This case study documents the functional impact of the Trulife A-Pace Anterior Lateral Strut Carbon Fibre AFO in a 62-year-old female with longstanding type 2 diabetes, established peripheral neuropathy, and a new unilateral left-sided drop foot presentation. The etiology was a common peroneal mononeuropathy, confirmed on electrodiagnostic study, with an indeterminate trigger but presumed multifactorial in the setting of underlying diabetic microvascular disease and mechanical compression from prolonged cross-legged sitting.
Lower Extremity Review
lerEXPO Highlights: 5 Insights That Are Changing How We Treat Flatfoot
Flatfoot is frequently marginalized in clinical conversations as a mere structural quirk–a low arch that requires little more than an orthotic. Yet, for patients, it represents a progressive biomechanical failure and a source of chronic, lifestyle-altering pain. For the surgical community, it has long been a battlefield of competing philosophies. How do 15 of the world’s leading orthopedic minds find common ground on a condition so riddled with nuance?
By Jeff Dikis, DPM, Brad Abicht, DPM, FACFAS and Julio Ortiz, DPM, FACFAS
Insurance Prior Authorization Reform: Why It Matters for Podiatrists
There’s a quiet but meaningful shift happening in the way insurance companies handle prior authorizations. For those of us in podiatry, it has the potential to change how we deliver care in very practical ways. Starting (it has been reported) January 1, several of the country’s largest insurers, such as UnitedHealthcare, Humana, and Aetna are planning to adopt a single, standardized approach for pre-treatment reviews.
By Mikel D. Daniels, DPM, MBA, President and Chief Medical Officer, WeTreatFeet Podiatry
Dirty Truth #10: Bottom Up and Top Down
Dirty Truth #10 is grounded in the old saying, “where the rubber meets the road.” When your foot strikes the ground, the ground hits you back. The foot goes from an unloaded state (swing phase) to a weight-bearing, interactive body, getting pushback during every step you take on that road. The equal and opposite force Newton promised us. This bottom-up view changes everything.
By Jay Segel, DPM; Sally Crawford, MS
Biointegrative Implants Reshape Foot and Ankle Surgery
For decades, metal hardware has been the standard in foot and ankle surgery. Screws, plates and pins have provided reliable fixation, enabling surgeons to stabilize bones and joints during healing. While effective, these materials often remain in the body permanently, and in some cases, require secondary procedures for removal due to irritation or complications.
By Keith Loria
Rock Climbing-Related Lower Extremity Injuries Treated at Hospital Emergency Departments
Rock climbing includes different disciplines such as traditional climbing (temporary rope anchoring placed during the climb), top rope or speed climbing (rope anchoring at the top of the wall, indoor only), sport climbing (ropes anchored at multiple fixed points while ascending), and bouldering (short distance climbing without ropes). It can be performed outdoors on natural terrain or outdoors and…
By Mathias B. Forrester, BS
lerEXPO Highlights: AI-Assisted Risk Stratification and Management in Diabetic Limb Salvage
The global prevalence of diabetes is increasing and is projected to affect 642 million people by 2040, highlighting the growing need for effective prevention, management, and supportive care. Diabetes can be associated with a range of health complications that require ongoing medical attention. Among these, diabetic foot conditions–particularly ulcerations and infections–are leading contributors to non-traumatic lower-limb amputations.
By Dr. Laura Shin
Rethinking the Role of the Plantar Fascia’s Windlass Mechanism
Ever since Sahelanthropus tchadensis stood upright 7 million years ago, the feet of our common ancestors have undergone a series of important structural changes necessary to accommodate the functional requirements of bipedal locomotion. While the feet of arboreal primates were well-adapted for grasping branches during movement through tree canopies, their hypermobile midfoot and adducted great toe led to instability and buckling during the push-off phase of gait…
By Tom Michaud, DC, and Nicolas Haelewijn, Ph. D.
The Halo Effect of Technology in Podiatric Practice
When patients enter a podiatry office, their impressions begin forming immediately. Before any history is taken or exam performed, they are already processing what they see. Eyes are drawn to the physical space, the efficiency of the front desk, the demeanor of the staff. They enter the treatment room and notice the equipment in the room while waiting for the physician. These early signals shape expectations in ways that are both subtle and powerful.
By Mikel D. Daniels, DPM, MBA, President and Chief Medical Officer, WeTreatFeet Podiatry
CAGA 101: The 12 Dirty Truths of Foot Mechanics
If you have been following our articles, you may have noticed a trend in how computer-aided gait analysis (CAGA) data can help characterize unavoidable and avoidable truths about your 2 feet and the long-term consequences. When it comes to footwear, even research supports the fact that improper footwear and “wear and tear” over time will have negative impacts on foot health.
By Jay Segel, DPM; Sally Crawford, MS
Application Of Transcranial Pulse Stim in Rehab: Pain Management in Knee Osteoarthritis
Knee osteoarthritis (KOA) is the most prevalent form of arthritis among adults and a leading cause of disability worldwide. The condition affects hundreds of millions of individuals and represents a substantial burden on healthcare systems. Chronic knee pain is the primary symptom and frequently prompts individuals to seek medical care. However, the management of chronic osteoarthritis pain remains challenging.
CAGA 101: The 12 Dirty Truths of Foot Mechanics
Dirty Truth: #8 Every step is different – The Importance of Tracking Gait Variability Through Aging. This dirty truth sits like an unrecognized norm in our DNA and plays out like a knee-jerk reaction until we give it a little thought. We have 2 legs, 2 knees (no pun intended), 2 ankles, and 2 feet. The general public thinks they are the same in both form and function, but that is rarely the case.
By Jay Segel, DPM; Sally Crawford, MS
Guest Perspective: Important Message to Podiatrists and Pedorthists
One simple step in every patient evaluation can help save limbs and potentially save lives: assess the feet and lower legs for temperature on every patient who enters your office. A basic infrared temperature gun is inexpensive, easy to use, and widely available. Many clinicians already have one at home. These devices typically cost around $20–$25 and can be easily incorporated into daily clinical screening.
Making Diabetic Foot Care Financially Sustainable
Like many physicians, coming out of residency I thought I’d fix the world one bunion at a time. Somewhere between my 745 and 746th bunion procedure, I came to the realization that while I was helping to relieve the pain my patients were feeling, this might not be a way for me to make a difference. Taking an objective look at my practice, I decided to focus on diabetics. That was the point that made me ask how I could make a practice financially viable with this as a focus.
By Mikel D. Daniels, DPM, MBA, President and Chief Medical Officer, WeTreatFeet Podiatry
lerEXPO Highlights: Minimally Invasive Achilles Tendon Repair and Post-op Rehabilitation–How Quick Can We Go
Achilles tendon ruptures are among the most devastating lower extremity injuries an athlete can face. Historically, the medical community has been divided between traditional open surgery and non-operative management. While open surgery effectively lowers the risk of re-rupture, the posterior ankle’s poor blood supply can sometimes lead to severe wound complications that can end careers. High-profile cases, such as NFL player Robert Mathis and…
By Kirk McCullough, MD
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