Revista Internacional de Ciencias Podológicas
The Revista Internacional de Ciencias Podológicas (ISSN-e 1989-5151) publishes work on chiropody, a science that studies the inflictions and deformities of the feet and lower limbs as well as repercussions on other organs or systems in the human body. The aim of the journal is thereby to research lower limb pathologies and be used as an instrument for scientific-technical updates. The journal is intended for Chiropody professionals as well as specialists in Orthopaedic Surgery, Rheumatology, Dermatology and Radiology who wish to disseminate their research on foot and lower limb pathologies.
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Reliability of the angular kinematic of knee and ankle during the running in the sagittal plane measured with Younext Direct Motion Capture®
The popularity of running has increased remarkably the past forty years. Its popularity and the large number of injuries make running the most studied physical activity in the area of ​​biomechanics. In clinical practice, joint kinematics during running are primarily quantified by two-dimensional motion-analysis software. Younext Direct Motion Capture® (Podoactiva S.L., Huesca) is a software that analyzes the kinematic parameters during the running in the sagittal plane. The main goal of this study was to determine the reliability and repeatability of the angular kinematics of the knee and ankle in the sagittal plane in a healthy population using Younext Direct Motion Capture®. Observational pilot study of concordance. 8 subjects (5 men and 3 women) were filmed while running on a treadmill, obtaining three recordings of the running cycle of each participant in the first session. A second session of recordings was made 7 days after the first recording to re-record following the same protocol. The intraclass correlation coefficient (ICC) was calculated to determine the intra-session reliability and inter-session reliability of the software when measuring the kinematics of the knee and the ankle. Very good intra-session and inter-session reliability (ICC> 0.81) were obtained for both ankle and knee measurements. This study showed that Younext Direct Motion Capture® software is reliable for analyzing the angular kinematics of the knee and ankle during running in a healthy adult population.
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Implication of the students of the Degree of Podiatry in the teaching innovation of Microbiology
Our focus here is to improve teaching methods in University microbiology classes and the development of educational practices that explicit engage students while enhacing how they learn Microbiology. These practices including inquiry-based learning (IBL) in which students are actively engaged in the learning process for improving the skills to be acquired as part of their effective learning . This study included 63 Microbiology students of Second Year Degree in Podiatry at the Complutense University (Academic Year 2017-2018), and calculated the percentage of students who used these resources 4 IBL, 3 IBL , 2IBL , 1IBL , and that did not participate in any and subsequently related to the student performance in the Microbiology exam . The IBL questions that were done in class ,were included in the virtual campus , including the correction .Students who prepared IBL scored higher en exam questions , findings also indicate that this activity can measure learning and improve exam preparation. We believe that the benefits of active learning methods with virtual campus over lecture instruction are consistent and can increases student performance in Microbiology.
Dianostic support with ecography in plant papillomas: clinical case
Cutaneous warts are benign intraepidermal skin tumors with a variety of manifestations including common warts (verrucae vulgaris), palmar and plantar warts (palmar and plantar warts), mosaic warts, flat warts (flat warts) generally diagnosed by their clinical appearance although the definitive diagnosis depends on the histopathological examination. Ultrasound can define its extent, exact locations and blood flow patterns being extremely useful in difficult cases, especially when symptoms such as pain persist over time. It can also give pre-surgical information relevance and can finally provide important insights into associated conditions of the foot.
Comparison of conservative and surgical treatment in acute Achilles tendon rupture
The objective of this review was to compare the surgical treatment and the conservative treatment to see which was the most effective in a new rupture. There were contradictory results. The key seems to be the rehabilitation protocol after the intervention. A search was made in databases (Pubmed, Cochrane and PEDro) to find articles comparing both treatments. They were screened according to the inclusion and exclusion criteria. We found out that studies that do not use a rehabilitation protocol with loading had a result in favor of surgical treatment to avoid recurrence (P = 0.002). However, the studies that used this protocol didn’t find as much difference of new rupture between conservative and surgical treatment (P = 0.05). It was found that the surgical treatment was related to the increase in complications (P = 0.004). In conclusion, the surgical treatment is related to a lower rate of new rupture, unless there were a rehabilitation protocol of early weighting. In this case, the recurrence rate is similar for both treatments, always bearing in mind that open surgery is related to more complications.
Experimental studies of gait biomechanics during pregnancy: systematic review of clinical trials. (2000-2018)
Background: Pregnancy is a moment in a woman's life whose physiological, hormonal, and morphological changes generate great bodily changes. These changes occur in a very short period of time and cause a loss of stability and a series of kinematic and kinetic changes in their gait that cause falls and musculoskeletal discomfort in the lower limb and foot. Methods: A review of the scientific literature has been carried out to identify possible scientific studies on gait and pregnancy. The main biomedical search engines and databases were consulted: Medline-Pubmed, Enfispo, Scielo and Science Direct®. The search period was comprised February-June 2018. Results: In our search we found 912 summaries of articles with the selected keywords. 892 articles of the aforementioned were excluded after reading them because they did not meet the selection criteria of the study. Therefore, we obtained 20 relevant. Conclusion: There are experimental studies that show changes in the kinematics, kinetics of the trunk, pelvis, lower limb and foot in pregnancy and postpartum.
Botulinum toxin type A and shock waves for the treatment of chronic pains in plantar fasciitis
Plantar fasciitis is a common foot disorder that affects 1 in 10 people between 40 and 60 years old, affecting daily activity in especially athletic and overweight patients. Numerous treatments have been described that are carried out and that mostly exert a positive effect on the improvement of pain. In this review, a compilation of studies included in meta-analysis on the effectiveness of the infiltration of botulinum toxin type A and extracorporeal shock waves is performed, when other conservative treatments have not been satisfactory. Both treatments proved to be quite encouraging, improving pain by up to 60% in the vast majority of patients studied.
Efficacy of the Ponseti method in the treatment of equine foot
Background: Clubfoot is a congenital musculoskeletal deformity characterized by heel varus, hindfoot equinus, mid-foot cavus and forefoot adduction. It is the most common defect that affects between 1 and 7 births in every 1000. Left untreated, clubfoot may lead to pain and disability throughout the person´s life. Ponseti method has become the main treatment modality for the management of clubfoot producing good long-term results. The aim of this manuscript was to determine the efficacy of the Ponseti method for the treatment of CTEV and to evaluate the evolution of patients based on the recurrence rate, tenotomies rates and surgeries. Also determine if the age of children influences the success of the treatment. Methods: A search strategy completed examined Pubmed from inception to April 2018. Search terms included clubfoot, Ponseti method and equinovarus. Meta-analysis, systematic reviews, randomized control trials and case series were included. The reference lists of the selected articles were also examined. Results: Twenty-seven articles were included in this review. The current literature shows a success of the Ponseti method of 78-92%. Conclusion: Ponseti treatment for clubfoot has encouraging results in terms of attaining a functionally and cosmetically foot and lessening the extent of surgical correction in cases in which it does not reach the expected results. Further research is needed to generate higher quality evidence with larger sample sizes which evaluate the severity of the deformity with the same measures. Another lack was the absence of a definition of treatment failure with the reasons.
Foot temperature as a predictor of ulcers in Diabetes Mellitus
The Diabetic Foot is one of the most important complications of Diabetes Mellitus due to the possibility of suffering a plantar ulcer that leads to an amputation. Diabetic peripheral neuropathy occurs in 60-70 % of subjects with Diabetes Mellitus and is characterized by a disturbance of tactile and painful sensitivity, the alteration of the threshold of vibration and thermal perception for temperature thresholds to heat and cold. The temperature of the feet of subjects with Diabetes Mellitus without diabetic peripheral neuropathy is lower than with the presence of diabetic peripheral neuropathy. There is a correlation between the increase in temperature and the appearance of lesions on the feet, because the temperature increases in the areas of risk of ulceration due to the inflammation itself and to the enzymatic autolysis of the tissues, prior to the appearance of a ulceration of Charcot arthropathy. RESULTS: Currently, two types of temperature measurement techniques are used: thermography and thermometry. Thermography tests are classified into thermo sensitive infrared liquid crystal plates, and the thermometry tests are divided into infrared and thermal sensors. The thermal assessment should be included in the neurological examination protocols of the feet in Diabetes Mellitus because it is an effective, non-invasive test and decreases the rate of ulcer appearance. CONCLUSIONS: It is considered that a difference of 2.2º C, in the same point of both because of a subject, indicates the appearance of own injuries of the Diabetic Foot, either an ulceration if there is an injury, or a Charcot arthropathy. Scientific evidence indicates that controlling the temperature of the feet decreases the rate of ulcerations in Diabetes Mellitus. We advocate the inclusion of thermal assessment in the protocol of exploration of subjects with Diabetes Mellitus, due to its effectiveness in the prevention of ulcerations and its short time of screening.
Adaptation of the teaching of microbiology in the degree of podology, including practical teaching
With the adaptation to the EHEA (European Higher Education Area ), Microbiology has begun to be taught within the field of Biopathology, introducing as a teaching activity the practical credits of Microbiology in order to improve the skills that students should acquire as part of their integral training. The results of the evaluation of 34 students of the 2011-2012 academic year were compared, analyzing the results between the question of theoretical-practical integration (TP) and the one that had only been explained in the theoretical class (T). Significant differences were found ( p <0.001) between the average score of the students who had passed the course and those who had not passed it for the T test, while these means were not statistically significant for the TP test. We can conclude that the learning evaluated in the question TP has been satisfactory in both groups, even students who have not passed the course have achieved good results in this test.
Evolución de úlcera digital por presión utilizando terapia plasma rico en plaquetas con coágulo
The cure of ulcers poses a problem as much for its chronicity as for the economic cost that they entail. The studies that are being carried out try to find new ways in the cure of ulcers of the different etiologies, among these studies highlights the cure of ulcers using platelet-rich plasma with different forms of administration.After the reading of different protocols and forms of cure, it was decided to treat a patient with a digital ulcer by chronic pressure of 6 weeks of evolution, which did not improve with conventional treatments.The technique of cure by clot of platelet-rich plasma was used, peripheral blood was extracted, the clot was prepared and placed on the ulcer with a 5-day cure.The results obtained were very satisfactory and in a few weeks the ulcer was completely closed presenting a small wound that was discharged and cured with local antiseptic.
Effectiveness of laser treatment in plantar neuropathic diabetic foot ulcers. Literature review
The diabetic foot is an alteration induced by maintained hyperglycemia independently of the coexistence of ischemia, and previous traumatic trigger, which can produce ulceration of the foot, which supposes a high economic cost. This is the reason why it is essential to accelerate the process of tissue repair, with laser therapy being a very efficient therapeutic resource. The main objective of this work is to assess the effectiveness of the laser in the treatment of diabetic foot neuropathic ulcers. By bibliographic search in PubMed / Medline, Dialnet, Science Direct and Theseus databases, by keywords; diabetic foot, diabetic neuropathy, neuropathic ulcer, treatment and Laser. After conducting the search, 236 articles were found, of which 35 were included in the review. The work done has determined the effectiveness of this therapy. As a result of the limitations, it has not been possible to establish a uniform treatment protocol due to the lack of studies with a larger sample. Therefore, laser therapy can be used as adjuvant treatment neuropathic ulcers in diabetic patients
Achilles Tendon rupture: Post-surgical management to accelerate the return to sport activity
The rupture of the Achilles tendon is a disruption of the tendon, it is an injury present in the sports community. There are several risk factors, low vascularization, corticoid infiltration, fluoroquinolone, tendon degeneration or recurrence. We have two routes of conservative and surgical treatment. We found a lower proportion of tendon reinterruptions in surgical treatments.The functional treatment programs have documented satisfactory results for the early recovery of the lesion through randomized controlled trials and meta-analyzes.The use of Platelet Rich Plasma (PRP) as a treatment for musculoskeletal tissue injuries such as RTA in open surgical techniques is being evaluated. The purpose of this review is to assess the recovery through functional techniques and infiltrations of PRP for the early recovery of the RTA.
Relationship between sex, age and body mass index and the Foot Function Index in patients with plantar fasciitis
Plantar fasciitis is one of the lower limb pathologies that causes more impact on the person and it produces pain, disability and functional limitation. Some factors which increase the risk of plantar fasciitis such as female predominance, advanced age, and high body mass index (BMI). The impact of plantar fasciitis on people is quantified by scales to give us information in the clinic about the state of our patients. Methods and Objetives: A cross-sectional observational study was performed with 28 participants who are suffering plantar fasciitis and administered the FFI-sp in order to determine the relationship between the subcategories included in the FFI-sp with gender, age and BMI in patients with plantar fasciitis. Results: There have not been significant results indicating a relationship between gender, age and BMI with the subscales included in the FFI-sp. Conclusion: There´s no relationship between gender, age and body mass index with the Foot Function Index in patients with plantar fasciitis.
Value of the Silfverskiöld Test for the diagnosis of plantar fasciitis
Plantar fasciitis (PF) is described as the most common cause of heel pain. Although it is considered a multifactorial pathology, the limitation of dorsiflexion of the ankle is one of the most determining factors, predisposing to the development of pathologies in the lower limb.
Review about phenol-alcohol technique surgery on onychocryptosis treatment
Onychocryptosis is a common ungueal disease that usually affects to hallux, giving pain and functional limitation, being phenol-alcohol matricectomy the technique more used for these pathology thanks to it functional and static good results. The aim of this study was to make a review about this technique to show the improvement into different variables research for the author’s bibliography. The search was made through Medline® scientific gate (pubmed) with descriptors “onychocryptosis”, “phenol”, “phenol alcohol” and “phenol matricectomy alcohol”. After different filters application, 14 papers it was selected to make the review, and the analysis variables showed that there was a high prevalence of phenol-alcohol technique over phenol technique isolated; tobacco use can modify cicatrization times and antibiotics use can mask infections signs; a good praxis diminish recurrence and pain post-surgery, improving the quickly incorporation to normal live.
Comparison of Chevron and Scarf techniques for Hallux Valgus correction
Hallux Valgus is one of the most common pathologies today. There are many surgical techniques for their correction. The objective of this work was to carry out a literature review of two of the most frequently used techniques, The Chevron osteotomy, along with its modification, and the Scarf osteotomy, to determine which one obtains better results. The Chevron technique is performed by a V-shaped cut of 60° horizontal centered on the head of the first metatarsal, then moves the metatarsal head laterally with the purpose of narrowing the forefoot, reducing the intermetatarsal angle (IMA). The modification of this technique consists of incorporating an extended plantar limb, in order to increase the correction of this angle. The Scarf osteotomy has a horizontal “Z” shape on the axis of the first metatarsal. The most distal fragment moves to the side, also decreasing the AIM. Following this review, a heterogeneity of results was observed. More and better studies are required to determine the dominance of one technique over another. Most of the studies reviewed did not obtain significant differences between the two techniques. There is a slight preference of Chevron, based on IMA correction and hallux valgus angle (HVA), the simplicity of the technique, the osteosynthesis and the cost-effectiveness. However, most authors agree that satisfactory results depend on the experience of the surgeon.
Phenol alcohol technique for treating ingrown toenails. Average healing time and complications for a sample of between 10-65 years.
Introduction: The phenol alcohol chemical matricectomy is a surgical technique used for the definitive treatment of ingrown toenail. Aims: The objectives of the study were: 1. - Quantify the average healing time of patients in the sample subjected to matricectomy the nail art of phenol alcohol and 2. - Calculate the frequency of major complications of this procedure in our sample. Methods: To a sample of 62 patients for undergoing ingrown toenail from January 1, 2007 to January 1, 2012, and calculated the average healing time. The next step was to hold a draw with the complications that appeared between 0-60 days, and between 61-365 days, and calculated the frequency of occurrence of each of them in our sample. Results: It was found that the average healing time was 28 days. The complications were rare, being seroma the major complication. Highlighting the low rate of recurrence of 1.61% was obtained. Conclusions: Is a technique widely studied and controversial, it has undergone many changes. The performance of the technique as we described in our study provides very satisfactory results, with a low rate of complications and recurrences. Therefore we can conclude that it is a valid and effective for the treatment of ingrown toenail.
Stress fracture is a solution of partial or complete continuity as a result of excessive or repeated loads, an acute and severe tide, resulting in a greater resorption compared to a weak tissue formation. The distribution of the most common stress fractures in the tibia, the tarsal bones and the metatarsals and several are the risk factors for the production of the injury such as extrinsic factors related to sports equipment and physical conditioning and factors intrinsic factors such as age, sex, race, bone density and metabolic level. This article aims to perform a systematic review on the bones of the smallest, most sensitive members of the lesion, the distribution of patients’ age, sex, intrinsic and extrinsic risk factors, the treatment to be applied the recommendations that should be communicated as health services for the prevention of injury in training
The ultrasound as a diagnostic and following value in a clinical case of bursitis adventitious
Introduction: The adventitious bursas are structures that appear in the adulthood, as a mechanism of protection against physical forces on the tissue. The reaction to stress by an axial load on the sesamoids will produce repetitive microtrauma, being the main cause an excessive plantar flexion of M1.Clinically we observed signs of inflammation and a fluctuating mass with pain on palpation. Clinical case: We present a 47-year-old woman presented with pain and swelling in the plantar region of the 1st metatarsophalangeal joint of the right foot, of 4 weeks of evolution. In the exploration an increase in the volume of the 1st plantar MTF was observed, with signs of heat, flushing, erythema with pain on direct palpation and joint mobility, which in running and standing caused it to limp. It is confirmed sonographically and radiographically “Active inflammatory bowel bursitis of biomechanical etiology”. Discussion: The treatment was conservative as described by various authors, with excellent results, using foot supports and shoe modifications. No oral anti-inflammatory drugs or local infiltrations were administered. Conclusions: With the ultrasound, it has been possible to provide an accurate diagnosis with low cost, innocuous, in the chiropody consultation, being able to implement the treatment early.
Surgical versus Conservative Treatment for Acute Achilles Tendon Rupture
Background: Surgical repair is a common method of treatment of acute Achilles tendon rupture because, despite a higher risk of overall complications,it has been believed to offer a reduced risk of rerupture. However, recent analysis based on using early functional rehabilitation, have challenged this belief. The aim of this study is to evaluate the clinical effectiveness of both treatments. Methods: The search was performed using the following electronic bibliography databases (Medline, CINAHL, PubMed and Cochrane Library) to find studies comparing surgical and conservative treatment for acute Achilles tendon rupture. The selection of items was based on inclusion and exclusion criteria. Results: The studies showed that surgical treatment has a lower rate of rerupture (P=0.002) compared with nonsurgical treatment, but increases the risk of other complications (P=0.004). Subgroup analyses revealed significant differences in relation to scar adhesion (P<0.00001), superficial infection (P=0.05) and sensibility disturbance (P=0.0003) in the group undergoing surgery. Conclusions: Compared with conservative treatment, operative treatment can effectively reduce the risk of rerupture but increase the probability of complications, which is usually associated with open repair surgery. However, no sufficient evidence is available from current studies to support the belief that operation may lead to better functional recovery.
Jones Fracture. Surgical treatment or conservative treatment?
Jones’ fracture is defined as a transverse fracture located at the junction of the diaphysis with the proximal metaphysis in the fifth metatarsal and is one of the most common lesions that appear in the foot. It’s a poorly vascularized area, which leads to high rates of non-union of the fractures. It is diagnosed with a clinical examination, associated with radiological tests, three projections are necessary: lateral, antero-posterior and an oblique of 45º. There are different classifications such as Torg et al. and Dameron et al., which help us to establish a treatment, depending on the location of the fracture and its radiological evolution. The objective of this study is to perform a review in the scientific literature to evaluate the differences in the results between surgical treatment and conservative treatment, in relation to the time of union and the possible complications, thus determining which is the optimal treatment for these fractures. We conclude that conservative treatment is a viable option, but it leads to higher rates of non-union and greater time to return to physical activity than surgical treatment, although this may lead to a series of complications such as injury Sural nerve or a possible iatrogenic fracture of the metatarsal. The surgical treatment, which consists of the fixation with an intramedullary screw, has less time of reincorporation to the habitual activity and higher rates of consolidation by which it became the first choice in athletes.
Retrospective analysis of foot skin pathology in children
Cutaneous pediatric pathology is one of the most common consultations in our clinical practice having to know some peculiarities that pediatric patient has, and the need to maintain a good interprofessional relationship with the rest of health professionals who simultaneously treat these patients. The objectives of the study were to number the different pathologies that affect the child’s skin in the podiatry consultation to determine their prevalence and protocol of action within the framework of a multidisciplinary team. A retrospective descriptive study of a sample of 328 clinical histories, from the podiatry consultation, was carried out from November 2004 to February 2013, which met the inclusion criteria of being a pediatric patient with dermatological problems at the foot level . Thus, the results show that 52% were female pediatric patients and 48% were males with a mean age of 11.6 years, with the age ranges between 10-11 and 16-17 with a higher incidence of pathology. The most diagnosed pathologies were plantar warts, ingrown toenails and hyperhidrosis, followed by mycosis, with predominance of topical treatments. The months with a larger number of pediatric patients with skin and nail problems were September, November and July. The interprofessional relations through an exhaustive report directed towards his pediatrician, gives good results.
Evidence of orthopodiatric treatment affected by rheumatoid arthritis on foot
Background: Rheumatoid arthritis affects more women. The prevalence in our country is 0.5%. It should be approached by a multidisciplinary team. Characteristic foot signs` are synovitis of joints, enthesitis, rheumatoid nodules and vasculitis. The conservative treatment modalities are: orthotics, footwear, stretching, manual therapy and therapeutic exercises even by Tai -chi. Objectives: To evaluate the scientific evidence on the conservative treatment of rheumatoid foot with orthotics and therapeutic footwear. Aware of progress and that is the most suitable option for treating this disease that affects the feet. Material and methods: We carried out a literature review of the past 15 years in Pubmed . Results: We found the relationship between pain forefoot metatarsophalangeal subluxation and erosion of articular cartilage with increasing pressure to plantar metatarsal level which justifies conducting orthosis treatment aimed at reducing it. Conservative treatment is aimed at the use of orthoses and shoe therapy to improve pain, gait and functionality. There is scientific evidence for treating metatarsalgia with different types of orthotics that not only help improve the pain but also reduce the number of swollen joints. The combination with therapeutic shoe with or without external changes produces better results. Conclusion: There is little scientific evidence on the use of orthosis treatment for rheumatoid foot but found some articles that support its effectiveness, so it is essential to carry out studies in this field.
Effectiveness of negative pressure therapy in diabetic foot ulcer: systematic review
Background: Diabetic foot ulcers are one of the major causes of disability in patients with Diabetes Mellitus (DM). The Negative Pressure Wound Therapy (NPWT) is one of the major procedures in his treatment, estimulating granulation, draining exudate and reducing edema.e Objectives: To realize a systematic review about the effectiveness and the real clinical application of NPWT use in diabetic foot ulcers. Methods: The literature search has been made in November 2016 in PubMed, CINAHL, SciELO and Web of Science databases, with the kew words (“negative pressure wound therapy” OR “vacuum assisted closure” OR “vacuum sealing drainage”) AND (“diabetic foot” OR “diabetic wound” OR “diabetic ulcer”). Were selected publications whose designs were randomized clinical trials (RCTs), according PRISMA declaration criteria, and whose objective was to analyze the study objective. Results: Twelve RCTs were found with sufficient methodological quality. 7 of the RCTs used as the main variable the surface of the wound bed and 5 used the time to granulation. Conclusions: NPWT get a greater granulation area, a smaller wound healing time and a minor time to start the granulatio
Subungueal glomic tumor at hallux: case report
The case report of a 65 year-old patient is described, who was attended in our clinic for subungueal pain on the first finger with nail elevation and deformity, which prevented her from wearing shoes. Surgery was performed on the lateral border of the nail and the third of the distal phalange of the first finger. The results of complementary tests and histological evaluation revealed a glomus tumor with no evidence of malignancy. At 30 days discomfort had completely disappeared, so that he returned to his usual working activities.
Treatment of Diabetic foot Ulcers: A review
Mellitus diabetes has gained the tittle of epidemy of the 21st century, in which the diabetic food is one its critics complication. Objective: To describe newfangled treatments which allow the cure of diabetic ulcerous. Methods: Research of articles published on ”Pubmed” and “Scielo”, as well as the review of the available bibliography on Rey Juan Carlos University unit January the 3rd 2016. Results: They have been revised the following techniques: The care standards, electromechanical therapies, such as shock waves, topical negative pressure, ozone or hiperbaric oxygen; growing factors and biological skin equivalents, amongst others; out of twelve articles. Discussion: the therapy based on ozone, low cathodic continuous flow, bio-ingeniering skin substitutes, hialuronic-fibroblasts autolugous and Targeted are beneficial therapies. The shock waves, topical negative pressure and the hiperbaric oxygen received a low evidence level. The use of endogenous growing factors recommended above the locals. There is a confrontation in the articles about Dermagraft. Surgical debridement is the most efficient, but larval therapy (biological debridement) is become more relevant. In discharge, splint or total contact plaster and splint or instantaneous total contact plaster resulted useful. Conclusions: The existent treatments for UDF are various. There is not a specific action protocol, it must be adapted to the patient. More medical tests are required for homogeneous and comparable results to be generated amongst researches.
Occupational hazards in the podiatrist profession. How to detect and prevent
Develop, with this review, an analysis of the occupational risk faced by health professionals, in particular, the podiatrists. In the field of health, the podiatrists is exposed to various factors, which can cause it, a number of problems, disorders or diseases, which primarily with knowledge of what is stated in the working day can be able to get its prevention. Highlight the changes that can suffer when exposed to constant noise as micromotors and turbines, latex allergies, biological risks, workplace violence, among others; Health, play an important role in basic and essential to ensure that healthcare professionals get the most efficiency and effectiveness, in the best conditions.
Relationship of Lunge and Jack test in calcaneal apophysitis (sever´s disease) in young soccer players
Sever´s Disease or calcaneal apophysitis occur before or during the early growth in children. Experienced after a new practice of psychical activity that involve running or jumping as soccer. It was described by Dr. J. W. Sever, due to detection of pain with localized sensitivity in the posterior area of the calcaneus bone in young people. The aim of the study is relate the Sever´s Disease incidence and restricted values of Lunge test. In the same way, the inability to activate the windlass mechanism measured through the Jack test related with Sever´s Disease incidence. We performed both test to 60 young soccer players divided in two groups (Sever = 30 young players, 10,84±0,79 years old and 16,87±0,85 IMC values; No Sever = 30 young players, 10,87±0,80 years old and y 17,58±1,41 IMC values). The results shows that a 26,7% of Sever´s Disease patient had a positive Jack test in right foot versus 10,0% of non Sever´s Disease patient (p=0,181). While for left foot, a 33,3% of Sever´s Disease patient had a positive Jack test versus 13,3% of non Sever´s Disease patient (p=0,125). On the other hand, Lunge test for right foot show a significant difference (p<0,01) between Sever´s Disease patient (32,2±3,6) and non Sever´s Disease patient (40,5±4,1). At the same way, in left foot between Sever´s Disease patient (32,1±3,6) and non Sever´s Disease patient (39,2±4,4) with a significant difference (p<0,01). The ankle dorsiflexion restriction measured by Lunge test is related with an incidence of Sever´s Disease. While, Jack test do not show a significant relationship.
Idiophatic toe walkers: sistematic review
The idiopathic toe walking march is characterized by the sole support of the forefoot area during the march. It is a disease developed in children from 2 years-age without any neurological or orthopedic impairment. This revisión consists in the comparison of multiple studies including different treatments, such as serial casting, physical therapy, botulinum toxin type A or surgical solutions. The aim is to clarify which of the treatments would be most efficient. The study performed searches of scientific articles on the march in infantile idiopathic toe walking and its treatment in Medline, CINAHL, PubMed, Web of Science and Cochrane Library data base. Two systematic reviews that met the inclusion criteria were selected. After having analysed all results of the different treatments the conclusion is, that there is no difference in effectiveness between them, mainly due to no important difference of treatment. Although there has been no major improvement walking in any of the treatment, the kinetics and the kinematic has improved with all treatments. An increase in the ankle dorsiflexion range of motion was also observed, but only it will be longterm retained in those groups of surgically treated patients. The number of complications that arise after conservative treatment and surgical was minimal. In conclusion we cannot determine which treatment provides more effectiveness promoting the necessity of further studies.
Osteotomies in the surgical treatment of hallux valgus
Choosing the perfect for abductus hallux valgus surgery technique has been an issue that surgeons have grappled for years with little success. Osteotomies are considered one of the techniques of choice for the treatment of deformity. Can be localized proximal, diaphyseal or distal of the first metatarsal. The question that has tried to answer, is whether there somewhere more appropriate to perform metatarsal osteotomies. It has also been tried to determine which of the osteotomies described brought greater angular correction with fewer complications.