Prevalence of musculoskeletal disorders in children´s foot: preliminary study

A la edad escolar ya se tiene la marcha, la funcionalidad y la morfología del pie característica del adulto pero aún no está completada la madurez esquelética. Esto hace que sea una edad propicia para realizar una adecuada prevención y un diagnóstico precoz de las alteraciones musculoesqueléticas de los pies y miembros inferiores. Hemos realizado un estudio transversal de prevalencia para conocer el estado de salud de los pies de los escolares. Se han evaluado 116 niños mediante una observación clínica y un estudio de la marcha con una plataforma de presiones. Los resultados más llamativos fueron que al 93% nunca se les había realizado una exploración similar, el 95% tenía alterado el reparto de presiones de la huella, un 75% presentaba alguna alteración en la dinámica (la más frecuente excesiva pronación en la fase de propulsión) y el mismo porcentaje de niños llevaban el calzado de talla pequeña. Más de la mitad tenía una huella anormal y el pie excesivamente pronado. Un 40% presentaba dolor, el 35% tenía pie cavo y un 10% pie plano. El 32% tenía alguna patología de antepie. El resto de alteraciones fueron menos frecuentes. Hemos encontrado una alta prevalencia de alteraciones, por lo que se evidencia una vez más la necesidad de hacer controles periódicos a estas edades e incluirlos dentro de los programas de educación para la salud y prevenir futuras complicaciones.At school age, children already have the functionality and foot morphology of adult but have not yet completed skeletal maturity. This makes it a proper age for appropriate prevention and early diagnosis of musculoskeletal disorders of the feet and lower limbs. We conducted a cross-sectional study of prevalence for the health of the feet of the schoolaged children. 116 children have been assessed by clinical observation and a study of gait with a pressure platform. The most striking results were that 93% never had made a similar exploration, 95% had altered pressure distribution footprint, 75% showed some alteration in the dynamics (the most frequent excessive pronation phase propulsion) and the same percentage of children wearing shoes small size. More than half had an abnormal trace excessively pronated foot. Meanwhile, 40% had pain, 35% had pes cavus and flatfoot 10%. Finally, 32% had one forefoot pathology. The remaining changes were less frequent. We found a high prevalence of alterations so it is further evidence of the need for regular checks at this age to prevent complications and implement programs of health education

Posicionamento bioético dos profissionais de saúde espanhóis: Um estudo semi-quantitativo

The present study was undertaken to examine the positions of Spanish health professionals on a variety of bioethical issues and to determine the relationships between these positions and the professionals’ religious beliefs and political views. The study sample consisted of 50 individuals randomly selected from a database of Spanish health professionals who had received solid training in bioethics. A structured questionnaire was designed that contained six closed questions on positions on biomedical advances and science and biotechnology (eugenics, use of nonimplanted embryos for experimental purposes, human cloning, and the idea that science should have limits) and the respondents’ sociopolitical and religious views, and assessment scales were developed for the responses. The distribution of the responses was subjected to statistical analysis using analysis of variance (ANOVA). For the items with responses scored on a Likert scale, the positions taken were moderately adverse, and the vast majority of respondents believed that there should be limits to science. Religious convictions had greater influence on the responses than political orientation. There was evidence that liberal beliefs corresponded with what the authors consider to be more progressive ideas about the bioethics issues addressed in the study. The important questions of bioethics require an interdisciplinary approach and a combination of state and private-sector action to strengthen the links between religion and science, keep general knowledge up to date, and properly train biotechnology professionals.Se realizó el presente estudio para examinar las posiciones de profesionales de la salud española sobre una variedad de temas bioéticos y determinar las relaciones entre estas posiciones y las creencias religiosas y puntos de vista políticos de los profesionales. La muestra del estudio consistió de 50 individuos seleccionados al azar de una base de datos de profesionales de la salud en España que habían recibido formación sólida en bioética. Se diseñó un cuestionario estructurado con seis preguntas cerradas sobre posiciones acerca de avances biomédicos, de ciencia y biotecnología (eugenesia, uso de embriones no implantados para propósitos experimentales, clonación humana y la idea de que la ciencia debería tener límites), y los puntos de vista sociopolíticos y religiosos de los respondientes, y se desarrollaron escalas de evaluación para las respuestas. Se sometió la distribución de las respuestas a análisis estadístico usando análisis de varianza (ANOVA). Para los elementos con respuestas valuadas con una escala Likert, las posiciones tomadas fueron moderadamente adversas y la inmensa mayoría de los respondientes creían que debería haber límites para la ciencia. Las convicciones religiosas tuvieron mayor influencia en las respuestas que la orientación política. Hubo evidencia de que las creencias liberales se correspondieron con las que el autor consideraba ideas más progresistas sobre temas de bioética abordados en el estudio. Las preguntas importantes de bioética requieren una aproximación interdisciplinaria y una combinación de acción estatal y del sector privado para fortalecer los vínculos entre religión y ciencia, mantener el conocimiento general actualizado y formar apropiadamente a los profesionales de la biotecnología.O presente estudo foi realizado para examinar a posição de profissionais de saúde da Espanha sobre uma variedade de temas bioéticos e determinar a correlação entre estas posições e crenças religiosas dos profissionais e pontos de vista políticos. A amostra estudada consistiu de 50 indivíduos selecionados aleatoriamente da base de dados de profissionais de saúde da Espanha que receberam sólido treinamento em bioética. Um questionário estruturado foi definido para conter seis questões fechadas sobre posições a cerca de avanços biomédicos, ciência e biotecnologia (eugenia, utilização de embriões não implantados para projetos experimentais, clonagem humana e a ideia de que a ciência deveria ter limites) e os pontos de vista sociopolítico e religioso dos respondentes, e escalas de avaliação foram desenvolvidas para as respostas. A distribuição das respostas foi objeto de análises estatísticas utilizando a análise de variância (ANOVA). Para os itens com respostas computadas pela escala de Likert, desde de ‘concorda fortemente’ a ‘discorda fortemente’, as posições tomadas foram moderadamente adversas, e a vasta maioria dos respondentes acreditaram que deveria haver limites para a ciência. Convicções religiosas tiveram maior influência nas respostas do que aquelas de orientação política. Houve evidência de que crenças liberais corresponderam com o que os autores consideram ser ideias mais progressistas sobre temas bioéticos direcionados pelo estudo. As importantes questões de bioética requerem uma abordagem interdisciplinar e uma ação combinada dos setores público (estatal) e privado para revigorar os elos entre religião e ciência, manter um conhecimento geral atualizado, e treinar adequadamente profissionais em biotecnologia

Actitudes Posturales de la extremidad inferior en los escolares durante las clases: Estudio Observacional

Introduction: The Human being and due to the developments, is developing skeletal muscle disorders of the lower limb directly associated with a bad attitude in postural sedestatión, children spend a large part of your life sitting in the classroom. Objectives: To evaluate the position taken at the lower extremity in seated posture of a group of schoolchildren during the period of attention to the teacher in the classroom; compare the different positions of children of different ages and gender. Materials and methods: direct and cross-sectional study of schoolchildren between 10 and 11 years belonging to a college in Early Childhood Education, Primary and Secondary Education in Madrid. The data was collected through observation sheet postural attitudes of spine, lower limb and foot at more sedestación to identify frequent according to gender. Results and Conclusions: There are differences in the way of sitting of children and girls, because girls are the attitudes presented with a higher proportion of lower limb rotational, while children took greater proportion of harmful attitudes in the foot. In conclusion we find it necessary to provide health education and hygiene for postural lower limb in schools and urge schools to have ergonomic furniture to minimize adverse effects on lower limb.Introduccion: El ser humano y debido a la evolución, está desarrollando alteraciones músculo esqueléticas de la extremidad inferior directamente relacionadas con una mala actitud postural en sedestación, los niños pasan una gran parte de su vida sentados en el aula. Objetivos: Valorar la posición que adopta la extremidad inferior en postura sedente de un grupo de escolares durante el periodo de atención al profesor en el aula; Comparar las diferentes posturas sedentes de niños de diferentes edades y género. Material y Métodos: Estudio observacional directo y transversal a escolares de entre 10 y 11 años pertenecientes a un colegio de Educación Infantil, Primaria y Secundaria de Madrid. La recogida de los datos fue a través de ficha de observación de actitues posturales de raquis, miembro inferior y pies en sedestación para determinar las mas frecuentes en función al género. Resultados y Conclusiones: Existen diferencias entre la forma de sentarse de los niños y de las niñas, ya que las niñas son la que con mayor proporción presentaron actitudes rotacionales de la extremidad inferior, en tanto los niños adoptaron mayor proporción de actitudes nocivas en el pie. Como conclusión encontramos necesario proporcionar educación sanitaria e higiene postural para la extremidad inferior en el ámbito escolar e instar a que los centros escolares a que dispongan de mobiliario ergonómico para minimizar efectos adversos en la extremidad inferior

Extensor Hallucis Capsularis o Tendón Accesorio del Extensor Hallucis Longus: Estudio anatómico y funcional, frecuencia y mediciones

The purpose of this study was to look closely at the anatomy of the extensor hallucis longus, ligament or tendon capsularis Accessory Extensor hallucis longus muscle; defi ne its occurrence frequency, it is a muscle that is not present in all feet and raises controversy in the reviewed literature. The ligament is a ligament capsularis dorsalis pedis group that accompanies the extensor hallucis longus muscle medial to it forever. We intend to demonstrate by our dissections, a ligament more common than it seems and where is its origin and insertion as well as their function, presentation and location by using photographs of cadaver feet and its width measures and characteristics. To achieve our object of study in this article, fi rst 50 dissected human cadaver fi ngers, making the relevant measurements.El objeto de éste estudio fue observar detenidamente la anatomía del Extensor Hallucis Longus, Ligamento Capsularis o Tendón Accesorio del músculo Extensor Hallucis Longus; definir su su frecuencia de aparición, pues es un músculo que no está presente en todos los pies y suscita controversia en la bibliografía consultada.El Ligamento Capsularis es un ligamento del grupo dorsal del pie, que acompaña al músculo Extensor Hallucis Longus siempre medial a él.Pretendemos demostrar con nuestras disecciones, que es un ligamento más habitual de lo que parece y, dónde está su origen e inserción, así como su función, presentación y ubicación mediante fotografías en pies de cadáver, así como medidas sobre su anchura y características particulares.Para conseguir nuestro objeto de estudio en éste artículo, se diseccionan 50 primeros dedos de cadáver humano, realizando las pertinentes mediciones

Plasma rich in growth factors (PRGF)

In most of the cases the objective of the medical research it is not centered solely in prolonging the time of life of the patient, but in improving the quality of he himself. Rich Plasma in Growth Factors is a novel and relatively recent technique applicable to the tissue repair. It consists of a simple system for the platelets proteins obtaining from a blood sample of the patient. In the scope of the podiatry, the application of PRGF allows to improve the evolution of patients with titular regenerative necessities in the foot and lower limb such as: to accelerate the osseous consolidation in the postoperative period, to shorten the time of resolution in diabetic ulcers or to improve the healing among other many. Diverse studies on the application of Factors of Growth have demonstrated excellent results in different medical specialties between which is the podiatry, therefore considers a technique of high effectiveness and clinical interest for their contribution to the scientific community.In most of the cases the objective of the medical research it is not centered solely in prolonging the time of life of the patient, but in improving the quality of he himself. Rich Plasma in Growth Factors is a novel and relatively recent technique applicable to the tissue repair. It consists of a simple system for the platelets proteins obtaining from a blood sample of the patient. In the scope of the podiatry, the application of PRGF allows to improve the evolution of patients with titular regenerative necessities in the foot and lower limb such as: to accelerate the osseous consolidation in the postoperative period, to shorten the time of resolution in diabetic ulcers or to improve the healing among other many. Diverse studies on the application of Factors of Growth have demonstrated excellent results in different medical specialties between which is the podiatry, therefore considers a technique of high effectiveness and clinical interest for their contribution to the scientific community

Hypertrophy of the Trochlearis Calcanei: Etiology, clinical manifestations and treatment

El diagnóstico de una hipertrofia de la tróclea o tuberosidad peroneal del calcáneo se asocia a una tenosinovitis estenosante del tendón del músculo Peroneo Largo o Corto. Hay autores que plantearon que la hipertrofia de la tróclea del calcáneo no provocaba dolor por si misma sino que se produce una exacerbación del dolor cuando el paciente utiliza un zapato que comprime el pie afecto, lo cual produce una irritación en la piel por la compresión a la que ésta estaba sometida, acompañada muchas veces por una afectación sensitiva superficial por atrapamiento del nervio Dorso Cutáneo Lateral.The diagnosis of troclear hypertrophy or fibular tuberosity of calcaneus is associated to stenotic tenosinovitis of long or short the peroneal tendon. There are authors states that troclear hypertrophy of calcaneus did not cause pain by itself but the pain increase when the patient uses a tight shoe that compresses the area affected, this compression produces skin irritation under the area affected accompanied often a sensorial affectation at level of the superficial nerve due to entrapment of dorso cutaneous lateral nerve

Footwear used by older people and a history of hyperkeratotic lesions on the foot : a prospective observational study

4 p.Inadequate footwear, painful and hyperkeratotic lesions (HL) are an extremely common problems amongst older people. Such problems increase the risk of falls, hamper mobility, reduction of quality of life, dignity, and ability to remain independent. The etiology of painful and feet conditions is poorly understood. To discover footwear preferences of older people, pain tolerance may favor presence of HL for the use of inadequate footwear in old age. A sample of 100 participants with a mean age of 74.90 ± 7.01 years attended an outpatient clinic where self-reported demographic data, frequency with which they checked their feet were recorded and measurements were taken of foot sensitivity. Additionally, all participants’ shoes were allocated into optimal, adequate, and dangerous categories based on design, structural and safety features, and materials. Only 12% of the sample population checked their feet every day, 37% revealed symptoms of neuropathy, 14% used optimal shoes, and 61% presented HL. In a bivariate analysis, no significant differences were observed. HL are associated with inadequate footwear, loss of sensitivity, and low frequency of foot health checks.S

Effectiveness of calcaneal osteotomy in surgical treatment of foot conditions: A Prisma statement guidelines compliant systematic review

[Abstract] Calcaneal osteotomy is a commonly established method used to correct various foot malalignment surgery problems that produce varus and valgus hindfoot abnormality as well as Haglund's deformity, cavovarus foot reconstruction, flatfoot deformity, plantar fasciitis, posterior tibial tendon insufficiency and planovalgus foot. After decades, several procedures in orthopaedic foot surgery have been suggested for reducing the risk of wound and neurovascular complications. The goal of this Prisma statement guidelines compliant systematic review was to establish the effectiveness and safety of calcaneal osteotomy in foot surgery. We have performed a novel systematic review of the current published literature in order to evaluate the scientific evidence now available on this association, assigning predefined exclusion and inclusion criteria. Eight investigations were selected which had 191 cases. The adult flatfoot, tibialis posterior reconstruction and cavovarus foot deformity were treated with different procedures of calcaneal osteotomy techniques. The adequate level of effectiveness of calcaneal osteotomy is associated with the kind and location of the incision, with or without screw application, in each specific foot condition. There is a limited number of scientific investigations of the effectiveness and safety of the different kinds of calcaneal osteotomy in foot surgery, and there is the need to enhance outcome knowledge on this foot surgery technique

Geometry of the Proximal Phalanx of Hallux and First Metatarsal Bone to Predict Hallux Abducto Valgus: A Radiological Study

[Abstract] Background Hallux abducto valgus (HAV) is one of the most common forefoot deformities in adulthood with a variable prevalence but has been reported as high as 48%. The study proposed that HAV development involves a skeletal parameter of the first metatarsal bone and proximal phalanx hallux (PPH) to determine if the length measurements of the metatarsal and PPH can be used to infer adult HAV. Methods All consecutive patients over 21 years of age with HAV by roentgenographic evaluation were included in a cross-sectional study. The control group included patients without HAV. The study included 160 individuals. We identified and assessed the following radiographic measurements to evaluate HAV: the distances from the medial (LDM), central (LDC), and lateral (LDL) aspects of the base to the corresponding regions of the head of the PPH. The difference between the medial and lateral aspect of PPH was also calculated. Results The reliability of the variables measured in 40 radiographic films show perfect reliability ranging from 0.941 to 1 with a small error ranging from 0.762 to 0. Also, there were no systematic errors between the two measurements for any variable (P > 0.05). The LDM PPH showed the highest reliability and lowest error. Conclusion It is more suitable to measure the LDM PPH instead of the LDC PPH when calculating the hallux valgus angle based on our reliability results. When the differences of the medial and lateral PPH are greater, the risk for developing HAV increases