Revista Espanola de Podologia最新文献

Introduction

Transthyretin family amyloid polyneuropathy also known as Corino Andrade's disease is an autosomal dominant inherited amyloidosis produced by mutations in the Transthyretin protein gene. The most frequent initial clinical symptom is a classic motor sensory syndrome, which starts in the feet and legs and then extends to the arms, trunk and nerves of the skull In Spain, endemic foci have been described in Mallorca and in Valverde del Camino (Huelva). The objective of the present study is to observe the most frequent podiatric disorders that suffer the individuals of this study based on the neuropathy that they suffer, as well as, to evaluate the role of the podiatrist in this condition.

Patients and methods

Preliminary fieldwork was carried out on a group of 12 individuals affected by natural transthyretin family amyloid polyneuropathy from Valverde del Camino (Huelva). A podiatric examination protocol was applied and evaluated different aspects related to this disease. A podological examination protocol was applied and different aspects related to this disease were evaluated.

Results

82% of the first symptoms of the disease perceived by our study group were in the feet. The most relevant results showed that the thermal, tactile, painful, vibratory and pressure sensations in the feet were altered. Achilles reflex was absent in a large percentage of individuals, as well as decreased dorsiflexion.

Discussion

The clinical variability of the disease indicates the relevance of a multidisciplinary approach, in which podiatrists can be key in the early detection and treatment of this condition.

Background

Functional hallux limitus (FHL) is a well-known multifactorial functional disruption defined as a clinical entity characterized by the difficulty of loading the metatarsal-phalangeal joint of the first finger to the dorsal flexion when weight-bearing. The objective of this study is to verify a possible relationship between a decrease in dorsiflexion of the talocrural joint with a limitation of the first phalangeal metatarsal joint.

Patients and methods

Weight-bearing Lunge test (WBLT) values of 26 participants were analyzed, 13 had FHL and 13 were controls. FHL test and WBLT were performed to the total of the sample. Three measurements were made for the WBLT to obtain its result as mean ± standard deviation in order to relate it to the presence of HLF. The T-Student test was performed on independent samples comparing the WBLT results on the cases and controls groups. The left and the right limbs were analyzed for the sample and a distinction was made between genders.

Results

Statistically significant differences were found between the cases group and the control group at the dorsal flexion range of motion for the right leg (30.84 ± 2.820 vs 34.92 ± 1.93; p < 0.05) but not for the left leg (31.00 ± 4.000 vs 34.30 ± 2.56; p = 0.19). In relation to the gender, the differences between cases–control were equally significant for the female and male genders on the right leg, but not on the left.

Conclusions

Based on the results obtained in the study, an association between HLF and a decrease in the range of motion of the talocrural joint has been found, although further studies are needed in order to correlate this biomechanical relation.

Introduction

Torpid evolution of diabetic foot ulcers (DFU) is a complex problem of health of patients and causes an increase in costs for the health system. Negative pressure therapy (NPT) is a treatment that accelerates healing by a negative pressure flow applied to the wound to stimulate a series of physiological processes in chronic wounds.

Patients and methods

We performed a retrospective case series study that evaluated the complications associated to NPT in the treatment of DFU in patients from the Diabetic Foot Unit of the Universidad Complutense de Madrid from 2011 to 2015.

Results

Fifty-seven (83.8%) patients who underwent NPT were analyzed and complications during the time that NPT was maintained were collected. Skin maceration of wound borders was found in 49% of the patients, bleeding (14%), necrosis (12%), local infection (7%) and local pain (2%).

Discussion

The periwound maceration was the most frequent complication and the most easily resolved. After resolution of the complications, 80% of the patients obtained a favorable result with the therapy, so it can be concluded that NPT is an effective and safe therapy for the treatment of DFU.

The Weil osteotomy is a common technique used in the treatment of lesser metatarsal deformities of the forefoot. In the last years a large amount of papers have been published showing its effectiveness and the complication rates of the Weil-type osteotomy. Although most of studies have shown an effectiveness in pain reduction close to 80–90%, complication rates are also relatively large in some reports. The present paper is intended to review clinical, radiological and cadaveric studies of the Weil osteotomy in an attempt to make a comprehensive review for the reader regarding all aspects of this common used technique.

Introduction

In sport activities, chronic tendinopathy is one of the most common degenerative pathology in the lower extremity. In this work we review what the literature says regarding the effectiveness of the technique of percutaneous electrolysis, as one of the most innovative treatments in the regeneration of tendons to solve these problems faster than with conventional rehabilitation methods.

Materials and method

A literature search was performed on several databases included: Pubmed, ScienceDirect, Dialnet, and Scielo. The terms used were: percutaneous electrolysis, tendinopathy, eccentric exercises, Achilles tendon, patella, and Epi Technique.

Results

It was included a total of 7 studies of which 4 were case series studies, 2 were articles of clinical cases and 1 was an experimental study in rats, but we found no randomized clinical trials or longitudinal studies. The results showed that the electrolysis could help to shorten the number of sessions and the duration of treatment of tendinopathies in lower limb reducing the recovery time of the patient. The combination of this technique with eccentric exercises appears to give better results. In addition, the studied technique is not painless.

Discussion

Percutaneous electrolysis is, a new technique that would broaden the therapeutic approach in terms of the physical and functional recovery in the treatment of the most common sports injuries in podiatric offices. The low quality of evidence reported on this technique reflects the need for studies with sound scientific evidence and randomized clinical trials that will deliver relevant search results regarding the technique and its effectiveness.

Introduction

The torpid evolution in the healing of diabetic foot ulcers (DFU) is a complex problem in the health of patients and causes an increase in costs for the health system. Negative Pressure Therapy (NPT) is a treatment that accelerates healing by a negative pressure flow to stimulate a series of physiological processes in chronic wounds.

Patients and methods

We performed a retrospective observational study that evaluated the complications associated to NPT in the treatment of DFU in patients from the Diabetic Foot Unit of the ComplutenseUniversity of Madrid from 2011 to 2015.

Results

We analysed 57 (83,8%) patients who underwent NPT and recollected every complications during the time NPT is maintained. Perilesional maceration was found in 49% of the patients, bleeding (14%), necrosis (12%), local infection (7%) and local pain (2%).

Discussion

The perilesional maceration was the most frequent complication and the most easily resolved. After resolution of the complications, 80% of the patients obtained a favorable result with the therapy, so it can be concluded that NPT is considered an effective and safe therapy in the treatment of DFU.