Revista Espanola de Podologia最新文献

Introduction

Diabetes is one of the most prevalent diseases in existence today, with an index of foot involvement of 15%. Therefore, it is necessary to implement effective measures to reduce the number of complications such us the promotion of self-care behaviors, which leads to an improvement in the quality of life and the reduction of possible associated complications as it has found in the literature.

Methods

The APD-UMA self-care survey and the SF-12 quality of life questionnaire were carried out on a sample of 50 people. With the objective of determining the existence of a relationship between quality of life, self-care and complications associated with diabetes.

Results

There were no significant results in any of the dimensions. Except for self-care parameters and physical health, a positive relationship was observed between the two.

Conclusions

A high score was obtained in the self-care questionnaire. In addition, we did not obtain a significant relationship between any of the variables, it was only observed that better physical health conditions generated a higher level of self-care.

We present a clinical case of revision of failed arthrodesis of the first metatarsophalangeal joint with conversion to a total metatarsophalangeal prothesis. The patient was a 63 years old woman who underwent two previous failed interventions due to hallux rigidus with arthrodesis at the first metatarsophalangeal articulation. The patient had persistent pain at Chopart's joint and at the external malleolus that worsened with gait. She referred pain at the lateral ligaments of the ankle with direct palpation and pain on the talonavicularis and calneus-cuboid joints with forced inversion of the foot. The present paper describes a novel technique to reverse an arthrodesis of the first metatarsophalangeal joint to a total joint replacement with Toefit-Plus™ implant thus restoring joint mobility. Pain relief was achieved and mobility of the first metatarsophalangeal joint was restored within its normal range of motion with a hypermobility of the first ray that required post-surgical treatment with plantar orthoses to improve functionality. At clinical evaluation patient presented active range of motion up to 40̊of dorsiflexion, achieved due to the restoration of functionality of the extensor hallucis longus after the intervention. A better knowledge of advantages and disadvantages of this surgical technique would allow an improved selection of the patients who would benefit from this technique after a failed arthrodesis of first metatarsophalangeal joint. Further studies are needed for a better understanding of the beneficts of this surgery through more clinical studies.

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 in the whole 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<.05) but not for the left leg (31,00 ± 4,000 vs 34,30 ± 2,56; P=.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.

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.

Onychomycosis treatment demands the necessary tools for its diagnosis. A proper interpretation of the results of the studies performed obtained by direct mycological analysis ensures that the treatment against onycomchosis is right. The restricted access to methods of diagnosis has conditioned our way of action to deal with this problem, creating a reputation of incurable diseases or requiring long-term and costly treatments with many side-effects. This clinical note provides a scientifically valid tool, low-cost and easy accessibility for the diagnosis of onychomycosis.

The present paper describes the technique for diagnosis from the beginning to the end with sample taking and direct exam technique by microscopy using potassium hydroxide, as well as its most common variations.

Althougth there are techniques of greater sensitivity, the technique described remains as a valid diagnosis tool, easy to implement and cost-effective.

Introduction

Diabetes mellitus is a chronic condition more frequent everytime due to the population aging and the habits. This condition causes a series of complications that can produce a negative impact on the quality of life of the patient and their environment. The principal aim of this article is to describe the impact that diabetes has on the patient's quality of life.

Material and methods

Bibliographical reviews have been carried out in different databases in which 60 articles have been obtained that study the impact on the quality of life and the different podiatric conditions related to diabetes mellitus; 25 articles have been used.

Results

The analyzed studies are descriptive, they use different quality of life questionnaires and it's been observed an impact in every complication.

Discussion

It's been verified, after this review, that the podiatric complications may produce a significant decrease in quality of life, especially regarding the physical limitations that may imposed. This may generate anxiety both in patients and in their relatives, as well as being an economic burden in many cases. Ulceration encompasses all of the above and is also the most frequent podiatric complication having the most major negative impact. Due to its simplicity, the instrument of measurement most commonly used is the SF-36 and its reduced forms.

Introduction

The aims of this study were to determine whether subjects with advanced hallux limitus show a diminished capacity of internal rotation of the lower limb and increased foot progression angle compared with normal population, to relate rotational and torsional patterns of lower limbs with the foot progression angle, and to compare methods of measurement of the foot progression angle.

Patients and methods

In 15 subjects with advanced hallux limitus, internal and external rotational pattern, internal and external hip rotation and tibial torsion were measured. The foot progression angle was obtained using a pressure platform and an inked latex carpet.

Results

The internal rotation of the lower limb was significantly lesser and the foot progression angle was significantly greater in individuals with advanced hallux limitus (P < .05). The Pearson correlation coefficient was −0,563 (P < .01) for the relationship between the foot progression angle and the internal rotational pattern. The measure of the foot progression angle in the inked latex carpet was significantly greater than in the pressure platform in the left foot (P < .05).

Conclusion

Subjects with advanced hallux limitus had a lesser capacity of internal rotation of the lower extremity and greater foot progression angle in comparison with normal population. Internal rotational pattern determines the greater foot progression angle. The foot progression angle values measured with the pressure platform differ from the inked latex carpet.