Development and Evaluation of a Surgical Direct Assessment Tool for Resident Training.

In podiatric residency training, minimum activity volume numbers are used to assess surgical competency. The purpose of this study was to develop a standardized direct assessment form as a complement to minimum activity volume numbers. Sixteen attending physicians completed 121 direct assessment forms, evaluating six podiatric medicine and surgery residents.

Passive Muscular Insufficiency: The Etiology of Gastrocnemius Equinus.

The current understanding is that gastrocnemius equinus is caused by a pathologic tightening of the muscle leading to decreased ankle joint dorsiflexion. However, an alternative hypothesis is that it is a normal limitation of available muscle length. Passive muscular insufficiency of the gastrocnemius muscle acts on a pathologic foot, which is poorly prepared to accept the forces from the gastrocnemius-soleus complex.

Update on Investigation Methods for Lower Extremity Biomechanics.

Imaging with biomechanical analysis augments the clinical examination and improves outcomes by correlating imaging findings with the examination. Plain film radiographs are the gold standard to assess osseous alignment. The biomechanical examination provides information to formulate an accurate assessment.

Surgical Biomechanics: Principles of Procedure Choice.

Surgical treatment of foot and ankle ailments is common, but in the past the choice of procedures was often dictated principally by positional considerations. This article reviews the use of the 2 primary biomechanical approaches, the kinematic and kinetic methods, and presents a novel unified method to guide surgical procedure choice, the kineticokinematic approach. Decision-making methods and resources are discussed and 2 case studies are presented to elucidate how this method may be used when choosing surgical procedures.

Excess Cost and Healthcare Resources Associated With Delayed Diagnosis of Charcot Foot.

The purpose of the present study was to demonstrate the effect of a delayed diagnosis of Charcot foot on acute care cost and usage. We used International Classification of Disease, Ninth Revision, Clinical Modification codes, and the California Office for Statewide Health Planning and Development 2009 to 2012 public patient discharge files to identify patients with type 2 diabetes mellitus and Charcot foot. The costs and length of stay were compared for those with a diagnosis of Charcot foot on admission compared with those who received a delayed diagnosis of Charcot foot before discharge.

History and lower extremity physical examination of the pediatric patient.

The pediatric foot and ankle examination is a specialized yet important skill for the modern podiatric medical practitioner. An organized and sequential history and physical examination yields a thorough database of information for which to establish a successful treatment regimen.