this patient group. Significant metalwork is required to hold these technically challenging deformities. Neuropathic Minimally Invasive Surgeries is an addition to the toolbox of management of the diabetic foot. It may potentially reduce the risk associated with large wounds and bony correction in this patient group. PMID:27524708

  14. 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

  15. The predictors of foot ulceration in patients with rheumatoid arthritis.

    PubMed

    Firth, Jill; Waxman, Robin; Law, Graham; Nelson, E Andrea; Helliwell, Philip; Siddle, Heidi; Otter, Simon; Butters, Violet; Baker, Lesley; Hryniw, Rosemary; Bradley, Sarah; Loughrey, Lorraine; Alcacer-Pitarch, Begonya; Davies, Samantha; Tranter, Jennifer

    2014-05-01

    This study was conducted to determine the predictors of foot ulceration occurring in patients with rheumatoid arthritis (RA) without diabetes. A multi-centre case control study was undertaken; participants were recruited from eight sites (UK). Cases were adults diagnosed with RA (without diabetes) and the presence of a validated foot ulcer, defined as a full thickness skin defect occurring in isolation on / below the midline of the malleoli and requiring > 14 days to heal. Controls met the same criteria but were ulcer naive. Clinical examination included loss of sensation (10g monofilament); ankle-brachial pressure index (ABPI); forefoot deformity (Platto); plantar pressures (PressureStat); RA disease activity (36 swollen/tender joint counts) and the presence of vasculitis. History taking included past ulceration/foot surgery; current medication and smoking status. Participants completed the Health Assessment Questionnaire (HAQ) and Foot Impact Scale. A total of 83 cases with 112 current ulcers and 190 ulcer naïve controls participated. Cases were significantly older (mean age 71 years; 95 % confidence interval [CI], 69-73 vs. 62 years, 60-64) and had longer RA disease duration (mean 22 years; 19-25 vs. 15, 13-17). Univariate analysis showed that risk of ulceration increases with loss of sensation; abnormality of ABPI and foot deformity. Plantar pressures and joint counts were not significant predictors. HAQ score and history of foot surgery were strongly associated with ulceration (odds ratio [OR] = 1.704, 95 % CI 1.274-2.280 and OR = 2.256, 95 % CI 1.294-3.932). Three cases and two controls presented with suspected cutaneous vasculitis. In logistic regression modelling, ABPI (OR = 0.04; 95 % CI, 0.01-0.28) forefoot deformity (OR = 1.14; 95 % CI, 1.08-1.21) and loss of sensation (OR = 1.22; 95 % CI, 1.10-1.36) predicted risk of ulceration. In patients with RA, ABPI, forefoot deformity and loss of sensation predict risk of ulceration

  16. Crustal deformation

    NASA Astrophysics Data System (ADS)

    Larson, Kristine M.

    1995-07-01

    Geodetic measurements of crustal deformation provide direct tests of geophysical models which are used to describe the dynamics of the Earth. Although geodetic observations have been made throughout history, only in the last several hundred years have they been sufficiently precise for geophysical studies. In the 19th century, these techniques included leveling and triangulation. Approximately 25 years ago, trilateration measurements were initiated by the USGS (United States Geological Survey) to monitor active faults in the United States. Several years later, NASA (National Aeronautics and Space Administration) begin an effort to measure plate tectonic motions on a global scale, using space geodetic techniques, VLBI (Very Long Baseline Interferometry) and SLR (Satellite Laser Ranging). The period covered by this report to the IUGG, 1991-1994, was a transition period in the field of crustal deformation. Trilateration measurements (previously the backbone of measurements across plate boundaries in the western United States and Alaska) have been abandoned. This system was labor-intensive, involved highly trained crews to carry out the observations, and only measured the length between sites. In addition, NASA drastically cut the budgets for VLBI and SLR during this period. Fixed site VLBI systems are still operational, but mobile VLBI measurements in North America have ceased. SLR measurements continue on a global scale, but the remaining crustal deformation measurements are now being made with the Global Positioning System (GPS). Nonetheless, because of the time scales involved, older geodetic data (including leveling, triangulation, and trilateration) continue to be important for many geophysical studies.

  17. Correlates of foot pain severity in adults with hallux valgus: a cross-sectional study

    PubMed Central

    2014-01-01

    Background Hallux valgus (HV) is highly prevalent and associated with progressive first metatarsophalangeal joint subluxation and osteoarthritis. The link between structural HV deformity and foot pain is unclear. This study investigated possible explanatory factors surrounding foot pain in HV, including radiographic HV angle and signs of joint degeneration. Methods Participants were 60 adults (53 female) with HV aged 20 to 75 years. Participant demographics and a range of radiographic, clinical and functional measures were considered potential correlates of foot pain. Self-reported foot pain (visual analogue scales and a dichotomous definition) was considered the dependent variable. Multivariate modelling was used to determine which characteristics and measures explained pain, with univariate analyses first used to screen potential variables. Results Approximately 20 to 30% of the variance in foot pain associated with HV could be explained by patient characteristics such as poorer general health status, lower educational attainment and increased occupational physical activity levels, in combination with some dynamic physical characteristics such as hallux plantarflexion weakness and reduced force-time integral under the second metatarsal during gait. Neither increasing lateral deviation of the hallux (HV angle) nor presence of first metatarsophalangeal joint osteoarthritis was associated with foot pain. Conclusions This study shows that passive structural factors, including HV angle, do not appear to be significant correlates of foot pain intensity in HV. Our data demonstrate the importance of considering patient characteristics such as general health and physical activity levels when assessing foot pain associated with HV. PMID:25028598

  18. Correction of a severe poliomyelitic equinocavovarus foot using an adjustable external fixation frame.

    PubMed

    Nomura, Issei; Watanabe, Koji; Matsubara, Hidenori; Nishida, Hideji; Shirai, Toshiharu; Tsuchiya, Hiroyuki

    2014-01-01

    One-stage surgical correction of severe equinocavovarus deformity can result in complications ranging from skin necrosis to tibial nerve palsy. Fewer complications have been reported when severe deformities were treated by gradual correction using external frames such as the Ilizarov external fixator or the Taylor Spatial Frame™. We describe a case of a 64-year-old female patient with severe poliomyelitic equinocavovarus whose deformity required her to ambulate using the dorsum of her right foot as a weightbearing surface. We treated the deformity with gradual correction using a Taylor Spatial Frame™, followed by ankle arthrodesis. At the most recent postoperative evaluation, 20 months after the initial surgery, the patient was pain free and ambulating on the sole of her right foot. PMID:23890796

  19. Posterior Ankle and Hind Foot Arthroscopy

    PubMed Central

    Gökkuş, Kemal; Aydın, Ahmet Turan

    2014-01-01

    Objectives: While anterior ankle arthroscopy is a widely accepted technique, posterior ankle/hind foot arthroscopy is still a relatively new procedure. The arthroscopic visualisation was often initially limited and vulnerabilty of the posteromedial neurovascular structures to injury scared orthopaedic surgeons. The goal of this review is to highlight the indications, and to present the long term follow up results of posterior ankle/hind foot arthroscopy. Methods: The study included 21 ankles in 21 patients (12 male and 9 female ).The mean age was 37.7 , the mean duration of preoperative symptoms 12.8 months . Arthroscopy performed with the patient prone , under general and spinal anesthesia with tourniquet hemostasis . Preoperative intravenous antibiotic prophylaxis is performed (cefazolin 1g) , sand bag placed under ipsilateral anteresuperior iliac spine to correct natural external rotated posture of the ankle and ankle is left hanging of the table so that it can moved freely during surgery. We applied noninvasive distraction method with simple rope which tied and knotted waist of the surgeon . The posterolateral and posteromedial portals which described by Van Dijk was utilized . The arthroscopic visualisation was often initially limited and careful debritement of some adipose tissue of the kager fat pad (Kager's fat pad, also known as the pre-Achilles fat pad) was necessary to create more space to aid visualization .The most valuable point to stay clear from trouble is to understand , know and aware where the flexor hallucis longus tendon exist .So neurovascular structures located beyond this tendon. Principally the process must advance into lateral to medial manner. The mean follow up period was 55 months. The most common preoperative diagnoses were osteochondral lesions of talus (ten ),painful os trigonum syndrome with (five )or without (three) FHL tenosynovitis (total eight ), posterior talofibular ligament thickenning (two ), Haglund’s deformity (one

  20. Foot landmarking for footwear customization.

    PubMed

    Luximon, Ameersing; Goonetilleke, Ravindra S; Tsui, Kwok L

    2003-03-15

    As consumers are becoming increasingly selective of what they wear on their feet, manufacturers are experiencing problems developing and fitting the right footwear. Literature suggests that shoes with a shape similar to feet may be comfortable because they attempt to maintain the feet in a neutral posture. The objective of this paper is to develop a metric to quantify mismatches between feet and lasts and also to be able to generate the two-dimensional outline of the foot using the minimum number of landmarks. Fifty Hong Kong Chinese were participants in the experiment. In addition to subject weight, height, foot length and foot width, the left foot outlines were drawn and 18 landmarks were marked on each of the two-dimensional foot outlines. A step-wise procedure was used to reduce the chosen 18 landmarks to eight, such that the mean absolute negative error (an indicator of 'tightness') between the foot outline and the modelled curve was 1.3 mm. These eight landmarks seem to show an improvement over those proposed by other researchers, thus showing the importance of choosing the right landmarks for modelling the foot. The positive and negative absolute errors were on average 1.8 mm and 1.3 mm respectively. Moreover, the mean errors for the toe region and for the rest of the foot were 1.7 mm and 1.6 mm respectively. The results indicate that the foot outline, an important component for footwear functionality and fitting, may be modelled using eight critical landmarks.

  1. Inflammatory Osteolysis in Diabetic Neuropathic (Charcot) Arthropathies of the Foot

    PubMed Central

    Sinacore, David R; Hastings, Mary K; Bohnert, Kathryn L; Fielder, Faye A; Villareal, Dennis T; Blair, Vilray P; Johnson, Jeffrey E

    2008-01-01

    Objective: Osteolysis and low bone mineral density (BMD) are underappreciated consequences of several chronic diseases that may elevate the risk for fracture. The purpose of this study was to assess tarsal BMD associated with acute inflammation (ie, inflammatory osteolysis) in individuals with chronic diabetes mellitus (DM), peripheral neuropathy (PN), and recent-onset neuropathic (Charcot) arthropathy (NCA) of the foot. Research Design and Methods: This was a case-control study of 32 people (11 men, 21 women) with DM, PN, and NCA of the foot or ankle. The subjects with DM, PN, and NCA were compared with 64 age-, sex-, and race-matched control subjects (24 men, 40 women) without DM, PN or NCA. Within the first 3 weeks of cast immobilization, BMD was estimated in both calcanei using quantitative ultrasonometry. Acute inflammation was confirmed by comparing skin temperature differences between the feet of the subjects with DM, PN, and NCA and the feet of the control subjects. Results: Skin temperature differences averaged 6.7°F (SD=4.0°F) (involved foot minus noninvolved foot) in the feet of the subjects with DM, PN, and NCA compared with 0.0°F (SD=1.3°F) in the feet of the control subjects. Calcaneal BMD averaged 384 mg/cm2 (SD=110) in the involved feet and 467 mg/cm2 (SD=123) in the noninvolved feet of the subjects with DM, PN, and NCA and 545 mg/cm2 (SD=121) in combined right and left feet of the control subjects. Conclusions: Inflammation in individuals with DM, PN, and NCA may contribute to or exacerbate a rapid loss of BMD. Inflammatory osteolysis may be a prominent factor responsible for both the spontaneous onset of neuropathic fracture and the insidious and progressive foot deformity that is the hallmark of the chronic Charcot foot. PMID:18801857

  2. 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.

  3. 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.

  4. 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...

  5. 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...

  6. 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...

  7. 24 CFR 3285.312 - Footings.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (incorporated by reference, see § 3285.4). (3) ABS footing pads. (i) ABS footing pads are permitted, provided... 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...

  8. 24 CFR 3285.312 - Footings.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (incorporated by reference, see § 3285.4). (3) ABS footing pads. (i) ABS footing pads are permitted, provided... 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...

  9. Dislocation processes and deformation twinning in nanocrystalline Al.

    SciTech Connect

    Yamakov, V.; Wolf, D.; Phillpot, S.R.; Gleiter, H.

    2002-01-29

    Using a recently developed, massively parallel molecular-dynamics (MD) code for the simulation of polycrystal plasticity, we analyze for the case of nanocrystalline Al the complex interplay among various dislocation and grain-boundary processes during low-temperature deformation. A unique aspect of this work, arising from our ability to deform to rather large plastic strains and to consider a rather large grain size, is the observation of deformation under very high grain-boundary and dislocation densities, i.e., in a deformation regime where they compete on an equal footing. We are thus able to identify the intra- and intergranular dislocation and grain-boundary processes responsible for the extensive deformation twinning observed in our simulations. This illustrates the ability of this type of simulations to capture novel atomic-level insights into the underlying deformation mechanisms not presently possible experimentally. smaller grain size, mobile dislocations must be nucleated from other sources, such as the GBs or grain junctions.

  10. The Diabetic Foot: The Never-Ending Challenge.

    PubMed

    Peter-Riesch, Bettina

    2016-01-01

    Diabetes, a major public health concern, is increasing in prevalence worldwide. A diabetic patient has an up to 25% lifetime risk of developing a foot ulcer condition that predisposes that patient to lower-extremity amputation. The underlying pathology is diabetic peripheral neuropathy and peripheral arterial disease (PAD) associated with deformities of foot anatomy due to motor neuropathy. Trauma, often secondary to ill-fitting shoes, precipitates skin breakdown, whereas PAD determines the prognosis for healing. Whenever optimal offloading is guaranteed, a neuropathic ulcer will heal, whereas an ulceration compromised by even a minor degree of arterial insufficiency has little chance of healing without revascularization. The population presenting with diabetic foot ulcers has shown a clear shift from neuropathic ulcers to neuro-ischaemic ulcers over the last two decades, underscoring the necessity to adapt management strategies to this condition. Cohort studies (the Eurodiale study group) teach us that the underlying problems are an absence of assessment of PAD, underuse of imaging and late referral for revascularization. Regarding reducing amputation rates in diabetes, a highly preventable complication, the situation is far from being under control. Prevention strategies targeting the high-risk population to avoid ulcer recurrence, optimized management by multidisciplinary foot care teams, integrated care with a clear definition of the patient itinerary and anticipated action to ameliorate ischaemia are promising options for the future.

  11. Living with Diabetes: Foot Complications

    MedlinePlus

    ... area and to prevent the ulcer from returning. Poor Circulation Poor circulation (blood flow) can make your foot less ... can control some of the things that cause poor blood flow. Don't smoke; smoking makes arteries ...

  12. Foot evaluation by infrared imaging.

    PubMed

    DiBenedetto, Margarete; Yoshida, Michael; Sharp, Mark; Jones, Bruce

    2002-05-01

    For better assessment of foot injury severity during basic military training, we evaluated a simple noninvasive technique: thermography. With this infrared imaging method, we determined normal foot parameters (from 30 soldiers before training), thermographic findings in different foot stress fractures (from 30 soldiers so diagnosed), and normal responses to abnormal stresses in 30 trainees who underwent the same training as the previous group but did not have musculoskeletal complaints. We found that normal foot thermograms show onion peel-like progressive cooling on the plantar surface, with a medially located warm center at the instep. Thermograms of injured feet show areas of increased heat, but excessive weight-bearing pressures on feet, new shoes, or boots also cause increased infrared emission even without discomfort. Differentiation remains difficult; however, thermography can detect injury early. It does not reveal exact diagnoses, but its greatest benefit is easy follow-up to monitor severity and healing. PMID:12053846

  13. Sesamoid Injuries in the Foot

    MedlinePlus

    ... the big toe “pushes off” during walking and running. The sesamoids also serve as a weight-bearing ... on the ball of the foot when walking, running, and jumping. Sesamoid injuries can involve the bones, ...

  14. Foot, leg, and ankle swelling

    MedlinePlus

    Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Painless swelling may affect both legs and may include the calves or ... of gravity makes the swelling most noticeable in the lower ...

  15. 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.

  16. Approach and treatment of the adult acquired flatfoot deformity.

    PubMed

    Vulcano, Ettore; Deland, Jonathan T; Ellis, Scott J

    2013-12-01

    Adult acquired flatfoot deformity (AAFD), embraces a wide spectrum of deformities. AAFD is a complex pathology consisting both of posterior tibial tendon insufficiency and failure of the capsular and ligamentous structures of the foot. Each patient presents with characteristic deformities across the involved joints, requiring individualized treatment. Early stages may respond well to aggressive conservative management, yet more severe AAFD necessitates prompt surgical therapy to halt the progression of the disease to stages requiring more complex procedures. We present the most current diagnostic and therapeutic approaches to AAFD, based on the most pertinent literature and our own experience and investigations. PMID:23765382

  17. Diabetic foot ulcer--A review on pathophysiology, classification and microbial etiology.

    PubMed

    Noor, Saba; Zubair, Mohammad; Ahmad, Jamal

    2015-01-01

    As the prevalence of diabetes is increasing globally, secondary complications associated to this endocrinal disorder are also ascending. Diabetic foot ulcers are potentially modifying complications. Disruption of harmony in glucose homeostasis causes hyperglycemic status, results in activation of certain metabolic pathways which in their abnormal state subsequently leads to development of vascular insufficiency, nerve damages headed by ulceration in lower extremity due to plantar pressures and foot deformity. Insult to foot caused by trauma at the affected site goes unnoticeable to patient due to loss of sensation. Among the above mention causes, resistance to infection is also considered as chief modulator of pathophysiological image of diabetic foot lesions. Healing as well as non-healing nature of ulcer relies upon the wound microbial communities and the extent of their pathogenicity. A validated classification system of foot ulcer is primarily necessary for clinicians in management of diabetic foot problems. Another aspect which needs management is proper identification of causative pathogen causing infection. The way of approaches presently employed in the diagnosis for treatment of foot ulcer colonized by different microbes is conventional techniques. Conventional diagnostic methods are widely acceptable since decades. But in recent years newly invented molecular techniques are exploring the use of 16S ribosomal regions specific to prokaryotes in bacterial identification and quantification. Molecular techniques would be a better choice if engaged, in finding the specific species harboring the wound.

  18. 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.

  19. 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.

  20. 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.

  1. The Charcot Foot in Diabetes

    PubMed Central

    Frykberg, Robert G.; Armstrong, David G.; Boulton, Andrew J.M.; Edmonds, Michael; Van, Georges Ha; Hartemann, Agnes; Game, Frances; Jeffcoate, William; Jirkovska, Alexandra; Jude, Edward; Morbach, Stephan; Morrison, William B.; Pinzur, Michael; Pitocco, Dario; Sanders, Lee; Wukich, Dane K.; Uccioli, Luigi

    2011-01-01

    The diabetic Charcot foot syndrome is a serious and potentially limb-threatening lower-extremity complication of diabetes. First described in 1883, this enigmatic condition continues to challenge even the most experienced practitioners. Now considered an inflammatory syndrome, the diabetic Charcot foot is characterized by varying degrees of bone and joint disorganization secondary to underlying neuropathy, trauma, and perturbations of bone metabolism. An international task force of experts was convened by the American Diabetes Association and the American Podiatric Medical Association in January 2011 to summarize available evidence on the pathophysiology, natural history, presentations, and treatment recommendations for this entity. PMID:21868781

  2. The foot and ankle examination.

    PubMed

    Papaliodis, Dean N; Vanushkina, Maria A; Richardson, Nicholas G; DiPreta, John A

    2014-03-01

    Most foot and ankle disorders can be diagnosed after a proper history and clinical examination and can be effectively managed in a primary care setting. It is important to assess the entirety of patient disorders that present as they can be multifactorial in cause. A broad differential should include disorders of bones, joints, muscles, neurovasculature, and surrounding soft tissue structures. Physical examination should be thorough and focused on inspection, palpation, range of motion, and appropriate special tests when applicable. This article highlights some of the salient features of the foot and ankle examination and diagnostic considerations.

  3. Find an Orthopaedic Foot and Ankle MD/DO

    MedlinePlus

    ... AOFAS / FootCareMD / Find a Surgeon Find an Orthopaedic Foot & Ankle Surgeon Page Content The Orthopaedic Distinction Who are Orthopaedic Foot & Ankle Surgeons? Orthopaedic foot and ankle surgeons are ...

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

    MedlinePlus

    ... can sometimes occur in adults. Symptoms of hand, foot, and mouth disease include fever, mouth sores, and a skin rash. More About Hand, Foot, and Mouth Disease (HFMD) Describes causes of the disease, its symptoms, ...

  5. 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 ...

  6. Sports Injuries to the Foot and Ankle

    MedlinePlus

    ... Field Hockey Football Injuries Golf Injuries Lacrosse Rugby Running Soccer Softball Tennis Volleyball Find an ACFAS Physician ... Foot and Ankle Although golf does not involve running or jumping, injuries can occur to the foot ...

  7. 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

  8. 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.

  9. 29 CFR 1910.136 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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) General... areas where there is a danger of foot injuries due to falling or rolling objects, or objects...

  10. 29 CFR 1918.104 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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 Foot... in areas where there is a danger of foot injuries due to falling or rolling objects or...

  11. 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...

  12. 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...

  13. 29 CFR 1918.104 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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 Foot... in areas where there is a danger of foot injuries due to falling or rolling objects or...

  14. 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...

  15. 29 CFR 1910.136 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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) General... areas where there is a danger of foot injuries due to falling or rolling objects, or objects...

  16. 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...

  17. 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...

  18. 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....

  19. 29 CFR 1915.156 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 7 2011-07-01 2011-07-01 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 29 CFR 1917.94 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 7 2011-07-01 2011-07-01 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...

  5. 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...

  6. 29 CFR 1910.136 - Foot protection.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 5 2014-07-01 2014-07-01 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...

  7. 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...

  8. 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...

  9. 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...

  10. 29 CFR 1915.156 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 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...

  11. 33 CFR 142.33 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 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 Foot... for foot injury to occur shall wear footwear meeting the specifications of ANSI Z41, except...

  12. 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...

  13. 33 CFR 142.33 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 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 Foot... for foot injury to occur shall wear footwear meeting the specifications of ANSI Z41, except...

  14. 29 CFR 1917.94 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 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...

  15. Why Does My Foot Fall Asleep?

    MedlinePlus

    ... Help White House Lunch Recipes Why Does My Foot Fall Asleep? KidsHealth > For Kids > Why Does My Foot Fall Asleep? Print A A A Text Size ... while you might have lost feeling in your foot, it might have felt heavy, or you might ...

  16. 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

  17. Nonoperative management of adult flatfoot deformities.

    PubMed

    Marzano, Roger

    2014-07-01

    Managing those with adult flatfoot deformities can be quite challenging, and the methods and devices used are wide-ranging based on the experience of the managing physician and the experience of the provider of the orthotic devices. A thorough biomechanical assessment is paramount to provide the most successful treatment due to the wide range of pathologic abnormalities and pathomechanics that lead to this painful disorder. Taking away pain while improving function for any patient is a rewarding aspect of clinical foot care, and the information covered in this article should arm the practitioner, or surgeon, with viable alternatives to surgical management.

  18. 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. PMID:27190996

  19. 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

  20. 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.

  1. 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

  2. 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. PMID:26406066

  3. Reconstruction of multiplanar deformity of the hindfoot and midfoot with internal fixation techniques.

    PubMed

    Dreher, Thomas; Hagmann, Sebastién; Wenz, Wolfram

    2009-09-01

    Reconstruction surgery of the midand hindfoot is a demanding challenge for foot surgeons. Satisfactory results depend not only on surgical technique and skills but also on the knowledge of underlying disorders, pathomechanics, and indication criteria. The cavovarus foot, the planovalgus foot, and Charcot's foot are some of the most challenging foot deformities, requiring different surgical strategies for their correction. Most of the osteotomies and fusions in children and adults can be fixed with transcutaneous Kirschner wires, which are inexpensive and easy to use and remove. The use of alternative fixation systems such as cannulated screws, compression screws, or angle-stable locking plates depends on patient age, vascular situation, risk for nonunion, and underlying pathology.

  4. [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.

  5. Strength of footing with punching shear preventers.

    PubMed

    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

  6. 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

  7. Synthetic Gecko Foot-hairs from Multiwalled Carbon Nanotubes

    NASA Astrophysics Data System (ADS)

    Dhinojwala, Ali

    2006-03-01

    The mechanism that allows a gecko lizard to climb any vertical surface and hang from a ceiling with one toe has attracted considerable interest and awe for over two millennia. Recent studies have discovered that the gecko's ability to defy gravity comes from its remarkable feet and toes. Each five-toed foot is covered with microscopic elastic hairs called setae. The ends of these hairs split into spatulas which come in contact with the surface and induce enough intermolecular [van der Waals, (VdW)] forces to hold them in place. Similarly, the same VdW forces act between our two hands when they are held together, but in this case, they do not stick to each other. The reason is that the roughness of our hands prevents them from coming close to each other at separations relevant for VdW forces. On the other hand, based on the gecko's foot anatomy, if our hands were made up of tiny elastic structures that were able to deform or bend at different length scales in accordance with the contact surface and correct for the roughness, then perhaps our hands could also adhere to the surfaces we touch. In my talk, I will present the recent advances we have made in fabricating polymer surfaces with multiwalled carbon nanotube hairs with strong nanometer-level adhesion forces that are 200 times higher than those observed for Gecko foot-hairs. This fabrication process allows the flexibility to create structures that are found in nature on the Gecko's foot and offer excellent potential for applications as dry adhesives for space, microelectronics and MEMS devices. This work was done in collaboration with Betul Yurdumakan, Nachiket Raravikar and Pulickel Ajayan.

  8. 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. PMID:26260010

  9. 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. PMID:24659509

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. Nonoperative treatment of neuro-osteoarthropathy of the foot: do we need new criteria?

    PubMed

    Chantelau, Ernst; Kimmerle, Renate; Poll, Ludger W

    2007-07-01

    The worst manifestation of neuro-osteoarthropathy of the pain-insensitive foot is the Charcot foot with its devastating osteoarticular destructions and irreversible deformities. New diagnostic tools such as MRI have revealed that mechanical injury and overuse is the origin of the condition. Traditionally, only feet with bone and joint damage apparent on plain radiographs (fracture and dislocation injuries) have undergone nonoperative treatment with off-loading and immobilization; however, treating painless, seemingly asymptomatic nonfracture injuries (bone bruise or bone marrow edema) with off-loading and immobilization has proven highly effective in preventing the Charcot foot. Whether pharmaceutical treatment has a role in terms of prevention or healing of osteoarticular destructions remains to be demonstrated.

  15. Bunionette Deformity Correction

    MedlinePlus

    ... Midfoot Ailments of the Heel Ailments of the Big Toe Ailments of the Smaller Toes Diabetic Foot ... Procedures Treatments of the Ankle Treatments of the Big Toe Treatments of the Heel Treatments of the ...

  16. [The organization of specialized care in case of pathology of foot and talocrural articulation].

    PubMed

    Pakhomov, I A

    2010-01-01

    The nozoological structure of podiatric pathology in Novosibirsk oblast is represented mainly by the injuries of talocrural articulation (39.2% of examined patients), deformation of foot (20.7%) and degenerative lesion of foot (15.9%), fractures of heel bone (4.2%). This pathology has higher social significance. The main cause of disability is the deforming arthritis of talocrural articulation (48.5%) and subtalar articulation (20.3%). The model of specialized podiatric care was developed and approved in the functioning of Novosibirsk specialized podiatric center. The model includes outpatient, diagnostic, treatment, rehabilitation stages. The implementation of this approach permits to avoid the re-appealability to municipal medical care system and application to the specialized medical institution. This approach precipitates the period of care delivering and decreases the possibility of disabling patients due to non-effective treatment of podiatric pathology in common curative institution.

  17. Laboratory evaluation of footings for lunar telescopes

    NASA Technical Reports Server (NTRS)

    Chua, Koon M.; Golis, Kelly M.; Johnson, Stewart W.

    1992-01-01

    Presented here are the results of laboratory experiments with diffferent footing shapes for lunar telescopes. These experiments used a variety of soils including some to simulate regolith response. Based on what is known of regolith and regolith-structure interaction, a shallow-multiple-contact points footing foundation can be adequately designed to support lunar telescopes. Plane-strain load-displacement tests were conducted with different footings and different lunar simulants in a deep transparent plexiglass container. The model footings considered include the rectangular, hemispherical, and spudcan designs. Simulants used to reproduce the mechanical properties of the lunar regolith were fly ash, crushed basalt with and without glass, and a processed lunar simulant. Load-displacement curves were obtained for the different footings in Ottawa sand and in the crushed basalt with glass. The spudcan footing was found to be self-digging and yet stiff, thus providing excellent lateral stability in a large variety of soils.

  18. Diabetic foot ulcer: assessment and management.

    PubMed

    Saraogi, Ravi Kant

    2008-02-01

    Diabetic foot ulcer is a rising health problem with rising prevalence of diabetes. It is the most important cause of non-traumatic foot amputations. Diabetic foot ulcers are primarily due to neuropathy and/or ischaemia, and are frequently complicated by infection. Up to 85% of all diabetic foot related problems are preventable through a combination of good foot care and appropriate education for patients and healthcare providers. The holistic care of diabetic foot ulcer patients requires a multidisciplinary team approach. Apart from blood sugar control, treatment of ulcer involves debridement, offloading, appropriate dressings, vascular maintenance and infection control. Use of adjunctive treatments such as various growth factors, skin replacement dressings and vacuum assisted closure will accelerate healing in selected cases.

  19. Treatment of nonunion and malunion of trauma of the foot and ankle using external fixation.

    PubMed

    Molloy, Andrew Peter; Roche, Andy; Narayan, Badri

    2009-09-01

    Salvage of nonunion and malunion of trauma of the foot and ankle is often challenging surgery. Internal fixation provides the mainstay of most orthopedic surgeons' treatment of these conditions. Patient systemic factors, local factors, and the complex nature of these often multiplanar deformities may make external fixation a more viable option. This article provides an overview of the principles and results of the use of external fixation. PMID:19712890

  20. 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

  1. Extracorporeal shockwave therapy in diabetic foot ulcers.

    PubMed

    Wang, Ching-Jen; Cheng, Jai-Hong; Kuo, Yur-Ren; Schaden, Wolfgang; Mittermayr, Rainer

    2015-12-01

    Diabetic foot ulcers (DFUs) are among the most common foot disorders with ulceration, infection, and gangrene that may ultimately lead to lower extremity amputation. The goals of treatment include the control of diabetes and proper shoe wear. An effective therapy and appropriate foot care are important in wound healing in DFUs. Recently, extracorporeal shockwave therapy (ESWT) was reported to significantly promote and accelerate the healing of complex soft tissue wounds as compared to the standard methods of treatment in DFUs. ESWT showed positive results in short-term and long-term outcomes in diabetic patients suffering from foot ulcers. In this article, we review the clinical results of ESWT in DFUs.

  2. 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.

  3. 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.

  4. 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. PMID:24479742

  5. 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.

  6. 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.

  7. The diabetic foot: a review.

    PubMed

    Ricco, J B; Thanh Phong, L; Schneider, F; Illuminati, G; Belmonte, R; Valagier, A; Régnault De La Mothe, G

    2013-12-01

    Diabetic foot ulceration (DFU) is among the most frequent complications of diabetes. Neuropathy and ischaemia are the initiating factors and infection is mostly a consequence. We have shown in this review that any DFU should be considered to have vascular impairment. DFU will generally heal if the toe pressure is >55 mmHg and a transcutaneous oxygen pressure (TcPO2) <30 mmHg has been considered to predict that a diabetic ulcer may not heal. The decision to intervene is complex and made according to the symptoms and clinical findings. If both an endovascular and a bypass procedure are possible with an equal outcome to be expected, endovascular treatments should be preferred. Primary and secondary mid-term patency rates are better after bypass, but there is no difference in limb salvage. Bedridden patients with poor life expectancy and a non-revascularisable leg are indications for performing a major amputation. A deep infection is the immediate cause of amputation in 25% to 50% of diabetic patients. Patients with uncontrolled abscess, bone or joint involvement, gangrene, or necrotising fasciitis have a "foot-at risk" and need prompt surgical intervention with debridement and revascularisation. As demonstrated in this review, foot ulcer in diabetic is associated with high mortality and morbidity. Early referral, non-invasive vascular testing, imaging and intervention are crucial to improve DFU healing and to prevent amputation. Diabetics are eight to twenty-four times more likely than non-diabetics to have a lower limb amputation and it has been suggested that a large part of those amputations could be avoided by an early diagnosis and a multidisciplinary approach.

  8. The diabetic foot: a review.

    PubMed

    Ricco, J B; Thanh Phong, L; Schneider, F; Illuminati, G; Belmonte, R; Valagier, A; Régnault De La Mothe, G

    2013-12-01

    Diabetic foot ulceration (DFU) is among the most frequent complications of diabetes. Neuropathy and ischaemia are the initiating factors and infection is mostly a consequence. We have shown in this review that any DFU should be considered to have vascular impairment. DFU will generally heal if the toe pressure is >55 mmHg and a transcutaneous oxygen pressure (TcPO2) <30 mmHg has been considered to predict that a diabetic ulcer may not heal. The decision to intervene is complex and made according to the symptoms and clinical findings. If both an endovascular and a bypass procedure are possible with an equal outcome to be expected, endovascular treatments should be preferred. Primary and secondary mid-term patency rates are better after bypass, but there is no difference in limb salvage. Bedridden patients with poor life expectancy and a non-revascularisable leg are indications for performing a major amputation. A deep infection is the immediate cause of amputation in 25% to 50% of diabetic patients. Patients with uncontrolled abscess, bone or joint involvement, gangrene, or necrotising fasciitis have a "foot-at risk" and need prompt surgical intervention with debridement and revascularisation. As demonstrated in this review, foot ulcer in diabetic is associated with high mortality and morbidity. Early referral, non-invasive vascular testing, imaging and intervention are crucial to improve DFU healing and to prevent amputation. Diabetics are eight to twenty-four times more likely than non-diabetics to have a lower limb amputation and it has been suggested that a large part of those amputations could be avoided by an early diagnosis and a multidisciplinary approach. PMID:24126512

  9. Stress Fractures of the Foot.

    PubMed

    Hossain, Munier; Clutton, Juliet; Ridgewell, Mark; Lyons, Kathleen; Perera, Anthony

    2015-10-01

    Stress fractures of the foot and ankle may be more common among athletes than previously reported. A low threshold for investigation is warranted and further imaging may be appropriate if initial radiographs remain inconclusive. Most of these fractures can be treated conservatively with a period of non-weight-bearing mobilization followed by gradual return to activity. Early surgery augmented by bone graft may allow athletes to return to sports earlier. Risk of delayed union, nonunion, and recurrent fracture is high. Many of the patients may also have risk factors for injury that should be modified for a successful outcome.

  10. Treatment of Progressive First Metatarsophalangeal Hallux Valgus Deformity: A Biomechanically Based Muscle-Strengthening Approach.

    PubMed

    Glasoe, Ward M

    2016-07-01

    Synopsis Hallux valgus is a progressive deformity of the first metatarsophalangeal joint that changes the anatomy and biomechanics of the foot. To date, surgery is the only treatment to correct this deformity, though the recurrence rate is as high as 15%. This clinical commentary provides instruction in a strengthening approach for treatment of hallux valgus deformity, by addressing the moment actions of 5 muscles identified as having the ability to counter the hallux valgus process. Unlike surgery, muscle strengthening does not correct the deformity, but, instead, reduces the pain and associated gait impairments that affect the mobility of people who live with the disorder. This review is organized in 4 parts. Part 1 defines the terms of foot motion and posture. Part 2 details the anatomy and biomechanics, and describes how the foot is changed with deformity. Part 3 details the muscles targeted for strengthening; the intrinsics being the abductor hallucis, adductor hallucis, and the flexor hallucis brevis; the extrinsics being the tibialis posterior and fibularis longus. Part 4 instructs the exercise and reviews the related literature. Instructions are given for the short-foot, the toe-spread-out, and the heel-raise exercises. The routine may be performed by almost anyone at home and may be adopted into physical therapist practice, with intent to strengthen the foot muscles as an adjunct to almost any protocol of care, but especially for the treatment of hallux valgus deformity. J Orthop Sports Phys Ther 2016;46(7):596-605. Epub 6 Jun 2016. doi:10.2519/jospt.2016.6704. PMID:27266887

  11. 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

  12. 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

  13. On Sound Footing: The Health of Your Feet

    MedlinePlus

    ... link, please review our exit disclaimer . Subscribe On Sound Footing The Health of Your Feet Your feet ... search Features A Bang to the Brain On Sound Footing Wise Choices Links Foot Health Tips Use ...

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

    MedlinePlus

    ... Genetics Home Health Conditions hand-foot-genital syndrome hand-foot-genital syndrome Enable Javascript to view the ... boxes. Download PDF Open All Close All Description Hand-foot-genital syndrome is a rare condition that ...

  15. The Vertical Coseismic Deformation Field of the Wenchuan Earthquake Based on the Combination of GPS and InSAR

    NASA Astrophysics Data System (ADS)

    Shan, Xin-jian; Qu, Chun-yan; Guo, Li-min; Zhang, Guo-hong; Song, Xiao-gang; Jiang, Yu; Zhang, Gui-Fang; Wen, Shao-yan; Wang, Chi-sheng; Xu, Xiaobo; Liu, Yunhua

    2015-05-01

    Vertical coseisimic deformation near seismogenic fault provides meaningful information for understanding of rupture characteristics of the seismogenic fault and focal mechanism. Taking Wenchuan thrust earthquake for an example, we interpolate GPS horizontal observed deformation using Biharmonic spline interpolation and derive them into East-Westward or North-Southward deformation field. We first use reliable GPS observed value to correct InSAR reference point and to unify both GPS and InSAR coordinate frame, and then obtain a continuous vertical deformation field by combined calculation of GPS and InSAR LOS deformation field. The results show that the vertical deformation of both hanging wall and foot wall of the fault decreases rapidly, with deformation greater than 30cm within 50km across the fault zone. The uneven distribution of the vertical deformation has some peak values at near fault, mainly distributed at the southern section (Yingxiu), the middle (Beichuan) and the northern end (Qingchuan) of the seismogenic fault.

  16. 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.

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

    PubMed

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

    2015-01-01

    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

  18. 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.

  19. “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

  20. 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.

  1. [The "diabetic foot" syndrome. An overview].

    PubMed

    Chantelau, E

    1999-01-01

    Amputation has been used most frequently to treat the diabetic foot syndrome, occlusive microangiopathy being suspected as the underlying cause. This paradigm is obsolete: most diabetic foot lesions are due to traumatic painless (neuropathic) infections. Evidence is presented for alternative treatment strategies to effectively reduce exorbitant amputation rates in diabetic patients.

  2. Comparative Anatomy of the Hand and Foot.

    ERIC Educational Resources Information Center

    Postiglione, Ralph A.

    1983-01-01

    Presents an activity to articulate comparison of the hand and foot. Students carefully cut out corresponding hand/foot parts (carpals, tarsals, metacarpals, metatarsals, and phalanges) from enlarged diagrams and paste them on paper for comparative analysis. Sample student inferences and diagrams used for the activity are provided. (JN)

  3. Efficient foot motor control by Neymar's brain.

    PubMed

    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.

  4. 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...

  5. 24 CFR 3285.312 - Footings.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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...

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

    MedlinePlus

    ... Fashion’s Pandora’s Box? A A A | Print | Share Cosmetic Foot Surgery: Fashion’s Pandora’s Box? Foot and ankle ... extreme and imprudent as it may sound, the cosmetic surgery craze isn't just for faces anymore- ...

  7. 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-...

  8. 24 CFR 3285.312 - Footings.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... methods and practices that prevent the effects of frost heave by one of the following methods: (1) Conventional footings. Conventional footings must be placed below the frost line depth for the site unless an... frost line depth is not available from the LAHJ, a registered professional engineer,...

  9. Basketball injuries of the foot and ankle.

    PubMed

    McDermott, E P

    1993-04-01

    Foot and ankle injuries in basketball are discussed in three unrelated categories in this article. This includes a practical differential diagnosis of ankle sprains, acute conditions of the mid and hindfoot, overuse syndromes of nerve entrapment, fascial strain, synovitis, joint subluxation, and inflammation resulting from repetitive stress. The diagnosis and treatment of tendon inflammation of the extrinsic foot musculature is also reviewed.

  10. A national approach to diabetes foot risk stratification and foot care.

    PubMed

    Leese, G P; Stang, D; Pearson, D W

    2011-08-01

    The Scottish Diabetes Foot Action Group (SDG) has developed and introduced a national strategy plan for diabetic foot care across Scotland. This has involved the implementation of an evidence-based national foot screening and risk stratification programme that has already covered 61% of the population in just the first two years. Nationally agreed patient information foot leaflets and professional education material have been introduced, and a consensus for antibiotic use in the diabetic foot has been published. Information on multidisciplinary specialist foot services has been collected, indicating that 58% of Health Board areas have consultants with dedicated sessions in their job plan to a foot clinic, and 42% had integrated orthotic involvement. The SDG aims to increase these figures. Work has been undertaken to support local podiatry networks and improve communication between the specialist centre and the community. At a national level the SDG is working with Foot in Diabetes UK (FDUK) to recognize key podiatry skills by developing core competencies and a competency framework for the diabetes podiatrist and diabetes orthotist. The annual Scottish Diabetes Survey indicates some improvement in amputation rates with prevalence decreasing from 0.8% to 0.5%, and improved recording of foot ulceration at a national level. This national strategy has helped highlight the importance and difficulties facing diabetes foot care and should help to continue to improve the quality of care of people with diabetes who have foot-related problems.

  11. Deformable bearing seat

    NASA Technical Reports Server (NTRS)

    Moreman, O. S., III (Inventor)

    1977-01-01

    A deformable bearing seat is described for seating a bearing assembly in a housing. The seat includes a seating surface in the housing having a first predetermined spheroidal contour when the housing is in an undeformed mode. The seating surface is deformable to a second predetermined spherically contoured surface when the housing is in a deformed mode. The seat is particularly adaptable for application to a rotating blade and mounting ring assembly in a gas turbine engine.

  12. The diabetic foot management - recent advance.

    PubMed

    Sinwar, Prabhu Dayal

    2015-03-01

    Diabetic ulceration of the foot represents a major global medical, social and economic problem. It is the commonest major end-point of diabetic complications. Diabetic neuropathy and peripheral vascular disease are the main etiological factors in foot ulceration and may act alone, together, or in combination with other factors such as microvascular disease, biomechanical abnormalities, limited joint mobility and increased susceptibility to infection. In the diabetic foot, distal sensory polyneuropathy is seen most commonly. The advent of insulin overcame the acute problems of ketoacidosis and infection, but could not prevent the vascular and neurological complications. Management of diabetic neuropathic ulcer by appropriate and timely removal of callus, control of infection and reduction of weight bearing forces. Management of diabetic ischaemic foot are medical management, surgical management and percutaneous transluminal angioplasty of stenosed and occluded lower extremity arteries. Foot ulceration in persons with diabetes is the most frequent precursor to amputation. PMID:25638739

  13. An overview of the Charcot foot pathophysiology

    PubMed Central

    Kaynak, Gökhan; Birsel, Olgar; Güven, Mehmet Fatih; Öğüt, Tahir

    2013-01-01

    Charcot arthropathy of the foot is a rare but devastating complication of diabetes that remains to be a challenging issue for the foot and ankle surgeons. Charcot foot fails to be an obvious diagnostic option that comes to mind, even in a pathognomonic clinical appearance. The rarity of the disorder, more common pathologies that mimic the condition, and the self-limiting prognosis deviate the clinician from the right diagnosis. The clinical challenges in the diagnosis of Charcot foot require in-depth investigations of its enigmatic nature to establish useful guidelines. Yet, this goal seems to be beyond reach, without a holistic view of the immense literature concerning the pathophysiology of the disorder. The primary objective of this article is to put together and review the recent advancements about the etiology and intrinsic mechanisms of diabetic Charcot foot. PMID:23919113

  14. 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.

  15. Deformed discrete symmetries

    NASA Astrophysics Data System (ADS)

    Arzano, Michele; Kowalski-Glikman, Jerzy

    2016-09-01

    We construct discrete symmetry transformations for deformed relativistic kinematics based on group valued momenta. We focus on the specific example of κ-deformations of the Poincaré algebra with associated momenta living on (a sub-manifold of) de Sitter space. Our approach relies on the description of quantum states constructed from deformed kinematics and the observable charges associated with them. The results we present provide the first step towards the analysis of experimental bounds on the deformation parameter κ to be derived via precision measurements of discrete symmetries and CPT.

  16. Fluctuations as stochastic deformation

    NASA Astrophysics Data System (ADS)

    Kazinski, P. O.

    2008-04-01

    A notion of stochastic deformation is introduced and the corresponding algebraic deformation procedure is developed. This procedure is analogous to the deformation of an algebra of observables like deformation quantization, but for an imaginary deformation parameter (the Planck constant). This method is demonstrated on diverse relativistic and nonrelativistic models with finite and infinite degrees of freedom. It is shown that under stochastic deformation the model of a nonrelativistic particle interacting with the electromagnetic field on a curved background passes into the stochastic model described by the Fokker-Planck equation with the diffusion tensor being the inverse metric tensor. The first stochastic correction to the Newton equations for this system is found. The Klein-Kramers equation is also derived as the stochastic deformation of a certain classical model. Relativistic generalizations of the Fokker-Planck and Klein-Kramers equations are obtained by applying the procedure of stochastic deformation to appropriate relativistic classical models. The analog of the Fokker-Planck equation associated with the stochastic Lorentz-Dirac equation is derived too. The stochastic deformation of the models of a free scalar field and an electromagnetic field is investigated. It turns out that in the latter case the obtained stochastic model describes a fluctuating electromagnetic field in a transparent medium.

  17. Fluctuations as stochastic deformation.

    PubMed

    Kazinski, P O

    2008-04-01

    A notion of stochastic deformation is introduced and the corresponding algebraic deformation procedure is developed. This procedure is analogous to the deformation of an algebra of observables like deformation quantization, but for an imaginary deformation parameter (the Planck constant). This method is demonstrated on diverse relativistic and nonrelativistic models with finite and infinite degrees of freedom. It is shown that under stochastic deformation the model of a nonrelativistic particle interacting with the electromagnetic field on a curved background passes into the stochastic model described by the Fokker-Planck equation with the diffusion tensor being the inverse metric tensor. The first stochastic correction to the Newton equations for this system is found. The Klein-Kramers equation is also derived as the stochastic deformation of a certain classical model. Relativistic generalizations of the Fokker-Planck and Klein-Kramers equations are obtained by applying the procedure of stochastic deformation to appropriate relativistic classical models. The analog of the Fokker-Planck equation associated with the stochastic Lorentz-Dirac equation is derived too. The stochastic deformation of the models of a free scalar field and an electromagnetic field is investigated. It turns out that in the latter case the obtained stochastic model describes a fluctuating electromagnetic field in a transparent medium.

  18. Challenge of Mesenchymal Stem Cells Against Diabetic Foot Ulcer.

    PubMed

    Şener, Leyla Türker; Albeniz, Işıl

    2015-01-01

    Mesenchymal stem cells (MSCs) play an important role in embryonic development and tissue regeneration in adult life owing to their high competency and self-renewal features. MSCs represent an important stem cell population with multipotent capabilities that may have high utility for translational clinical applications. MSCs can differentiate into a variety of cell types, especially fascia originated cells, and provide soluble factors for regeneration of tissues and organs. In in vitro environments, stem cells are capable of reproducing while preserving their properties; therefore, assuming stem cells could be reproduced in sufficient quantity, they would be appropriate for genetic operations. Stem cells can be used in tissue engineering, preventing rejection of bone marrow/ stem cell grafts by supporting hematopoiesis and recovery of autoimmune diseases, and cell therapy through their immunosuppressive properties. Mesenchymal stem cells have the potential capability to renew deformed organs and assist in tissue repair. In the field of wound healing, use of BM-MSCs is effective through modulating inflammation, extracellular matrix production, migration of keratinocytes, and angiogenesis for cell therapies. A significant complication of diabetes is diabetic foot ulcers, which affect quality of life and threaten life. In this article, we review recent studies with favorable results related to MSCs, which have become an important area of study in terms of tissue regeneration and regenerative medicine with diabetic foot ulcers.

  19. Misunderstanding of foot drop in a patient with charcot-marie-tooth disease and lumbar disk herniation.

    PubMed

    Han, Youngmin; Kim, Kyoung-Tae; Cho, Dae-Chul; Sung, Joo-Kyung

    2015-04-01

    We report the case of 57-year-old woman diagnosed with Charcot-Marie-Tooth (CMT) disease and lumbar disk herniation (LDH). She had left leg weakness and foot numbness, foot deformity (muscle atrophy, high arch, and clawed toes). The lumbar spine MRI showed LDH at L4-5. Additionally, electrophysiology results were consistent with chronic peripheral motor-sensory polyneuropathy (axonopathy). In genetic testing, 17p11.2-p12 duplication/deletions characteristic of CMT disease were observed. We confirmed the patient's diagnosis as CMT disease and used conservative treatment. PMID:25932299

  20. 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.

  1. The management of complications following the treatment of flatfoot deformity.

    PubMed

    Lin, Jason S; Myerson, Mark S

    2011-01-01

    Adult acquired flatfoot deformity encompasses a wide spectrum of clinical conditions. Current management approaches have emerged from a growing understanding of its manifestations, which have been learned from decades of clinical trial and error. Although surgical trends continue to evolve, many basic principles and practices have endured. Adult flatfoot deformity can arise from multiple causes, the most common of which remains posterior tibial tendon rupture with subsequent elongation of secondary supportive structures. Regardless of the cause, the fundamental goals of surgical management include correcting peritalar subluxation, restoring hindfoot-midfoot-forefoot relationships and muscle balance, attaining a plantigrade foot, and preserving motion when possible. Surgical correction may be associated with a variety of potential problems, including errors in decision making, undertreatment, overcorrection, and technical mistakes. These complications can lead to adjacent joint arthritis, recurrent deformity, rigidity, nonunion, and persistent pain. PMID:21553784

  2. Bacteriology of diabetic foot lesions.

    PubMed

    Anandi, C; Alaguraja, D; Natarajan, V; Ramanathan, M; Subramaniam, C S; Thulasiram, M; Sumithra, S

    2004-01-01

    Clinical grading and bacteriological study of 107 patients with diabetic foot lesions revealed polymicrobial aetiology in 69 (64.4%) and single aetiology in 21 (19.6%). Among 107 patients 62 had ulcer. Of these 31 had mixed aerobes. Twenty six patients with cellulitis and 12 with gangrene had more than 5 types of aerobes and anaerobes such as E. coli, Klebsiella spp., Pseudomonas spp., Proteus spp., Enterobactor spp., Enterococci spp., Clostridium perfringens, Bacteroides spp., Prevotella spp. and Peptostreptococcus spp. It was noted that 50 out of 62 patients with ulcer, and all the patients with cellulitis and gangrene were given surgical management and treated with appropriate antibiotics based on antimicrobial susceptibility testing. PMID:17642727

  3. The immersion foot syndrome. 1946.

    PubMed

    Ungley, C C; Channell, G D; Richards, R L

    2003-01-01

    1. Prolonged exposure of the extremities to cold insufficient to cause tissue freezing produces a well-defined syndrome. 'Immersion foot' is one of the descriptive but inaccurate terms applied to this syndrome. The clinical features, aetiology, pathology, prevention, and treatment of immersion foot are considered in detail. A discussion on pathogenesis is also included. 2. In the natural history of a typical case of immersion foot there are four stages: the period of exposure and the pre-hyperaemic, hyperaemic, and post-hyperaemic stages. 3. During exposure and immediately after rescue the feet are cold, numb, swollen, and pulseless. Intense vasoconstriction sufficient to arrest blood-flow is believed to be the predominant factor during this phase. 4. This is followed by a period of intense hyperaemia, increased swelling, and severe pain. Hyperaemia is due to the release in chilled and ischaemic tissues of relatively stable vasodilator metabolites; pain may be the result of relative anoxia of sensory nerve-endings. 5. Within 7-10 days of rescue the intense hyperaemia and swelling subside and pain diminishes in intensity. A lesser degree of hyperaemia may persist for several weeks. Objective disturbances of sensation and sweating and muscular atrophy and paralysis now become apparent. These findings are correlated with damage to the peripheral nerves. 6. After several weeks the feet become cold-sensitive; when exposed to low temperature they cool abnormally and may remain cold for several hours. Hyperhidrosis frequently accompanies this cold-sensitivity. The factors responsible for these phenomena are incompletely understood; several possible explanations are considered. 7. Severe cases may develop blisters and gangrene. The latter is usually superficial and massive loss of tissue is rare. 8. The hands may be affected but seldom as severely as the feet. The essential features of immersion hand are the same as those of immersion foot. 9. Prognosis depends upon

  4. Changes in multi-segment foot biomechanics with a heat-mouldable semi-custom foot orthotic device

    PubMed Central

    2011-01-01

    Background Semi-custom foot orthoses (SCO) are thought to be a cost-effective alternative to custom-made devices. However, previous biomechanical research involving either custom or SCO has only focused on rearfoot biomechanics. The purpose of this study was therefore to determine changes in multi-segment foot biomechanics during shod walking with and without an SCO. We chose to investigate an SCO device that incorporates a heat-moulding process, to further understand if the moulding process would significantly alter rearfoot, midfoot, or shank kinematics as compared to a no-orthotic condition. We hypothesized the SCO, whether moulded or non-moulded, would reduce peak rearfoot eversion, tibial internal rotation, arch deformation, and plantar fascia strain as compared to the no-orthoses condition. Methods Twenty participants had retroreflective markers placed on the right limb to represent forefoot, midfoot, rearfoot and shank segments. 3D kinematics were recorded using an 8-camera motion capture system while participants walked on a treadmill. Results Plantar fascia strain was reduced by 34% when participants walked in either the moulded or non-moulded SCO condition compared to no-orthoses. However, there were no significant differences in peak rearfoot eversion, tibial internal rotation, or medial longitudinal arch angles between any conditions. Conclusions A semi-custom moulded orthotic does not control rearfoot, shank, or arch deformation but does, however, reduce plantar fascia strain compared to walking without an orthoses. Heat-moulding the orthotic device does not have a measurable effect on any biomechanical variables compared to the non-moulded condition. These data may, in part, help explain the clinical efficacy of orthotic devices. PMID:21693032

  5. 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

  6. Resurgent deformation quantisation

    SciTech Connect

    Garay, Mauricio; Goursac, Axel de; Straten, Duco van

    2014-03-15

    We construct a version of the complex Heisenberg algebra based on the idea of endless analytic continuation. The algebra would be large enough to capture quantum effects that escape ordinary formal deformation quantisation. -- Highlights: •We construct resurgent deformation quantisation. •We give integral formulæ. •We compute examples which show that hypergeometric functions appear naturally in quantum computations.

  7. 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

  8. Amputation and reamputation of the diabetic foot.

    PubMed

    Armstrong, D G; Lavery, L A; Harkless, L B; Van Houtum, W H

    1997-06-01

    The authors compare the level of foot amputation by age, prevalence of arterial disease as a precipitating factor, gender, and ethnicity in persons with diabetes mellitus. Medical records were abstracted for each hospitalization for a lower extremity amputation from January 1 to December 31, 1993, in six metropolitan statistical areas in south Texas. Amputation level was defined by ICD-9-CM codes and were categorized as foot, leg, and thigh amputations. Foot-level amputations were further subcategorized as hallux or first ray, middle, fifth, multiple digit or ray, and midfoot amputations. Only the highest amputation level for each individual was used in the analysis. Of 1,043 subjects undergoing a lower extremity amputation in south Texas in the year 1993, 477 received their amputation at the level of the foot. African-Americans requiring a foot-level amputation were at significantly higher risk to undergo a midfoot-level amputation than was the rest of the population. Nearly 40% of all subjects undergoing a foot-level amputation had a previous history of amputation. However, nearly 40% of subjects undergoing foot amputations had not been diagnosed either before or during admission with peripheral arterial occlusive disease, suggesting a causal pathway dependent primarily on neuropathy. This implies that better screening of diabetic patients with appropriate risk-directed treatment at the primary care level may significantly impact the large number of preventable diabetes-related lower extremity amputations.

  9. 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

  10. Development of a Subject-Specific Foot-Ground Contact Model for Walking.

    PubMed

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

    2016-09-01

    Computational walking simulations could facilitate the development of improved treatments for clinical conditions affecting walking ability. Since an effective treatment is likely to change a patient's foot-ground contact pattern and timing, such simulations should ideally utilize deformable foot-ground contact models tailored to the patient's foot anatomy and footwear. However, no study has reported a deformable modeling approach that can reproduce all six ground reaction quantities (expressed as three reaction force components, two center of pressure (CoP) coordinates, and a free reaction moment) for an individual subject during walking. This study proposes such an approach for use in predictive optimizations of walking. To minimize complexity, we modeled each foot as two rigid segments-a hindfoot (HF) segment and a forefoot (FF) segment-connected by a pin joint representing the toes flexion-extension axis. Ground reaction forces (GRFs) and moments acting on each segment were generated by a grid of linear springs with nonlinear damping and Coulomb friction spread across the bottom of each segment. The stiffness and damping of each spring and common friction parameter values for all springs were calibrated for both feet simultaneously via a novel three-stage optimization process that used motion capture and ground reaction data collected from a single walking trial. The sequential three-stage process involved matching (1) the vertical force component, (2) all three force components, and finally (3) all six ground reaction quantities. The calibrated model was tested using four additional walking trials excluded from calibration. With only small changes in input kinematics, the calibrated model reproduced all six ground reaction quantities closely (root mean square (RMS) errors less than 13 N for all three forces, 25 mm for anterior-posterior (AP) CoP, 8 mm for medial-lateral (ML) CoP, and 2 N·m for the free moment) for both feet in all walking trials. The

  11. 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.

  12. 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.

  13. Treatment of diabetic foot ulcer: an overview strategies for clinical approach.

    PubMed

    Dalla Paola, Luca; Faglia, Ezio

    2006-11-01

    Diabetic foot disease is a major health problem, which concerns 15% of the 200 million patients with diabetes worldwide. Major amputation, above or below the knee, is a feared complication of diabetes. More than 60% of non-traumatic amputations in the western world are performed in the diabetic population. Many patients who undergo an amputation, have a history of ulceration. Major amputations increase morbility and mortality and reduce the patient's quality of life. Treatment of foot complications is one of the main items in the absorption of economic and health resources addressed to the diabetic population. It is clear that effective treatment can bring about a reduction in the number of major amputations. Over recent years, we have seen a significant increase in knowledge about the physiopathological pathways of this complication, together with improvements in diagnostic techniques, but above all a standardized conservative therapeutic approach, which allows limb salvage in a high percentage of cases. This target has been achieved in specialized centers. An important prelude to diabetic foot treatment is the differing diagnosis of neuropathic and neuroischemic foot. This differentiation is essential for effective treatment. Ulceration in neuropathic foot is due to biomechanical stress and high pressure, which involves the plantar surface of toes and metatarsal heads. Treatment of a neuropathic plantar ulcer must correct pathological plantar pressures through weight bearing relief. Surgical treatment of deformities, with or without ulcerations, is effective therapy. A neuropathic ulcer that is not adequately treated can become a chronic ulcer that does not heal. An ulcer that does not heal for many months has a high probability of leading to osteomyelitis, for which treatment with antibiotics is not useful and which usually requires a surgical procedure. Charcot neuroarthropathy is a particular complication of neuropathy which may lead to fragmentation or

  14. 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

  15. Using three-dimensional gait data for foot/ankle orthopaedic surgery.

    PubMed

    de Vries, Gwyneth; Roy, Kevin; Chester, Victoria

    2009-01-01

    We present the case of a forty year old male who sustained a torn carotid during strenuous physical activity. This was followed by a right hemispheric stroke due to a clot associated with the carotid. Upon recovery, the patient's gait was characterized as hemiparetic with a stiff-knee pattern, a fixed flexion deformity of the toe flexors, and a hindfoot varus. Based on clinical exams and radiographs, the surgical treatment plan was established and consisted of correction of the forefoot deformities, possible hamstrings lengthening, and tendon transfer of the posterior tibial tendon to the dorsolateral foot. To aid in surgical planning, a three-dimensional gait analysis was conducted using a state-of-the-art motion capture system. Data from this analysis provided insight into the pathomechanics of the patient's gait pattern. A forefoot driven hindfoot varus was evident from the presurgical data and the tendon transfer procedure was deemed unnecessary. A computer was used in the OR to provide surgeons with animations of the patient's gait and graphical results as needed. A second gait analysis was conducted 6 weeks post surgery, shortly after cast removal. Post-surgical gait data showed improved foot segment orientation and position. Motion capture data provides clinicians with detailed information on the multisegment kinematics of foot motion during gait, before and during surgery. Further, treatment effectiveness can be evaluated by repeating gait analyses after recovery. PMID:19997521

  16. Biomechanical behavior of valgus foot in children with cerebral palsy: A comparative study.

    PubMed

    Guo, Junchao; Wang, Lizhen; Mo, Zhongjun; Chen, Wei; Fan, Yubo

    2015-09-18

    Valgus foot (VF) is the most common foot deformity in children with cerebral palsy (CP), which seriously affects the foot balance in standing and posture control in walking. Little information about the locus and stress of internal bones was available. To accurately describe the biomechanical behavior of the internal bones of VF in CP, we compared the locus and stress of internal bones between the normal foot (NF) and VF by finite element models. Compared with the NF, displacement of the talus and navicular drop in VF increased by 109% and 171% in vertical direction respectively, and the locus of talus had a tendency to clockwise rotation and downward movement in coronal plane. In addition, the abduction angle of forefoot in VF increased up to 10.3°, which was twice more than that in the NF. Moreover, the lateral metatarsophalangeal joints were upward tilted 6.3° comparing with touchdown posture of NF, and peak von Mises stress of the internal bones in VF model concentrated on the fourth metatarsal. The simulation showed that locus of the forefoot, downward rotation of talus head and navicular drop were meaningful to quantify the collapse of medial longitudinal arch. It would provide some suggestions to the rehabilitation treatments of the CP children's VF.

  17. The diabetic foot in 2015: an overview.

    PubMed

    Markakis, K; Bowling, F L; Boulton, A J M

    2016-01-01

    In 2015, it can be said that the diabetic foot is no longer the Cinderella of diabetic complications. Thirty years ago there was little evidence-based research taking place on the diabetic foot, and there were no international meetings addressing this topic. Since then, the biennial Malvern Diabetic Foot meetings started in 1986, the American Diabetes Association founded their Foot Council in 1987, and the European Association for the Study of Diabetes established a Foot Study Group in 1998. The first International Symposium on the Diabetic Foot in The Netherlands was convened in 1991, and this was soon followed by the establishment of the International Working Group on the Diabetic Foot that has produced useful guidelines in several areas of investigation and the management of diabetic foot problems. There has been an exponential rise in publications on diabetic foot problems in high impact factor journals, and a comprehensive evidence-base now exists for many areas of treatment. Despite the extensive evidence available, it, unfortunately, remains difficult to demonstrate that most types of education are efficient in reducing the incidence of foot ulcers. However, there is evidence that education as part of a multi-disciplinary approach to diabetic foot ulceration plays a pivotal role in incidence reduction. With respect to treatment, strong evidence exists that offloading is the best modality for healing plantar neuropathic foot ulcers, and there is also evidence from two randomized controlled trials to support the use of negative-pressure wound therapy in complex post-surgical diabetic foot wounds. Hyperbaric oxygen therapy exhibits the same evidence level and strength of recommendation. International guidelines exist on the management of infection in the diabetic foot. Many randomized trials have been performed, and these have shown that the agents studied generally produced comparable results, with the exception of one study in which tigecycline was shown to

  18. Hand-foot-mouth disease (image)

    MedlinePlus

    Hand-foot-and-mouth disease is a viral infection caused by Coxsackievirus that usually begins in the throat. Symptoms include; fever, sore throat, ulcers in the throat, headache, and a rash with blisters on the palms of the ...

  19. Osteoarthritis of the Foot and Ankle

    MedlinePlus

    ... osteoarthritis develops as a result of abnormal foot mechanics such as flat feet or high arches. A ... prescribed to provide support to improve the foot’s mechanics or cushioning to help minimize pain. Bracing. Bracing, ...

  20. Advanced Canard in 12 Foot Tunnel

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Advanced-concepts model plane with front canards, winglets and pusher propellers, in 12 Foot Low-Speed Tunnel. Photograph published in Winds of Change, 75th Anniversary NASA publication, (page 12), by James Schultz.

  1. [Diabetic, neuropathic, arteriopathic foot and dressing choice].

    PubMed

    Lowe, S; Kayoumi, M

    2012-11-14

    The definition for the diabetic foot is infection, ulceration or destruction of deep tissues of the foot associated with neuropathy or peripheral vascular disease in the lower extremity of people with diabetes. Non-diabetic patients may suffer the same risks when neuropathy and arteriopathy are present. Knowing that 85% of amputations are preceded by foot ulcers, prevention is primordial. At the onset of an ulcer, immediate treatment must be undertaken and preferably by an interdisciplinary team. Delayed healing and increased risk of infection are often due to an associated vascular disease. While the array of dressings is expansive there is no «gold standard» treatment or «miracle dressing» described for foot ulcers. The management consists of wound analysis, debridement, woundcare and especially offloading.

  2. Diabetic foot ulcer management: the podiatrist's perspective.

    PubMed

    Turns, Martin

    2013-12-01

    Diabetic foot complications result from two broad pathologies-neuropathic and neuro-ischaemic feet. It is important for diabetic patients to have at least a yearly review of foot ulcer risk factors, and they should have a corresponding risk classification agreed based on this assessment. Diabetic foot ulcer assessment should include a wound classification tool, which can give an indication of wounds at greater risk of non-healing or amputation. The treatment of diabetic foot ulcers should be part of a comprehensive care plan that should also include treatment of infection, frequent debridement (if deemed appropriate by a skilled specialist clinician), biomechanical offloading, blood glucose control and treatment of comorbidities. Clinicians should base dressing selection on the wound's location, size and depth, amount of exudate, presence of infection or necrosis and the condition of the surrounding tissue.

  3. 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

  4. 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.

  5. The management of the infected diabetic foot.

    PubMed

    Caravaggi, Carlo; Sganzaroli, Adriana; Galenda, Paolo; Bassetti, Matteo; Ferraresi, Roberto; Gabrielli, Livio

    2013-01-01

    Diabetes is a chronic disease with a worldwide increasing trend. Foot complications, closely related to neuropathy and obstructive peripheral vascular disease, are responsible for more than 1 million of leg amputations every year. Foot infection can dramatically increase the risk of amputation. Although many ulcer classification systems have been proposed to stratify the severity of the infectious process, the definition of a specific therapeutic approach still remains an unsolved problem. A Diabetic Foot Triage and an Integrated Surgical Protocol are proposed to identify a diagnostic flowchart and a step-by-step surgical protocol that can be applied in the treatment of diabetic foot infection. Considering the rapid climbing of multidrug resistant strains it is very important to rationalize the use of antibiotics utilizing them only for the treatment of true infected ulcers. PAD is widely considered the most important factor conditioning the outcome of a diabetic foot ulcer. Currently no randomized control trials are reported in the international literature directly comparing open versus endovascular revascularisation in diabetic patients with CLI. Insufficient data are available to demonstrate whether open bypass surgery or endovascular interventions are more effective in these patients. A decisional flow chart in choosing the best revascularization strategy in diabetic patients with CLI is proposed. Goals and technical aspects of emergency and elective surgical procedures in diabetic foot are analysed to evaluate critical aspects and to suggest proper surgical choices.

  6. 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. PMID:27587513

  7. [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. PMID:27627777

  8. [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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. Foot anomalies and proximal symphalangism.

    PubMed

    Shaw, Lauren; McCaul, Janet; Irwin, Greg J; Huntley, James S

    2012-09-01

    We report the case of a 2-week-old girl born at term (by vaginal delivery and without antenatal or perinatal events) who was referred as having "bilateral talipes and bilateral proximal symphalangism of little and ring fingers." The "talipes" was atypical with marked equinus and varus, but no cavus or adductus of the midfoot. Her mother had both symphalangism (absence of proximal interphalangeal joints) of middle, ring, and little fingers bilaterally and fixed pes planus with a rigid fixed hindfoot-and these deformities had also been present from birth. The maternal grandmother was similarly affected. However, the neonatal subject has an unaffected older sibling; maternal siblings are also unaffected. The three affected people did not have other obvious musculoskeletal abnormalities. Because of the coalitions, the child's atypical talipes was managed by a modified Kite's procedure. Symphalangism-coalition syndromes may be associated with conductive deafness because of fusion of the auditory ossicles.

  14. Reverse Kirner's deformity: case report.

    PubMed

    Lau, Yeong J; Tonkin, Michael A

    2009-03-01

    Kirner's deformity is a rare congenital deformity, usually of the little finger, with volar and radial bowing of the distal phalanx. The etiology of this deformity is unclear. We describe a case of a 9-year-old girl with radiographic changes classic for Kirner's deformity but with the curvature and nail changes in the dorsal direction.

  15. Diagnostics and treatment of the diabetic foot.

    PubMed

    Apelqvist, Jan

    2012-06-01

    Every 30 s, a lower limb is amputated due to diabetes. Of all amputations in diabetic patients 85% are preceded by a foot ulcer which subsequently deteriorates to a severe infection or gangrene. There is a complexity of factors related to healing of foot ulcers including strategies for treatment of decreased perfusion, oedema, pain, infection, metabolic disturbances, malnutrition, non-weight bearing, wound treatment, foot surgery, and management of intercurrent disease. Patients with diabetic foot ulcer and decreased perfusion do often not have rest pain or claudication and as a consequence non-invasive vascular testing is recommended for early recognition of ulcers in need of revascularisation to achieve healing. A diabetic foot infection is a potentially limb-threatening condition. Infection is diagnosed by the presence or increased rate of signs inflammation. Often these signs are less marked than expected. Imaging studies can diagnose or better define deep, soft tissue purulent collections and are frequently needed to detect pathological findings in bone. The initial antimicrobial treatment as well as duration of treatment is empiric. There is a substantial delay in wound healing in diabetic foot ulcer which has been related to various abnormalities. Several new treatments related to these abnormalities have been explored in wound healing with various successes. An essential part of the strategy to achieve healing is an effective offloading. Many interventions with advanced wound management have failed due to not recognizing the need for effective offloading. A multidisciplinary approach to wounds and foot ulcer has been successfully implemented in different centres with a substantial decrease in amputation rate.

  16. Hindfoot Deformity Corrected With Double Versus Triple Arthrodesis: Radiographic Comparison.

    PubMed

    DeVries, J George; Scharer, Brandon

    2015-01-01

    Hindfoot fusion is capable of correcting hindfoot deformities. Typically, this has been done through triple arthrodesis. Recently, there has been some discussion of a double arthrodesis, sparing the calcaneocuboid joint. We compared the radiographic corrective ability of these 2 fusion techniques. A retrospective radiographic review was performed of 20 consecutive triple arthrodeses (triple) and 20 consecutive talonavicular and subtalar arthrodesis with calcaneocuboid preservation (double). Additional midfoot arthrodesis or osteotomy was performed as needed in each group. The preoperative measurements were compared to those from standing weightbearing films after fusion postoperatively. The angular measurements included the anteroposterior and lateral talar–first metatarsal line (Meary's and Simmons) and the anteroposterior and lateral talocalcaneal angle. Both groups demonstrated a statistically significant reduction in deformity and a return to more normal radiographic findings after arthrodesis (p < .05). The 2 groups did not differ statistically in preoperative deformity or correction obtained (p > .05). Traditionally, triple arthrodesis has been advocated for significant hindfoot deformity that is irreducible. Recent studies have questioned the need for inclusion of the calcaneocuboid joint in the arthrodesis, in particular, in a pronated, valgus-type foot. In addition, others have advocated a strictly medial approach to hindfoot fusion, necessarily avoiding the calcaneocuboid joint. Our findings agree with the assertion that hindfoot deformity can be adequately and reliably corrected through hindfoot arthrodesis whether or not the calcaneocuboid joint is included. PMID:25432460

  17. 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.

  18. Nineteen-Foot Diameter Explosively Driven Blast Simulator

    SciTech Connect

    VIGIL,MANUEL G.

    2001-07-01

    This report describes the 19-foot diameter blast tunnel at Sandia National Laboratories. The blast tunnel configuration consists of a 6 foot diameter by 200 foot long shock tube, a 6 foot diameter to 19 foot diameter conical expansion section that is 40 feet long, and a 19 foot diameter test section that is 65 feet long. Therefore, the total blast tunnel length is 305 feet. The development of this 19-foot diameter blast tunnel is presented. The small scale research test results using 4 inch by 8 inch diameter and 2 foot by 6 foot diameter shock tube facilities are included. Analytically predicted parameters are compared to experimentally measured blast tunnel parameters in this report. The blast tunnel parameters include distance, time, static, overpressure, stagnation pressure, dynamic pressure, reflected pressure, shock Mach number, flow Mach number, shock velocity, flow velocity, impulse, flow duration, etc. Shadowgraphs of the shock wave are included for the three different size blast tunnels.

  19. A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable.

    PubMed

    Bus, Sicco A; van Netten, Jaap J

    2016-01-01

    Diabetic foot ulceration poses a heavy burden on the patient and the healthcare system, but prevention thereof receives little attention. For every euro spent on ulcer prevention, ten are spent on ulcer healing, and for every randomized controlled trial conducted on prevention, ten are conducted on healing. In this article, we argue that a shift in priorities is needed. For the prevention of a first foot ulcer, we need more insight into the effect of interventions and practices already applied globally in many settings. This requires systematic recording of interventions and outcomes, and well-designed randomized controlled trials that include analysis of cost-effectiveness. After healing of a foot ulcer, the risk of recurrence is high. For the prevention of a recurrent foot ulcer, home monitoring of foot temperature, pressure-relieving therapeutic footwear, and certain surgical interventions prove to be effective. The median effect size found in a total of 23 studies on these interventions is large, over 60%, and further increases when patients are adherent to treatment. These interventions should be investigated for efficacy as a state-of-the-art integrated foot care approach, where attempts are made to assure treatment adherence. Effect sizes of 75-80% may be expected. If such state-of-the-art integrated foot care is implemented, the majority of problems with foot ulcer recurrence in diabetes can be resolved. It is therefore time to act and to set a new target in diabetic foot care. This target is to reduce foot ulcer incidence with at least 75%.

  20. Radiologic Patterning of Hallux Deformity in Rheumatoid Arthritis and Its Relationship to Flatfoot.

    PubMed

    Matsumoto, Takumi; Nakada, Izumi; Juji, Takuo; Nakamura, Ichiro; Ito, Katsumi

    2016-01-01

    Hallux deformities other than hallux valgus, especially those in the sagittal plane, have not yet been elucidated in the feet of patients with rheumatoid arthritis. The objectives of the present study were to classify rheumatoid arthritis hallux deformity in both the horizontal and the sagittal planes and investigate its relationship with flatfoot. Using a cross-sectional study design, we assessed patients with rheumatoid arthritis (527 feet in 274 patients) using radiographs and classified the deformity patterns of the great toes using cluster analysis. Of the 274 patients, the range of motion in the metatarsophalangeal joint was clinically investigated in 44 (16.1%) patients. The great toes could be divided into 5 clusters according to the characteristic configuration as follows: cluster I (normal type), cluster II (hallux valgus type), cluster III (boutonniere type), cluster IV (boutonniere with hallux valgus type), and cluster V (swan-neck type). Radiographic measurements revealed the characteristic deformities of each cluster, including splayed foot for cluster II; flat foot, metatarsal primus elevatus, and plantar displacement of the proximal phalanx for cluster III; and a mixture of these characteristics for cluster IV. Plantar displacement of the proximal phalanx, which was a specific characteristic of the boutonniere deformity, correlated significantly with the decreased dorsiflexion in the metatarsophalangeal joint. Our classification method revealed the relationship of hallux deformity in the sagittal plane to flatfoot and also demonstrated the usefulness of measuring basal phalanx displacement in predicting the range of motion of the metatarsophalangeal joint.

  1. Radiologic Patterning of Hallux Deformity in Rheumatoid Arthritis and Its Relationship to Flatfoot.

    PubMed

    Matsumoto, Takumi; Nakada, Izumi; Juji, Takuo; Nakamura, Ichiro; Ito, Katsumi

    2016-01-01

    Hallux deformities other than hallux valgus, especially those in the sagittal plane, have not yet been elucidated in the feet of patients with rheumatoid arthritis. The objectives of the present study were to classify rheumatoid arthritis hallux deformity in both the horizontal and the sagittal planes and investigate its relationship with flatfoot. Using a cross-sectional study design, we assessed patients with rheumatoid arthritis (527 feet in 274 patients) using radiographs and classified the deformity patterns of the great toes using cluster analysis. Of the 274 patients, the range of motion in the metatarsophalangeal joint was clinically investigated in 44 (16.1%) patients. The great toes could be divided into 5 clusters according to the characteristic configuration as follows: cluster I (normal type), cluster II (hallux valgus type), cluster III (boutonniere type), cluster IV (boutonniere with hallux valgus type), and cluster V (swan-neck type). Radiographic measurements revealed the characteristic deformities of each cluster, including splayed foot for cluster II; flat foot, metatarsal primus elevatus, and plantar displacement of the proximal phalanx for cluster III; and a mixture of these characteristics for cluster IV. Plantar displacement of the proximal phalanx, which was a specific characteristic of the boutonniere deformity, correlated significantly with the decreased dorsiflexion in the metatarsophalangeal joint. Our classification method revealed the relationship of hallux deformity in the sagittal plane to flatfoot and also demonstrated the usefulness of measuring basal phalanx displacement in predicting the range of motion of the metatarsophalangeal joint. PMID:27289217

  2. Microsurgical Reconstruction of Plantar Ulcers of the Insensate Foot.

    PubMed

    Kadam, Dinesh

    2016-06-01

    Background Plantar, neuropathic, or trophic ulcers are often found in patients with decreased sensation in the foot. These ulcers can be complicated by infection, deformity, and increased patient morbidity. Excision results in wider defects and local tissues are often insufficient for reconstruction Methods Total 26 free flaps were used in 25 patients to reconstruct plantar ulcers between years 2007 and 2013. The etiology included diabetic neuropathy (n = 13), leprosy (n = 3), spinal/peripheral nerve injury (n = 7), spina bifida (n = 1), and peripheral neuropathy (n = 1). The duration of the ulcer ranged from 1 to 18 years. Fifteen patients had associated systemic comorbidities and six had previous attempts. Free flaps used in reconstruction were the anterolateral thigh flap (n = 18), radial artery forearm flap (n = 4), and the gracilis muscle flap (n = 4). Recipient vessels were the posterior tibial artery (end to side) in 19 and the dorsalis pedis artery in 7. Results The average age at presentation was 44.6 years with mean duration of ulcer of 5.8 years predominantly located over weight-bearing areas. Mean size of ulcer was 59.45 cm(2) and mean follow-up period was 48 months. All flaps survived except a partial loss. Average time to resume ambulation was 6 weeks. Three patients had recurrence with mean follow-up of 48 months. Secondary flap reduction and bony resection was done in four. Conclusion Microvascular reconstruction of the sole has advantages of vascularity, adequate tissue, and leaving rest of the foot undisturbed for offloading. Three significant local conditions influencing selection and transfer of the flap include (1) distally located forefoot ulcers, (2) extensive subcutaneous fibrosis secondary to frequent inflammation, and (3) Charcot arthropathy. In our series, the anterolateral thigh flap is our first choice for reconstruction of these defects.

  3. 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. PMID:22052587

  4. 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.

  5. 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.'

  6. 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

  7. Effect of Custom-Molded Foot Orthoses on Foot Pain and Balance in Children With Symptomatic Flexible Flat Feet

    PubMed Central

    Lee, Hong-Jae; Lim, Kil-Byung; Yoo, JeeHyun; Yun, Hyun-Ju; Jeong, Tae-Ho

    2015-01-01

    Objective To evaluate the effect of custom-molded foot orthoses on foot pain and balance in children with symptomatic flexible flat foot 1 month and 3 months after fitting foot orthosis. Method A total of 24 children over 6 years old with flexible flat feet and foot pain for at least 6 months were recruited for this study. Their resting calcaneal stance position and calcaneal pitch angle were measured. Individual custom-molded rigid foot orthoses were prescribed using inverted orthotic technique to control foot overpronation. Pain questionnaire was used to obtain pain sites, degree, and frequency. Balancing ability was determined using computerized posturography. These evaluations were performed prior to custom-molded foot orthoses, 1 month, and 3 months after fitting foot orthoses. Result Of 24 children with symptomatic flexible flat feet recruited for this study, 20 completed the study. Significant (p<0.001) improvements in pain degree and frequency were noted after 1 and 3 months of custom-molded foot orthoses. In addition, significant (p<0.05) improvement in balancing ability was found after 3 months of custom-molded foot orthoses. Conclusion Short-term use of custom-molded foot orthoses significantly improved foot pain and balancing ability in children with symptomatic flexible flat foot. PMID:26798604

  8. 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.

  9. Women's musculoskeletal foot conditions exacerbated by shoe wear: an imaging perspective.

    PubMed

    Goud, Ajay; Khurana, Bharti; Chiodo, Christopher; Weissman, Barbara N

    2011-04-01

    The predominance of several musculoskeletal foot conditions in women are largely the result of biomechanical alterations caused by ill-fitting shoes. In particular, the altered biomechanics (associated with high-heeled shoes and shoes with a narrowed toe box) has been linked to the genesis of hallux valgus, hammer toe deformity, Haglund syndrome, metatarsal stress fracture, Freiberg infraction, and Morton neuroma. In reviewing the imaging findings of several of these conditions, we emphasize the role of radiographs, special radiographic views, and the utility of more costly studies, such as magnetic resonance imaging.

  10. Residual radiation damage in the mouse foot after exposure to heavy particles

    SciTech Connect

    Carpenter, S.G.; Raju, M.R.

    1981-02-01

    Mice receiving a first treatment with graded doses of various heavy charged particles to one of their hind legs were re-exposed to a fixed dose of x rays eight months later to study the memory of residual damage from the first treatment. No significant memory of the first radiation exposure was observed for acute skin reaction. However, there is an indication of memory for foot deformity. The results do not seem to indicate any significant differences in memory after exposure to /sup 60/Co gamma rays compared with protons or heavy ions, if biological effectiveness of the doses is taken into consideration.

  11. Residual radiation damage in the mouse foot after exposure to heavy particles

    SciTech Connect

    Carpenter, S.G.; Raju, M.R.

    1981-02-01

    Mice receiving a first treatment with graded doses of various heavy charged particles (protons and heavy ions) to one of their hind legs were re-exposed to a fixed dose of x rays eight months later to study the memory of residual damage from the first treatment. No significant memory of the first radiation exposure was observed for acute skin reaction. However, there is an indication of memory for foot deformity. The results do not seem to indicate any significant differences in memory after exposure to 60Co gamma rays compared with protons or heavy ions, if biological effectiveness of the doses is taken into consideration.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. Deformed Quantum Statistics

    NASA Astrophysics Data System (ADS)

    Inomata, Akira

    1997-03-01

    To understand possible physical consequences of quantum deformation, we investigate statistical behaviors of a quon gas. The quon is an object which obeys the minimally deformed commutator (or q-mutator): a a† - q a†a=1 with -1≤ q≤ 1. Although q=1 and q=-1 appear to correspond respectively to boson and fermion statistics, it is not easy to create a gas which unifies the boson gas and the fermion gas. We present a model which is able to interpolates between the two limits. The quon gas shows the Bose-Einstein condensation near the Boson limit in two dimensions.

  18. Macrodystrophia lipomatosa of foot involving great toe.

    PubMed

    Gaur, A K; Mhambre, A S; Popalwar, H; Sharma, R

    2014-06-01

    Macrodystrophia lipomatosa is a rare form of congenital disorder in which there is localized gigantism characterized by progressive overgrowth of all mesenchymal elements with a disproportionate increase in the fibroadipose tissues. The adipose tissue infiltration involves subcutaneous tissue, periosteum, nerves and bone marrow. Most of the cases reported have hand or foot involvement. Patient seeks medical help for improving cosmesis or to get the size of the involved part reduced in order to reduce mechanical problems. We report a case of macrodystrophia lipomatosa involving medial side of foot with significant enlargement of great toe causing concern for cosmesis and inconvenience due to mechanical problems. The X-rays showed increased soft tissue with more of adipose tissue and increased size of involved digits with widening of ends. Since the patient's mother did not want any surgical intervention he was educated about foot care and proper footwear design was suggested. PMID:24703060

  19. 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

  20. Macrodystrophia lipomatosa of foot involving great toe.

    PubMed

    Gaur, A K; Mhambre, A S; Popalwar, H; Sharma, R

    2014-06-01

    Macrodystrophia lipomatosa is a rare form of congenital disorder in which there is localized gigantism characterized by progressive overgrowth of all mesenchymal elements with a disproportionate increase in the fibroadipose tissues. The adipose tissue infiltration involves subcutaneous tissue, periosteum, nerves and bone marrow. Most of the cases reported have hand or foot involvement. Patient seeks medical help for improving cosmesis or to get the size of the involved part reduced in order to reduce mechanical problems. We report a case of macrodystrophia lipomatosa involving medial side of foot with significant enlargement of great toe causing concern for cosmesis and inconvenience due to mechanical problems. The X-rays showed increased soft tissue with more of adipose tissue and increased size of involved digits with widening of ends. Since the patient's mother did not want any surgical intervention he was educated about foot care and proper footwear design was suggested.

  1. Anatomical Characteristics and Surgical Treatments of Pincer Nail Deformity

    PubMed Central

    Jung, Dong Ju; Kim, Jae Hee; Lee, Hee Young; Kim, Dong Chul; Lee, Se Il

    2015-01-01

    Background Pincer nail deformity is a transverse overcurvature of the nail. This study aimed to define the anatomical characteristics of pincer nail deformity and to evaluate the surgical outcomes. Methods A retrospective review was conducted on 20 cases of pincer nail deformity of the great toe. Thirty subjects without pincer nail deformity or history of trauma of the feet were selected as the control group. Width and height indices were calculated, and interphalangeal angles and base widths of the distal phalanx were measured with radiography. We chose the surgical treatment methods considering perfusion-related factors such as age, diabetes mellitus, kidney disease, and peripheral vascular disease. The zigzag nail bed flap method (n=9) and the inverted T incision method (n=11) were used to repair deformities. The outcomes were evaluated 6 months after surgery. Results The interphalangeal angle was significantly greater in the preoperative patient group (14.0°±3.6°) than in the control group (7.9°±3.0°) (P<0.05). The postoperative width and height indices were very close to the measurements in the control group, and most patients were satisfied with the outcomes. Conclusions We believe that the width and height indices are useful for evaluating the deformity and outcomes of surgical treatments. We used two different surgical methods for the two patient groups with respect to the perfusion-related factors and found that the outcomes were all satisfactory. Consequently, we recommend taking into consideration the circulatory condition of the foot when deciding upon the surgical method for pincer nail deformity. PMID:25798393

  2. A review of the biomechanics of the diabetic foot.

    PubMed

    van Schie, C H M

    2005-09-01

    In general, diabetic foot ulcers result from abnormal mechanical loading of the foot, such as repetitive moderate pressure applied to the plantar aspect of the foot while walking. Diabetic peripheral neuropathy causes changes in foot structure, affecting foot function and subsequently leading to increased plantar foot pressure, which is a predictive risk factor for the development of diabetic foot ulceration. Prevention of diabetic foot ulceration is possible by early identification of the insensitive foot, therefore a foot "at risk," and by protecting the foot from abnormal biomechanical loading. Abnormal foot pressures can be reduced using several different approaches, including callus debridement, prescription of special footwear, injection of liquid silicone, Achilles tendon lengthening, and so forth. Off-loading of the diabetic wound is a key factor in successful wound healing, as it is associated with reduced inflammatory and accelerated repair processes. Pressure relief can be achieved using various off-loading modalities including accommodative dressing, walking splints, ankle-foot orthosis, total contact cast, and removable and irremovable cast walkers.

  3. Foot and Ankle Injuries in Runners.

    PubMed

    Tenforde, Adam S; Yin, Amy; Hunt, Kenneth J

    2016-02-01

    Foot and ankle injuries account for nearly one-third of running injuries. Achilles tendinopathy, plantar fasciopathy, and ankle sprains are 3 of the most common types of injuries sustained during training. Other common injuries include other tendinopathies of the foot and ankle, bone stress injuries, nerve conditions including neuromas, and joint disease including osteoarthritis. This review provides an evidence-based framework for the evaluation and optimal management of these conditions to ensure safe return to running participation and reduce risk for future injury. PMID:26616180

  4. 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.

  5. Small Joint Arthroscopy in the Foot.

    PubMed

    Reeves, Christopher L; Shane, Amber M; Payne, Trevor; Cavins, Zac

    2016-10-01

    Arthroscopy has advanced in the foot and ankle realm, leading to new innovative techniques designed toward treatment of small joint abnormality. A range of abnormalities that are currently widespread for arthroscopic treatment in larger joints continues to be translated to congruent modalities in the small joints. Small joint arthroscopy offers relief from foot ailments with a noninvasive element afforded by arthroscopy. Early studies have found comparable results from arthroscopic soft tissue procedures as well as arthrodesis of the small joints when compared with the standard open approach. PMID:27599441

  6. 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.

  7. [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.

  8. Foot preferences during resting in wildfowl and waders.

    PubMed

    Randler, Christoph

    2007-03-01

    Footedness in birds has been reported, e.g., in parrots and chickens, but the direction of footedness remained unclear. Is a bird left-footed because it uses its left foot for holding and handling food, or is it right-footed because it uses the right foot for stabilisation and balancing while perching? In 2004 and 2006 I examined footedness in wildfowl and waders while the birds were performing a single task: roosting on the ground on one foot. Avocet (Recurvirostra avosetta), northern shoveller (Anas clypeata), oystercatcher (Haematopus ostralegus), and Eurasian curlew (Numenius arquata) were right-footed. Another 21 species did not show any significant foot preferences. This study provides some evidence that asymmetries in preferential foot use in birds may be triggered by a preference during postural control. PMID:17365634

  9. 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

  10. 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

  11. 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

  12. Measurement system for 3-D foot coordinates and parameters

    NASA Astrophysics Data System (ADS)

    Liu, Guozhong; Li, Yunhui; Wang, Boxiong; Shi, Hui; Luo, Xiuzhi

    2008-12-01

    The 3-D foot-shape measurement system based on laser-line-scanning principle and the model of the measurement system were presented. Errors caused by nonlinearity of CCD cameras and caused by installation can be eliminated by using the global calibration method for CCD cameras, which based on nonlinear coordinate mapping function and the optimized method. A local foot coordinate system is defined with the Pternion and the Acropodion extracted from the boundaries of foot projections. The characteristic points can thus be located and foot parameters be extracted automatically by the local foot coordinate system and the related sections. Foot measurements for about 200 participants were conducted and the measurement results for male and female participants were presented. 3-D foot coordinates and parameters measurement makes it possible to realize custom-made shoe-making and shows great prosperity in shoe design, foot orthopaedic treatment, shoe size standardization, and establishment of a feet database for consumers.

  13. The diabetic foot: an overview of assessment and complications.

    PubMed

    Turns, Martin

    Diabetic foot problems are a common complication of diabetes mellitus and can lead to morbidity and mortality. Foot disease is the leading cause of non-traumatic lower-limb amputation in the developed world (National Institute for Health and Clinical Excellence (NICE), 2004). Diabetic foot disease is a result of three main pathologies, which can occur singly or in combination. These are: peripheral neuropathy, peripheral arterial disease and infection. Consequences of these pathologies are ulceration, Charcot foot, painful neuropathy, gangrene and amputation (NICE, 2004). This article offers a podiatrist perspective of the management of diabetic foot problems, from initial assessment to the management of complex foot disease. Patients with a diabetic foot problem must be assessed thoroughly and referred to the local multidisciplinary team, where appropriate (NICE, 2004). Recurrence of ulcers is common, and therefore good foot health education, adequate footwear and regular podiatry, if required, must be an integral part of the patient's review process (NICE, 2004). PMID:21841646

  14. 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

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

    MedlinePlus

    ... Print | Share Avoid Kids Foot Problems with the Right Shoes Before you head to the store to ... College of Foot and Ankle Surgeons (ACFAS), All Rights Reserved. Privacy Statement | Disclaimer | Terms and Conditions | Site ...

  16. MEMS Actuated Deformable Mirror

    SciTech Connect

    Papavasiliou, A; Olivier, S; Barbee, T; Walton, C; Cohn, M

    2005-11-10

    This ongoing work concerns the creation of a deformable mirror by the integration of MEMS actuators with Nanolaminate foils through metal compression boning. These mirrors will use the advantages of these disparate technologies to achieve dense actuation of a high-quality, continuous mirror surface. They will enable advanced adaptive optics systems in large terrestrial telescopes. While MEMS actuators provide very dense actuation with high precision they can not provide large forces typically necessary to deform conventional mirror surfaces. Nanolaminate foils can be fabricated with very high surface quality while their extraordinary mechanical properties enable very thin, flexible foils to survive the rigors of fabrication. Precise metal compression bonding allows the attachment of the fragile MEMS actuators to the thin nanolaminate foils without creating distortions at the bond sites. This paper will describe work in four major areas: (1) modeling and design, (2) bonding development, (3) nanolaminate foil development, (4) producing a prototype. A first-principles analytical model was created and used to determine the design parameters. A method of bonding was determined that is both strong, and minimizes the localized deformation or print through. Work has also been done to produce nanolaminate foils that are sufficiently thin, flexible and flat to be deformed by the MEMS actuators. Finally a prototype was produced by bonding thin, flexible nanolaminate foils to commercially available MEMS actuators.

  17. Transfer involving deformed nuclei

    SciTech Connect

    Rasmussen, J.O.; Guidry, M.W.; Canto, L.F.

    1985-03-01

    Results are reviewed of 1- and 2-neutron transfer reactions at near-barrier energies for deformed nuclei. Rotational angular momentum and excitation patterns are examined. A strong tendency to populating high spin states within a few MeV of the yrast line is noted, and it is interpreted as preferential transfer to rotation-aligned states. 16 refs., 12 figs.

  18. 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

  19. 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

  20. q-Deformed and c-Deformed Harmonic Oscillators

    NASA Astrophysics Data System (ADS)

    Sogami, I. S.; Koizumi, K.; Mir-Kasimov, R. M.

    2003-10-01

    Hamilton functions of classical deformed oscillators (c-deformed oscillators) are derived from Hamiltonians of q-deformed oscillators of the Macfarlane and Dubna types. A new scale parameter, lq, with the dimension of length, is introduced to relate a dimensionless parameter characterizing the deformation with the natural length of the harmonic oscillator. Contraction from q-deformed oscillators to c-deformed oscillators is accomplished by keeping lq finite while taking the limit hbar → 0. The c-deformed Hamilton functions for both types of oscillators are found to be invariant under discrete translations: the step of the translation for the Dubna oscillator is half of that for the Macfarlane oscillator. The c-deformed oscillator of the Macfarlane type has propagating solutions in addition to localized ones. Reinvestigation of the q-deformed oscillator carried out in the light of these findings for the c-deformed systems proves that the q-deformed systems are invariant under the same translation symmetries as the c-deformed systems and have propagating waves of the Bloch type.

  1. 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

  2. [Presurgical and postsurgical orthotic management of the rheumatoid foot].

    PubMed

    Carl, H D; Swoboda, B

    2012-10-01

    Foot complaints remain frequent in patients with rheumatoid arthritis (RA) even in the era of biological anti-rheumatic drugs. Orthotic management of rheumatoid foot disorders is able to improve mobility and thus the quality of life in RA patients. This article highlights the preoperative and postoperative orthotic management of the rheumatoid arthritic foot.

  3. 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)

  4. 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.

  5. [A girl with a cold foot].

    PubMed

    Rouwet, E V; Ten Raa, S; Verhagen, H J M

    2016-01-01

    A 14-year-old girl presented with a progressively cold, pale foot. Pedal pulses were absent and there was sensory and motor loss. CT angiography revealed a thromboembolic occlusion of the crural arteries and a popliteal artery entrapment. Following thromboembolectomy with popliteal artery patch angioplasty and release of the gastrocnemius muscle, the girl fully recovered.

  6. 49 CFR 214.115 - Foot protection.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...(a) and 1 CFR part 51. Copies may be obtained from American National Standards Institute, 25 West... 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...

  7. 49 CFR 214.115 - Foot protection.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...(a) and 1 CFR part 51. Copies may be obtained from American National Standards Institute, 25 West... 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...

  8. 49 CFR 214.115 - Foot protection.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...(a) and 1 CFR part 51. Copies may be obtained from American National Standards Institute, 25 West... 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...

  9. 49 CFR 214.115 - Foot protection.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...(a) and 1 CFR part 51. Copies may be obtained from American National Standards Institute, 25 West... 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...

  10. 49 CFR 214.115 - Foot protection.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ...(a) and 1 CFR part 51. Copies may be obtained from American National Standards Institute, 25 West... 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...

  11. Morbidity after crush injuries to the foot.

    PubMed

    Myerson, M S; McGarvey, W C; Henderson, M R; Hakim, J

    1994-08-01

    By retrospective review of hospital records and by follow-up clinical examinations, we evaluated 58 patients with crush injuries to the foot treated at our institution between 1986 and 1990. All patients had received initial treatment according to a standardized protocol determined by the type and magnitude of the injury. Patients were examined at a mean interval of 3.3 years (range 2-4) after injury, and the functional outcome was determined according to a foot trauma rating scale. Based on this scoring system, 46% of the patients had good functional outcome, 29% had fair results, and 25% had poor results. There was a significant correlation between a good functional outcome and careful adherence to the treatment protocol; however, some patients fared poorly regardless of treatment. Poor results occurred if treatment was not immediately initiated, if soft-tissue coverage was delayed (in those who experienced severe, mangling-type injuries necessitating partial foot amputation), if patients subsequently had neuritis or reflex sympathetic dystrophy, or if patients were involved in ongoing workers' compensation and litigation. We conclude that because crush injuries of the foot may be associated with prolonged morbidity, initial management should be directed toward recognition and treatment of compartment syndromes, early soft-tissue coverage, and rigid skeletal stabilization to enhance soft-tissue healing. PMID:7965298

  12. On-the-Job Foot Health

    MedlinePlus

    ... hidden hazards. ◆ Be considerate. Watch out for other workers’ safety. ◆ Follow the rules. Don't cut corners. Use ... workplace. Only one out of four victims of job- related foot injury wear any type of safety shoe or boot, ...

  13. Imaging of the foot and ankle.

    PubMed

    Pavlov, H

    1990-09-01

    The foot and ankle are subjected to daily stresses and strains ranging from normal walking activities to the excessive forces encountered in the active sports enthusiast. These traumatic events as well as systemic and local arthritic conditions and tumors can be temporarily or permanently disabling. Early, expedited, and cost-efficient diagnosis is the daily challenge for the radiologist, clinician, and patient. PMID:1975109

  14. Diabetic foot complications: diagnosis and management.

    PubMed

    Giurini, John M; Lyons, Thomas E

    2005-09-01

    Foot complications in patients with diabetes mellitus are a challenge to the health care industry. A great deal of expenditure is due to the management of diabetic foot complications. This places a great burden on the health care industry. It also places a great burden on those diabetic patients with foot complications and their families. Therefore, their effective management in an efficient manner is crucial to our patients. To deal with these problems, a dedicated, knowledgeable, and experienced multidisciplinary team is key. Intervention at the earliest possible time yields the best outcome. Prevention is the focus for those with no ulcerations. For those with ulcerations, prompt recognition and treatment is key. The importance of classifying ulcerations according to size, depth, presence or absence of infection, and vascular status can not be overstated. Proper offloading is vital for those with neuropathic lesions. Recognition of patients with a component of ischemia and vascular intervention to increase perfusion will aid in wound healing. Of course deep infection requires immediate drainage. All efforts of those in the multidisciplinary team are directed at the restoration and maintenance of an ulcer-free foot which is important in enabling our patients to maintain their ambulatory status.

  15. Stress fractures of the foot and leg.

    PubMed

    Meyer, S A; Saltzman, C L; Albright, J P

    1993-04-01

    Stress fractures are overuse injuries of bone. Basketball players are particularly prone to develop the notoriously "troublesome" stress fractures of the foot and leg. This article reviews the pathogenesis, epidemiology, diagnosis, and treatment of stress fractures, with specific emphasis on the care of the basketball athlete.

  16. Is the Eichenholtz classification still valid for the diabetic Charcot foot?

    PubMed

    Chantelau, Ernst Adolf; Grützner, Gotthard

    2014-01-01

    In his 1966 monograph "Charcot joints", Sidney N. Eichenholtz (1909-2000) described "three well defined stages … in the course and development of a Charcot joint", based on plain X-rays of 68 patients. Since then, medical imaging has advanced very much: computed tomography and magnetic resonance imaging (MRI) scans exceed plain X-ray by far in detecting foot fractures and other injuries. The earliest, nondeforming, X-ray-negative inflammatory stage of the acute Charcot joint of the diabetic foot can be visualised only by use of MRI. This stage, which Eichenholtz evidently failed to recognise, will heal without significant arthropathy, if treated in time. By contrast, the stages considered by Eichenholtz inevitably result in major arthropathy and foot deformity. Hence, superseding the Eichenholtz classification is overdue. We propose an MRI-based classification comprising two severity grades (0 and 1, according to absence/presence of cortical fractures) and two stages (active/inactive, according to presence/absence of skeletal inflammation).

  17. The effects of lumbar stabilization exercises on foot pressure of older individuals while walking.

    PubMed

    Jung, Sunmi; Shim, Jemyung; Mun, Dongchul

    2015-01-01

    [Purpose] The purpose of this study was to examine the effect of lumbar stabilization on pressure distribution in old women. [Subjects] The subjects of this study were 14 women aged 65 or older who agreed to participate in this study. They had a sufficient range of motion and muscle strength to perform the postures in this study's program and were without gait problems, congenital deformity, orthopedic disorder, or neurological disorder. [Methods] The participants performed a group exercise program that promotes lumbar stabilization for 50 minutes per session by following the instructions of a physical therapist. Gait Analyzer was used to measure the foot pressure of individual participants from three measurements for each lumbar stabilization exercise, and the mean values were used. The mean values were then compared between before and after the exercises by paired t-test. [Results] Pressure in F3 and F6 statistically significantly decreased from 2.06±1.23% N/cm(2) to 1.55±1.02% N/cm(2) and from 7.40±1.52% N/cm(2) to 5.95±1.76% N/cm(2), respectively, after the intervention, but no significant differences were found in the other foot areas. [Conclusion] The lumbar stabilization exercises affected the pressure evenly over the entire foot and, in particular, in the inner area of the forefoot.

  18. 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

  19. Symmetry of foot alignment and ankle flexibility in paediatric Charcot-Marie-Tooth disease

    PubMed Central

    Burns, Joshua; Ouvrier, Robert; Estilow, Tim; Shy, Rosemary; Laurá, Matilde; Eichinger, Kate; Muntoni, Francesco; Reilly, Mary M.; Pareyson, Davide; Acsadi, Gyula; Shy, Michael E.; Finkel, Richard S.

    2012-01-01

    Background Charcot-Marie-Tooth disease is the most common inherited nerve disorder and typically presents with pes cavus foot deformity and ankle equinus during childhood. Level in the variation of symmetry of musculoskeletal lower limb involvement across the clinical population is unknown, despite early reports describing gross asymmetry. Methods We measured foot alignment and ankle flexibility of the left and right limbs using accurate and reliable standardised paediatric outcome measures in 172 patients aged 3–20 years with a variety of disease subtypes recruited from the United States, United Kingdom, Italy and Australia. Findings While a large range of differences existed between left and right feet for a small proportion of children, there was no overall significant difference between limbs. Interpretation There are two important implications of these findings. Children with Charcot-Marie-Tooth disease generally exhibit symmetrical foot alignment and ankle flexibility between limbs. As such, analysing one limb only for biomechanical-related research is appropriate and satisfies the independence requirements for statistical analysis. However, because there are large differences between feet for a small proportion of children, an individualised limb-focused approach to clinical care is required. PMID:22424781

  20. 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.

  1. Local infiltration of liposome bupivacaine in foot and ankle surgery: case-based reviews.

    PubMed

    Herbst, Steven A

    2014-10-01

    Foot and ankle surgical procedures, ranging from simple procedures, such as bunionectomy and correction of hammer toe, to more complex surgery, such as ankle fusion and ankle replacement, are extremely painful. Moreover, there is increasing interest in performing these procedures in an outpatient setting. Nerve blocks are extensively used in foot and ankle surgery, and commonly used techniques include sciatic nerve block with saphenous nerve augmentation; ankle block; and local, digital, or field block. Whereas more extensive blocks are associated with increased medical risk, higher cost, and delayed ambulation, more local approaches may not provide an adequate duration of effect. EXPAREL® (bupivacaine liposome injectable suspension) is an extended-release local anesthetic that can be infiltrated directly into the surgical site by the orthopedic surgeon to provide continuous and effective analgesia at the site of surgical injury for up to 72 hours. Two cases that illustrate the use of EXPAREL® in foot and ankle surgery are described. The first case involves ankle replacement in an active 58-year-old man with a 20-plus-year history of arthritis. The second case involves a young woman undergoing surgery for a talar neck fracture-dislocation with an open injury, dislocated subtalar joint, avascular talus, and considerable deformity. Both patients reported excellent control of postsurgical pain. PMID:25303454

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

    PubMed

    Liu, Yu-Bin; Jiang, Shu-Yun; Zhao, Li; Yu, Yan; 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

  3. 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.

  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. [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. PMID:19857299

  6. 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.

  7. Deformed wing virus.

    PubMed

    de Miranda, Joachim R; Genersch, Elke

    2010-01-01

    Deformed wing virus (DWV; Iflaviridae) is one of many viruses infecting honeybees and one of the most heavily investigated due to its close association with honeybee colony collapse induced by Varroadestructor. In the absence of V.destructor DWV infection does not result in visible symptoms or any apparent negative impact on host fitness. However, for reasons that are still not fully understood, the transmission of DWV by V.destructor to the developing pupae causes clinical symptoms, including pupal death and adult bees emerging with deformed wings, a bloated, shortened abdomen and discolouration. These bees are not viable and die soon after emergence. In this review we will summarize the historical and recent data on DWV and its relatives, covering the genetics, pathobiology, and transmission of this important viral honeybee pathogen, and discuss these within the wider theoretical concepts relating to the genetic variability and population structure of RNA viruses, the evolution of virulence and the development of disease symptoms.

  8. 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.

  9. 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.

  10. 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.

  11. Postlaminectomy cervical deformity.

    PubMed

    Deutsch, Harel; Haid, Regis W; Rodts, Gerald E; Mummaneni, Praveen V

    2003-09-15

    Postlaminectomy cervical kyphosis is an important consideration when performing surgery. Identifying factors predisposing to postoperative deformity is essential. The goal is to prevent postlaminectomy cervical kyphosis while exposing the patient to minimal additional morbidity. When postlaminectomy kyphosis does occur, surgical correction is often required and performed via an anterior, posterior, or combined approach. The authors discuss the indications for surgical approaches as well as clinical results. PMID:15347223

  12. 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

  13. Deformation of wrinkled graphene.

    PubMed

    Li, Zheling; Kinloch, Ian A; Young, Robert J; Novoselov, Kostya S; Anagnostopoulos, George; Parthenios, John; Galiotis, Costas; Papagelis, Konstantinos; Lu, Ching-Yu; Britnell, Liam

    2015-04-28

    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

  14. 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

  15. 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.

  16. Treatment of Madelung's deformity.

    PubMed

    Saffar, P; Badina, A

    2015-12-01

    Treatment of Madelung's deformity is still controversial. We reviewed retrospectively 19 patients with Madelung's deformity (two bilateral, 21 cases) who underwent surgery to the radius and ulna to improve range of motion, decrease pain and improve appearance of the wrist. Nineteen patients underwent 21 distal radial osteotomy procedures using three different techniques: subtraction, addition or dome osteotomy. Ulnar shortening and redirection of the distal ulna was performed in 12 cases; a long oblique osteotomy was used in 10 of these cases. The Sauvé-Kapandji technique was performed in five cases, an ulnar distal epiphysiodesis in two cases and a combination of osteotomy and epiphysiodesis in one case. The aim was to reduce the distal radial slope and to restore the orientation and congruity of the distal radio-ulnar joint and to improve its function. Pain was reduced as a result of the procedure: more than 75% of the cases had no or intermittent pain at the review. Pronation improved from 63° to 68° (P=0.467, not significant) and supination improved from 48° to 72° on average (P=0.034, significant). Grip strength increased from 11 to 18 kgf (P=0.013, significant). Madelung's deformity is not always a benign condition and it responds well to corrective osteotomies. PMID:26525609

  17. The influence of football boot construction on ball velocity and deformation

    NASA Astrophysics Data System (ADS)

    Taha, Zahari; Azri Aris, Mohd; Hasnun Arif Hassan, Mohd

    2013-12-01

    Research on the biomechanical properties of football boots has received little scientific attention. Recently, modern and scientific football boots has been developed that afford excellent ball control, shooting and running ability. Different constructions of football boot deliver different velocity and deformation of the ball. In this study, three commercially available football boots were compared during kicking in terms of, ball velocity and deformation of the ball. A subject performed three repetitive shots of the ball into the net for each football boot model. The footballer's foot and the ball velocity were recorded using a high speed camera. From the recorded video, the kicking velocity, ball velocity and ball deformation were measured. Based on the foot and ball velocity data, the Coefficient of Restitution (COR) was calculated. The results obtained show the COR value varies with different boots (CORBootA = 0.89, CORBootB = 0.59, CORBootC = 0.47) thus delivers different ball velocities at same kicking foot velocity (Uleg = 14 ms-1). It is apparent that the Boot A was made with the best upper material (Teijin synthetic leather), design and also construction of the boot.

  18. 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

  19. 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

  20. Deformation of the Dirac equation

    NASA Astrophysics Data System (ADS)

    Faizal, Mir; Kruglov, Sergey I.

    2016-10-01

    In this paper, we will first clarify the physical meaning of having a minimum measurable time. Then we will combine the deformation of the Dirac equation due to the existence of minimum measurable length and time scales with its deformation due to the doubly special relativity. We will also analyze this deformed Dirac equation in curved spacetime, and observe that this deformation of the Dirac equation also leads to a nontrivial modification of general relativity. Finally, we will analyze the stochastic quantization of this deformed Dirac equation on curved spacetime.

  1. Sex estimation from foot dimensions in an indigenous Indian population.

    PubMed

    Sen, Jaydip; Kanchan, Tanuj; Ghosh, Shila

    2011-01-01

    Dismembered/severed human remains are frequently found in cases of mass disasters and criminal mutilation. Sex estimation from foot dimensions, therefore, has a vital role in establishing personal identity. There is a paucity of literature on this issue from various Indian populations. The "Rajbanshi" is one such indigenous population located in the state of West Bengal, India. The present study attempts to estimate sex from foot length, foot breadth, and foot index among 350 living adult Rajbanshi (175 men and 175 women) individuals (age range: 18-50 years). The study concludes that foot dimensions show significant sex differences. Both sectioning point and regression analyses can be used to estimate sex from foot dimensions. However, multiple regression models appear to have the maximum accuracy in sex differentiation. Although statistically significant sex differences are evident for foot index, its practical utility appears to be limited because of considerable overlap.

  2. 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

  3. Multi-plug insole design to reduce peak plantar pressure on the diabetic foot during walking

    PubMed Central

    Actis, Ricardo L.; Ventura, Liliana B.; Lott, Donovan J.; Smith, Kirk E.; Commean, Paul K.; Hastings, Mary K.; Mueller, Michael J.

    2009-01-01

    There is evidence that appropriate footwear is an important factor in the prevention of foot pain in otherwise healthy people or foot ulcers in people with diabetes and peripheral neuropathy. A standard care for reducing forefoot plantar pressure is the utilization of orthotic devices such as total contact inserts (TCI) with therapeutic footwear. Most neuropathic ulcers occur under the metatarsal heads, and foot deformity combined with high localized plantar pressure, appear to be the most significant factors contributing to these ulcers. In this study, patient-specific finite element models of the second ray of the foot were developed to study the influence of TCI design on peak plantar pressure (PPP) under the metatarsal heads. A typical full contact insert was modified based on the results of finite element analyses, by inserting 4 mm diameter cylindrical plugs of softer material in the regions of high pressure. Validation of the numerical model was addressed by comparing the numerical results obtained by the finite element method with measured pressure distribution in the region of the metatarsal heads for a shoe and TCI condition. Two subjects, one with a history of forefoot pain and one with diabetes and peripheral neuropathy, were tested in the laboratory while wearing therapeutic shoes and customized inserts. The study showed that customized inserts with softer plugs distributed throughout the regions of high plantar pressure reduced the PPP over that of the TCI alone. This supports the outcome as predicted by the numerical model, without causing edge effects as reported by other investigators using different plug designs, and provides a greater degree of flexibility for customizing orthotic devices than current practice allows. PMID:18266017

  4. [Transfer of the posterior tibialis tendon to restore an active dorsiflexion of the foot].

    PubMed

    Mehling, I; Lanz, U; Prommersberger, K-J; Fuhrmann, R A; van Schoonhoven, J

    2012-01-01

    After lesions of the peroneal nerve or damage of the tibialis anterior muscle a lack of active dorsiflexion leads to a drop foot deformity. Ober (1933) described a transfer of the posterior tibialis tendon to the dorsum of the foot to restore active extension of the foot. The aim of this retrospective study was to evaluate the results of this method and to compare our results with those in the literature.Between 1992 and 2004 we performed a posterior tibialis tendon transfer in 16 patients with an average age of 40 years. 10 patients suffered from complete peroneal nerve palsy, which was due to a traumatic lesion (n=8) or iatrogenic damage (n=2). 3 patients had an incomplete peroneal nerve palsy caused by iatrogenic lesion (n=2) and lumbar disc herniation (n=1). 3 patients demonstrated a malfunction of the anterior tibial muscle following a compartment syndrome. 14 patients were available for a clinical follow-up after an average of 64 months. Clinical assessment included the hindfoot, muscular strength, pain, limitation of function and subjective satisfaction. The clinical result was evaluated using the Stanmore score (0-100).8 patients were very satisfied and 2 were satisfied with their results, 4 patients were not satisfied. 11 patients had no pain. The active dorsal ankle extension averaged - 5.7° (10 to - 30°). The Stanmore score revealed an average of 62 points with an excellent result in 2, a good result in 5, a fair result in 2 and a poor result in 5 patients.Transfer of the posterior tibial muscle to restore active dorsiflexion of the foot is a therapeutic option. As it is known from the literature objective results were mostly fair, but there was a high degree of satisfaction among the patients. PMID:22382906

  5. 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

  6. Surgical reconstruction of a congenital foot deformity: hallux varus with brachymetatarsia of the first metatarsal.

    PubMed

    Glickman, S H; Cornfield, R H

    1990-01-01

    A literature review of the etiologies and treatments of both hallux varus and brachymetatarsia is presented. An unusual case report of a young girl with bilateral congenital hallux varus and brachymetatarsia of the first metatarsal is then discussed. A detailed account of the surgical correction consisting of autogenous bone grafts from adjacent metatarsals proved to demonstrate excellent biomechanical and cosmetic results. PMID:2258572

  7. 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.

  8. [Subintimal angioplasty and diabetic foot revascularisation].

    PubMed

    Pierret, Charles; Tourtier, Jean-Pierre; Bordier, Lise; Blin, Emmanuel; Duverger, Vincent

    2011-01-01

    Diabetic wounds foot are responsible for 5-10% minor or major amputation in France. In fact, amputation risk of lower limbs is 15-30% higher for diabetic patients. University of Texas classification (UT) is the reference for diabetic foot wound. It distinguish non ischemic and ischemic wound with more amputation. If ischaemia is combined, revascularization may be considered for salvage of the limb. Some revascularization techniques are well known: as surgical by-pass, angioplasty with or without stent, or hybrid procedures with the both. Subintimal angioplasty is a more recent endovascular technique, in assessment for old patients who are believed to be unsuitable candidates for conventional by-pass or angioplasty.

  9. Imaging in Foot and Ankle Arthritis.

    PubMed

    Wilkinson, Victoria H; Rowbotham, Emma L; Grainger, Andrew J

    2016-04-01

    The foot and ankle are commonly involved in a range of arthritides that affect the joints, bones, and soft tissues. Accurate plain film interpretation can often aid the diagnosis and monitor disease progression and treatment response. Ultrasound and MRI afford superior depiction of the soft tissues, and advances over recent years have centered on early detection of synovitis, enabling earlier diagnosis and treatment. Advantages and disadvantages of the imaging techniques of radiography, multidetector computed tomography, ultrasound, and MRI are discussed, as is optimization of these modalities for the assessment of the anatomically complex joints of the foot and ankle. Diagnostic features enabling differentiation between rheumatoid arthritis, seronegative spondyloarthropathies, osteoarthritis, gout, crystal deposition disease, pigmented villonodular synovitis, Charcot arthropathy, septic arthritis, synovial osteochondromatosis, hemophilia, and reflex sympathetic dystrophy are also reviewed. PMID:27336451

  10. 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.

  11. 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.

  12. Tendon transfers for the drop foot.

    PubMed

    Schweitzer, Karl M; Jones, Carroll P

    2014-03-01

    The paralytic drop foot represents a challenging problem for even the most experienced orthopedic surgeon. Careful patient selection, thorough preoperative examination and planning, and application of tendon transfer biomechanical and physiologic principles outlined in this article can lead to successful results, either through a posterior tibialis tendon transfer, Bridle transfer, or variations on these procedures. Achilles lengthening or gastrocnemius recession may also be needed at the time of tendon transfer. PMID:24548510

  13. Diagnostic dilemmas in foot and ankle injuries

    SciTech Connect

    Keene, J.S.; Lange, R.H.

    1986-07-11

    Differential diagnosis of foot and ankle injuries should include (1) stress fractures of the great toe sesamoids, the shaft of the fifth metatarsal, and the tarsal navicular bone; (2) transchondral talar-dome fractures; (3) fractures of the os trigonum; and (4) dislocating peroneal tendons. Diagnosis of these injuries is challenging because the initial roentgenograms often are normal, and special clinical tests and ancillary studies are required.

  14. 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.

  15. 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.

  16. The pathway to foot ulceration in diabetes.

    PubMed

    Boulton, Andrew J M

    2013-09-01

    It should now be possible to achieve a reduction in the incidence of foot ulceration and amputations as knowledge about pathways that result in both these events increases. However, despite the universal use of patient education and the hope of reducing the incidence of ulcers in high-risk patients, there are no appropriately designed large, randomized controlled trials actually confirming that education works. It has been recognized for some years that education as part of a multidisciplinary approach to care of the diabetic foot can help to reduce the incidence of amputations in certain settings. Ultimately, however, a reduction in neuropathic foot problems will only be achieved if we remember that the patients with neuropathic feet have lost their prime warning signal—pain—that ordinarily brings patients to their doctor. Very little training is offered to health care professionals as to how to deal with such patients. Much can be learned about the management of such patients from the treatment of individuals with leprosy: if we are to succeed, we must realize that with loss of pain there is also diminished motivation in the healing of and prevention of injury. PMID:23992891

  17. Health literacy and diabetic foot ulcer healing.

    PubMed

    Margolis, David J; Hampton, Michelle; Hoffstad, Ole; Malay, D Scot; Thom, Stephen

    2015-01-01

    The adherence by patients to diabetic foot ulcer therapy is often difficult. The goal of this study was to begin to understand how a patient's health literacy affects their foot ulcer management decisions. Initially using a cross-sectional study design, we evaluated diabetics with foot ulcers within 4 weeks of being asked to participate in a longitudinal study. We assessed health literacy using measures of general health literacy, diabetes health literacy, diabetes self-efficacy, and diabetes numeracy. Individuals enrolled in the study had higher health literacy based on the Short Test of Functional Health Literacy in Adults [33.8 (SD 2.3) versus 27.3 (SD 9.6); p = 0.009] as compared to individuals who previously declined an invitation to enroll in the study. Furthermore, patients with lower Short Test of Functional Health Literacy in Adults scores had larger (p = 0.04) and older (p = 0.125) wounds (markers for poorer prognosis). Other measures of literacy showed similar results. In conclusion, those with diminished health literacy were less likely to enroll in an investigational study and had wounds that were less likely to heal.

  18. 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

  19. Can We Measure the Heel Bump? Radiographic Evaluation of Haglund's Deformity.

    PubMed

    Bulstra, Gythe H; van Rheenen, Thijs A; Scholtes, Vanessa A B

    2015-01-01

    Haglund's deformity is a symptomatic posterosuperior deformity of the heel. The lateral radiograph of the ankle will show a prominent, large, posterosuperior part of the calcaneus, which can be measured using the Fowler and Philips angle (FPA, the angle between the posterior and plantar surface of the calcaneus) and the calcaneal pitch angle (CPA, the angle between the sole of the foot and the plantar part of the calcaneus). Although these angles are commonly used, these radiographic angle measurements have never shown a relationship with Haglund's deformity. In 78 patients (51% male) with symptomatic Haglund's deformity and a control group of 100 patients (41% male) with no heel complaints, we measured the FPA and CPA on weightbearing lateral radiographs of the foot. Using an unpaired t tests, no significant difference was found between the 2 groups in the FPA (p = .40). We measured a significant difference in the CPA between the Haglund group and the control group (p = .014). Subgroup analysis showed that this difference was mainly found in females (p < .00), with no significant difference seen in the males (p < .48). Females with Haglund's deformity will have a greater CPA than will females without Haglund's deformity. The CPA showed a difference between the Haglund and non-Haglund groups, although mainly in females. Although the evidence from our study is limited, it would be interesting to study the CPA further, because it implicates the verticalization of the calcaneus. This change in position results in extra traction on the Achilles tendon and can eventually cause tendinitis and bursitis. Radiographic measurement should be used as an auxiliary tool. If the calcaneus tends to change position, it would be interesting to understand this process, which could eventually lead to improvement in the treatment of Haglund's deformity.

  20. Ultrasoft, highly deformable microgels.

    PubMed

    Bachman, Haylee; Brown, Ashley C; Clarke, Kimberly C; Dhada, Kabir S; Douglas, Alison; Hansen, Caroline E; Herman, Emily; Hyatt, John S; Kodlekere, Purva; Meng, Zhiyong; Saxena, Shalini; Spears, Mark W; Welsch, Nicole; Lyon, L Andrew

    2015-03-14

    Microgels are colloidally stable, hydrogel microparticles that have previously been used in a range of (soft) material applications due to their tunable mechanical and chemical properties. Most commonly, thermo and pH-responsive poly(N-isopropylacrylamide) (pNIPAm) microgels can be fabricated by precipitation polymerization in the presence of the co-monomer acrylic acid (AAc). Traditionally pNIPAm microgels are synthesized in the presence of a crosslinking agent, such as N,N'-methylenebisacrylamide (BIS), however, microgels can also be synthesized under 'crosslinker free' conditions. The resulting particles have extremely low (<0.5%), core-localized crosslinking resulting from rare chain transfer reactions. AFM nanoindentation of these ultralow crosslinked (ULC) particles indicate that they are soft relative to crosslinked microgels, with a Young's modulus of ∼10 kPa. Furthermore, ULC microgels are highly deformable as indicated by a high degree of spreading on glass surfaces and the ability to translocate through nanopores significantly smaller than the hydrodynamic diameter of the particles. The size and charge of ULCs can be easily modulated by altering reaction conditions, such as temperature, monomer, surfactant and initiator concentrations, and through the addition of co-monomers. Microgels based on the widely utilized, biocompatible polymer polyethylene glycol (PEG) can also be synthesized under crosslinker free conditions. Due to their softness and deformability, ULC microgels are a unique base material for a wide variety of biomedical applications including biomaterials for drug delivery and regenerative medicine.

  1. Estimation of stature from foot length and foot breadth among the Rajbanshi: an indigenous population of North Bengal.

    PubMed

    Sen, Jaydip; Ghosh, Shila

    2008-10-25

    In forensic anthropology, estimation of stature from feet dimensions plays a significant role in establishing personal identity. There is a scarcity of literature on the estimation of stature from foot length and foot breadth among various Indian populations, including the indigenous populations found in the northern part of the state of West Bengal, India. The Rajbanshis and the Meches are two such indigenous populations. The present study is an attempt to understand the relationship between stature and feet dimensions among Rajbanshi male and female individuals of North Bengal, India. Measurements of stature, foot length and foot breadth were recorded from 350 adult Rajbanshi and 100 adult Meche individuals (age range: 18-50 years) residing in different villages located in the Darjeeling District of West Bengal. The Technical Error of Measurements was within the accepted limits. The results of the present study indicate that female Rajbanshi individuals exhibit shorter stature and smaller feet than their male counterparts. Using ANOVA, it is determined that there was significant differences (p<0.05) in stature, foot length and foot breadth between sexes. Using paired t-test, it is further observed that bilateral variation was significant (p<0.05) within sexes with respect to foot length, but not with foot breadth (p>0.05). Stature, foot length and foot breadth are positively and significantly correlated with each other (p<0.01). The higher correlation coefficient between stature and foot length over that of stature and foot breadth points to the fact that foot length, rather than foot breadth, is more accurate in estimating stature. Sexual dimorphism is more pronounced than bilateral differences among Rajbanshi individuals. Using linear regression, it is observed that stature was strongly dependent on foot length and foot breadth. Foot breadth is strongly dependent on foot length. Prediction of stature is more accurate by using step-wise multiple regression. Age

  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. 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.

  4. Investigations of Potential Phenotypes of Foot Osteoarthritis: Cross‐Sectional Analysis From the Clinical Assessment Study of the Foot

    PubMed Central

    Marshall, Michelle; Thomas, Martin J.; Menz, Hylton B.; Myers, Helen L.; Thomas, Elaine; Downes, Thomas; Peat, George; Roddy, Edward

    2016-01-01

    Objective To investigate the existence of distinct foot osteoarthritis (OA) phenotypes based on pattern of joint involvement and comparative symptom and risk profiles. Methods Participants ages ≥50 years reporting foot pain in the previous year were drawn from a population‐based cohort. Radiographs were scored for OA in the first metatarsophalangeal (MTP) joint, first and second cuneometatarsal, navicular first cuneiform, and talonavicular joints according to a published atlas. Chi‐square tests established clustering, and odds ratios (ORs) examined symmetry and pairwise associations of radiographic OA in the feet. Distinct underlying classes of foot OA were investigated by latent class analysis (LCA) and their association with symptoms and risk factors was assessed. Results In 533 participants (mean age 64.9 years, 55.9% female) radiographic OA clustered across both feet (P < 0.001) and was highly symmetrical (adjusted OR 3.0, 95% confidence interval 2.1, 4.2). LCA identified 3 distinct classes of foot OA: no or minimal foot OA (64%), isolated first MTP joint OA (22%), and polyarticular foot OA (15%). After adjustment for age and sex, polyarticular foot OA was associated with nodal OA, increased body mass index, and more pain and functional limitation compared to the other classes. Conclusion Patterning of radiographic foot OA has provided insight into the existence of 2 forms of foot OA: isolated first MTP joint OA and polyarticular foot OA. The symptom and risk factor profiles in individuals with polyarticular foot OA indicate a possible distinctive phenotype of foot OA, but further research is needed to explore the characteristics of isolated first MTP joint and polyarticular foot OA. PMID:26238801

  5. Shape Determination for Deformed Cavities

    SciTech Connect

    Lee, Lie-Quan; Akcelik, Volkan; Chen, Sheng; Ge, Lixin; Li, Zenghai; Ng, Cho; Xiao, Liling; Ko, Kwok; Ghattas, Omar; /Texas U.

    2006-10-04

    A realistic superconducting RF cavity has its shape deformed comparing to its designed shape due to the loose tolerance in the fabrication process and the frequency tuning for its accelerating mode. A PDE-constrained optimization problem is proposed to determine the deformation of the cavity. A reduce space method is used to solve the PDE-constrained optimization problem where design sensitivities were computed using a continuous adjoint approach. A proof-of-concept example is given in which the deformation parameters of a single cavity-cell with two different types of deformation were computed.

  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. 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

  8. Care of Patients with Diabetic Foot Disease in Oman.

    PubMed

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

    2016-08-01

    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

  9. 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.

  10. Pathogenesis of foot ulcers and the need for offloading.

    PubMed

    Rathur, H M; Boulton, A J

    2005-04-01

    Diabetic foot ulceration represents a major medical, social and economic problem all over the world. While more than 5% of diabetic patients have a history of foot ulceration, the cumulative lifetime incidence may be as high as 15%. Ethnic differences exist in both ulcer and amputation incidences. Foot ulceration results from the interaction of several contributory factors, the most important of which is neuropathy. The use of the total-contact cast is demonstrated in the treatment of plantar neuropathic ulcers. Histological evidence suggests that pressure relief results in chronic foot ulcers changing their morphological appearance by displaying some features of an acute wound. Thus, repetitive stresses on the insensate foot appear to play a major role in maintaining ulcer chronicity. It is hoped that research activity in foot disease will ultimately result in fewer ulcers and less amputation in diabetes.

  11. 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

  12. 6-Axis Force/Moment Sensor In Humanoid Robot Foot

    NASA Astrophysics Data System (ADS)

    Ai-Faifi, Badrih; Al-Shammary, Maryam; Al-Shehry, Zinab

    2014-07-01

    The foot is the most Important part of the humanoid .Thought the sensor of the robot can understand the environment In which they live, it is important to developed an intelligent foot. In order to walk on uneven terrain safely this poster describes an intelligent foot with 6- axis force/moment sensors for humanoid robot that is one of the solution that can help the robot to walk in uneven terrain safely.

  13. Optimal foot shape for a passive dynamic biped.

    PubMed

    Kwan, Maxine; Hubbard, Mont

    2007-09-21

    Passive walking dynamics describe the motion of a biped that is able to "walk" down a shallow slope without any actuation or control. Instead, the walker relies on gravitational and inertial effects to propel itself forward, exhibiting a gait quite similar to that of humans. These purely passive models depend on potential energy to overcome the energy lost when the foot impacts the ground. Previous research has demonstrated that energy loss at heel-strike can vary widely for a given speed, depending on the nature of the collision. The point of foot contact with the ground (relative to the hip) can have a significant effect: semi-circular (round) feet soften the impact, resulting in much smaller losses than point-foot walkers. Collisional losses are also lower if a single impulse is broken up into a series of smaller impulses that gradually redirect the velocity of the center of mass rather than a single abrupt impulse. Using this principle, a model was created where foot-strike occurs over two impulses, "heel-strike" and "toe-strike," representative of the initial impact of the heel and the following impact as the ball of the foot strikes the ground. Having two collisions with the flat-foot model did improve efficiency over the point-foot model. Representation of the flat-foot walker as a rimless wheel helped to explain the optimal flat-foot shape, driven by symmetry of the virtual spoke angles. The optimal long period foot shape of the simple passive walking model was not very representative of the human foot shape, although a reasonably anthropometric foot shape was predicted by the short period solution.

  14. Facts that every vascular surgeon needs to know about the diabetic foot.

    PubMed

    Edmonds, M

    2014-04-01

    This paper describes important aspects of the diabetic foot which the vascular surgeon needs to understand to efficiently manage the diabetic foot. Firstly, it emphasises the three main pathologies which come together in the diabetic foot, namely neuropathy, ischemia and immunopathy, the latter predisposing to infection. As a result of neuropathy, the signs and symptoms of tissue breakdown, infection and ischemia may be minimal. Nevertheless the pathology emanating from such clinical events proceeds rapidly without the body being aware of it and the end stage of tissue death and necrosis is quickly reached. It is important to have a prompt system of evaluation and intervention to prevent the rapid progression to necrosis. Thus, secondly, the paper describes a simple rapid assessment of the diabetic foot, which comprises inspection, palpation and sensory testing and leads on to a modern classification and staging of the diabetic foot. This classifies six subdivisions of the diabetic foot: foot with neuropathic ulceration, Charcot foot, neuroischemic foot, critically ischemic foot, acutely ischemic foot and renal ischemic foot and six stages in the natural history of each of these subdivisions: normal foot, high risk foot, ulcerated foot, infected foot, necrotic foot and unsalvageable foot. Thirdly, it describes modern management of the diabetic foot, emphazising wound care and revascularization within the context of a multidisciplinary care team that provides integrated care focused in a diabetic foot clinic, to which patients with diabetes should have easy and rapid access. Members of the team include podiatrist, nurse, orthotist, physician, radiologist and surgeons.

  15. Experimental deformation of rocksalt

    NASA Astrophysics Data System (ADS)

    Handin, J.; Russell, J. E.; Carter, N. L.

    Using newly designed apparatus for triaxial-compression testing of 10 by 20-cm cores of Avery Island rocksalt at constant strain-rates between 10-4 and 10-6/s, temperatures between 100° and 200°C, and confining pressures of 3.4 and 20 MPa, comparing our data with those of other workers on the same material, and observing natural deformations of rocksalt, we find that (1) constant-strain-rate and quasi-constant stress-rate tests (both often called quasi-static compression tests) yield essentially similar stress-strain relations, and these depend strongly on strain rate and temperature, but not confining pressure; (2) fracture excluded, the deformation mechanisms observed for differential stresses between 0.5 and 20 MPa are intracrystal-line slip (dislocation glide and cross-slip) and polygonization (dislocation glide and climb by ion-vacancy pipe diffusion); (3) the same steady-state strain rate ɛ., and flow stress are reached at the same temperature in both constant-strain-rate and constant-stress (creep) tests, but the strain-time data from transient creep tests do not match the strain-hardening data unless the initial strain, ɛ0 (time-dependent in rocksalt) is accounted for; in creep tests the clock is not started until the desired constant stress is reached; (4) because the stress-strain curve contains the entire history of the deformation, the constant-strain-rate test rather than the creep test may well be preferred as the source of constitutive data; (5) furthermore, if the stress or temperature of the creep test is too low to achieve the steady state in laboratory time, one cannot predict the steady-state flow stress or strain rate from the transient response alone, whereas we can estimate them rather well from constant-strain-rate data even when strain rates are too high or temperatures too low to reach the steady state within a few hours; (6) the so-called "baseline creep law", giving creep strain, ɛ = ea[1-exp(-ξt)]+ɛ. ss t, where ea, ξ, and

  16. Diagnosis and management of infection in the diabetic foot.

    PubMed

    Peters, Edgar J G; Lipsky, Benjamin A

    2013-09-01

    Foot infections are common in persons with diabetes mellitus. Most diabetic foot infections occur in a foot ulcer, which serves as a point of entry for pathogens. Unchecked, infection can spread contiguously to involve underlying tissues, including bone. A diabetic foot infection is often the pivotal event leading to lower extremity amputation, which account for about 60% of all amputations in developed countries. Given the crucial role infections play in the cascade toward amputation, all clinicians who see diabetic patients should have at least a basic understanding of how to diagnose and treat this problem.

  17. IBA in deformed nuclei

    SciTech Connect

    Casten, R.F.; Warner, D.D.

    1982-01-01

    The structure and characteristic properties and predictions of the IBA in deformed nuclei are reviewed, and compared with experiment, in particular for /sup 168/Er. Overall, excellent agreement, with a minimum of free parameters (in effect, two, neglecting scale factors on energy differences), was obtained. A particularly surprising, and unavoidable, prediction is that of strong ..beta.. ..-->.. ..gamma.. transitions, a feature characteristically absent in the geometrical model, but manifest empirically. Some discrepancies were also noted, principally for the K=4 excitation, and the detailed magnitudes of some specific B(E2) values. Considerable attention is paid to analyzing the structure of the IBA states and their relation to geometric models. The bandmixing formalism was studied to interpret both the aforementioned discrepancies and the origin of the ..beta.. ..-->.. ..gamma.. transitions. The IBA states, extremely complex in the usual SU(5) basis, are transformed to the SU(3) basis, as is the interaction Hamiltonian. The IBA wave functions appear with much simplified structure in this way as does the structure of the associated B(E2) values. The nature of the symmetry breaking of SU(3) for actual deformed nuclei is seen to be predominantly ..delta..K=0 mixing. A modified, and more consistent, formalism for the IBA-1 is introduced which is simpler, has fewer free parameters (in effect, one, neglecting scale factors on energy differences), is in at least as good agreement with experiment as the earlier formalism, contains a special case of the 0(6) limit which corresponds to that known empirically, and appears to have a close relationship to the IBA-2. The new formalism facilitates the construction of contour plots of various observables (e.g., energy or B(E2) ratios) as functions of N and chi/sub Q/ which allow the parameter-free discussion of qualitative trajectories or systematics.

  18. 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

  19. 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.

  20. Mechanism and design analysis of articulated ankle foot orthoses for drop-foot.

    PubMed

    Alam, Morshed; Choudhury, Imtiaz Ahmed; Bin Mamat, Azuddin

    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.

  1. A Pacinian hyperplasia of the foot.

    PubMed

    Satge, D; Nabhan, J; Nandiegou, Y; Hermann, B; Goburdhun, J; Labrousse, F

    2001-04-01

    A case of Pacinian hyperplasia of the right great toe is reported. Pacinian hyperplasia is a rare benign and recently recognized painful lesion composed of an excess of well formed or hyperplastic Pacinian corpuscules, normaly involved in sensory innervation. This lesion that is usually observed in the hand, must be distinguished from nerve tumors harboring onion-bulb structure which are not true well formed Pacinian corpuscules and from Morton neuroma. Pacinian hyperplasia is considered a reactive lesion and not a true neoplasm. To our knowledge, this case is the first described in the foot.

  2. Phaeohyphomycotic cyst in the Foot by Exophiala.

    PubMed

    Ch, Karunakarreddy; Thejaswids, Poornachandra; Kini, Hema; Shenoy, Suchitra; Prabhu, Shivananda

    2014-11-01

    A 52-year-old male, presented to us with a swelling over plantar aspect of right foot following trauma. Clinically it was a cystic swelling diagnosed as an abscess; ultrasound showed thick walled multilocular collection with thick echogenic debris, following which complete excision of the swelling was done. A part of the swelling was sent for histopathological examination and cut section showed thick purulent material. Other part sent for culture sensitivity grew, Exophiala, which belongs to Dematiaceous group of fungi. Surgical excision with antifungal treatment is the management in general for fungal cyst, whereas in our case complete excision was done without antifungal treatment. PMID:25584264

  3. Foot and Ankle Stress Fractures in Athletes.

    PubMed

    Greaser, Michael C

    2016-10-01

    The incidence of stress fractures in the general athletic population is less than 1%, but may be as high as 15% in runners. Stress fractures of the foot and ankle account for almost half of bone stress injuries in athletes. These injuries occur because of repetitive submaximal stresses on the bone resulting in microfractures, which may coalesce to form complete fractures. Advanced imaging such as MRI and triple-phase bone scans is used to evaluate patients with suspected stress fracture. Low-risk stress fractures are typically treated with rest and protected weight bearing. High-stress fractures more often require surgical treatment. PMID:27637667

  4. [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.

  5. Future research on foot and mouth disease.

    PubMed

    Kitching, R P

    2002-12-01

    The recent outbreaks of foot and mouth disease (FMD) in Argentina, Europe, Japan, the Republic of Korea, South Africa and Uruguay have brought to world attention the devastating effects of the disease in a naïve population and the social and economic costs of control and eradication. The fact that much still remains unknown about the natural history of FMD virus came as a surprise to some. This paper attempts to identify where research should be directed in order to be better prepared in the future.

  6. 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.

  7. A basic study on quantitative evaluation of 3-dimensional foot contact with an inertial sensor for FES foot drop correction.

    PubMed

    Shiotani, Maho; Watanabe, Takashi

    2015-01-01

    In these days, FES is used to control ankle dorsiflexion of hemiplegic gait. Since not only dorsiflexion but also 3-dimensional foot contact isimportant for gait stability in hemiplegic gait, evaluation and control system of 3-dimensional foot contact with FES is needed to correct foot movement. In this study, the timing of initial contact and the timing when foot movement became stationary in the sagittal plane were detected, and the inclination angles in the sagittal and the frontal planes at these timings were used for evaluation. Using the inclination angles, 10 m walking of a hemiplegic subject under the 4 different gait conditions were quantitatively evaluated. The gait conditions were without FES, stimulation to the tibialis anterior, stimulation to the common peroneal nerve, and stimulation to both the tibialis anterior and the common peroneal nerve. Result of evaluation with the inclination angles showed that stimulation to the tibialis anterior could control foot contact appropriately in the sagittal plane, and stimulation to the common peroneal nerve was better to control foot inclination angle in the frontal plane. Inclination angle at the beginning of the stance phase indicated that FES system which used in clinical site commonly is not appropriate to control 3-dimensional foot contact. It was shown that inclination angle at the beginning of the stance phase was useful to evaluate 3-dimensional foot movements for FES foot drop correction.

  8. 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.

  9. 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).

  10. [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.

  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. PMID:22007412

  12. Effectiveness of modified ankle foot orthosis of low-temperature thermoplastics in idiopathic congenital talipes equino varus.

    PubMed

    Solanki, Punita Vasant; Sheth, Binoti Arun; Poduval, Murali; Sams, Stephen Brian Austin

    2010-07-01

    The aim of this study was to study the effectiveness of modified ankle foot orthosis fabricated from low-temperature thermoplastics, as an alternative orthosis for the maintenance of correction in idiopathic congenital talipes equino varus (CTEV) deformity. The study was conducted in infants after the completion of the Ponseti serial manipulation and cast treatment, with or without, percutaneous Achilles tenotomy. Both male and female infants with unilateral or bilateral CTEV deformity were included in our study. A custom-made modified ankle foot orthosis was fabricated on the day of the removal of the last plaster of Paris cast. Initial clinical assessment, including medical history, Pirani score, modified Dimeglio score, clinical method of evaluating tibial torsion, ankle and foot range of motion were carried out on the day of the fabrication of the orthosis. Follow-up assessments were carried out at regular intervals for a duration of 6 months. All infants were provided with a set of exercises in the outpatient department three to five times per week, and other sessions were carried out by the caregivers in the form of home exercise programmes, daily every 2 h. In our study, we had 40 infants. Of these, 12 were lost to follow-up. The remaining 28 infants (22 males and six females) were included in the study. Of the 28 infants, six were left sided, seven were right sided and 15 were bilateral cases. The age at which cast treatment was initiated ranged from 1 week to 8 months, and the age at which modified ankle foot orthosis was given ranged from 1 month 1 week to 15 months. The average number of plaster of Paris casts given was six. Sixteen infants required tenotomy. We found that there was a significant reduction in the Pirani and modified Dimeglio scores from baseline to the third and to the sixth months, that is, improvement and/or maintenance of the baseline scores of Pirani and modified Dimeglio was observed (P<0.05). The difference in the Pirani and

  13. Endothelial progenitor cells in diabetic foot syndrome.

    PubMed

    Drela, Ewelina; Stankowska, Katarzyna; Kulwas, Arleta; Rość, Danuta

    2012-01-01

    In the late 20th century endothelial progenitor cells (EPCs) were discovered and identified as cells capable of differentiating into endothelial cells. Antigens characteristic of endothelial cells and hematopoietic cells are located on their surface. EPCs can proliferate, adhere, migrate and have the specific ability to form vascular structure, and they have a wide range of roles: They participate in maintaining hemostasis, and play an important part in the processes of vasculogenesis and angiogenesis. They are sources of angiogenic factors, especially vascular endothelial growth factor (VEGF). EPCs exist in bone marrow, from which they are recruited into circulation in response to specific stimuli. Tissue ischemia is thought to be the strongest inductor of EPC mobilization. Local ischemia accompanies many pathological states, including diabetic foot syndrome (DFS). Impaired angiogenesis--in which EPCs participate--is typical of DFS. An analysis of the available literature indicates that in diabetic patients the number of EPCs declines and their functioning is impaired. Endothelial progenitor cells are crucial to vasculogenesis and angiogenesis during ischemic neovascularization. The pathomechanisms underlying impaired angiogenesis in patients with DFS is complicated, but the discovery of EPCs has shed new light on the pathogenesis of many diseases, including diabetes foot syndrome.

  14. Foot microcirculation and blood rheology in diabetes.

    PubMed

    Zioupos, P; Barbenel, J C; Lowe, G D; MacRury, S

    1993-03-01

    Diabetes mellitus is associated with circulatory abnormalities. The blood flow in the skin of the dorsum of the foot and haemorheological variables were measured in 36 subjects. They were divided into three equal groups of diabetic patients: those with neuropathy, and both age and sex matched non-diabetic subjects; all were characterized by age, duration of diabetes and blood biochemistry. High and low shear rate blood viscosities were measured; aggregation was characterized using a Myrerene Aggregometer. The microcirculation in the skin of the dorsum of the foot was measured using a laser Doppler flowmeter. Measurements were made at room temperature with the subjects supine with the leg horizontal, and then with the lower leg vertical; the measurements were repeated at 42 degrees C. Both diabetic groups had significantly increased low shear whole blood viscosity compared with normal subjects. The aggregation index was significantly greater in diabetic neuropaths than normal subjects. There were significant differences in the depth of vasomotor activity between the three groups, with the diabetic neuropaths commonly showing no motor activity at room temperature. The only significant correlations were between equilibrium laser Doppler values with the limb horizontal and both the low and high shear whole blood viscosities.

  15. Microsurgical management of the diabetic foot.

    PubMed

    Rainer, Christian; Schwabegger, Anton H; Meirer, Romed; Perkmann, Reinhold; Ninkovic, Marina; Ninkovic, Milomir

    2003-11-01

    Allthough there has been dramatic progress in limb salvage in recent decades, management of nonhealing wounds in diabetic patients continues to present a dilemma for the reconstructive surgeon. However, the acceptance of free-flap resurfacing of diabetic foot ulcers has increased in recent years. This study reviews 10 microvascular free muscle flaps in nine patients over a mean follow-up period of 44 months. Five patients had evidence of peripheral vascular disease. There was one flap loss, and nine flaps were transferred successfully. No perioperative mortality was encountered. The operations required a long, costly hospitalization (average hospital stay was 40 days). Seven of eight patients whose flaps survived had complications related to the free-flap recipient site. These seven patients underwent 20 secondary surgical procedures due to arterial and venous thrombosis, partial necrosis of the skin grafts, minor local infections, and gangrene or necrosis of the remaining toes. In three patients, progressive ischemic necrosis of the remaining toes, with total survival of the flap, was attributed to a microvascular steal phenomenon. However, all eight patients whose flaps survived subsequently ambulated on their flaps. The study demonstrates that microvascular surgery may result in functional lower-extremity salvage in diabetic patients with foot wounds that are not treatable by local flaps or skin grafts, and are destined for amputation.

  16. Behavior of captive white-footed mice.

    PubMed

    Kavanau, J L

    1967-03-31

    Detailed studies of the behavior of captive white-footed mice have cast a number of old problems in new perspectives. Many responses of small captive mammals cannot be interpreted at face value because of severe distortions of behavior that are caused by depriving the wild animal of natural outlets for activity. Confined animals are likely to seize upon and repeatedly exercise virtually any opportunities to modify (and alter their relationships with) their surroundings. In addition they have a strong tendency to counteract nonvolitional and "unexpected" deviations from the status quo. As a result, their responses do not bear an immutable relationship to the nature of the stimulus or other variable being modified; stimuli and activities that are rewarding in certain circumstances are avoided in others. These aspects of behavior have been illustrated by studies of nest occupancy, running in motordriven wheels, and control of intensity of illumination. The results of the control-of-illumination studies suggest the complex interplay of tendencies to modify features of the environment, to avoid conditions imposed compulsorily, and to select preferred levels of illumination. The importance of split-second timing, coordination, and quick reflex actions in the running of activity wheels is indicated by the fact that experienced white-footed mice prefer running in square "wheels" and wheels with hurdles to running in plain round wheels. The relatively conservative behavior of these mice in selecting between multiple sources of food and water and different types of activity wheels suggests the need for careful experimental design in free-choice studies with inexperienced animals. The tendency of trained animals to give some so-called "incorrect" responses even after long experience can be interpreted most reasonably in terms of the adaptive value of a certain degree of variability of behavior in the wild. White-footed mice readily master complex regimes in which several

  17. Characterization of laterally deformable elastomer membranes for microfluidics

    NASA Astrophysics Data System (ADS)

    Lee, S. J.; C-Y Chan, J.; Maung, K. J.; Rezler, E.; Sundararajan, N.

    2007-05-01

    This work presents experimental characterization and numerical modeling of laterally deflecting polydimethylsiloxane (PDMS) membranes under pneumatic actuation. The device for this study is a membrane valve seat that partially closes a perpendicular fluid microchannel, fabricated using single-layer soft lithography. Membranes with thickness between 8 and 14 µm have been experimentally tested up to 207 kPa, and maximum lateral displacement beyond 20 µm has been demonstrated. Investigation of geometric parameters by factorial design shows that the height of the membrane is more dominant than the width and thickness, and this is attributed to the zero-displacement boundary condition at the foot of the membrane where it is bonded to a flat substrate. A numerical model that incorporates hyperelastic material testing data shows close agreement with the deflection behavior of experimental samples, accurately predicting that a membrane of 10 µm thick, 100 µm wide and 45 µm tall deflects approximately 13 µm at 207 kPa. Simulation further shows that sidewall effects from bulk compression of the elastomer material in the actuation cavity have a significant effect, reducing maximum displacement by as much as 15% over predictions based on deformation that is limited strictly to the membrane only. Experimental yield, SEM imaging and stress simulations emphasize that the membrane foot region requires the greatest attention in terms of process development.

  18. Flatfoot deformity in children and adolescents: surgical indications and management.

    PubMed

    Bouchard, Maryse; Mosca, Vincent S

    2014-10-01

    Most children with flatfeet are asymptomatic and will never require treatment. In general, flatfoot deformity is flexible and will not cause pain or disability; it is a normal variant of foot shape. Thus, it is essential to reassure and educate patients and parents. A flatfoot with a contracture of the Achilles tendon may be painful. In these cases, a stretching program may help relieve pain. Scant convincing evidence exists to support the use of inserts or shoe modifications for effective relief of symptoms, and there is no evidence that those devices change the shape of the foot. The surgeon must be vigilant to identify the rare rigid flatfoot. Indications for flatfoot surgery are strict: failure of prolonged nonsurgical attempts to relieve pain that interferes with normal activities and occurs under the medial midfoot and/or in the sinus tarsi. In nearly all cases, an associated contracture of the heel cord is present. Osteotomies with supplemental soft-tissue procedures are the best proven approach for management of [corrected] flatfoot.

  19. Deforming the hippocampal map.

    PubMed

    Touretzky, David S; Weisman, Wendy E; Fuhs, Mark C; Skaggs, William E; Fenton, Andre A; Muller, Robert U

    2005-01-01

    To investigate conjoint stimulus control over place cells, Fenton et al. (J Gen Physiol 116:191-209, 2000a) recorded while rats foraged in a cylinder with 45 degrees black and white cue cards on the wall. Card centers were 135 degrees apart. In probe trials, the cards were rotated together or apart by 25 degrees . Firing field centers shifted during these trials, stretching and shrinking the cognitive map. Fenton et al. (2000b) described this deformation with an ad hoc vector field equation. We consider what sorts of neural network mechanisms might be capable of accounting for their observations. In an abstract, maximum likelihood formulation, the rat's location is estimated by a conjoint probability density function of landmark positions. In an attractor neural network model, recurrent connections produce a bump of activity over a two-dimensional array of cells; the bump's position is influenced by landmark features such as distances or bearings. If features are chosen with appropriate care, the attractor network and maximum likelihood models yield similar results, in accord with previous demonstrations that recurrent neural networks can efficiently implement maximum likelihood computations (Pouget et al. Neural Comput 10:373-401, 1998; Deneve et al. Nat Neurosci 4:826-831, 2001). PMID:15390166

  20. 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

  1. Skin and nail mycoses in patients with diabetic foot.

    PubMed

    Papini, M; Cicoletti, M; Fabrizi, V; Landucci, P

    2013-12-01

    Diabetes mellitus affects all socioeconomic and age groups and its incidence is rapidly increasing worldwide. The diabetic foot complication represents one of the most complex and serious complications in these patients. Fungal infections can also contribute to the severity of the diabetic foot. The aim of the present study was to evaluate the prevalence of foot skin and toenail mycosis in a group of 75 patients with diabetic foot complication and in a matched control group. Diabetic patients showed onychomycosis in 53.3% and foot skin mycosis in 46.7% of the cases, with a prevalence of both fungal infections significantly higher than that observed in the control group. At least one type of these fungal infections was present in 69.3% of diabetic subjects with a highly significant difference compared to control group (P<0.001). Trichophyton rubrum and Trichophyton interdigitale were the most common species responsible of both nail and skin infections. Candida spp, Fusarium spp, Aspergillus spp and other moulds. were found in about 1/3 onychomycosis. Previous toe amputation was significantly associated with both skin and nail mycosis. The present study confirms that both tinea pedis and onychomycosis have a high prevalence in subjects suffering from diabetic foot complication, and that the problem of fungal infections of the foot in diabetic subjects is still highly underestimated. Consequently, there is an important clinical rationale for careful mycological examination of diabetic foot and an adequate treatment tailored for each individual patient according to the fungal species involved.

  2. 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...

  3. 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...

  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, 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...

  6. 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...

  7. 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...

  8. 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:…

  9. 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

  10. 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.

  11. 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.

  12. Functional limitations due to foot involvement in spondyloarthritis.

    PubMed

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

    2016-07-01

    [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

  13. Management of diabetic foot ulcers: evaluation of case studies.

    PubMed

    Torkington-Stokes, Rachel; Metcalf, Daniel; Bowler, Philip

    2016-08-11

    This article explores local barriers to diabetic foot ulcer healing, and describes the use of a dressing designed to manage exudate, infection and biofilm (AQUACEL® Ag+ dressing (AQAg+)) on recalcitrant diabetic foot ulcers. The authors consider four case studies that demonstrate how managing local barriers to wound healing with antimicrobial and anti-biofilm dressings in protocols of care can improve outcomes for patients.

  14. Innovations in plantar pressure and foot temperature measurements in diabetes.

    PubMed

    Bus, S A

    2016-01-01

    Plantar pressure and temperature measurements in the diabetic foot primarily contribute to identifying abnormal values that increase risk for foot ulceration, and they are becoming increasingly more integrated in clinical practice and daily life of the patient. While plantar pressure measurements have long been present, only recently evidence shows their importance in ulcer prevention, as a data-driven approach to therapeutic footwear provision. The long-term monitoring of plantar pressures with the option to provide feedback, when alarming pressure levels occur, is a promising development in this area, although more technical and clinical validation is required. Shear is considered important in ulcer aetiology but is technically difficult to measure. Innovative research is underway to assess if foot temperature can act as a useful surrogate for shear. Because the skin heats up before it breaks down, frequent monitoring of foot temperature can identify these warning signals. This approach has shown to be effective in preventing foot ulcers. Innovation in diagnostic methods for foot temperature monitoring and evidence on cost effectiveness will likely facilitate implementation. Finally, monitoring of adherence to offloading treatment using temperature-based sensors has proven to be a feasible and relevant method with a wide range of possible research and patient care applications. These innovations in plantar pressure and temperature measurements illustrate an important transfer in diabetic foot care from subjective to objective evaluation of the high-risk patient. They demonstrate clinical value and a large potential in helping to reduce the patient and economic burden of diabetic foot disease.

  15. Supersymmetric q-deformed quantum mechanics

    SciTech Connect

    Traikia, M. H.; Mebarki, N.

    2012-06-27

    A supersymmetric q-deformed quantum mechanics is studied in the weak deformation approximation of the Weyl-Heisenberg algebra. The corresponding supersymmetric q-deformed hamiltonians and charges are constructed explicitly.

  16. Perceptual transparency from image deformation.

    PubMed

    Kawabe, Takahiro; Maruya, Kazushi; Nishida, Shin'ya

    2015-08-18

    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

  17. Inelastic deformation in crystalline rocks

    NASA Astrophysics Data System (ADS)

    Rahmani, H.; Borja, R. I.

    2011-12-01

    The elasto-plastic behavior of crystalline rocks, such as evaporites, igneous rocks, or metamorphic rocks, is highly dependent on the behavior of their individual crystals. Previous studies indicate that crystal plasticity can be one of the dominant micro mechanisms in the plastic deformation of crystal aggregates. Deformation bands and pore collapse are examples of plastic deformation in crystalline rocks. In these cases twinning within the grains illustrate plastic deformation of crystal lattice. Crystal plasticity is governed by the plastic deformation along potential slip systems of crystals. Linear dependency of the crystal slip systems causes singularity in the system of equations solving for the plastic slip of each slip system. As a result, taking the micro-structure properties into account, while studying the overall behavior of crystalline materials, is quite challenging. To model the plastic deformation of single crystals we use the so called `ultimate algorithm' by Borja and Wren (1993) implemented in a 3D finite element framework to solve boundary value problems. The major advantage of this model is that it avoids the singularity problem by solving for the plastic slip explicitly in sub steps over which the stress strain relationship is linear. Comparing the results of the examples to available models such as Von Mises we show the significance of considering the micro-structure of crystals in modeling the overall elasto-plastic deformation of crystal aggregates.

  18. Software tool for the prosthetic foot modeling and stiffness optimization.

    PubMed

    Strbac, Matija; Popović, Dejan B

    2012-01-01

    We present the procedure for the optimization of the stiffness of the prosthetic foot. The procedure allows the selection of the elements of the foot and the materials used for the design. The procedure is based on the optimization where the cost function is the minimization of the difference between the knee joint torques of healthy walking and the walking with the transfemural prosthesis. We present a simulation environment that allows the user to interactively vary the foot geometry and track the changes in the knee torque that arise from these adjustments. The software allows the estimation of the optimal prosthetic foot elasticity and geometry. We show that altering model attributes such as the length of the elastic foot segment or its elasticity leads to significant changes in the estimated knee torque required for a given trajectory.

  19. 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.

  20. 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

  1. Software Tool for the Prosthetic Foot Modeling and Stiffness Optimization

    PubMed Central

    Štrbac, Matija; Popović, Dejan B.

    2012-01-01

    We present the procedure for the optimization of the stiffness of the prosthetic foot. The procedure allows the selection of the elements of the foot and the materials used for the design. The procedure is based on the optimization where the cost function is the minimization of the difference between the knee joint torques of healthy walking and the walking with the transfemural prosthesis. We present a simulation environment that allows the user to interactively vary the foot geometry and track the changes in the knee torque that arise from these adjustments. The software allows the estimation of the optimal prosthetic foot elasticity and geometry. We show that altering model attributes such as the length of the elastic foot segment or its elasticity leads to significant changes in the estimated knee torque required for a given trajectory. PMID:22536296

  2. Manufacture of Passive Dynamic ankle-foot orthoses using selective laser sintering.

    PubMed

    Faustini, Mario C; Neptune, Richard R; Crawford, Richard H; Stanhope, Steven J

    2008-02-01

    Ankle-foot orthosis (AFO) designs vary in size, shape, and functional characteristics depending on the desired clinical application. Passive Dynamic (PD) Response ankle-foot orthoses (PD-AFOs) constitute a design that seeks to improve walking ability for persons with various neuromuscular disorders by passively (like a spring) providing variable levels of support during the stance phase of gait. Current PD-AFO manufacturing technology is either labor intensive or not well suited for the detailed refinement of PD-AFO bending stiffness characteristics. The primary objective of this study was to explore the feasibility of using a rapid freeform prototyping technique, selective laser sintering (SLS), as a PD-AFO manufacturing process. Feasibility was determined by replicating the shape and functional characteristics of a carbon fiber AFO (CF-AFO). The study showed that a SLS-based framework is ideally suited for this application. A second objective was to determine the optimal SLS material for PD-AFOs to store and release elastic energy; considering minimizing energy dissipation through internal friction is a desired material characteristic. This study compared the mechanical damping of the CF-AFO to PD-AFOs manufactured by SLS using three different materials. Mechanical damping evaluation ranked the materials as Rilsan D80 (best), followed by DuraForm PA and DuraForm GF. In addition, Rilsan D80 was the only SLS material able to withstand large deformations. PMID:18270017

  3. Lower-Extremity Amputation Risk After Charcot Arthropathy and Diabetic Foot Ulcer

    PubMed Central

    Sohn, Min-Woong; Stuck, Rodney M.; Pinzur, Michael; Lee, Todd A.; Budiman-Mak, Elly

    2010-01-01

    OBJECTIVE To compare risks of lower-extremity amputation between patients with Charcot arthropathy and those with diabetic foot ulcers. RESEARCH DESIGN AND METHODS A retrospective cohort of patients with incident Charcot arthropathy or diabetic foot ulcers in 2003 was followed for 5 years for any major and minor amputations in the lower extremities. RESULTS After a mean follow-up of 37 ± 20 and 43 ± 18 months, the Charcot and ulcer groups had 4.1 and 4.7 amputations per 100 person-years, respectively. Among patients <65 years old at the end of follow-up, amputation risk relative to patients with Charcot alone was 7 times higher for patients with ulcer alone and 12 times higher for patients with Charcot and ulcer. CONCLUSIONS Charcot arthropathy by itself does not pose a serious amputation risk, but ulcer complication multiplicatively increases the risk. Early surgical intervention for Charcot patients in the absence of deformity or ulceration may not be advisable. PMID:19825822

  4. Effects of Wearing Different Personal Equipment on Force Distribution at the Plantar Surface of the Foot

    PubMed Central

    Woitge, Sandra; Finze, Susanne; Mittelmeier, Wolfram

    2013-01-01

    Background. The wearing of personal equipment can cause specific changes in muscle activity and posture. In the present study, we investigated the influence of differences in equipment related weight loading and load distribution on plantar pressure. In addition, we studied functional effects of wearing different equipment with a particular focus on relevant changes in foot shape. Methods. Static and dynamic pedobarography were performed on 31 male soldiers carrying increasing weights consisting of different items of equipment. Results. The pressure acting on the plantar surface of the foot increased with higher loading, both under static and dynamic conditions (p < 0.05). We observed an increase in the contact area (p < 0.05) and an influence of load distribution through different ways to carry the rifle. Conclusions. The wearing of heavier weights leads to an increase in plantar pressure and contact area. This may be caused by flattening of the transverse and longitudinal arches. The effects are more evident in subjects with flat feet deformities which seem to flatten at an earlier load condition with a greater amount compared to subjects with normal arches. Improving load distribution should be a main goal in the development of military equipment in order to prevent injuries or functional disorders of the lower extremity. PMID:23766714

  5. 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.

  6. A neuromechanical strategy for mediolateral foot placement in walking humans

    PubMed Central

    Rankin, Bradford L.; Buffo, Stephanie K.

    2014-01-01

    Stability is an important concern during human walking and can limit mobility in clinical populations. Mediolateral stability can be efficiently controlled through appropriate foot placement, although the underlying neuromechanical strategy is unclear. We hypothesized that humans control mediolateral foot placement through swing leg muscle activity, basing this control on the mechanical state of the contralateral stance leg. Participants walked under Unperturbed and Perturbed conditions, in which foot placement was intermittently perturbed by moving the right leg medially or laterally during the swing phase (by ∼50–100 mm). We quantified mediolateral foot placement, electromyographic activity of frontal-plane hip muscles, and stance leg mechanical state. During Unperturbed walking, greater swing-phase gluteus medius (GM) activity was associated with more lateral foot placement. Increases in GM activity were most strongly predicted by increased mediolateral displacement between the center of mass (CoM) and the contralateral stance foot. The Perturbed walking results indicated a causal relationship between stance leg mechanics and swing-phase GM activity. Perturbations that reduced the mediolateral CoM displacement from the stance foot caused reductions in swing-phase GM activity and more medial foot placement. Conversely, increases in mediolateral CoM displacement caused increased swing-phase GM activity and more lateral foot placement. Under both Unperturbed and Perturbed conditions, humans controlled their mediolateral foot placement by modulating swing-phase muscle activity in response to the mechanical state of the contralateral leg. This strategy may be disrupted in clinical populations with a reduced ability to modulate muscle activity or sense their body's mechanical state. PMID:24790168

  7. The ground deformation field induced by a listric thrust fault with an overburden soil layer

    NASA Astrophysics Data System (ADS)

    Zeng, Shaogang; Cai, Yong'en

    2013-12-01

    The surface deformation field induced by a listric thrust fault with a thick, overburden soil layer is studied in this paper by the finite element method (FEM). The results show: (a) The maximum slip induced by the buried fault is not located at upper tip of the fault, but below it. (b) The vertical displacement changes remarkably near the fault, forming a fault scarp. With the increase of the soil layer thickness, the height of the scarp is decreased for the same earthquake magnitude. (c) The strong strain zone on the surface is localized near the projection of the fault tip on the ground surface. The horizontal strains in the zone are in tension above the hanging wall and in compression above the foot wall, and the vertical strains in the zone are vice versa, which is favorable for tensileshear, compression-shear fissures above hanging wall and foot wall, respectively.

  8. 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. PMID:22194576

  9. Anisotropic Ripple Deformation in Phosphorene.

    PubMed

    Kou, Liangzhi; Ma, Yandong; Smith, Sean C; Chen, Changfeng

    2015-05-01

    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.

  10. 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.

  11. Shear deformation in granular materials

    SciTech Connect

    Bardenhagen, S.G.; Brackbill, J.U.; Sulsky, D.L.

    1998-12-31

    An investigation into the properties of granular materials is undertaken via numerical simulation. These simulations highlight that frictional contact, a defining characteristic of dry granular materials, and interfacial debonding, an expected deformation mode in plastic bonded explosives, must be properly modeled. Frictional contact and debonding algorithms have been implemented into FLIP, a particle in cell code, and are described. Frictionless and frictional contact are simulated, with attention paid to energy and momentum conservation. Debonding is simulated, with attention paid to the interfacial debonding speed. A first step toward calculations of shear deformation in plastic bonded explosives is made. Simulations are performed on the scale of the grains where experimental data is difficult to obtain. Two characteristics of deformation are found, namely the intermittent binding of grains when rotation and translation are insufficient to accommodate deformation, and the role of the binder as a lubricant in force chains.

  12. 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.

  13. Anatomy of gravitationally deformed slopes

    NASA Astrophysics Data System (ADS)

    Chigira, Masahiro; Yamasaki, Shintaro; Hariyama, Takehiro

    2010-05-01

    Deep-seated gravitational slope deformation is the deformation of rocks as well as slope surfaces, but the internal structures have not been well observed and described before. This is mainly due to the difficulty in obtaining undisturbed samples from underground. We analyzed the internal deformational structures of gravitationally deformed slopes by using high quality drilled cores obtained by hybrid drilling technique, which has been recently developed and can recover very fragile materials that could not be taken by the conventional drilling techniques. Investigated slopes were gravitationally deformed out-facing slopes of pelitic schist and shale. The slope surfaces showed deformational features of small steps, depressions, knobs, and linear depressions, but had no major main scarp and landslide body with well-defined outline. This is indicative of slow, deep-seated gravitational deformation. Most of these small deformational features are hidden by vegetations, but they are detected by using airborne laser scanner. Drilled cores showed that the internal deformation is dominated by the slip and tearing off along foliations. Slippage along foliations is conspicuous in pelitic schist: Pelitic schist is sheared, particularly along black layers, which are rich in graphite and pyrite. Graphite is known to be a solid lubricant in material sciences, which seems to be why shearing occurs along the black layers. Rock mass between two slip layers is sheared, rotated, fractured, and pulverized; undulation of bedding or schistosity could be the nucleation points of fracturing. Tearing off along foliations is also the major deformation mode, which forms jagged morphology of rock fragments within shear zones. Rock fragments with jagged surface are commonly observed in "gouge", which is very different from tectonic gouge. This probably reflects the low confining pressures during their formation. Microscopic to mesoscopic openings along fractures are commonly observed with

  14. Foot pedal operated fluid type exercising device

    NASA Technical Reports Server (NTRS)

    Crum, G. W.; Sauter, R. J. (Inventor)

    1973-01-01

    A foot pedal operated exercising device is reported that contains a dynamometer formed of a pair of cylinders each containing a piston. The pistons are linked to each other. The upper portions of the two cylinders are joined together by a common opening to provide a common fluid reservoir and each piston is provided with a one way check valve to maintain an adequate supply of working fluid. Fluid from the driven cylinder is transmitted to the other cylinder through separate constant force spring biased valves each valve takes the predominant portion of the pressure drop thereby providing a constant force hydraulic dynamometer. A device is provided to determine the amount of movement of piston travel.

  15. Sensory receptors in the equine foot.

    PubMed

    Bowker, R M; Brewer, A M; Vex, K B; Guida, L A; Linder, K E; Sonea, I M; Stinson, A W

    1993-11-01

    Two types of sensory receptors were located in the equine foot, using anatomic techniques. Histologic examination of stained hoof sections revealed lamellated corpuscles in the hoof dermis, which had many of the morphologic characteristics of Pacinian corpuscles. These sensory receptors were restricted to the palmar (caudal) aspects of the solar dermis of the heel. A second type of receptor was detected by use of immunocytochemistry, indicating apparently naked nerve endings containing the neuropeptide calcitonin gene-related peptide-like immunoreactivity in skin, solar dermal tubules, and the digital cushion. This peptide is an example of a sensory neurotransmitter contained in dorsal root ganglion cells and is believed to exist only in unmyelinated sensory nerve fibers. These 2 morphologic structures may be used for detection of sensory stimuli, such as pressure (or vibratory senses) and pain, respectively, in horses during various locomotory gaits.

  16. 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. PMID:27217177

  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. Foote's Law and its application to cameras

    NASA Astrophysics Data System (ADS)

    Kim, Charles C.

    2016-05-01

    In modeling and characterizing a focal plane array (FPA) with a uniform source, estimating the irradiance on the FPA is inevitable. Many have developed needed formulas for the estimate. Those formulas mostly focus on one pixel of the FPA on the optical axis, ignoring all the other pixels. I use Foote's law here to derive the formulas for all the pixels in a simple configuration where the FPA is directly exposed to the uniform source. I extend the formulas for two more configurations: the FPA enclosed with a baffle and the FPA housed with a lens. My results are compared with some existing formulas. They show differences, yet reach an agreement with some approximations. My formulas are useful for modeling and trade study for cameras, especially for the cameras with wide field of view.

  19. Symmetries in Connection Preserving Deformations

    NASA Astrophysics Data System (ADS)

    Ormerod, Christopher M.

    2011-05-01

    We wish to show that the root lattice of Bäcklund transformations of the q-analogue of the third and fourth Painlevé equations, which is of type (A2+A1)(1), may be expressed as a quotient of the lattice of connection preserving deformations. Furthermore, we will show various directions in the lattice of connection preserving deformations present equivalent evolution equations under suitable transformations. These transformations correspond to the Dynkin diagram automorphisms.

  20. Polymicrobial biofilms by diabetic foot clinical isolates.

    PubMed

    Mottola, Carla; Mendes, João J; Cristino, José Melo; Cavaco-Silva, Patrícia; Tavares, Luís; Oliveira, Manuela

    2016-01-01

    Diabetes mellitus is a major chronic disease that continues to increase significantly. One of the most important and costly complications of diabetes is foot ulceration that may be colonized by pathogenic and antimicrobial resistant bacteria, which may express several virulence factors that could impair treatment success. These bacterial communities can be organized in polymicrobial biofilms, which may be responsible for diabetic foot ulcer (DFU) chronicity. We evaluated the influence of polymicrobial communities in the ability of DFU isolates to produce biofilm, using a microtiter plate assay and a multiplex fluorescent in situ hybridization, at three time points (24, 48, 72 h), after evaluating biofilm formation by 95 DFU isolates belonging to several bacterial genera (Staphylococcus, Corynebacterium, Enterococcus, Pseudomonas and Acinetobacter). All isolates were biofilm-positive at 24 h, and the amount of biofilm produced increased with incubation time. Pseudomonas presented the higher biofilm production, followed by Corynebacterium, Acinetobacter, Staphylococcus and Enterococcus. Significant differences were found in biofilm formation between the three time points. Polymicrobial communities produced higher biofilm values than individual species. Pseudomonas + Enterococcus, Acinetobacter + Staphylococcus and Corynebacterium + Staphylococcus produced higher biofilm than the ones formed by E. faecalis + Staphylococcus and E. faecalis + Corynebacterium. Synergy between bacteria present in dual or multispecies biofilms has been described, and this work represents the first report on time course of biofilm formation by polymicrobial communities from DFUs including several species. The biological behavior of different bacterial species in polymicrobial biofilms has important clinical implications for the successful treatment of these infections.

  1. Epidemiology of diabetic foot and management of foot problems in India.

    PubMed

    Viswanathan, Vijay

    2010-09-01

    Diabetes the global epidemic is rapidly increasing at an alarming rate. Developing countries like India harbor the majority of diabetic people and by the year 2030 AD India will have the largest number of diabetic patients. Diabetic foot is one of the common diabetic complications found in India. Both aerobic and anaerobic pathogens form the etiology for diabetic foot infection. Members of the Enterobacteriaceae family were the most prominent among the aerobes while members of the Genus Peptostreptococcus and Clostridium were most prominent among the anaerobes. Ulcers infected with anaerobic pathogens showed a longer healing time than ulcers infected with aerobic pathogens. Oxidative stress is one of the major markers of inflammatory response and oxidative stress markers such as lipid peroxidation, thiobarbituric acid reactive substance (TBARS), Superoxide Dismutase (SOD), Catalase, G Peroxidase, G-S Peroxidase and plasma total antioxidant play a major role in the nonhealing of diabetic foot ulcers. Growth factors such as platelet-derived growth factor (PDGF), transforming growth factor (VEGF), and epidermal growth factor (EGF) are needed for normal wound repair, while proteases such as matrix metalloproteinase (MMP) and serine proteases found in chronic wounds delay the healing process.

  2. Mixing of discontinuously deforming media.

    PubMed

    Smith, L D; Rudman, M; Lester, D R; Metcalfe, G

    2016-02-01

    Mixing of materials is fundamental to many natural phenomena and engineering applications. The presence of discontinuous deformations-such as shear banding or wall slip-creates new mechanisms for mixing and transport beyond those predicted by classical dynamical systems theory. Here, we show how a novel mixing mechanism combining stretching with cutting and shuffling yields exponential mixing rates, quantified by a positive Lyapunov exponent, an impossibility for systems with cutting and shuffling alone or bounded systems with stretching alone, and demonstrate it in a fluid flow. While dynamical systems theory provides a framework for understanding mixing in smoothly deforming media, a theory of discontinuous mixing is yet to be fully developed. New methods are needed to systematize, explain, and extrapolate measurements on systems with discontinuous deformations. Here, we investigate "webs" of Lagrangian discontinuities and show that they provide a template for the overall transport dynamics. Considering slip deformations as the asymptotic limit of increasingly localised smooth shear, we also demonstrate exactly how some of the new structures introduced by discontinuous deformations are analogous to structures in smoothly deforming systems. PMID:26931594

  3. 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.

  4. 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.

  5. Standardizing Foot-Type Classification Using Arch Index Values

    PubMed Central

    Weil, Rich; de Boer, Emily

    2012-01-01

    ABSTRACT Purpose: The lack of a reliable classification standard for foot type makes drawing conclusions from existing research and clinical decisions difficult, since different foot types may move and respond to treatment differently. The purpose of this study was to determine interrater agreement for foot-type classification based on photo-box-derived arch index values. Method: For this correlational study with two raters, a sample of 11 healthy volunteers with normal to obese body mass indices was recruited from both a community weight-loss programme and a programme in physical therapy. Arch index was calculated using AutoCAD software from footprint photographs obtained via mirrored photo-box. Classification as high-arched, normal, or low-arched foot type was based on arch index values. Reliability of the arch index was determined with intra-class correlations; agreement on foot-type classification was determined using quadratic weighted kappa (κw). Results: Average arch index was 0.215 for one tester and 0.219 for the second tester, with an overall range of 0.017 to 0.370. Both testers classified 6 feet as low-arched, 9 feet as normal, and 7 feet as high-arched. Interrater reliability for the arch index was ICC=0.90; interrater agreement for foot-type classification was κw=0.923. Conclusions: Classification of foot type based on arch index values derived from plantar footprint photographs obtained via mirrored photo-box showed excellent reliability in people with varying BMI. Foot-type classification may help clinicians and researchers subdivide sample populations to better differentiate mobility, gait, or treatment effects among foot types. PMID:23729964

  6. 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

  7. Perioperative Assessment of Myocardial Deformation

    PubMed Central

    Duncan, Andra E.; Alfirevic, Andrej; Sessler, Daniel I.; Popovic, Zoran B.; Thomas, James D.

    2014-01-01

    Evaluation of left ventricular performance improves risk assessment and guides anesthetic decisions. However, the most common echocardiographic measure of myocardial function, the left ventricular ejection fraction (LVEF), has important limitations. LVEF is limited by subjective interpretation which reduces accuracy and reproducibility, and LVEF assesses global function without characterizing regional myocardial abnormalities. An alternative objective echocardiographic measure of myocardial function is thus needed. Myocardial deformation analysis, which performs quantitative assessment of global and regional myocardial function, may be useful for perioperative care of surgical patients. Myocardial deformation analysis evaluates left ventricular mechanics by quantifying strain and strain rate. Strain describes percent change in myocardial length in the longitudinal (from base to apex) and circumferential (encircling the short-axis of the ventricle) direction and change in thickness in the radial direction. Segmental strain describes regional myocardial function. Strain is a negative number when the ventricle shortens longitudinally or circumferentially and is positive with radial thickening. Reference values for normal longitudinal strain from a recent meta-analysis using transthoracic echocardiography are (mean ± SD) −19.7 ± 0.4%, while radial and circumferential strain are 47.3 ± 1.9 and −23.3 ± 0.7%, respectively. The speed of myocardial deformation is also important and is characterized by strain rate. Longitudinal systolic strain rate in healthy subjects averages −1.10 ± 0.16 sec−1. Assessment of myocardial deformation requires consideration of both strain (change in deformation), which correlates with LVEF, and strain rate (speed of deformation), which correlates with rate of rise of left ventricular pressure (dP/dt). Myocardial deformation analysis also evaluates ventricular relaxation, twist, and untwist, providing new and noninvasive methods to

  8. National Trends in Foot and Ankle Arthrodesis: 17-Year Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey.

    PubMed

    Best, Matthew J; Buller, Leonard T; Miranda, Alejandro

    2015-01-01

    Foot and ankle arthrodesis reliably reduces pain and functional disability among patients with arthritis and deformity. Since its introduction in 1953, improvements in surgical technique have enhanced the outcomes and reduced complications. However, little is known regarding US national trends of foot and ankle arthrodesis. The present study sought to use the most recently available Centers for Disease Control and Prevention data to investigate changes in the usage of inpatient and ambulatory foot and ankle arthrodesis. Cases of foot and ankle arthrodesis were identified using the National Hospital Discharge Survey and National Survey of Ambulatory Surgery, and the data were analyzed for trends in demographics, treatment, and usage. From 1994 to 2006, the population-adjusted rates of foot and ankle arthrodeses increased by 146% (8.2/100,000 capita to 20.2/100,000 capita). The number of outpatient arthrodeses performed with arthroscopic assistance increased by 858%. The population-adjusted rate of outpatient and inpatient procedures increased by 415% and 17%, respectively. The gender-adjusted rates increased by 59% for males and 209% for females. The age-adjusted rates increased among patients >35 years old in both settings. The use of peripheral nerve blocks during ambulatory procedures increased from 3.3% to 10.1%. Private insurance was the largest compensator. In conclusion, the rate of foot and ankle arthrodesis increased dramatically from 1990 to 2007 using the most up-to-date publicly available data. Knowledge of these national practice patterns could aid policy-makers and surgeons in appropriately allocating healthcare resources to ensure quality patient care. PMID:26213159

  9. National Trends in Foot and Ankle Arthrodesis: 17-Year Analysis of the National Survey of Ambulatory Surgery and National Hospital Discharge Survey.

    PubMed

    Best, Matthew J; Buller, Leonard T; Miranda, Alejandro

    2015-01-01

    Foot and ankle arthrodesis reliably reduces pain and functional disability among patients with arthritis and deformity. Since its introduction in 1953, improvements in surgical technique have enhanced the outcomes and reduced complications. However, little is known regarding US national trends of foot and ankle arthrodesis. The present study sought to use the most recently available Centers for Disease Control and Prevention data to investigate changes in the usage of inpatient and ambulatory foot and ankle arthrodesis. Cases of foot and ankle arthrodesis were identified using the National Hospital Discharge Survey and National Survey of Ambulatory Surgery, and the data were analyzed for trends in demographics, treatment, and usage. From 1994 to 2006, the population-adjusted rates of foot and ankle arthrodeses increased by 146% (8.2/100,000 capita to 20.2/100,000 capita). The number of outpatient arthrodeses performed with arthroscopic assistance increased by 858%. The population-adjusted rate of outpatient and inpatient procedures increased by 415% and 17%, respectively. The gender-adjusted rates increased by 59% for males and 209% for females. The age-adjusted rates increased among patients >35 years old in both settings. The use of peripheral nerve blocks during ambulatory procedures increased from 3.3% to 10.1%. Private insurance was the largest compensator. In conclusion, the rate of foot and ankle arthrodesis increased dramatically from 1990 to 2007 using the most up-to-date publicly available data. Knowledge of these national practice patterns could aid policy-makers and surgeons in appropriately allocating healthcare resources to ensure quality patient care.

  10. 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.

  11. The clinical assessment study of the foot (CASF): study protocol for a prospective observational study of foot pain and foot osteoarthritis in the general population

    PubMed Central

    2011-01-01

    Background Symptomatic osteoarthritis (OA) affects approximately 10% of adults aged over 60 years. The foot joint complex is commonly affected by OA, yet there is relatively little research into OA of the foot, compared with other frequently affected sites such as the knee and hand. Existing epidemiological studies of foot OA have focussed predominantly on the first metatarsophalangeal joint at the expense of other joints. This three-year prospective population-based observational cohort study will describe the prevalence of symptomatic radiographic foot OA, relate its occurrence to symptoms, examination findings and life-style-factors, describe the natural history of foot OA, and examine how it presents to, and is diagnosed and managed in primary care. Methods All adults aged 50 years and over registered with four general practices in North Staffordshire, UK, will be invited to participate in a postal Health Survey questionnaire. Respondents to the questionnaire who indicate that they have experienced foot pain in the preceding twelve months will be invited to attend a research clinic for a detailed clinical assessment. This assessment will consist of: clinical interview; physical examination; digital photography of both feet and ankles; plain x-rays of both feet, ankles and hands; ultrasound examination of the plantar fascia; anthropometric measurement; and a further self-complete questionnaire. Follow-up will be undertaken in consenting participants by postal questionnaire at 18 months (clinic attenders only) and three years (clinic attenders and survey participants), and also by review of medical records. Discussion This three-year prospective epidemiological study will combine survey data, comprehensive clinical, x-ray and ultrasound assessment, and review of primary care records to identify radiographic phenotypes of foot OA in a population of community-dwelling older adults, and describe their impact on symptoms, function and clinical examination findings

  12. Ultrasound-guided interventions of the foot and ankle.

    PubMed

    Yablon, Corrie M

    2013-02-01

    Ultrasound (US) provides excellent delineation of tendons and ligaments in the foot and ankle and provides real-time visualization of a needle during interventions, yielding greater accuracy and efficacy than the traditional blind approach using anatomical landmarks. For this reason, US is rapidly gaining acceptance as the preferred modality for guiding interventions in the foot and ankle where the anatomy is complex, neurovascular structures should be identified, and precise technique is demanded. In the foot and ankle, US is especially useful to guide tendon sheath, bursal, and Achilles paratenon injections, Morton neuroma injections, plantar fascial injections, and joint aspirations and injections.

  13. [Microbiology and antibiotic treatment of diabetic foot infection].

    PubMed

    Zanella, Marie-Céline; Kressmann, Benjamin; Wuarin, Lydia; Coulin, Benoit; Maître, Sophie; Suva, Domizio; Lipsky, Benjamin A; Uçkay, Ilker

    2016-04-13

    In diabetic patients, foot ulcer is a common problem which prevalence during life is about 25%. Infection occurs as a complication in almost 50% of cases, is associated with significant morbidity and a reduced quality of life and is sometimes the trigger leading to amputation. Ulcers and infections occur among patients with predisposing factors such as peripheral neuropathy and arterial insufficiency, and require a multi-disciplinary care system. The knowledge of the microbiology of diabetic foot infection is necessary for a wise use of empirical and targeted antibiotic therapy. This article will focus on the definition and diagnosis of diabetic foot infection, on the main aspects of its microbiology and antibiotic treatment.

  14. A Rare Cause of Foot Pain With Golf Swing

    PubMed Central

    Petrera, Massimo; Dwyer, Tim; Ogilvie-Harris, Darrell J.

    2013-01-01

    The os vesalianum is an uncommon accessory bone of the foot, located proximally to the base of the fifth metatarsal. It is usually asymptomatic and detected incidentally on radiographs. This is a case of bilateral os vesalianum, symptomatic only in the right foot, in a golf player. After a failed nonoperative treatment, the os vesalianum in the symptomatic foot was excised and the peroneus brevis tendon reattached using a suture anchor. The functional outcome was excellent, and the patient returned to golf 8 weeks after surgery. PMID:24459554

  15. Hand, foot and mouth disease - a short case report

    PubMed Central

    Kashyap, Rajesh-Shanker

    2015-01-01

    Hand, foot and mouth disease, that was once considered a disease of cattle, has been emerging as a common human childhood disease in the last few years. It is a viral disease characterized by a brief febrile illness and typical vesicular rashes. In rare cases, patients may also develop neurological complications. This report describes a case of hand, foot and mouth disease, presented with typical clinical features in the South Indian region. Key words:Hand, foot and mouth disease, viral lesions, blisters. PMID:26155357

  16. Kinematic gait analysis in children with valgus deformity of the hindfoot.

    PubMed

    Svoboda, Zdenek; Honzikova, Lucie; Janura, Miroslav; Vidal, Tabata; Martinaskova, Eliska

    2014-01-01

    Deformities of the feet in children can influence not only optimal foot development but also the development of other body segments. The aim of the study was to compare the hip and pelvis kinematics in groups of children with and without valgus deformity of the hindfoot. Three groups of children participated in the study: bilateral hindfoot valgosity (11 children, age 5.4 ± 1.4 years), unilateral hindfoot valgosity (14 children, age 5.6 ± 1.6 years) and the control group (8 children, 4.8 ± 1.2). Hindfoot valgus angle was measured clinically during standing. Hindfoot valgosity was considered in the range of 6 to 20 degrees. Kinematic data from five trials for each child was obtained using the Vicon MX system (six infrared cameras, frequency 200 Hz, Vicon Motion Systems, Oxford, UK). The results of our study showed significantly higher pelvic anteversion during the whole gait cycle for both unilateral and bilateral hindfoot valgosity children and significantly higher hip external rotation during the first half of the stance phase in bilateral deformity. The differences in the hip and pelvis kinematics, when compared to the control group, are higher for the group with bilateral deformity than in the group with unilateral deformity.

  17. Deformation of second and third quantization

    NASA Astrophysics Data System (ADS)

    Faizal, Mir

    2015-03-01

    In this paper, we will deform the second and third quantized theories by deforming the canonical commutation relations in such a way that they become consistent with the generalized uncertainty principle. Thus, we will first deform the second quantized commutator and obtain a deformed version of the Wheeler-DeWitt equation. Then we will further deform the third quantized theory by deforming the third quantized canonical commutation relation. This way we will obtain a deformed version of the third quantized theory for the multiverse.

  18. 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. PMID:27374013

  19. 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

  20. 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

  1. 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.

  2. Recursively minimally-deformed oscillators

    NASA Astrophysics Data System (ADS)

    Katriel, J.; Quesne, C.

    1996-04-01

    A recursive deformation of the boson commutation relation is introduced. Each step consists of a minimal deformation of a commutator [a,a°]=fk(... ;n̂) into [a,a°]qk+1=fk(... ;n̂), where ... stands for the set of deformation parameters that fk depends on, followed by a transformation into the commutator [a,a°]=fk+1(...,qk+1;n̂) to which the deformed commutator is equivalent within the Fock space. Starting from the harmonic oscillator commutation relation [a,a°]=1 we obtain the Arik-Coon and Macfarlane-Biedenharn oscillators at the first and second steps, respectively, followed by a sequence of multiparameter generalizations. Several other types of deformed commutation relations related to the treatment of integrable models and to parastatistics are also obtained. The ``generic'' form consists of a linear combination of exponentials of the number operator, and the various recursive families can be classified according to the number of free linear parameters involved, that depends on the form of the initial commutator.

  3. Mixing of discontinuously deforming media

    NASA Astrophysics Data System (ADS)

    Smith, L. D.; Rudman, M.; Lester, D. R.; Metcalfe, G.

    2016-02-01

    Mixing of materials is fundamental to many natural phenomena and engineering applications. The presence of discontinuous deformations—such as shear banding or wall slip—creates new mechanisms for mixing and transport beyond those predicted by classical dynamical systems theory. Here, we show how a novel mixing mechanism combining stretching with cutting and shuffling yields exponential mixing rates, quantified by a positive Lyapunov exponent, an impossibility for systems with cutting and shuffling alone or bounded systems with stretching alone, and demonstrate it in a fluid flow. While dynamical systems theory provides a framework for understanding mixing in smoothly deforming media, a theory of discontinuous mixing is yet to be fully developed. New methods are needed to systematize, explain, and extrapolate measurements on systems with discontinuous deformations. Here, we investigate "webs" of Lagrangian discontinuities and show that they provide a template for the overall transport dynamics. Considering slip deformations as the asymptotic limit of increasingly localised smooth shear, we also demonstrate exactly how some of the new structures introduced by discontinuous deformations are analogous to structures in smoothly deforming systems.

  4. Transverse deformations of extreme horizons

    NASA Astrophysics Data System (ADS)

    Li, Carmen; Lucietti, James

    2016-04-01

    We consider the inverse problem of determining all extreme black hole solutions to the Einstein equations with a prescribed near-horizon geometry. We investigate this problem by considering infinitesimal deformations of the near-horizon geometry along transverse null geodesics. We show that, up to a gauge transformation, the linearised Einstein equations reduce to an elliptic PDE for the extrinsic curvature of a cross-section of the horizon. We deduce that for a given near-horizon geometry there exists a finite dimensional moduli space of infinitesimal transverse deformations. We then establish a uniqueness theorem for transverse deformations of the extreme Kerr horizon. In particular, we prove that the only smooth axisymmetric transverse deformation of the near-horizon geometry of extreme Kerr, such that cross-sections of the horizon are marginally trapped surfaces, corresponds to that of the extreme Kerr black hole. Furthermore, we determine all smooth and biaxisymmetric transverse deformations of the near-horizon geometry of the five-dimensional extreme Myers-Perry black hole with equal angular momenta. We find a three parameter family of solutions such that cross-sections of the horizon are marginally trapped, which is more general than the known black hole solutions. We discuss the possibility that they correspond to new five-dimensional vacuum black holes.

  5. Quantifying torso deformity in scoliosis

    NASA Astrophysics Data System (ADS)

    Ajemba, Peter O.; Kumar, Anish; Durdle, Nelson G.; Raso, V. James

    2006-03-01

    Scoliosis affects the alignment of the spine and the shape of the torso. Most scoliosis patients and their families are more concerned about the effect of scoliosis on the torso than its effect on the spine. There is a need to develop robust techniques for quantifying torso deformity based on full torso scans. In this paper, deformation indices obtained from orthogonal maps of full torso scans are used to quantify torso deformity in scoliosis. 'Orthogonal maps' are obtained by applying orthogonal transforms to 3D surface maps. (An 'orthogonal transform' maps a cylindrical coordinate system to a Cartesian coordinate system.) The technique was tested on 361 deformed computer models of the human torso and on 22 scans of volunteers (8 normal and 14 scoliosis). Deformation indices from the orthogonal maps correctly classified up to 95% of the volunteers with a specificity of 1.00 and a sensitivity of 0.91. In addition to classifying scoliosis, the system gives a visual representation of the entire torso in one view and is viable for use in a clinical environment for managing scoliosis.

  6. Could failure of the spring ligament complex be the driving force behind the development of the adult flatfoot deformity?

    PubMed

    Williams, Geraint; Widnall, James; Evans, Paul; Platt, Simon

    2014-01-01

    We conducted an investigation into the relative associations of magnetic resonance imaging (MRI)-defined pathologic features of the spring ligament and/or tibialis posterior tendon with radiographic evidence of a planovalgus foot position. A total of 161 patient images (MRI and plain radiographs) obtained from the foot and ankle clinic (2008 to 2011) were retrospectively reviewed. All 161 patients (64 male and 97 female; mean age 45.9 years, range 18 to 86) were included in the analysis. Lateral weightbearing radiographs were analyzed for the talo-first metatarsal angle ≥ 5°, calcaneal pitch ≤ 20°, and talocalcaneal angle ≥ 45°. A positive finding for ≥ 1 measurements identified a radiographic planovalgus position of the foot. The radiographic deformity was analyzed against the MRI evidence of either spring ligament or tibialis posterior tendon pathologic features for significance (p < .05). Evidence of a spring ligament abnormality was strongly associated with a planovalgus foot position, reaching high levels of statistical significance in all 3 categories of radiographic deformity (odds ratio 9.2, p < .0001). Abnormalities of the tibialis posterior tendon failed to demonstrate significance, unless grade I changes were excluded, and grade II and III appearances were analyzed in isolation (odds ratio 2.9, p = .04). Although absolute causal relationships were not tested, this investigation has clearly demonstrated that MRI-defined abnormalities of the spring ligament complex are possibly of at least equal importance to tibialis posterior dysfunction for the presence of a moderate to severe radiographic planovalgus foot position.

  7. Could failure of the spring ligament complex be the driving force behind the development of the adult flatfoot deformity?

    PubMed

    Williams, Geraint; Widnall, James; Evans, Paul; Platt, Simon

    2014-01-01

    We conducted an investigation into the relative associations of magnetic resonance imaging (MRI)-defined pathologic features of the spring ligament and/or tibialis posterior tendon with radiographic evidence of a planovalgus foot position. A total of 161 patient images (MRI and plain radiographs) obtained from the foot and ankle clinic (2008 to 2011) were retrospectively reviewed. All 161 patients (64 male and 97 female; mean age 45.9 years, range 18 to 86) were included in the analysis. Lateral weightbearing radiographs were analyzed for the talo-first metatarsal angle ≥ 5°, calcaneal pitch ≤ 20°, and talocalcaneal angle ≥ 45°. A positive finding for ≥ 1 measurements identified a radiographic planovalgus position of the foot. The radiographic deformity was analyzed against the MRI evidence of either spring ligament or tibialis posterior tendon pathologic features for significance (p < .05). Evidence of a spring ligament abnormality was strongly associated with a planovalgus foot position, reaching high levels of statistical significance in all 3 categories of radiographic deformity (odds ratio 9.2, p < .0001). Abnormalities of the tibialis posterior tendon failed to demonstrate significance, unless grade I changes were excluded, and grade II and III appearances were analyzed in isolation (odds ratio 2.9, p = .04). Although absolute causal relationships were not tested, this investigation has clearly demonstrated that MRI-defined abnormalities of the spring ligament complex are possibly of at least equal importance to tibialis posterior dysfunction for the presence of a moderate to severe radiographic planovalgus foot position. PMID:24556481

  8. A multi-segment foot model based on anatomically registered technical coordinate systems: method repeatability and sensitivity in pediatric planovalgus feet.

    PubMed

    Saraswat, Prabhav; MacWilliams, Bruce A; Davis, Roy B; D'Astous, Jacques L

    2013-01-01

    Several multisegment foot models have been proposed and some have been used to study foot pathologies. These models have been tested and validated on typically developed populations; however application of such models to feet with significant deformities presents an additional set of challenges. For the first time, in this study, a multisegment foot model is tested for repeatability in a population of children with symptomatic abnormal feet. The results from this population are compared to the same metrics collected from an age matched (8-14 years) typically developing population. The modified Shriners Hospitals for Children, Greenville (mSHCG) foot model was applied to ten typically developing children and eleven children with planovalgus feet by two clinicians. Five subjects in each group were retested by both clinicians after 4-6 weeks. Both intra-clinician and inter-clinician repeatability were evaluated using static and dynamic measures. A plaster mold method was used to quantify variability arising from marker placement error. Dynamic variability was measured by examining trial differences from the same subjects when multiple clinicians carried out the data collection multiple times. For hindfoot and forefoot angles, static and dynamic variability in both groups was found to be less than 4° and 6° respectively. The mSHCG model strategy of minimal reliance on anatomical markers for dynamic measures and inherent flexibility enabled by separate anatomical and technical coordinate systems resulted in a model equally repeatable in typically developing and planovalgus populations.

  9. 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

  10. Foot Modeling and Smart Plantar Pressure Reconstruction from Three Sensors

    PubMed Central

    Ghaida, Hussein Abou; Mottet, Serge; Goujon, Jean-Marc

    2014-01-01

    In order to monitor pressure under feet, this study presents a biomechanical model of the human foot. The main elements of the foot that induce the plantar pressure distribution are described. Then the link between the forces applied at the ankle and the distribution of the plantar pressure is established. Assumptions are made by defining the concepts of a 3D internal foot shape, which can be extracted from the plantar pressure measurements, and a uniform elastic medium, which describes the soft tissues behaviour. In a second part, we show that just 3 discrete pressure sensors per foot are enough to generate real time plantar pressure cartographies in the standing position or during walking. Finally, the generated cartographies are compared with pressure cartographies issued from the F-SCAN system. The results show 0.01 daN (2% of full scale) average error, in the standing position. PMID:25400713

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

    MedlinePlus

    ... Midfoot Ailments of the Heel Ailments of the Big Toe Ailments of the Smaller Toes Diabetic Foot ... Procedures Treatments of the Ankle Treatments of the Big Toe Treatments of the Heel Treatments of the ...

  12. 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

  13. 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

  14. 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

  15. 10. Detail of Derrick Foot Showing Pipe Construction, Looking Southwest ...

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

    10. Detail of Derrick Foot Showing Pipe Construction, Looking Southwest - David Renfrew Oil Rig, East side of Connoquenessing Creek, 0.4 mile North of confluence with Thorn Creek, Renfrew, Butler County, PA

  16. Argon beam coagulation in foot and ankle surgery.

    PubMed

    Adams, Melissa L; Steinberg, John S

    2011-01-01

    In this brief report, we introduce the principles, indications, advantages, disadvantages, and surgical techniques involved in the use of argon beam coagulation in foot and ankle surgery. PMID:21907597

  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. 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

  20. 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