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At least 217 records · Page 12Linked to original sources

Diabetic patients with foot burns.

We describe six patients with non-insulin dependent (Type 2) diabetes mellitus (NIDDM) and thermal foot injury admitted to the Burn Centre in Rotterdam. They were all male with a mean age of 56.8 (range 47-63) years. The median patients' delay before admission was 27 (range 1-56) days. Five patients needed amputation. Healing of the wounds took a mean period of 9.5 (range 2-27) months. In two patients healing of the wounds took more than 1 year; these two patients also had recurrent foot burns. Neurological evaluation in four patients confirmed severe polyneuropathy and severe loss of heat pain, warmth, and cold sensation.

Burns↗

Car-tyre friction injuries of the foot in children.

In a prospective study, 25 cases of car-tyre friction injuries of the foot in children were included. The mechanism of injury was similar in all patients: As the car-tyre impacted on the child's foot, the driver was usually trying to stop the car resulting in an injury of variable severity, depending on the amount of energy absorbed by the foot. The site of injury varied according to the position of the foot in relation to the tyre at the time of impact. Sixteen out of the 25 patients presented with acute injuries. The severity of foot injury was classified into five grades and the plan of management in these patients was guided by the grade of the acute injury. The remaining nine patients presented with secondary deformity and principles of secondary reconstruction were also demonstrated with clinical examples. Prevention of these injuries are discussed.

Accidents, Traffic↗

[Gait analysis after intra-articular calcaneus fractures].

We retrospectively compared 20 patients with displaced intra-articular calcaneal fractures by clinical assessment and dynamic pedography. Eleven were treated operatively, 9 conservatively. The purpose was to identify differences in post-traumatic gait performance and to correlate the pedographic data to a clinical score to show its reliability. Twenty individuals without a history of foot injuries were used as a control group. Both groups had restricted motion in the subtalar joint, increased hindfoot and midfoot loading and decreased forefoot loading. Furthermore, they showed prolonged contact phases and an impaired ability to speed up gait during the toe-off phase. Load transfer from the hindfoot to the forefoot showed typical distribution patterns. The operatively treated group showed better functional results with fewer subjective complaints.

Adult↗

Severe hypothermic injury to the foot and ankle caused by continuous cryocompression therapy.

Iatrogenic hypothermic injury in the treatment of traumatic disorders is a rare complication. Cryocompression therapy is widely used in the treatment of pre- and postoperative pain and swelling, but hypothermic damage to the soft tissues has not yet been reported. We present a case in which a patient sustained a hypothermic injury after continuous preoperative cryocompression therapy of an ankle fracture. The patient developed skin epidermolysis, partial nerve damage, muscle atrophy and clawing of the toes. The possible causes of this unusual injury are discussed.

Acute Disease↗

War wounds to the foot.

Thirty-nine patients with foot injuries were admitted to the Clinic for Orthopedic Surgery in Lovran during the war against Croatia. All of them were soldiers wounded by antipersonnel mines. All of the patients were treated using the same protocol. Primary wound care included debridement, necrectomy, and three-dimensional external fixation with or without Kirschner wires. External fixation facilitated postoperative wound care, prevented vicious contracture position, and made fracture healing possible with early weight bearing.

Amputation, Surgical↗

The bicycle spoke injury: an avoidable accident?

A prospective study of the bicycle spoke injury over a 1-year period included a total of 71 spoke injuries. Of these, 67 injuries occurred on an adult bicycle and four occurred on a child's bicycle. All children sustained ankle and foot injuries, which consisted of contusion and superficial abrasion (N = 45), skin loss (N = 10), skin laceration (N = 4), and undisplaced fractures (N = 12). A biomechanical study was conducted to investigate the use of a protective cover over the wheel to prevent the foot from slipping between the spokes. Wind resistance studies showed that a cover with a mesh size of 10 mm hexagonal could prevent this and at the same time stop the cover from acting as a sail if a flat cover without holes was used instead. The mesh cover, however, will prevent the toes from entering between the spokes but will not prevent the foot from becoming jammed between the wheel and the fork. To prevent this, a plastic shield to bridge the gap between the fork and the horizontal upright has been designed. With these modifications, the bicycle spoke injury can become an injury of the past.

Adolescent↗

Foot and ankle injuries in dance.

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

Achilles Tendon↗

The epidemiology of foot and ankle injuries in sports.

A 6 1/2-year review of 16,754 injuries seen in a multispecialty sports medicine clinic found that 25 per cent of the 12,681 injuries in the top 19 sports occurred at the ankle and foot. The percentages of foot and ankle injuries varied substantially from sport to sport, as did the proportion of sprains versus overuse injuries at each location. An appreciation of the patterns and numbers of injuries presenting to a sports medicine facility can be helpful in patient management and can aid the planning of both clinical investigations and educational programs.

Ankle Injuries↗

The Cheshire Foot Pain and Disability Survey: a population survey assessing prevalence and associations.

Previous foot studies have consistently reported high prevalence estimates in self-reported foot disorders. Few population studies, however, have attempted to assess the impact of foot problems in terms of pain and disability so that the burden associated with foot pain is unknown. A cross-sectional postal survey was conducted on a random community sample of 4780 individuals with 3417 (84%) responding. Subjects reporting foot pain in the past month, current pain and marking one item on the Manchester Foot Pain and Disability Index were classified as having disabling foot pain. Those with disabling foot pain and a random sample with no symptoms (matched for age and gender) received a follow-up interview and standardised foot examination. Self-reported nail problems, corns and callosities, swollen feet, foot deformities and recent foot injuries were found to be associated with disabling foot pain. Foot disability was also associated with pain in the shoulder, axial skeleton, hip/upper leg and knee along with other indicators of poor general health. Clinician diagnosed foot problems associated with disabling foot pain were swollen feet, knee and foot joint tenderness. Only 36% of persons with disabling foot pain received professional foot treatment in the 6 months preceding the survey. The results showed that 323/3417 (9.5%) reported symptoms of disabling foot pain and that this condition is likely to be multi-factorial in origin. Further work is necessary to understand more about the extent and type of unmet need and on how patients presenting with symptoms of disabling foot pain should best be managed.

Adolescent↗

Injuries in runners: a prospective study of alignment.

OBJECTIVE: To determine if measurable lower extremity alignment is a risk factor for overuse running injuries. DESIGN: Prospective cohort study. SETTING: Thirty-two week marathon training program. PATIENTS OR PARTICIPANTS: Three hundred fifty-five volunteers from the marathon training program began the study; 255 finished the study. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Past training and injury history was determined by questionnaire, and five lower extremity alignment measures were performed at the beginning of the training program: arch index (AI), heel valgus (HV), knee tubercle-sulcus angle (TSA), knee varus (KV), and leg-length difference (LLD). Overuse injuries, incurred by the runners and categorized by anatomic parts, were recorded during the training period. RESULTS: Ninety subjects experienced overuse injuries. Multivariate analyses with stepwise Poisson regression showed few consistent relationships between alignment and overuse injury rates. Higher AI was protective against overall injuries and knee injuries; higher HV was protective against knee and foot injuries; higher TSA was associated with shin injuries; higher KV was associated with shin injuries; and low LLD was associated with more overall injuries. CONCLUSIONS: Minor variations in lower extremity alignment do not appear conclusively to be major risk factors for overuse injuries in runners. Because of the study limitations and the likely multifactorial nature of running injuries, further study is suggested, perhaps in more novice runners.

Adult↗

Treatment approaches following foot and ankle injury.

A complete and effective rehabilitation program begins with a thorough subjective and objective evaluation of the problem and injury presented. Biomechanical changes, whether they are anatomically induced or as a result of a form of compensation, must be identified and properly addressed. During the initial phase of rehabilitation, the issues of pain and swelling often must be resolved before full range of motion and return to normal strength can be achieved successfully during the more advanced stages. It is important to incorporate the entire lower quadrant in exercises that are designed to improve proprioception and function, using both in open and closed kinetic chain exercises. Finally, the demands to which the patient is returning to must be recognized to successfully complete the recovery phase.

Ankle Injuries↗

Handgun injuries to the foot: treatment of low-velocity, high-energy wound types.

The authors present several cases of gunshot injury to the foot. Classification of wounds according to weapon type and caliber is discussed, as well as treatment rationale. Emphasis is placed on the need for detailed wound history and classification as precursors to adequate therapy. The low-velocity, high-energy wound type is introduced, and its variation from the current low- and high-velocity classifications discussed.

Adolescent↗

Foot type and overuse injury in triathletes.

Abnormal foot morphology has been suggested to contribute to overuse injuries in athletes. This study investigated the relationship between foot type and injury incidence in a large sample of competitive triathletes not wearing foot orthoses during a 6-month retrospective analysis and a 10-week prospective cohort study. Foot alignment was measured using the Foot Posture Index and the Valgus Index, and participants were assigned to supinated, pronated, and normal foot-type groups. Overall, 131 triathletes sustained 155 injuries during the study. Generally, foot type was not a major risk factor for injury; however, there was a fourfold increased risk of overuse injury during the competition season in athletes with a supinated foot type. The results of this study show that triathletes with a supinated foot type are more likely to sustain an overuse injury.

Adolescent↗

Foot evaluation by infrared imaging.

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.

Adolescent↗

Skiing injuries in children and adults: a comparative study from an 8-year period.

The investigation is a retrospective analysis of 2756 skiing injuries from two centers in a Swedish skiing area during the years 1972 to, and including, 1979. The relative frequency of lower extremity injuries successively diminished, while a corresponding increase of upper extremity injuries was found. The relative frequency of ankle and foot injuries declined, while the frequency of knee injuries did not change, knee injuries still being the most common skiing injury. The relative frequency of fractures of the lower leg showed a statistically significant decrease, but, in children, constituted 16% of all injuries at the end of the investigation period. Further studies, with special regard to the children's prerequisites, seem to be necessary to define the desired characteristics of an optimally functioning safety binding for children.

Adolescent↗

Toothpick puncture injuries of the foot in children.

We reviewed the medical records of five children seen between January 1997 and September 2003 for toothpick puncture injuries of the foot. Failure to visualize retained toothpicks by plain radiographs delayed early removal. Patients subsequently developed recurrent foot cellulitis, complicated by foot osteomyelitis in three cases. Ultrasound, computed tomography or magnetic resonance imaging detected the toothpicks. These imaging tools should be considered for initial evaluation of these patients.

Adolescent↗

Foot and ankle injuries in dance.

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

Ankle Injuries↗