Comparative study between nail retraining with gauze bandaging and the nail remodeling with acrylics as a conservative treatment for stage I and IIa onychocryptosis

Objective: Onychocryptosis is one of the most prevalent onychopathies, being a frequent reason for consultation in podiatric clinical practice. Conservative treatments are the first therapeutic choice, with nail remodeling using clotrimazole gel emerging as an alternative, although its medium-term effectiveness is unknown. The objective of this study was therefore to compare the efficacy of the technique of nail retraining using gauze bandaging with that of nail remodeling for the conservative treatment of stage I and IIA onychocryptosis. Methods: An analytical, randomized clinical trial study was performed following a longitudinal and prospective design. A sample was selected of 20 subjects presenting stage I and IIA onychocryptosis. Of these, 10 cases formed the group of nail retraining using gauze bandaging, and the other 10 the nail remodeling group. The presence of recurrence in a 3-month period was evaluated. Results: Before the intervention, the patients in the retraining group presented pain of 6.7 ± 1.9 vs. 6.8 ± 1.6 in the remodeling group, with no significant difference between the two (p = 0.900). After the 3-month follow-up period, seven of the retraining group patients presented recurrence of onychocryptosis vs. only one in the remodeling group. Conclusion: The technique of nail remodeling has a lower recurrence rate than that of nail retraining with gauze bandaging, with the pain, inflammation, and infection reported being less, and with greater patient satisfactio

Thermal differences in the plantar surface of skin the foot after using three different lining materials for plantar orthotics.

The lining materials of plantar orthoses are chosen for their hardness, breathability, and moisture absorption, but without there being any clear scientific criterion. Thermographic analysis would provide information about the thermal response of the sole of the foot, and would thereby allow the choice to be adapted in accordance with this criterion. The objective of this study was to evaluate plantar temperatures after the use of three materials with different characteristics. Plantar temperatures were analyzed by using a FLIR E60BX thermographic camera on 36 participants (15 men and 21 women, 24.6 ± 8.2 years old, 67.1 ± 13.6 kg, and 1.7 ± 0.09 m). Measurements were made before and after (3 h) the use of three lining materials for plantar orthoses (Material 1: PE copolymer; Material 2: EVA; Material 3: PE-EVA copolymer) on different days. For Material 1 (PE), the temperature under the heel was significantly higher after exercise, increasing from 30.8 ± 2.9 °C to 31.9 ± 2.8 °C (p = 0.008), and negative correlations were found between room temperature and the pre/post temperature difference for the big toe (r = −0.342, p = 0.041) and the 1st metatarsal head (r = −0.334, p = 0.046). No significant pre/post temperature differences were found with the other materials. The three materials thermoregulated the plantar surface efficiently by maintaining the skin temperature at levels similar to those evaluated before exercise. If PE is used as a lining material, it should be avoided for the heel area in patients with hyperhidrosis or those with a tendency to suffer from skin pathologies due to excess moisture

Running thermoregulation effects using bioceramics versus polyester fibres socks

The feet, covered by socks and shoes during running, undergo an increase of temperature. The aim of this study was to reduce heat generation in the feet of athletes during running by wearing novel thermoregulatory socks impregnated with bioceramic materials. Thirty male athletes ran a half-marathon (21.0975 km) wearing polyester based with bioceramic fibres (zirconium silicate and titanium oxide) and control socks (polyester). The average temperatures were measured with a thermographic camera (FLIR e60bx) before and after the run. Nine regions of interests were evaluated in the plantar surface and eight in the dorsum. Before running, the plantar region with the highest temperature was the inner midfoot (plantar arch) with 30.3 2.1◦C on the control sock and 30.2 2.1◦C on the bioceramic one. After running, smaller temperatures were found at the plantar surface of five regions of interests: heel, inner midfoot, first and fifth metatarsal heads and first toe and all the dorsal regions of the bioceramic socks. The amount of temperature reduction from the bioceramic sock was between –1.1 and –1.3◦C in heel, inner midfoot, first MTH and first toe (plantar) and 1.3◦C at the dorsum of first and fifth toes. Polyester-based socks with bioceramic fibre materials, due to far-infrared radiation, promote cooler temperatures on the sock surface after running. This effect is more effective in heel, the inner midfoot and the first MTH and could help improve the behaviour of the sock to make it denser in bioceramics and preventing running lesions, like blisters

Longitudinal Analysis of Plantar Pressures with Wear of a Running Shoe

Running shoes typically have a lifespan of 300–1000 km, and the plantar pressure pattern during running may change as the shoe wears. So, the aim of this study was to determine the variation of plantar pressures with shoe wear, and the runner’s subjective sensation. Maximun Plantar Pressures (MMP) were measured from 33 male recreational runners at three times during a training season (beginning, 350 km, and 700 km) using the Biofoot/IBV® in-shoe system (Biofoot/IBV®, Valencia, Spain). All the runners wore the same shoes (New Balance® 738, Boston, MA, USA) during this period, and performed similar training. The zones supporting most pressure at all three study times were the medial (inner) column of the foot and the forefoot. There was a significant increase in pressure on the midfoot over the course of the training season (from 387.8 to 590 kPa, p = 0.003). The runners who felt the worst cushioning under the midfoot were those who had the highest peak pressures in that area (p = 0.002). The New Balance® 738 running shoe effectively maintains the plantar pressure pattern after 700 km of use under all the zones studied except the midfoot, probably due to material fatigue or deficits of the specific cushioning systems in that area.Junta de Extremadura y Fondo Europeo de Desarrollo Regional (FEDER) GR15073 y GR1817

Angioleiomyoma in the foot: a case report

[Resumen] Las tumoraciones de partes blandas de los pies no suelen tener un diagnóstico clínico preciso. El angioleiomioma es un tumor cutáneo benigno que se origina del músculo liso de los vasos sanguíneos, es doloroso y poco frecuente. Se presenta el caso de un paciente con una tumoración subcutánea dolorosa en el pie que tras exéresis y estudio histológico del mismo se diagnostica de angioleiomioma.[Abstract] Soft tissue tumours of the feet usually don´t have a precise clinical diagnosis. Angioleiomyoma is a benign cutaneous tumour that originates from the smooth muscle of the blood vessels. It is painful and infrequent. We present the case of a patient with a painful subcutaneous tumour in the foot that after excision and histological study is diagnosed of angioleiomyom

The impact of associated tenotomies on the outcome of incomplete phalangeal osteotomies for lesser toe deformities

Partial or incomplete osteotomy (IO) of the phalanx is recently described in the literature. However, the clinical outcome and the rate of complications when applied to lesser toe deformities (LTD) have been never addressed. This study aims to find out if the association of tenotomies to incomplete or partial phalanx osteotomies has a significant impact on the clinical outcomes, the occurrence of complications, and the recovery time after surgery. Methods: A retrospective review of two cohorts of cases operated in our institution for hallux abductus valgus (HAV) and associated LTD from 2008 to 2014 was carried out. The surgical correction of both HAV and the associated LTD was always performed by minimally invasive techniques. The study included a total of 223 patients (723 IO in 556 toes). In 129 cases, the IO for LTD correction was performed without tenotomies, and in 94, the procedure was combined with flexor and/or extensor tenotomies. Patients were assessed with the American Orthopaedic Foot and Ankle Society (AOFAS) questionnaire before surgery and at 6- and 12-month follow-up. Results: The mean preoperative AOFAS score before surgery was similar in both cohorts. At 12-month follow-up, the cohort without tenotomies showed better recovery (95.7 ± 2.8 versus 92.5 ± 6.8; p < 0.01). AOFAS scores decreased as the number of associated LTD increased (r = − 0.814; p < 0.001). Cases operated on by PO + tenotomy showed a high rate of complications such as delayed union of the osteotomy (p < 0.01), hypertrophic callus (p < 0.01), phalangeal fracture at the osteotomy site (p < 0.01), and lack of correction (p < 0.05). The overall occurrence of adverse events was 38.6% in cases operated by PO + tenotomy and 13.9% in cases receiving PO alone (p < 0.0001). Cases operated on without tenotomy showed a shorter time to complete recovery for daily life activities (37.4 ± 2.3 versus 43.0 ± 1.7 days; p < 0.01). Conclusion: The performance of associated tenotomies to incomplete phalanx osteotomies provides worse clinical outcomes, higher complication rates, and longer recovery time as compared to similar forefoot surgeries without tenotomies.Podologí

The influence of sock composition on the appearance of foot blisters in hikers

Introduction: Socks are of fundamental importance in reducing friction and in controlling the temperature and humidity of the foot, thus preventing the appearance of blisters. However, the influence of sock fibres (synthetic vs. natural) on blistering during long-distance hiking has received little research attention. Aims: This study evaluates the influence of sock fibres on the appearance of foot blisters in hikers. Method: The sample consisted of 203 male and female hikers, mean age 35.8 ± 14.5 years, from 22 countries. All were interviewed and assessed at shelters on the French route of the Camino de Santiago (Spain). Sociodemo- graphic and clinical data were obtained for each hiker; other study data included the number of blisters on the foot, whether the socks were wet at the end of the day, the model of sock used and the nature of its constituent fibres. Results: Among the hikers interviewed, 68.5% presented foot blisters. 74.2% used socks with predominantly synthetic fibres, compared to 25.9% whose socks were mainly composed of natural fibres. On average, they had walked 253.7 km. Hiking in wet socks was associated with a 1.94 times greater risk of experiencing foot blisters (95% CI 1.04–3.61) (p = 0.035). Multivariate analysis showed that the proportion of natural/synthetic fibres in the composition of the sock was not related to the presence of blisters. Conclusions: The use of wet socks heightens the risk of foot blisters in hikers, but the composition of the sock is not associated with blistering. We recommend hikers change their socks in long stages to maintain feet dry and so avoiding the appereance of blistersUniversidad de Málaga. Campus de Excelencia Internacional Andalucía TEC

Terapias complementarias en cirugía podológica

Este artículo presenta una serie de terapias complementarias, como son la homeopatía, la fitoterapia y la oligoterapia, en relación con la cirugía del pie. Éstas terapias nos serán de gran ayuda como coadyuvantes en las terapias prequirúrgicas y posquirúrgicas, así como en el mismo transcurso de la cirugía

Establishing normative foot posture index values for the paediatric population: a cross-sectional study

Antecedentes: el índice de postura del pie (FPI) es una herramienta de observación diseñada para medir la posición del pie. Su fiabilidad está bien establecida y proporciona valores de referencia normativos para la población en general. Sin embargo, esto no es así para la población pediátrica. El objetivo de este estudio es determinar los valores de referencia de FPI en la infancia, teniendo en cuenta la edad y el sexo. Métodos: este estudio transversal incluyó a 1.762 escolares (863 niños y 899 niñas) de 6 a 11 años, de Málaga, Granada y Plasencia (España). En todos los casos, dos podólogos experimentados obtuvieron las mediciones de FPI en ambos pies. Luego se realizó un análisis descriptivo y se determinaron los percentiles de las variables, con un nivel de significancia de P <0.05. Resultados: Los resultados del FPI consolidado para la población de muestra arrojaron valores medios de 3.74 (SD 2.93) puntos para el pie derecho y 3.83 (SD 2.92) para el izquierdo. El percentil 50 fue de 4 puntos para ambos sexos y para ambos pies, a excepción del pie derecho entre las chicas, que fue ligeramente inferior, en 3 puntos. El percentil 85, que se considera que representa el límite entre el pie normal y el pronado entre los niños, fue de 6 puntos, uniformemente entre los sujetos. Conclusiones: como valor normativo de FPI para la población pediátrica, recomendamos el percentil 50, es decir, 4 puntos, para niños, de ambos sexos, con edades comprendidas entre los 6 años. Este valor disminuye progresivamente con la edad, hasta 3 puntos FPI para niños de 11 años. El percentil 85 para el pie pronated y el percentil 4 para el pie supinado se puede considerar el límite patológico.Background: The Foot Posture Index (FPI) is an observational tool designed to measure the position of the foot. Its reliability is well established, and it provides normative reference values for the general population. However, this is not so for the paediatric population. The aim of this study is to determine FPI reference values in childhood, taking into account age and gender. Methods: This cross-sectional study included 1,762 school children (863 boys and 899 girls) aged 6–11 years, from Málaga, Granada and Plasencia (Spain). In every case, FPI measurements were obtained for both feet by two experienced podiatrists. A descriptive analysis was then conducted and the percentiles of the variables determined, with a significance level of P < 0.05. Results: The consolidated FPI results for the sample population produced mean values of 3.74 (SD 2.93) points for the right foot and 3.83 (SD 2.92) for the left. The 50th percentile was 4 points for both genders and for both feet, except for the right foot among the girls, which was slightly lower, at 3 points. The 85th percentile, which is considered to represent the boundary between the normal and the pronated foot among children, was 6 points, uniformly among the subjects. Conclusions: As a normative FPI value for the paediatric population, we recommend the 50th percentile, i.e. 4 points, for children, of both genders, aged 6 years. This value progressively falls with age, to 3 FPI points for children aged 11 years. The 85th percentile for the pronated foot and the 4th percentile for the supinated foot can be considered the pathological boundary.peerReviewe

Plantar pressures values related with appearance of mechanical hyperkeratosis before and after surgery of mild hallux valgus

BackgroundHyperkeratoses are thickenings of the stratum corneum, provoked by deviation of the ray and excessive plantar pressures. They are very common under the first metatarsal head (MTH) and on the big toe when there exists hallux valgus. The objective of this study was to assess plantar pressures pre- and post-surgery to try to define the threshold values that could determine the appearance of keratopathies.Materials and methodsSeventy-nine patients (100 feet) who had undergone percutaneous distal soft-tissue release and the Akin procedure were evaluated prospectively. The BioFoot/IBV® in-shoe system was used for objective baropodometric functional evaluations of the heel, midfoot, first through fifth MTHs, hallux, and lesser toes. The presence or absence of a hyperkeratosis (HK) or plantar callus under the first MTH or hallux was recorded. The average follow-up time at which the measurements were repeated was 28.1 months.ResultsPre-surgery, 62 feet presented a painful HK on the big toe, while post-surgery, only 9 of the feet presented the same lesion. Patients who presented a prior HK at the first metatarsophalangeal (MTP) joint had a mean pressure of 417.2 ± 254.5 kPa as against a value of 359.6 ± 185.1 kPa for the rest. Post-surgery, these values dropped to 409.8 and 346.3 kPa, respectively.ConclusionPatients with HK presented an 11% greater mean pressure than those without. The values obtained with the BioFoot/IBV® system in the present study can therefore be considered predictive of the appearance of HK under the first MTH and on the side of the big toe