1
|
Zhu T, Qiu X, Deng H, Feng H, Chen J, Huang Z, Li J, Liu S, Wang S, Gu Z, Wu Z, Yang Q, Liu G, Sechi LA, Caggiari G, You C, Fu G. Clinical analysis of 1301 children with hand and foot fractures and growth plate injuries. BMC Musculoskelet Disord 2024; 25:270. [PMID: 38589862 PMCID: PMC11000401 DOI: 10.1186/s12891-024-07407-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/02/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Fractures of hands and feet are common in children, but relevant epidemiological studies are currently lacking. We aim to study the epidemiological characteristics of hand and foot fractures and growth plate injuries in children and provide a theoretical basis for their prevention, diagnosis, and treatment. METHODS We retrospectively analyzed the data of children with hand and foot fractures who were hospitalized at Shenzhen Children's Hospital between July 2015 and December 2020. Data on demographic characteristics, fracture site, treatment method, etiology of injury, and accompanying injuries were collected. The children were divided into four age groups: infants, preschool children, school children, and adolescents. The fracture sites were classified as first-level (the first-fifth finger/toe, metacarpal, metatarsal, carpal, and tarsal) and second-level (the first-fifth: proximal phalanx, middle phalanx, distal phalanx, metacarpal, and metatarsal) sites. The changing trends in fracture locations and injury causes among children in each age group were analyzed. RESULTS Overall, 1301 children (1561 fractures; 835 boys and 466 girls) were included. The largest number of fractures occurred in preschool children (n = 549, 42.20%), with the distal phalanx of the third finger being the most common site (n = 73, 15.57%). The number of fractures in adolescents was the lowest (n = 158, 12.14%), and the most common fracture site was the proximal phalanx of the fifth finger (n = 45, 29.61%). Of the 1561 fractures, 1143 occurred in the hands and 418 in the feet. The most and least common first-level fracture sites among hand fractures were the fifth (n = 300, 26.25%) and first (n = 138, 12.07%) fingers, respectively. The most and least common first-level foot fracture locations were the first (n = 83, 19.86%) and fourth (n = 26, 6.22%) toes, respectively. The most common first-level and second level etiologies were life related injuries (n = 1128, 86.70%) and clipping injuries (n = 428, 32.90%), respectively. The incidence of sports injuries gradually increased with age, accounting for the highest proportion in adolescents (26.58%). Hand and foot fractures had many accompanying injuries, with the top three being nail bed injuries (570 cases, 36.52%), growth plate injuries (296 cases, 18.96%), and distal severed fracture (167 cases, 10.70%). Among the 296 growth plate injuries, 246 occurred on the hands and 50 on the feet. CONCLUSIONS In contrast to previous epidemiological studies on pediatric hand and foot fractures, we mapped the locations of these fractures, including proximal, shaft, distal, and epiphyseal plate injuries. We analyzed the changing trends in fracture sites and injury etiologies with age. Hand and foot fractures have many accompanying injuries that require attention during diagnosis and treatment. Doctors should formulate accident protection measures for children of different ages, strengthen safety education, and reduce the occurrence of accidental injuries.
Collapse
Affiliation(s)
- Tianfeng Zhu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Xin Qiu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Hansheng Deng
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
- Department of Biomedical Sciences, University of Sassari, 07100, Sassari, Italy
- Orthopaedic Department, Sassari University Hospital, 07100, Sassari, Italy
| | - Haoran Feng
- Shenzhen Pediatrics Institute of Shantou University Medical College, Shantou, People's Republic of China
| | - Jianlin Chen
- Shenzhen Pediatrics Institute of Shantou University Medical College, Shantou, People's Republic of China
| | - Zilong Huang
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Jiahui Li
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Shizhe Liu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Shuaiyin Wang
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Zhenkun Gu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | - Zhengyu Wu
- Clinical research center, Hefei cancer hospital, Chinese academy of sciences, Hefei, People's Republic of China
| | - Qisong Yang
- Hefei center for disease control and prevention, Hefei, People's Republic of China
| | - Gen Liu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China
| | | | | | - Chao You
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China.
| | - Guibing Fu
- Shenzhen Children's Hospital, Shenzhen, People's Republic of China.
| |
Collapse
|
2
|
Lorkowski J, Pokorski M. Harmful female footwear: A public health perspective. Heliyon 2023; 9:e21297. [PMID: 38027653 PMCID: PMC10651440 DOI: 10.1016/j.heliyon.2023.e21297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/09/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Footwear fashion is an instance of a socially formed attitude affecting somatic population health. High-heeled, particularly pointy-toed shoes are posed to structurally distort and overload feet leading to musculoskeletal sequelae. Here we compiled multilanguage website images presenting female footwear produced by the top manufacturers to assess the advertising effects on the prevailing height of heels worn by women. The method was based on the analysis of websites using the command "woman shoes" in scores of languages of the Internet Google browser. We then compared the results of the internet search with those of a live street surveillance of the footwear worn by 100 adult women in the downtown Warsaw metropolis in Poland. We found that stiletto heels with pointed shoe tips significantly predominated in images representing the countries belonging to the Western cultural sphere compared to less affluent world areas where low or flat heels prevailed. However, we noted a gradual departure from the fashion of high heels over the last decade, confirmed by live street surveillance, liable to reflect changes in the website presentations of top shoe manufacturers consistent with increasing awareness of potential harm by high heels. Yet the female aptitude for wearing more physiologic shoe models appears to exceed that resulting from marketing campaigns. Doing away with high-heeled pointy-toed shoes requires intensification of pro-health preventive measures in the field of public health.
Collapse
Affiliation(s)
- Jacek Lorkowski
- Department of Orthopedics, Traumatology, and Sports Medicine, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, 137 Woloska Street, 02-507, Warsaw, Poland
| | - Mieczyslaw Pokorski
- Institute of Health Sciences, Opole University, 68 Katowicka Street, 45-060, Opole, Poland
| |
Collapse
|
3
|
Osborne JWA, Menz HB, Whittaker GA, Landorf KB. Development of a foot and ankle strengthening program for the treatment of plantar heel pain: a Delphi consensus study. J Foot Ankle Res 2023; 16:67. [PMID: 37789375 PMCID: PMC10546707 DOI: 10.1186/s13047-023-00668-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND People with plantar heel pain (PHP) have reduced foot and ankle muscle function, strength and size, which is frequently treated by muscle strengthening exercises. However, there has been little investigation of what exercises are used and there is no sound evidence base to guide practice. This study aimed to develop a consensus-driven progressive muscle strengthening program for PHP. METHODS Thirty-eight experts were invited to participate in the study over three rounds. Round 1 was an open-ended questionnaire that provided the core characteristics of progressive strengthening programs designed for three different adult patient types with PHP (younger athletic, overweight middle-aged, older), which were presented as vignettes. In Round 2, experts indicated their agreement to the proposed exercises and training variables. In Round 3, experts were presented with amendments to the exercises based on responses from Round 2 and indicated their agreement to those changes. Consensus was achieved when > 70% of experts agreed. RESULTS Two experts were ineligible and 12 declined, leaving 24 (67%) who participated in Round 1. Eighteen (75%) completed all three rounds. From Round 1, progressive strengthening programs were developed for the three vignettes, which included 10 different exercises and three training variables (sets / repetitions, weight, and frequency). In Round 2, 68% (n = 17) of exercises and 96% (n = 72) of training variables reached consensus. In Round 3, only exercise changes were presented and 100% of exercises reached consensus. CONCLUSIONS This study provides three progressive strengthening programs agreed to by experts that can be used in future clinical trials to determine the effectiveness of muscle strengthening for PHP. In addition, clinicians could use the programs as part of a rehabilitation strategy with the caveat that they may change as more research is conducted.
Collapse
Affiliation(s)
- John W A Osborne
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, 3086, Australia.
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, 3086, Australia.
| | - Hylton B Menz
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, 3086, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, 3086, Australia
| | - Glen A Whittaker
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, 3086, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, 3086, Australia
| | - Karl B Landorf
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Victoria, 3086, Australia
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Victoria, 3086, Australia
| |
Collapse
|
4
|
Lan RY, Jiang JY, Yu T, Zhang WH, Han LX, Ren XP. [Microsurgical thinned anterolateral thigh perforator flap to repair soft tissue defects of foot and ankle]. Zhongguo Gu Shang 2023; 36:701-7. [PMID: 37605906 DOI: 10.12200/j.issn.1003-0034.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
OBJECTIVE To explore method and clinical effect of microsurgical thinned anterolateral thigh perforator flap to repair soft tissue defects of foot and ankle. METHODS From March 2017 to January 2022, totally 20 patients with soft tissue defects of ankle joint were treated with micro-thinning anterolateral perforator flap for free transplantation, included 13 males and 7 females, aged from 22 to 58 years old with an average of (36.45±12.36) years old. The size of flap ranged from 8.0 cm×5.0 cm to 20.0 cm×12.0 cm. Before operation, perforating vessels on the anterolateral thigh region were detected and marked with a portable Doppler detector. For the defect width less than 8 cm, 11 patients were repaired with a single flap. For the defect width more than 8 cm, the wound could not be sutured directly, and the lobulated flap technique was used in 9 patients, the width was converted to length, and the donor site was closed directly. Under the microscope, all flaps were thinened in a stepwise manner from the center of the pedicle to the periphery. After operation, survival of the flap, the shape, texture, sensory function recovery were observes, and recovery of foot function was evaluated by Maryland foot function evaluation standard. RESULTS All 20 patients with microsurgical thinned anterolateral thigh perforator flaps were survived. Venous crisis occurred in 1 patient due to subcutaneous hematoma, after removal of the hematoma, the crisis was relieved and the flap survived successfully. The wounds in the donor and recipient sites healed well, and only linear scars left in the donor sites. Twenty patients were followed up for 3 to 26 months after operation, good shape of flaps without bloated, and good texture. The two-point discrimination of free flaps ranged from 9.0 to 16.0 mm, and the protective sensation was restored. The ankle flexion and extension function recovered well and patients could walk normally. According to Maryland foot function evaluation standard, 8 patients got excellent result, 10 patients good and 2 middle. CONCLUSION Microsurgical thinned anterolateral thigh perforator flap is an ideal method to repair soft tissue defects in functional area of foot and ankle, with good appearance and texture of the flap, no need for re-plastic surgery, reduced hospitalization costs, and less donor site damage.
Collapse
Affiliation(s)
- Rong-Yu Lan
- Department of Reconstructive and Microsurgery, Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning 530011, Guangxi, China
| | - Ji-Yong Jiang
- Department of Hand and Foot Microsurgery, Guangzhou Peace Orthopaedics Hospital, Guangzhou 510315, Guangdong, China
| | - Tian Yu
- Department of Hand and Foot Microsurgery, Guangzhou Peace Orthopaedics Hospital, Guangzhou 510315, Guangdong, China
| | - Wei-Hua Zhang
- Department of Reconstructive and Microsurgery, Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning 530011, Guangxi, China
| | - Lin-Xuan Han
- Department of Reconstructive and Microsurgery, Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning 530011, Guangxi, China
| | - Xiao-Ping Ren
- Department of Reconstructive and Microsurgery, Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning 530011, Guangxi, China
| |
Collapse
|
5
|
Alruwaii F, Molligan JF, Ilaslan H, John I, Herradura AS, Alkashash A, Chen S, Nystrom L, Kilpatrick SE, Reith JD, Wenger DE, Powell GM, Fritchie KJ. Osteoid osteomas of the hands and feet: a series of 71 cases. Virchows Arch 2023:10.1007/s00428-023-03576-9. [PMID: 37294448 DOI: 10.1007/s00428-023-03576-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/28/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023]
Abstract
Osteoid osteomas typically arise in the long bones of extremities. Patients often report pain relieved by NSAIDS, and radiographic findings are often sufficient for diagnosis. However, when involving the hands/feet, these lesions may go unrecognized or misdiagnosed radiographically due to their small size and prominent reactive changes. The clinicopathologic features of this entity involving the hands and feet are not well-described. Our institutional and consultation archives were searched for all cases of pathologically confirmed osteoid osteomas arising in the hands and feet. Clinical data was obtained and recorded. Seventy-one cases (45 males and 26 females, 7 to 64 years; median 23 years) arose in the hands and feet, representing 12% of institutional and 23% of consultation cases. The clinical impression often included neoplastic and inflammatory etiologies. Radiology studies demonstrated a small lytic lesion in all cases (33/33), the majority of which had a tiny focus of central calcification (26/33). Nearly, all cases demonstrated cortical thickening and/or sclerosis and perilesional edema which almost always had an extent two times greater than the size of the nidus. Histologic examination showed circumscribed osteoblastic lesions with formation of variably mineralized woven bone with single layer of osteoblastic rimming. The most common growth pattern of bone was trabecular (n = 34, 48%) followed by combined trabecular and sheet-like (n = 26, 37%) with only 11 (15%) cases presenting with pure sheet-like growth pattern. The majority (n = 57, 80%) showed intra-trabecular vascular stroma. No case showed significant cytology atypia. Follow up was available for 48 cases (1-432 months), and 4 cases recurred. Osteoid osteomas involving the hands and feet follow a similar age and sex distribution as their non-acral counterparts. These lesions often present with a broad differential diagnosis and may initially be confused with chronic osteomyelitis or a reactive process. While the majority of cases have classic morphologic features on histologic exam, a small subset consists solely of sheet-like sclerotic bone. Awareness that this entity may present in the hands and feet will help pathologists, radiologists, and clinicians accurately diagnose these tumors.
Collapse
Affiliation(s)
- Fatimah Alruwaii
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Jeremiah F Molligan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Hakan Ilaslan
- Department of Radiology, Cleveland Clinic, Cleveland, OH, USA
| | - Ivy John
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Ahmad Alkashash
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Shaoxiong Chen
- Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, IN, USA
| | - Lukas Nystrom
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Scott E Kilpatrick
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - John D Reith
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Doris E Wenger
- Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN, USA
| | - Garret M Powell
- Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN, USA
| | - Karen J Fritchie
- Department of Anatomic Pathology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
| |
Collapse
|
6
|
Skidmore S, Prior Y, Nester C, Bird S, Vasilica C. Where do you stand?: an exploration of perspectives toward feet, foot health, and footwear using innovative digital methods. J Foot Ankle Res 2023; 16:25. [PMID: 37106384 PMCID: PMC10141949 DOI: 10.1186/s13047-023-00621-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The cost of losing foot health is significant to the person, healthcare systems, and economy, with diabetes related foot health issues alone costing over £1 billion annually in the UK. Yet many foot health problems are preventable through alternative health behaviour. It is therefore important to understand how feet, foot health and footwear are conceptualised to gain understanding about how these might influence foot health behaviour and inform health messages that seek to protect or improve foot health through altered health behaviour. This research seeks to explore attitudes and beliefs and identify phenomena that may act as barriers or motivators to the proactive self-management of foot health. METHODS Public conversations involving 2,699 expressions related to feet, footwear or foot health on Facebook, Twitter, and Instagram were extracted. Conversations on Facebook and Twitter were scraped with NVivo's NCapture plugin whereby data is extracted and downloaded to NVivo. Extracted files were uploaded to the Big Content Machine (software developed at the University of Salford) which facilitated the search for keywords 'foot', 'feet', 'footwear', 'shoe', and 'shoes'. Instagram was scraped by hand. Data was analysed using a Thematic Analysis approach. RESULTS Three themes were identified; 1) connections and disconnections derived from social and cultural constructs, 2) phenomena beyond attitudes and beliefs that relate to symbolic representations and the impact when foot health is lost, and 3) phenomena relating to Social Media as a conduit for the exploration of attitudes and beliefs. CONCLUSIONS This novel research exemplifies complex and sometimes incongruous perspectives about feet including their value for what they facilitate, contrasted with negative feelings about the negative impact that can have aesthetically when feet work hard. Sometimes feet were devalued, with expressions of disgust, disconnection, and ridicule. The importance of contextual, social, and cultural phenomena with implications for optimising foot health messages. Knowledge gaps including factors related to children's foot health and development, and how to treat foot health problems. The power of communities with shared experience to influence decisions, theories, and behaviour about foot health was also revealed. While people do talk about feet in some social contexts, it is not always in a way that promotes overt, positive foot health behaviour. Finally, this research demonstrates the benefit of exploring perspectives in uncontrived settings and illuminates the potential utility of social media (SoMe) platforms Facebook, Instagram, and Twitter as vehicles to promote foot health self-management behaviour that is responsive to the social and demographic variances of engagers who inhabit those spaces.
Collapse
Affiliation(s)
- Sue Skidmore
- School of Health & Society, University of Salford, Brian Blatchford Building, Frederick Road Campus, Salford, M6 6PU, UK.
| | - Yeliz Prior
- School of Health & Society, University of Salford, Brian Blatchford Building, Frederick Road Campus, Salford, M6 6PU, UK
| | - Christopher Nester
- MacKay Building School of Health and Rehabilitation, Keele University, Keele, ST5 5BG, UK
| | - Sam Bird
- School of Health & Society, University of Salford, Brian Blatchford Building, Frederick Road Campus, Salford, M6 6PU, UK
| | - Cristina Vasilica
- School of Health & Society, University of Salford, Brian Blatchford Building, Frederick Road Campus, Salford, M6 6PU, UK
| |
Collapse
|
7
|
Spencer RK, Jin JQ, Elhage KG, Davis MS, Hakimi M, Bhutani T, Liao W. Comparative efficacy of biologics and oral agents in palmoplantar psoriasis and palmoplantar pustulosis: A systematic review and network meta-analysis of randomized clinical trials. J Am Acad Dermatol 2023:S0190-9622(23)00746-6. [PMID: 37121476 DOI: 10.1016/j.jaad.2023.04.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/12/2023] [Accepted: 04/16/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Riley K Spencer
- Department of Dermatology, University of California San Francisco, San Francisco, CA; Arizona College of Osteopathic Medicine, Midwestern University, Glendale, AZ
| | - Joy Q Jin
- Department of Dermatology, University of California San Francisco, San Francisco, CA; School of Medicine, University of California San Francisco, San Francisco, CA
| | - Kareem G Elhage
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Mitchell S Davis
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Marwa Hakimi
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Tina Bhutani
- Department of Dermatology, University of California San Francisco, San Francisco, CA
| | - Wilson Liao
- Department of Dermatology, University of California San Francisco, San Francisco, CA.
| |
Collapse
|
8
|
Munshi M, Borradori L, Yawalkar N, Heidemeyer K. Pool Toes: A Case Report. Case Rep Dermatol 2023; 15:31-34. [PMID: 36747917 PMCID: PMC9898809 DOI: 10.1159/000529079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 01/01/2023] [Indexed: 02/05/2023] Open
Abstract
Pool toes, a sport-related dermatosis, are caused by mechanical friction and water exposure, resulting in a special variant of irritant contact dermatitis. It is common in children, often misdiagnosed, and rarely reported. Here we report a case of a 7-year-old girl who developed this unusual type of frictional dermatitis; a pool toes diagnosis has been made. With topical corticosteroids, favorable results have been achieved. The recovery and healing process will be facilitated if one is aware of the underlying causes of such dermatitis and ceases the triggering factors.
Collapse
Affiliation(s)
- Mohammad Munshi
- Department of Dermatology, Inselspital - Bern University Hospital, University of Bern, Bern, Switzerland
| | - Luca Borradori
- Department of Dermatology, Inselspital - Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nikhil Yawalkar
- Department of Dermatology, Inselspital - Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kristine Heidemeyer
- Department of Dermatology, Inselspital - Bern University Hospital, University of Bern, Bern, Switzerland
| |
Collapse
|
9
|
Abstract
In this article, the author discusses the role of the podiatrist in sustaining and maintaining foot health. A number of core podiatry problems that are most commonly seen in the population are described, along with possible treatment options and when to refer to a podiatrist. The author also explains what is required to carry out a diabetic foot assessment, providing helpful links to resources and literature to aid practitioners' understanding of the processes involved, as well as providing a list of foot care tips to aid self-care.
Collapse
Affiliation(s)
- Lisa Farndon
- Clinical Research Podiatrist/Research Lead, Integrated Community Care Directorate, Sheffield Teaching Hospitals NHS Foundation Trust
| |
Collapse
|
10
|
Longstreth GF, Grypma L, Willis BA, Anderson KC. Foot Torture (Falanga): Ten Victims with Chronic Plantar Hyperpigmentation. Am J Med 2021; 134:278-281. [PMID: 32941848 DOI: 10.1016/j.amjmed.2020.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Falanga is a widespread form of torture, but details of the chronic skin sequelae on physical examination are unreported. METHODS In an organization dedicated to the care of torture victims, we prospectively documented examination findings in 10 consecutive, black African falanga victims. RESULTS Ten individuals (8 men) suffered 1 or more episodes of falanga, most recently 9 to 29 months (9 cases) or 10 years (1 case) earlier. Examination revealed 3 to 50 or more pigmented macules, most greater than or equal to 0.5 cm in size, on both soles of all 10 victims. The degree of pigmentation and border distinctness of the lesions varied. Two cases had plantar tenderness. CONCLUSIONS Plantar hyperpigmentation was present in all cases 9 months to 10 years after suffering falanga. This physical sign can support victims' legal requests for political asylum, and its recognition can aid physicians who care for torture victims.
Collapse
Affiliation(s)
| | - Lydia Grypma
- Survivors of Torture, International. San Diego, Calif
| | | | | |
Collapse
|
11
|
Gonzalez AE, Pineda Gutierrez A, Kern AM, Takahashi KZ. Association between foot thermal responses and shear forces during turning gait in young adults. PeerJ 2021; 9:e10515. [PMID: 33552710 PMCID: PMC7819117 DOI: 10.7717/peerj.10515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/17/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The human foot typically changes temperature between pre and post-locomotion activities. However, the mechanisms responsible for temperature changes within the foot are currently unclear. Prior studies indicate that shear forces may increase foot temperature during locomotion. Here, we examined the shear-temperature relationship using turning gait with varying radii to manipulate magnitudes of shear onto the foot. METHODS Healthy adult participants (N = 18) walked barefoot on their toes for 5 minutes at a speed of 1.0 m s-1 at three different radii (1.0, 1.5, and 2.0 m). Toe-walking was utilized so that a standard force plate could measure shear localized to the forefoot. A thermal imaging camera was used to quantify the temperature changes from pre to post toe-walking (ΔT), including the entire foot and forefoot regions on the external limb (limb farther from the center of the curved path) and internal limb. RESULTS We found that shear impulse was positively associated with ΔT within the entire foot (P < 0.001) and forefoot (P < 0.001): specifically, for every unit increase in shear, the temperature of the entire foot and forefoot increased by 0.11 and 0.17 °C, respectively. While ΔT, on average, decreased following the toe-walking trials (i.e., became colder), a significant change in ΔT was observed between radii conditions and between external versus internal limbs. In particular, ΔT was greater (i.e., less negative) when walking at smaller radii (P < 0.01) and was greater on the external limb (P < 0.01) in both the entire foot and forefoot regions, which were likely explained by greater shear forces with smaller radii (P < 0.0001) and on the external limb (P < 0.0001). Altogether, our results support the relationship between shear and foot temperature responses. These findings may motivate studying turning gait in the future to quantify the relationship between shear and foot temperature in individuals who are susceptible to abnormal thermoregulation.
Collapse
Affiliation(s)
- Angel E. Gonzalez
- Department of Biomechanics, University of Nebraska—Omaha, Omaha, NE, United States of America
| | - Ana Pineda Gutierrez
- Department of Biomechanics, University of Nebraska—Omaha, Omaha, NE, United States of America
| | - Andrew M. Kern
- Department of Biomechanics, University of Nebraska—Omaha, Omaha, NE, United States of America
| | - Kota Z. Takahashi
- Department of Biomechanics, University of Nebraska—Omaha, Omaha, NE, United States of America
| |
Collapse
|
12
|
Conde M, Hendry GJ, Woodburn J, Skelton DA. ´ Feet are second class citizens`: exploring the perceptions of Scottish and Portuguese older adults about feet, falls and exercise- a qualitative study. J Foot Ankle Res 2020; 13:66. [PMID: 33176825 PMCID: PMC7659063 DOI: 10.1186/s13047-020-00434-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/28/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Foot problems are likely to contribute to falls risk in older adults. Foot and ankle exercises may be beneficial, but uptake may be influenced by cultural factors. Few studies have explored the views of older adults from different cultural backgrounds about foot-specific falls risk factors, and foot and ankle falls prevention exercises. Objectives To explore the views of Scottish and Portuguese community-dwelling older adults who have experienced a fall, about any foot risk factors for falls, and foot and ankle exercises. Methods Cross-cultural qualitative study with (n = 6) focus groups exploring the perceptions of Scottish (n = 10, mean age 76 yrs) and Portuguese older adults (n = 14, mean age 66 years) aged, applying thematic analysis. Results One main theme `evolving awareness about feet and falls prevention´ and three subthemes; (i) Feet are often forgotten, (ii) the important role of footwear, (iii) need to look at my feet and do the exercises were identified. Scottish participants had more experience of falls prevention but there was a lack of knowledge surrounding foot-specific falls risk factors, and the role of ankle and foot exercise in the prevention of falls. Portuguese participants exhibited a fatalistic approach to falls. Conclusions Older adults from both nations had little knowledge of foot-specific falls risk factors, being initially unaware of the functional status of their feet and of the role of exercise in foot care and falls management. There were differences between national groups that should be accounted for when developing culturally adequate interventions.
Collapse
Affiliation(s)
- Monserrat Conde
- School of health and Life Sciences, Glasgow Caledonian University, Govan Mbeki Building, G4 0BA, Glasgow, Scotland, UK.
| | - Gordon J Hendry
- School of health and Life Sciences, Glasgow Caledonian University, Govan Mbeki Building, G4 0BA, Glasgow, Scotland, UK
| | - Jim Woodburn
- School of health and Life Sciences, Glasgow Caledonian University, Govan Mbeki Building, G4 0BA, Glasgow, Scotland, UK
| | - Dawn A Skelton
- School of health and Life Sciences, Glasgow Caledonian University, Govan Mbeki Building, G4 0BA, Glasgow, Scotland, UK
| |
Collapse
|
13
|
Cherry L, Gates L, Arden NK, Bowen CJ. Lifetime occupation is not associated with radiographic osteoarthritis of the first metatarsophalangeal joint in a cohort study of UK women. J Foot Ankle Res 2020; 13:61. [PMID: 33004072 PMCID: PMC7528246 DOI: 10.1186/s13047-020-00429-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 09/22/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The study aim was to determine whether lifetime occupation was associated with the presence of radiographic osteoarthritis (ROA) of the first metatarsophalangeal joint (MTPJ) in women. METHOD Data were collected from the prospective, population-based Chingford 1000 Women study. This cohort of women, aged 45-64 years at inception, was established in 1989 from a single general practice in Chingford, UK. Data has subsequently been collected repeatedly. Data from baseline, year six and year ten was used for the purposes of this cross-sectional study. The primary outcome was the presence of dorsal view ROA of the first MTPJ. The main exposure was lifetime occupation, categorised according to levels of occupation previously defined via international consensus: 1. Sedentary, 2. Light, 3. Light manual, 4. Heavy manual. Logistic regression analyses were conducted to quantify the relationship between lifetime occupation type and the presence of ROA of the first MTPJ, adjusting for age, body mass index and lifetime high-heeled footwear use as potential interactive variables for each decade. RESULTS Data for 209 women were included within this study. The mean (SD) age was 57 (±5.2) years. Predominant lifetime occupation was reported as sedentary by 51.7%, as light by 0%, as light manual by 33.5% and as heavy manual by 14.8% of participants. There were no statistical associations between lifetime occupation type and the presence of ROA of the first MTPJ in either the unadjusted (OR = 0.99, CI = 0.78-1.26,P = 0.96) partially adjusted (for age and BMI; OR = 1.00, CI = 0.78-1.29, P = 0.99) or fully adjusted models (for age, BMI and lifetime high heel footwear use for each decade of working life (OR = 1.02, CI = 0.79-1.31, P = 0.91); high-heel footwear use up to 20s (OR = 0.83, CI = 0.71-1.31, P = 0.83); high-heel footwear use in 20-30s (OR = 1.00, CI = 0.75-1.3, P = 0.98); high-heel footwear use in 30-40s (OR = 1.00, CI = 0.70-1.42, P = 0.99); high-heel footwear use in 40-50s (OR = 0.90, CI = 0.58-1.40, P = 0.65); high-heel footwear use in 50s (OR = 0.63,CI = 0.36-1.09, P = 0.10). CONCLUSIONS The findings suggest that lifetime occupation is not associated with the presence of ROA of the fist metatarsophalangeal joint. There does not appear to be any interactive effect between lifetime occupation, lifetime high-heel footwear use, age or BMI and ROA of the first MTPJ. In later life a positive trend towards increased ROA in those who reported lifetime high-heel footwear use was noted and this may be worthy of further research.
Collapse
Affiliation(s)
- L Cherry
- School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK. .,Department of Podiatry, Solent NHS Trust, Southampton, UK.
| | - L Gates
- School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Southampton, UK
| | - N K Arden
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Southampton, UK
| | - C J Bowen
- School of Health Sciences, University of Southampton, Building 67, University Road, Southampton, SO17 1BJ, UK.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Southampton, UK
| |
Collapse
|
14
|
Balkaran RL, Teelucksingh SS, Naidu RS, Lutchmansingh KE, Morris LA, Tripathi V, Teelucksingh S. The Use of the Slipping Slipper Sign to Explore the Connection between the Feet and the Mouth in Patients with Diabetes Mellitus. P R Health Sci J 2020; 39:216-221. [PMID: 32663921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Both periodontal disease and peripheral neuropathy are complications associated with poorly controlled diabetes. This study aimed to determine whether periodontal disease was more prevalent and more severe among patients with severe diabetic peripheral neuropathy. METHODS A case-control study was performed; 46 patients with and 48 without the slipping slipper sign (SSS)-a surrogate clinical marker for severe peripheral neuropathy-were recruited from a diabetic outpatient clinic. Demography and data from the Basic Periodontal Examination (BPE) were assessed, in addition to the patients' periodontal health by 2 examiners blinded to patients' SSS status. Multivariate logistic regression was used to evaluate the associations between the risk factors for and the presence of the SSS, adjusting for age, gender, and ethnicity. RESULTS The mean age of the sample was 55.8 years (±10.69 years). Most of the participants (77.7%) had either never been to a dentist or had last attended a dental clinic more than a year before this examination, and 83% did not have a dentist. Periodontal disease was advanced in 61.7%, and there was no association between the SSS and periodontal disease. Dental-service utilization variables were significantly associated with the SSS. Patients who did not have a regular dentist were more than 7 times more likely to have the SSS than were those who did (OR = 7.70; 95% CI: 1.12 53.21). CONCLUSION In diabetic patients, oral health-related risk factors, such as not having a dentist, wearing a denture or dentures, and visiting a dentist once a year or more, may be associated with systemic complications, including peripheral neuropathy. Early collaboration between dentists and doctors on the care of patients with diabetes is recommended.
Collapse
Affiliation(s)
- Ramaa Lalita Balkaran
- School of Dentistry, Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad & Tobago
| | | | - Rahul Siram Naidu
- School of Dentistry, Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad & Tobago
| | | | - Lerissa Aimee Morris
- School of Dentistry, Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad & Tobago
| | - Vrijesh Tripathi
- Department of Mathematics and Statistics, University of the West Indies, St. Augustine, Trinidad & Tobago
| | - Surujpal Teelucksingh
- Department of Clinical Medical Sciences, Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad & Tobago
| |
Collapse
|
15
|
Martínez-Jiménez EM, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Rodríguez-Sanz D, Díaz-Velázquez JI, Casado-Hernández I, Mazoteras-Pardo V, López-López D. Acute effects of myofascial induction technique in plantar fascia complex in patients with myofascial pain syndrome on postural sway and plantar pressures: A quasi-experimental study. Phys Ther Sport 2020; 43:70-6. [PMID: 32114316 DOI: 10.1016/j.ptsp.2020.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/20/2020] [Accepted: 02/20/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The prevalence of myofascial pain syndrome varies from 21% 93%. Several studies have shown that myofascial induction is effective in treating myofascial pain syndrome. Although these techniques have shown some effectiveness in clinical practice, there have been little study into their effects, and have deep effects. The purpose of this study was to investigate if the application of a single myofascial induction technique for each foot, targeted to the plantar fascia resulted in changes in balance and footprint variables. DESIGN A quasi-experimental study. SETTING An outpatient clinic. SUBJECTS 20 healthy participants (12 females and 8 males) were evaluated pre and post Myofascial induction technique for each foot in plantar fascia during 5 min. METHODS We measured static footprint and stabilometry variables in asymptomatic subjects. The footprint surface area was divided: bilateral rear foot, bilateral midfoot, bilateral fore foot. RESULTS We found differences in the footprint variables: maximun pressure in forefoot (p = 0.025), surface in forefoot (p = 0.03). The myofascial induction has no effects on stabilometry variables. CONCLUSIONS The immediate effects of the longitudinal technique of myofascial induction of the plantar fascia are the increase of surface and maximum pressure in fore foot.
Collapse
|
16
|
Morrison SC, Tait M, Bong E, Kane KJ, Nester C. Symptomatic pes planus in children: a synthesis of allied health professional practices. J Foot Ankle Res 2020; 13:5. [PMID: 31998410 PMCID: PMC6979376 DOI: 10.1186/s13047-020-0372-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/20/2020] [Indexed: 11/27/2022] Open
Abstract
Background This study sought to explore professional perspectives on the assessment and management of symptomatic pes planus in children. Methods Data was collected from three professional groups (podiatrists, physiotherapists, and orthotists) with experience of managing foot problems in children. The survey was undertaken in the United Kingdom via a self-administered, online survey. Data was captured over a four-month period in 2018. Results Fifty-five health professionals completed the survey and the results highlighted that assessment techniques varied between professions, with standing tip-toe and joint range of motion being the most common. Treatment options for children were diverse and professionals were adopting different strategies as their first line intervention. All professions used orthoses. Conclusions There were inconsistencies in how the health professionals assessed children presenting with foot symptoms, variation in how the condition was managed and differences in outcome measurement. These findings might be explained by the lack of robust evidence and suggests that more effort is needed to harmonise assessment and treatment approaches between professions. Addressing discrepancies in practice could help prioritise professional roles in this area, and better support the management of children with foot pain.
Collapse
Affiliation(s)
| | | | | | - Kyra J Kane
- 2Wascana Rehabilitation Centre, Saskatchewan Health Authority, Saskatchewan, Canada
| | - Chris Nester
- 3School of Health and Society, University of Salford, Salford, UK
| |
Collapse
|
17
|
Cancela-Díez B, López-Delgado D, Aneiros-Fernandez J, Ruiz-Villaverde R. A Case of Intertriginous and Flexural Exanthema caused by Amoxicillin. Sultan Qaboos Univ Med J 2019; 19:e369-e371. [PMID: 31897322 PMCID: PMC6930026 DOI: 10.18295/squmj.2019.19.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/22/2019] [Accepted: 09/17/2019] [Indexed: 11/16/2022] Open
Abstract
We report a 50-year-old male patient who presented to the Dermatological Outpatient Clinic at the Hospital Universitario San Cecilio, Granada, Spain, in 2017 with symmetrical inguinal eruption and eruption on the dorsum of both feet four hours after the intake of amoxicillin. Physical examination showed confluent non-palpable purpuric macules covering the dorsum of both feet and medial malleolus, giving rise to dusky erythema in some areas. Only oral antihistamines were prescribed and cutaneous exanthema resolved within three weeks. Symmetric drug-related intertriginous and flexural exanthema (SDRIFE) is a sub-type of systemic allergic contact dermatitis, where previous sensitisation can only be demonstrated in up to 50% of patients by skin patch testing. Therefore, a provocation test was performed with amoxicillin without prior skin patch testing. As drug provocation produced the same reaction, the patient was diagnosed with SDRIFE. A parvovirus B19 infection was ruled out by negative serology. SDRIFE is challenging to distinguish from other skin rashes with similar features and distribution; it is important to be aware of these characteristics and their possible causes.
Collapse
|
18
|
Otjen JP, Sousa TC, Bauer JM, Thapa M. Cerebral palsy - beyond hip deformities. Pediatr Radiol 2019; 49:1587-1594. [PMID: 31686165 DOI: 10.1007/s00247-019-04519-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/29/2019] [Accepted: 08/28/2019] [Indexed: 11/25/2022]
Abstract
Cerebral palsy is a neurologic condition with myriad musculoskeletal and articular manifestations. While every patient is unique with innumerable variations in presentation, symptoms and treatments, there are broad themes and recognizable patterns of development. Many of these findings spill over to other neurodevelopmental disorders, and lessons learned from children with cerebral palsy translate well to multiple neurologic conditions. This review focuses on the more common manifestations involving the spine, knee, foot and ankle, with an emphasis on collecting and describing imaging features, along with clinical and radiologic pearls and pitfalls.
Collapse
Affiliation(s)
- Jeffrey P Otjen
- Department of Radiology, Seattle Children's Hospital, University of Washington, Mail Stop MA.7.220, 4800 Sand Point Way NE, Seattle, WA, 98105, USA
| | - Ted C Sousa
- Department of Orthopedic Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Jennifer M Bauer
- Department of Orthopedic Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Mahesh Thapa
- Department of Radiology, Seattle Children's Hospital, University of Washington, Mail Stop MA.7.220, 4800 Sand Point Way NE, Seattle, WA, 98105, USA.
| |
Collapse
|
19
|
Frossard L, Leech B, Pitkin M. Inter-participant variability data in loading applied on osseointegrated implant by transtibial bone-anchored prostheses during daily activities. Data Brief 2019; 26:104510. [PMID: 31667273 PMCID: PMC6811920 DOI: 10.1016/j.dib.2019.104510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/19/2019] [Accepted: 09/05/2019] [Indexed: 10/31/2022] Open
Abstract
The data in this paper are related to the research article entitled "Loading applied on osseointegrated implant by transtibial bone-anchored prostheses during daily activities: Preliminary characterization of prosthetic feet" (Frossard et al., 2019: Accepted). This article contains the individual and grouped loading characteristics applied on transtibial osseointegrated implant generated while walking with bone-anchored prostheses including prosthetic feet with different index of anthropomorphicity. Inter-participant variability was presented for (A) the spatio-temporal characteristics, (B) the loading boundaries and (C) the loading local extremum during walking, ascending and descending ramp and stairs. These initial inter-participant variability benchmark datasets are critical to improve the efficacy and safety of prosthetic components for transtibial prostheses as well as the design of future automated algorithms and clinical trials. Online repository contains the files: https://doi.org/10.17632/vhc6sf7ngy.1.
Collapse
Affiliation(s)
| | - Barry Leech
- Barry Leech Prosthetics & Orthotics Pty Ltd, Southport, Australia
| | - Mark Pitkin
- Tufts University, Boston, MA, USA.,Poly-Orth International, Sharon, MA, USA
| |
Collapse
|
20
|
Brown MA, Handley D, Simon A. Raynaud's phenomenon manifesting as progressive abnormal MRI bone marrow signal in the toes. Radiol Case Rep 2019; 14:1320-4. [PMID: 31516646 DOI: 10.1016/j.radcr.2019.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 08/10/2019] [Accepted: 08/16/2019] [Indexed: 11/24/2022] Open
Abstract
Objective The purpose of this report is to discuss the
presentation and the progressive magnetic resonance imaging (MRI) findings in a
single patient with clinically-diagnosed Raynaud's phenomenon
(RP). Conclusion RP can present as non-specific toe pain and manifest
as progressive abnormal MRI bone marrow signal in the toes. In addition to
patient presentation and clinical assessment, this information could contribute
to earlier diagnosis and treatment of RP and other coexisting rheumatologic
disorders.
Collapse
|
21
|
Conde M, Hendry G, Skelton DA. The Footfall Programme: participant experiences of a lower limb, foot and ankle exercise intervention for falls prevention - an exploratory study. J Frailty Sarcopenia Falls 2019; 4:78-90. [PMID: 32300722 PMCID: PMC7155362 DOI: 10.22540/jfsf-04-078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Despite growing evidence that foot and ankle exercise programmes are effective for falls prevention, little is known about older adults' views and preferences of programme components for long-term maintenance. The aims of this study were to explore the experiences and acceptability of Scottish and Portuguese older adults of undertaking a home-based foot, ankle and lower limb exercise intervention. METHODS Ten Scottish (mean age 76 years, 7 female) and fourteen Portuguese (mean age 66 years, 12 female) community-dwelling older adults undertook the programme for one week, followed by focus group discussions (2-6 people per group), guided by a semi-structured interview guide. Data was analysed using thematic analysis. RESULTS Seven themes were identified:Assessment, Group exercise taster, Home based exercise; Footfall programme kit, Midweek phone call, Reasons for participation and the Research Process. Programme components, support telephone calls and research procedures were generally well accepted by participants and they valued having a contribution to the design. They preferred a blended home and intermittent group-based programme format for motivation and progression and recommended changes to some of the exercises and equipment to reduce barriers to participation. Some cultural differences emerged, including importance of the functional assessments for Portuguese participants, time issues and difficulty in completion of the exercise diary, reflecting lower literacy levels. CONCLUSIONS Participants found the programme acceptable but preferred a blended home and occasional group-based programme for adherence and motivation. A strong educational component to improve health literacy and simple paperwork completion to avoid data loss in future studies with Portuguese older adults is important.
Collapse
Affiliation(s)
- Monserrat Conde
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Gordon Hendry
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| | - Dawn A. Skelton
- School of Health & Life Sciences, Institute of Applied Health Research, Glasgow Caledonian University, Glasgow, UK
| |
Collapse
|
22
|
Frossard L, Leech B, Pitkin M. Inter-participant variability data in characterization of anthropomorphicity of prosthetic feet fitted to bone-anchored transtibial prosthesis. Data Brief 2019; 25:104195. [PMID: 31406899 PMCID: PMC6685672 DOI: 10.1016/j.dib.2019.104195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 06/18/2019] [Indexed: 11/30/2022] Open
Abstract
The data in this paper are related to the research article entitled “Automated characterization of anthropomorphicity of prosthetic feet fitted to bone-anchored transtibial prosthesis” (Frossard et al., 2019: DOI: 10.1109/TBME.2019.2904713). This article contains the individual angles of dorsiflexion and bending moments generated while walking with transtibial bone-anchored prostheses including prosthetic feet with different index of anthropomorphicity. Inter-participant variability were presented for the (A) position of the load cell measuring directly to the bending moments, (B) patterns of angles of dorsiflexion and bending moment as well as moment-angle curves and (C) variations of magnitude of angles of dorsiflexion as well as the raw and bodyweight-normalized bending moments between toe contact and heel off. These initial inter-participant variability benchmark datasets are critical to design future automated algorithms and clinical trials. Online repository contains the files: https://eprints.qut.edu.au/127745/1/127745.pdf.
Collapse
Affiliation(s)
| | - Barry Leech
- Barry Leech Prosthetics & Orthotics Pty Ltd, Southport, Australia
| | - Mark Pitkin
- Tufts University, Boston, MA, USA.,Poly-Orth International, Sharon, MA, USA
| |
Collapse
|
23
|
Pablos A, Gómez-Olivencia A, Maureille B, Holliday TW, Madelaine S, Trinkaus E, Couture-Veschambre C. Neandertal foot remains from Regourdou 1 (Montignac-sur-Vézère, Dordogne, France). J Hum Evol 2019; 128:17-44. [PMID: 30825980 DOI: 10.1016/j.jhevol.2018.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 11/04/2018] [Accepted: 11/05/2018] [Indexed: 11/30/2022]
Abstract
Regourdou is a well-known Middle Paleolithic site which has yielded the fossil remains of a minimum of two Neandertal individuals. The first individual (Regourdou 1) is represented by a partial skeleton while the second one is represented by a calcaneus. The foot remains of Regourdou 1 have been used in a number of comparative studies, but to date a full description and comparison of all the foot remains from the Regourdou 1 Neandertal, coming from the old excavations and from the recent reanalysis of the faunal remains, does not exist. Here, we describe and comparatively assess the Regourdou 1 tarsals, metatarsals and phalanges. They display traits observed in other Neandertal feet, which are different from some traits of the Sima de los Huesos (Atapuerca) hominins and of Middle Paleolithic, Upper Paleolithic and recent modern humans. These Neandertal features are: a rectangular talar trochlea with a large lateral malleolar facet, a broad talar head, a broad calcaneus with a projecting sustentaculum tali, a wide and wedged navicular with a projecting medial tubercle, large and wide bases of the lateral metatarsals, and mediolaterally expanded and robust phalanges that also show hallux valgus in a strongly built hallux.
Collapse
Affiliation(s)
- Adrián Pablos
- Centro Nacional de Investigación sobre La Evolución Humana-CENIEH, Burgos, Spain; Área de Antropología Física, Departamento de Ciencias de La Vida, Universidad de Alcalá-UAH, Alcalá de Henares, Madrid, Spain; Centro Mixto UCM-ISCIII de Investigación sobre Evolución y Comportamiento Humanos, Madrid, Spain.
| | - Asier Gómez-Olivencia
- Departamento de Estratigrafía y Paleontología, Facultad de Ciencia y Tecnología, Euskal Herriko Unibertsitatea (UPV/EHU), Barrio Sarriena s/n, 48940 Leioa, Spain; IKERBASQUE, Basque Foundation for Science, Spain; Équipe de Paléontologie Humaine, UMR 7194, CNRS, Département de Préhistoire, Muséum National d'Histoire naturelle, Musée de l'Homme, 17, Place Du Trocadéro, 75016 Paris, France; Centro Mixto UCM-ISCIII de Investigación sobre Evolución y Comportamiento Humanos, Madrid, Spain
| | - Bruno Maureille
- Univ. Bordeaux, CNRS, Ministère de La Culture et de la Communication, PACEA UMR 5199, Allée Geoffroy Saint-Hilaire, FR-33615 Pessac, France
| | - Trenton W Holliday
- Department of Anthropology, Tulane University, New Orleans, LA 70118, USA; Evolutionary Studies Institute, University of the Witwatersrand, South Africa
| | - Stéphane Madelaine
- Musée national de Préhistoire, Les Eyzies-de-Tayac, France; Univ. Bordeaux, CNRS, Ministère de La Culture et de la Communication, PACEA UMR 5199, Allée Geoffroy Saint-Hilaire, FR-33615 Pessac, France
| | - Erik Trinkaus
- Department of Anthropology, Washington University, St. Louis, MO 63130, USA
| | - Christine Couture-Veschambre
- Univ. Bordeaux, CNRS, Ministère de La Culture et de la Communication, PACEA UMR 5199, Allée Geoffroy Saint-Hilaire, FR-33615 Pessac, France
| |
Collapse
|
24
|
Lipsitz LA, Manor B, Habtemariam D, Iloputaife I, Zhou J, Travison TG. The pace and prognosis of peripheral sensory loss in advanced age: association with gait speed and falls. BMC Geriatr 2018; 18:274. [PMID: 30419857 PMCID: PMC6233369 DOI: 10.1186/s12877-018-0970-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 11/01/2018] [Indexed: 02/08/2023] Open
Abstract
Background Peripheral sensory loss is considered one of many risk factors for gait impairments and falls in older adults, yet no prospective studies have examined changes in touch sensation in the foot over time and their relationship to mobility and falls. Therefore, we aimed to determine the prevalence and progression of peripheral sensory deficits in the feet of older adults, and whether sensory changes are associated with the slowing of gait and development of falls over 5 years. Methods Using baseline, and 18 and 60 month followup data from the Maintenance Of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Study in Boston, MA, we determined changes in the ability to detect stimulation of the great toe with Semmes Weinstein monofilaments in 351 older adults. We used covariate-adjusted repeated measures analysis of variance to determine relationships between sensory changes and gait speed or fall rates. Results Subjects whose sensory function was consistently impaired over 5 years had a significantly steeper decline in gait speed (− 0.23 m/s; 95% CI: -0.28 to − 0.18) compared to those with consistently intact sensory function (− 0.12 m/s; 95% CI: -0.15 to − 0.08) and those progressing from intact to impaired sensory function (− 0.13 m/s; − 0.16 to − 0.10). Compared to subjects with consistently intact sensation, those whose sensory function progressed to impairment during followup had the greatest risk of falls (adjusted risk ratio = 1.57 (95% confidence interval = 1.12 to 2.22). Conclusions Our longitudinal results indicate that a progressive decline in peripheral touch sensation is a risk factor for mobility impairment and falls in older adults.
Collapse
Affiliation(s)
- Lewis A Lipsitz
- Hebrew SeniorLife Institute for Aging Research, 1200 Centre Street, Boston Roslindale, MA, 02131, USA. .,Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Brad Manor
- Hebrew SeniorLife Institute for Aging Research, 1200 Centre Street, Boston Roslindale, MA, 02131, USA.,Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Daniel Habtemariam
- Hebrew SeniorLife Institute for Aging Research, 1200 Centre Street, Boston Roslindale, MA, 02131, USA
| | - Ikechukwu Iloputaife
- Hebrew SeniorLife Institute for Aging Research, 1200 Centre Street, Boston Roslindale, MA, 02131, USA
| | - Junhong Zhou
- Hebrew SeniorLife Institute for Aging Research, 1200 Centre Street, Boston Roslindale, MA, 02131, USA.,Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Thomas G Travison
- Hebrew SeniorLife Institute for Aging Research, 1200 Centre Street, Boston Roslindale, MA, 02131, USA.,Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| |
Collapse
|
25
|
Głowacka-Mrotek I, Sowa M, Nowikiewicz T, Siedlecki Z, Hagner W, Zegarski W. Foot posture in female patients 5 years after breast-conserving surgery: a case-control study. Breast Cancer 2018; 25:325-333. [PMID: 29368210 PMCID: PMC5906506 DOI: 10.1007/s12282-018-0835-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 01/10/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE Along with the improvement in the outcomes of breast cancer treatment being observed in the recent years, long-term studies to assess distant adverse effects of the treatment have become increasingly important. The objective of this study was to assess the foot posture in patients subjected to breast-conserving therapy. The assessment was made 5 years after the surgical procedure. METHODS 116 female patients (mean age of 58.75 years) were qualified into a case-control study. Foot posture on the operated breast side (F1) as well as on the contralateral side (F2) was evaluated using a computer-based foot analysis tool as an extension of projection moiré-based podoscopic examination. Comparisons were made for the following parameters: limb load, L-foot length, W-foot width, L/W-Wejsflog index, ALPHA-hallux valgus angle, BETA-little toe varus angle, GAMMA-heel angle, KY-Sztriter-Godunov index, CL-Clarke's angle, HW-heel width. RESULTS Five years after BCT, patients placed higher load on the foot on the side of the healthy breast (p = 0.0011). No statistically significant differences were observed between F1 and F2 with respect to other foot posture parameters (p > 0.05). No statistically significant differences were observed in foot posture parameters in patients having undergone BCT + ALND (axillary lymph node dissection) procedure as compared to patients subjected to BCT + SLNB (sentinel lymph node biopsy) procedure (p > 0.05). CONCLUSIONS No changes in foot posture were observed in patients 5 years after the BCT procedure. The type of the surgical procedure related to the lymph nodes within the axillary fossa has no effect on changes in foot posture.
Collapse
Affiliation(s)
- Iwona Głowacka-Mrotek
- Department of Rehabilitation, Collegium Medicum of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.
| | - Magdalena Sowa
- Department of Surgical Oncology, Collegium Medicum of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.,Department of Laser Therapy and Physiotherapy, Collegium Medicum of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Tomasz Nowikiewicz
- Department of Surgical Oncology, Collegium Medicum of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.,Department of Clinical Breast Cancer and Reconstructive Surgery, Oncology Centre-Prof. F. Łukaszczyk Memorial Hospital, Bydgoszcz, Poland
| | - Zygmunt Siedlecki
- Department of Neurosurgery, Collegium Medicum of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Wojciech Hagner
- Department of Rehabilitation, Collegium Medicum of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Wojciech Zegarski
- Department of Surgical Oncology, Collegium Medicum of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| |
Collapse
|
26
|
McQueen P, Gates L, Marshall M, Doherty M, Arden N, Bowen C. The effect of variation in interpretation of the La Trobe radiographic foot atlas on the prevalence of foot osteoarthritis in older women: the Chingford general population cohort. J Foot Ankle Res 2017; 10:54. [PMID: 29234466 PMCID: PMC5723087 DOI: 10.1186/s13047-017-0239-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/27/2017] [Indexed: 11/26/2022] Open
Abstract
Background The prevalence of foot osteoarthritis (OA) is much less understood than hip, knee and hand OA. The foot is anatomically complex and different researchers have investigated different joints with lack of methodological standardisation across studies. The La Trobe Foot Atlas (LFA) is the first to address these issues in providing quantitative assessment of radiographic foot OA, but has not been tested externally. The aim of this study was to evaluate three different interpretive approaches to using the LFA for grading OA when scoring is difficult due to indistinct views of interosseous space and joint contour. Methods Foot radiographs of all remaining participants (n = 218) assessed in the Chingford Women Study 23 year visit (mean (SD) for age: 75.5 years (5.1)) were scored using the LFA defined protocol (Technique 1). Two revised scoring strategies were applied to the radiographs in addition to the standard LFA analyses. Technique 2 categorised joints that were difficult to grade as ‘missing’. Technique 3 included joints that were difficult to grade as an over estimated score. Radiographic OA prevalence was defined for the foot both collectively and separately for individual joints. Results When radiographs were scored using the LFA (Technique 1), radiographic foot OA was present in 89.9%. For Technique 2 the presence of radiographic foot OA was 83.5% and for Technique 3 it was 97.2%. At the individual joint level, using Technique 1, the presence of radiographic foot OA was higher with a wider range (18.3–74.3%) than Technique 2 (17.9–46.3%) and lower with a wider range (18.3–74.3%) than Technique 3 (39.9–79.4%). Conclusion The three different ways of interpreting the LFA scoring system when grading of individual joints is technically difficult and result in very different estimates of foot OA prevalence at both the individual joint and global foot level. Agreement on the best strategy is required to improve comparability between studies.
Collapse
Affiliation(s)
- Peter McQueen
- Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, Southampton, SO17 1BJ UK.,Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Southampton, Southampton, UK
| | - Lucy Gates
- Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, Southampton, SO17 1BJ UK.,Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Southampton, Southampton, UK.,Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Oxford, Oxford, UK
| | - Michelle Marshall
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Michael Doherty
- Arthritis Research UK Pain Centre and Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Nigel Arden
- Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Oxford, Oxford, UK.,Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Catherine Bowen
- Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, Southampton, SO17 1BJ UK.,Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, University of Southampton, Southampton, UK
| |
Collapse
|
27
|
Edwards K, Borthwick A, McCulloch L, Redmond A, Pinedo-Villanueva R, Prieto-Alhambra D, Judge A, Arden N, Bowen C. Evidence for current recommendations concerning the management of foot health for people with chronic long-term conditions: a systematic review. J Foot Ankle Res 2017; 10:51. [PMID: 29201147 PMCID: PMC5700544 DOI: 10.1186/s13047-017-0232-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/09/2017] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Research focusing on management of foot health has become more evident over the past decade, especially related to chronic conditions such as diabetes. The level of methodological rigour across this body of work however is varied and outputs do not appear to have been developed or translated into clinical practice. The aim of this systematic review was to assess the latest guidelines, standards of care and current recommendations relative to people with chronic conditions to ascertain the level of supporting evidence concerning the management of foot health. METHODS A systematic search of electronic databases (Medline, Embase, Cinahl, Web of Science, SCOPUS and The Cochrane Library) for literature on recommendations for foot health management for people with chronic conditions was performed between 2000 and 2016 using predefined criteria. Data from the included publications was synthesised via template analysis, employing a thematic organisation and structure. The methodological quality of all included publications was appraised using the Appraisal for Research and Evaluation (AGREE II) instrument. A more in-depth analysis was carried out that specifically considered the levels of evidence that underpinned the strength of their recommendations concerning management of foot health. RESULTS The data collected revealed 166 publications in which the majority (102) were guidelines, standards of care or recommendations related to the treatment and management of diabetes. We noted a trend towards a systematic year on year increase in guidelines standards of care or recommendations related to the treatment and management of long term conditions other than diabetes over the past decade. The most common recommendation is for preventive care or assessments (e.g. vascular tests), followed by clinical interventions such as foot orthoses, foot ulcer care and foot health education. Methodological quality was spread across the range of AGREE II scores with 62 publications falling into the category of high quality (scores 6-7). The number of publications providing a recommendation in the context of a narrative but without an indication of the strength or quality of the underlying evidence was high (79 out of 166). CONCLUSIONS It is clear that evidence needs to be accelerated and in place to support the future of the Podiatry workforce. Whilst high level evidence for podiatry is currently low in quantity, the methodological quality is growing. Where levels of evidence have been given in in high quality guidelines, standards of care or recommendations, they also tend to be strong-moderate quality such that further strategically prioritised research, if performed, is likely to have an important impact in the field.
Collapse
Affiliation(s)
- Katherine Edwards
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Alan Borthwick
- Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, University Road, Southampton, Hampshire SO17 1BJ UK
| | - Louise McCulloch
- Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, University Road, Southampton, Hampshire SO17 1BJ UK
| | - Anthony Redmond
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Rafael Pinedo-Villanueva
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Daniel Prieto-Alhambra
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Andrew Judge
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Nigel Arden
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Catherine Bowen
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
- Faculty of Health Sciences, University of Southampton, Highfield Campus Building 45, University Road, Southampton, Hampshire SO17 1BJ UK
| |
Collapse
|
28
|
Wilson O, Hewlett S, Woodburn J, Pollock J, Kirwan J. Prevalence, impact and care of foot problems in people with rheumatoid arthritis: results from a United Kingdom based cross-sectional survey. J Foot Ankle Res 2017; 10:46. [PMID: 29090022 PMCID: PMC5658923 DOI: 10.1186/s13047-017-0229-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/16/2017] [Indexed: 11/20/2022] Open
Abstract
Background Foot symptoms in rheumatoid arthritis (RA) derive from a combination of inflammation, altered foot mechanics, deformity and secondary skin lesions. Guidelines recommend regular review of patients’ feet, but the extent to which the general population of RA patients report foot symptoms and access foot care has not been established. The aims of this study were to determine the prevalence, impact and care of foot problems in all patients with RA in one geographical area and identify factors associated with accessing foot care. Methods Cross-sectional survey of a random sample of patients with RA, who resided within a single community-based National Health Service (NHS) podiatry service. The questionnaire collected demographic data (age, gender, local deprivation score), clinical data (disease duration, arthritis medications, disability (Health Assessment Questionnaire (HAQ)), current foot problems, foot care accessed (podiatry, orthotics and/or orthopaedics) and care received, measures of impact (Foot Impact Scale) and ability to work. Results Of 1003 total eligible patients in the target population, 739 were posted survey packs. Of these 413 (56%) replied. Responders and non-responders had similar age (63.5 yr. vs.61.5 yr), gender (74.1%F vs. 75.2%F), and highest deprivation category (13.3% vs.15.9%). Of the responders 92.1% reported current foot problems: articular 73.8%, cutaneous lesions 65.4%, structural 57.6%, extra-articular 42.6%. Responders’ median (IQR) disease duration 10 (5–20) years, HAQ 1.5 (0.75–2.0), FISIF 10 (6–14) and FISAP 16 (7–23) and 37.8% reported impacts on work. While 69.5% had accessed foot care there were differences in the route of access (by gender and whether independent or NHS provision) and were older (64.9 yr. vs 60.4 yr. p = 0.001), had longer disease duration (12 yr. vs 7 yr. p < 0.001) and had a greater proportion of females (72.2% vs 61.7% p = 0.04) than those who had not accessed care. Conclusions Current foot problems were reported by 92.1% of the study sample and substantially impacted on life and work. While overall access to foot care was higher than anticipated, routes of access differed and extent of current problems suggests the provision of effective, timely and targeted care is a pressing need. Electronic supplementary material The online version of this article (10.1186/s13047-017-0229-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Oonagh Wilson
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Sarah Hewlett
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - James Woodburn
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Jon Pollock
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - John Kirwan
- School of Clinical Sciences, University of Bristol, Bristol, UK
| |
Collapse
|
29
|
Carvalho BKGD, Penha PJ, Penha NLJ, Andrade RM, Ribeiro AP, João SMA. The influence of gender and body mass index on the FPI-6 evaluated foot posture of 10- to 14-year-old school children in São Paulo, Brazil: a cross-sectional study. J Foot Ankle Res 2017; 10:1. [PMID: 28670344 PMCID: PMC5488407 DOI: 10.1186/s13047-016-0183-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 12/06/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is marked by changes to the body, including the feet. The Foot Posture Index (FPI-6) stands out from other foot type classification methods as valid, reliable, and multidimensional. However, the current literature differs according to age group, with little consolidation of normative data in school children, largely due to the influence of such factors as sex, age and body mass index (BMI). Thus, this study assesses foot posture in adolescents according to age, sex and BMI. METHODS The study evaluated 1.394 adolescents from Amparo and Pedreira regions in São Paulo, Brazil. Subjects were positioned barefoot on a wooden base and each foot was assessed by FPI-6 criteria. Each criterion was scored on a scale of -2 to +2, negative for supinated and positive for pronated posture. Initially the data were assessed for normality using the Shapiro-Wilk test and descriptive statistics were calculated. To investigate and compare the scores of FPI-6 with regards to age and body mass index, analysis of variance (ANOVA) was used, followed by post hoc Tukey. To compare the FPI-6 with regard to gender, an independent student t test was used. All data were analyzed using SPSS version 21.0 and the 5% significance level. RESULTS Boys had higher scores than girls (p = 0.037) for the right foot, and the group with normal BMI values scored higher than the obese group (p = 0.001). For the left foot, 11- and 13-year-olds differed (p = 0.024) with respect to age in general. The overweight and obese group scored lower than the normal BMI group (p = 0.039; p = 0.001, respectively). CONCLUSIONS Overall, the feet in this study were classified as normal, with a tendency to pronation, particularly in boys. There were differences between the 11 and 13 year groups and, with regard to BMI, there were higher scores for the group with normal BMI. Therefore, a higher BMI in adolescence is not indicative of a pronated foot type.
Collapse
Affiliation(s)
- Barbarah Kelly Gonçalves de Carvalho
- Faculty of Medicine, University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Musculoskeletal Evaluation Laboratory, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP: 05360-160 São Paulo, SP Brazil
| | - Patrícia Jundi Penha
- Faculty of Medicine, University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Musculoskeletal Evaluation Laboratory, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP: 05360-160 São Paulo, SP Brazil.,Department of Physical Therapy, Faculty of Human Sciences and Health, Pontifícia Universidade Católica de São Paulo, São Paulo, Brazil
| | - Nárima Lívia Jundi Penha
- Investigator in the Musculoskeletal Evaluation Laboratory, Department of Physical Therapy, Speech and Occupational Therapy, University of São Paulo, São Paulo, Brazil
| | - Rodrigo Mantelatto Andrade
- Faculty of Medicine, University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Musculoskeletal Evaluation Laboratory, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP: 05360-160 São Paulo, SP Brazil.,Department of Physical Therapy, Faculty of Human Sciences and Health, Pontifícia Universidade Católica de São Paulo, São Paulo, Brazil
| | - Ana Paula Ribeiro
- Faculty of Medicine, University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Musculoskeletal Evaluation Laboratory, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP: 05360-160 São Paulo, SP Brazil.,Department of Physical Therapy, Faculty of Medicine, University of Santo Amaro, São Paulo, Brazil
| | - Sílvia Maria Amado João
- Faculty of Medicine, University of São Paulo, Department of Physical Therapy, Speech and Occupational Therapy, Musculoskeletal Evaluation Laboratory, University of São Paulo, Rua Cipotânea, 51, Cidade Universitária, CEP: 05360-160 São Paulo, SP Brazil
| |
Collapse
|
30
|
Głowacka-Mrotek I, Sowa M, Siedlecki Z, Nowikiewicz T, Hagner W, Zegarski W. Evaluation of changes to foot shape in females 5 years after mastectomy: a case-control study. Breast Cancer Res Treat 2017; 163:287-294. [PMID: 28271310 PMCID: PMC5410211 DOI: 10.1007/s10549-017-4183-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 02/27/2017] [Indexed: 12/04/2022]
Abstract
Purpose The aim of this study was to evaluate changes in foot shape of women 5 years after undergoing breast amputation. Methods Evaluation of foot shape was performed using a non-invasive device for computer analysis of the plantar surface of the foot. Obtained results were compared between feet on the healthy breast side (F1) and on the amputated breast side (F2). Results 128 women aged 63.60 ± 8.83, 5–6 years after breast amputation were enrolled in this case–control study. Weight bearing on the lower extremity on the amputated breast side (F1) compared with the healthy breast side (F2) showed statistically significant differences (p < 0.01). Patients put more weight onto the healthy breast side. No statistically significant difference was found with regard to F1 and F2 foot length (p = 0.4239), as well as BETA (p = 0.4470) and GAMMA (p = 0.4566) angles. Highly statistically significant differences were noted with respect to foot width, ALPHA angle, and Sztriter–Godunov index—higher values were observed on the healthy breast side (p < 0.001). Highly statistically significant differences were also noted while comparing Clark’s angles, higher values being observed on the operated breast side (p < 0.001). Conclusions Differences in foot shape on the healthy breast side and amputated breast side constitute a long-term negative consequence of mastectomy, and can be caused by unbalanced weight put on feet on the healthy breast side compared to the amputated breast side.
Collapse
Affiliation(s)
- Iwona Głowacka-Mrotek
- Department of Rehabilitation, Collegium Medicum of the Nicolaus Copernicus University in Torun, Marii Curie-Skłodowskiej 9 Street, 85-094, Bydgoszcz, Poland.
| | - Magdalena Sowa
- Department of Surgical Oncology, Oncology Center in Bydgoszcz, Collegium Medicum of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland.,Department of Laser Therapy and Physiotherapy, Collegium Medicum of the Nicolaus Copernicus University in Torun, Toruń, Poland
| | - Zygmunt Siedlecki
- Department of Neurosurgery, Collegium Medicum of the Nicolaus Copernicus University in Torun, Toruń, Poland
| | - Tomasz Nowikiewicz
- Department of Surgical Oncology, Oncology Center in Bydgoszcz, Collegium Medicum of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Wojciech Hagner
- Department of Rehabilitation, Collegium Medicum of the Nicolaus Copernicus University in Torun, Marii Curie-Skłodowskiej 9 Street, 85-094, Bydgoszcz, Poland
| | - Wojciech Zegarski
- Department of Surgical Oncology, Oncology Center in Bydgoszcz, Collegium Medicum of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| |
Collapse
|
31
|
Radhakrishnan R, Emery KH, Merrow AC. Diffuse phalangeal signal abnormality on magnetic resonance imaging: phalangeal microgeodic disease. Pediatr Radiol 2017; 47:313-320. [PMID: 28101593 DOI: 10.1007/s00247-016-3763-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/25/2016] [Accepted: 12/05/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Phalangeal microgeodic disease is a rare and benign self-limited condition involving the phalanges, often in the setting of cold exposure, with characteristic MR imaging abnormalities. Radiographic case descriptions are predominantly from Asia and Europe, with only seven cases using MR to characterize phalangeal microgeodic disease. OBJECTIVE In this study we describe the MR imaging appearance of unusual and striking phalangeal signal abnormality compatible with phalangeal microgeodic disease at our institution in North America. MATERIALS AND METHODS We retrospectively reviewed cases presenting at our institution with unusual or unexplained phalangeal signal abnormalities between 2001 and 2014. We reviewed the MR imaging appearances in conjunction with radiographs and any other available imaging investigations. RESULTS Of 189 examinations reviewed during the study period, 8 imaging studies in 6 patients met the study inclusion criteria. Signal abnormality was present in 57 of 112 phalanges (51%), frequently involving the distal phalanges (70%, 28 of 40), followed by the middle phalanges (56%, 18 of 32) and the proximal phalanges (28%, 11 of 40). The pattern of involvement was most commonly diaphysis (38%), followed by metaphysis (32%) and epiphysis (30%). The extent of MR signal abnormality was greater than that suspected based on clinical presentation or on radiographs. CONCLUSION The presence of unexplained diffuse characteristic marrow involvement of multiple painful phalanges on MR images, often in the setting of cold exposure, should raise the possibility of phalangeal microgeodic disease. Consideration of this diagnosis based on MR findings would lead to a more conservative management and avoid unnecessary invasive diagnostic procedures.
Collapse
Affiliation(s)
- Rupa Radhakrishnan
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA.
| | - Kathleen H Emery
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
| | - Arnold C Merrow
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 5031, Cincinnati, OH, 45229, USA
| |
Collapse
|
32
|
Bongi SM, Ravenni G, Ciampi B, Del Rosso A, El Aoufy K. Biomechanical podiatric evaluation in an Italian cohort of patients with systemic sclerosis: A pilot study. Eur J Rheumatol 2016; 3:169-174. [PMID: 28149661 DOI: 10.5152/eurjrheum.2016.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 11/16/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Foot problems are often present in Systemic Sclerosis (SSc) patients, however studies regarding podiatric problems related to SSc are lacking and there are no data evaluating the foot biomechanical changes. The aim of the present pilot study was to evaluate podiatric problems in an Italian cohort of SSc patients by assessing received podiatric services, foot pain and disability and biomechanical foot deformity. MATERIAL AND METHODS 25 consecutive SSc patients were enrolled from the Division of Rheumatology, University of Florence. All SSc patients were assessed by: Standards of Care for People with Foot Musculoskeletal Health problems: Audit Tool, Foot Function Index (FFI), Weight and non-weight bearing foot joint assessment, (Foot Posture Index (FPI) and Gait Cycle), Health Assessment Questionnaire (HAQ) and Medical Outcomes Survey Short Form 36 (SF-36). RESULTS Audit Tool - Only 7 (28%) out of the 25 patients with SSc had a specific podiatric assessment and treatment: no patient received a foot health assessment within the first 6 months of disease diagnosis and no patient received information about foot involvement. 1 patient (4%) received foot assessment every year; 1 patient (4%) received specific information about the disease and 5 patients (20%) received information about the benefits of using adapted footwear and insoles. FFI - Values of pain, disability and activity limitations, reported in FFI, are 4.7±5.1, 5.1±3.2 and 3.2±3.1 (M±DS), respectively. Non-weight bearing foot joint assessment shows a rearfoot varus deformity in 64% of patients, forefoot varus deformity in 42% and 6% forefoot valgus deformity. Weight bearing foot joint assessment, through FPI shows a pronated foot 20% of patients with and 34% with highly pronated overall foot posture. Gait analysis shows that 64% of patients has a contact of the calcaneus in invertion while 36% in eversion. In the midstance, 78% have the foot in pronation and 22% in supination, while in propulsion 12% presents a takeoff of the foot in supination and 88% in the pronation. HAQ result is 1.13±0.80, SFI and SMI scales of SF-36 have scores of 32.38±10.65 and 38.67±11.40, respectively. CONCLUSION Our results shows that podiatric problems in SSc patients are common, serious but foot assessment and health care are inadequate. Thus, foot health information should be improved in order to better empower patients to self-manage low risk problems and help identify high-risk problems, which require specialist care.
Collapse
Affiliation(s)
- Susanna Maddali Bongi
- Division of Rheumatology, Department Of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giovanni Ravenni
- Division of Rheumatology, Department Of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Benedetta Ciampi
- Division of Rheumatology, Department Of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Angela Del Rosso
- Division of Rheumatology, Department Of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Khadija El Aoufy
- Division of Rheumatology, Department Of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| |
Collapse
|
33
|
Tornero-Caballero MC, Salom-Moreno J, Cigarán-Méndez M, Morales-Cabezas M, Madeleine P, Fernández-de-Las-Peñas C. Muscle Trigger Points and Pressure Pain Sensitivity Maps of the Feet in Women with Fibromyalgia Syndrome. Pain Med 2016; 17:1923-1932. [PMID: 27257287 DOI: 10.1093/pm/pnw090] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE : To investigate the presence of trigger points (TrPs) in feet musculature and topographical pressure sensitivity maps of the feet as well as the relationship between TrPs, pressure pain maps, and clinical variables in women with fibromyalgia (FMS). METHODS : Fifty-one FMS women and 24 comparable healthy women participated. TrPs within the flexor hallucis brevis, adductor hallucis, dorsal interossei, extensor digitorum brevis, and quadratus plantae, as well as external and internal gastrocnemius, were explored. Pressure pain thresholds (PPTs) were assessed in a blind manner over seven locations on each foot. Topographical pressure sensitivity maps of the plantar region were generated using the averaged PPT of each location. RESULTS : The prevalence rate of foot pain was 63% (n = 32). The number of active TrPs for each FMS woman with foot pain was 5 ± 1.5 without any latent TrPs. Women with FMS without foot pain and healthy controls had only latent TrPs (2.2 ± 0.8 and 1.5 ± 1.3, respectively). Active TrPs in the flexor hallucis brevis and adductor hallucis muscles were the most prevalent. Topographical pressure pain sensitivity maps revealed that FMS women with foot pain had lower PPT than FMS women without pain and healthy controls, and higher PPT on the calcaneus bone (P < 0.001). CONCLUSIONS : The presence of foot pain in women with FMS is high. The referred pain elicited by active TrPs in the foot muscles reproduced the symptoms in these patients. FMS women suffering foot pain showed higher pressure hypersensitivity in the plantar region than those FMS women without pain.
Collapse
Affiliation(s)
- Maria C Tornero-Caballero
- *Alumna de Doctorado, Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Jaime Salom-Moreno
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.,Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | | | - Matilde Morales-Cabezas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Pascal Madeleine
- Physical Activity and Human Performance group, SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain .,Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| |
Collapse
|
34
|
Abstract
Children with cerebral palsy are prone to development of musculoskeletal deformities. The underlying neurlogic insult may results in a loss of selective motor control, an increase in underlying muscle tone, and muscle imbalance, which can lead to abnormal deforming forces acting on the immature skeleton. The severely involved child is one who is at increased risk for developing progressive musculoskeletal deformities. Close surveillance and evaluation are key to addressing the underlying deformity and improving and maintaining overall function.
Collapse
Affiliation(s)
- Gilbert Chan
- Children's Orthopedics of Louisville, Kosair Children's Hospital, 3999 Dutchman's Lane, Plaza 1, 6th Floor, Louisville, KY 40207, USA.
| | - Freeman Miller
- Alfred I. DuPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803, USA
| |
Collapse
|
35
|
Hake S. Cutaneous manifestations of tuberous sclerosis. Ochsner J 2010; 10:200-204. [PMID: 21603378 PMCID: PMC3096212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
PURPOSE To describe a case of periungual masses probably related to tuberous sclerosis and to review the literature regarding tuberous sclerosis, including the historical, clinical, and diagnostic aspects. Also discussed is the long-term follow-up of the disease. METHODS Report of a case of periungual masses secondary to tuberous sclerosis and review of the literature from 1999 to 2009, with the use of MEDLINE (National Library of Medicine). RESULTS I describe a case of periungual masses occurring as a result of tuberous sclerosis. A literature review confirms periungual masses associated with tuberous sclerosis in most cases. Also, the observance of cutaneous manifestations is most helpful in the diagnosis of this disorder. CONCLUSION Tuberous sclerosis is an uncommon disorder, which has a variable clinical presentation. Tuberous sclerosis is associated with seizures and mental retardation. In the absence of these 2 signs/symptoms, physicians should still consider the diagnosis when presented with varied dermatologic conditions.
Collapse
Affiliation(s)
- Sue Hake
- Address correspondence to: Sue Hake, DPM, FACFAS, Department of Podiatry, Ochsner Medical Center–North Shore, Ochsner Clinic Foundation, 1000 Ochsner Blvd., Covington, LA 70433, Tel: 985-875-2828, Fax: 985-875-2771,
| |
Collapse
|