Publications by authors named "Patrick A DeHeer"

Background: Hallux abducto valgus (HAV), commonly referred to as a bunion, is a prevalent foot deformity with multifactorial etiology, including genetic predisposition, biomechanical abnormalities, and footwear choices. HAV is often managed conservatively with orthotic devices aimed at reducing deformity progression and alleviating associated pain. However, the effectiveness of orthotics in altering radiographic measurements of HAV remains debated.

View Article and Find Full Text PDF

Phlegmons are unencapsulated collections of inflammation that track along soft tissues in various parts of the human body. These soft-tissue lesions are uncommon in the lower extremities and can be difficult to identify and treat. This article presents a case of a plantar foot phlegmon in a nondiabetic patient that was recalcitrant to debridement and antibiotics.

View Article and Find Full Text PDF

Background: Burnout and medical resident well-being has become an increasingly studied topic in medical degree (MD) and doctor of osteopathic medicine (DO) fields and specialties, which has led to systemic changes in postgraduate education and training. Although an important topic to address for physicians of all experience levels and fields of practice, there is little research on this topic as it pertains specifically to the podiatric medical community.

Methods: A wellness needs assessment was developed and distributed to podiatric medical residents via electronic survey to assess overall wellness levels of residents and to highlight several subdomains of well-being in the training programs of the podiatric medical profession.

View Article and Find Full Text PDF
Article Synopsis
  • * Out of 249 patients, 73% were found to have ankle equinus, with a striking 98.4% of these patients exhibiting the condition bilaterally.
  • * The research indicated a higher prevalence of ankle equinus than previously reported, particularly among individuals with diabetes, higher body mass indexes, or overuse symptoms.
View Article and Find Full Text PDF
Article Synopsis
  • Morton's neuromas, commonly found between the lesser metatarsal heads in the foot, have been traditionally thought to mainly occur in the third interspace and in females, but this study observed them frequently in both the second and third interspaces in both sexes.
  • The research analyzed 582 MRI reports, focusing on 379 patients with confirmed cases of Morton's neuroma, examining factors like sex, age, and history of trauma.
  • The results revealed no significant differences in the location or characteristics of Morton's neuromas by sex, although male patients had a higher rate of plantar plate tears related to the condition.
View Article and Find Full Text PDF

Background: Morton's neuromas are abnormalities of the common digital nerve branch located between the lesser metatarsal heads. Historically, interdigital (Morton's) neuromas have been characterized as being most common in the third interspace and predominantly identified in females. The principal investigator observed Morton's neuromas commonly in both the 2nd and 3rd interspaces in both genders.

View Article and Find Full Text PDF
Article Synopsis
  • Nonoperational treatments for Morton's neuroma, like sclerosing injections, have mixed reviews since they may not affect nerve fibers at a cellular level.
  • A study was conducted comparing the effects of 4% ethanol sclerosing injections with corticosteroid injections in patients who still needed nerve removal due to pain.
  • Results showed that those who received nonsclerosing injections experienced more severe intraneural fibrosis, suggesting that sclerosing injections do lead to significant histologic changes in Morton's neuroma.
View Article and Find Full Text PDF

Background: The Evans osteotomy is a widely used procedure for the correction of adult and pediatric flexible flatfoot deformity. Locking plates are commonly used to stabilize the osteotomy and the allograft. However, there have been incidences of soft-tissue irritation caused by the hardware, requiring subsequent hardware removal.

View Article and Find Full Text PDF

A comprehensive lower extremity examination is a critical examination component for any type of injury in an athlete but should also be part of a preseason or preventive care program. Identification and treatment of biomechanical abnormalities and association with evidence-based risk factors for lower extremity disorders can be incorporated to potentially reduce risk or prevent acute and chronic injuries.

View Article and Find Full Text PDF

Background: Osteochondromas are benign osseous tumors encountered most routinely by physicians responsible for diagnosing musculoskeletal disorders. Often, these osseous lesions are identified following symptoms related to their impingement on adjacent soft tissue or bone.

Methods: This article presents a unique case of an asymptomatic osteochondroma of the distal fibula in a 29-year-old Caucasian woman that manifested clinically as an impingement on the tibial nerve.

View Article and Find Full Text PDF
Equinus and Lengthening Techniques.

Clin Podiatr Med Surg

April 2017

Equinus is linked to most lower extremity biomechanically related disorders. Defining equinus as ankle joint dorsiflexion less than 5° of dorsiflexion with the knee extended is the basis for evaluation and management of the deformity. Consistent evaluation methodology using a goniometer with the subtalar joint in neutral position and midtarsal joint supinated while dorsiflexing the ankle with knee extended provides a consistent clinical examination.

View Article and Find Full Text PDF

Background: Article citations are a well-accepted method of evaluating the influence or impact of a particular article. Other medical specialties have published the top cited articles in their specialty. To date, an analysis of the foot and ankle podiatric medicine-related article citation method has not been published.

View Article and Find Full Text PDF

Although the pediatric foot and ankle examination is essentially similar to that of the adult patient, there are subtle differences unique to a child's examination. The unique findings are discussed in this article based on the following: weight-bearing examination, gait evaluation, non-weight-bearing examination, vascular examination, neurologic examination, and dermatologic examination for pediatric patients. A comprehensive overview is provided; however, other challenges presented in evaluating children include management of a child's parents and a child's temperament.

View Article and Find Full Text PDF

Ankle joint arthrodesis should be considered the gold standard procedure for end-stage ankle arthritis in the appropriate patient. Incisional approach and fixation technique should be based on the patient and specific needs. Arthrodesis can be achieved with adequate resection of cartilage, good compression across the fusion site, stable fixation, proper postoperative protocol, and patient compliance.

View Article and Find Full Text PDF

This article argues the practice of first metatarsal phalangeal joint (MPJ) implant arthroplasty. Intermediate and long-term studies raise concerns about implant failure and longevity. Other causes for concern are silicone-induced synovitis and lymphadenopathy.

View Article and Find Full Text PDF
Triple arthrodesis.

Clin Podiatr Med Surg

April 2004

Article Synopsis
  • The triple arthrodesis is a final surgical procedure used to treat severe foot deformities.
  • Successful outcomes depend on choosing the right patients, using proper surgical techniques, and managing post-surgery care effectively.
  • The goal is to improve both the patient's foot function and the surgeon's results from the procedure.
View Article and Find Full Text PDF

The use of external fixation in foot and ankle surgery has steadily increased with the advent of devices geared toward the foot and ankle that have evolved over the past decade, as well as a greater understanding of the indications and advantages of external fixation. The application of external fixators in the forefoot may at first glance seem both limited and possibly overkill, but once the basics of external fixation and the types of devices available are understood the options for use become numerous.

View Article and Find Full Text PDF