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Gait Posture 2021 Jun 12;88:297-303. Epub 2021 Jun 12.

Department of Physical Therapy For Pediatrics, Faculty of Physical Therapy, Cairo University, Egypt.

Background: Flexible flatfeet are common among children being scarcely symptomatic requires no specific treatment and resolves spontaneously. However, flexible flatfoot tends to advance and deteriorate overtime and eventually resulting in significant impairments such as plantar fasciitis and patellofemoral pain syndrome.

Research Question: What is the effect of corrective exercises and neuromuscular electrical stimulation in children with flexible flatfeet?

Method: This is a randomized controlled trial with 72 children, seven to twelve yearsold, randomly assigned to either intervention or control group (36 children for each group) and engaged in a four months (3 sessions/week) of corrective exercise and neuromuscular electrical stimulation or corrective exercise and sham neuromuscular electrical stimulation respectively. Read More

Arthrosc Tech 2021 May 26;10(5):e1361-e1368. Epub 2021 Apr 26.

Orthopaedic, Sports Medicine and Arthroscopy, Instituto Nacional de Rehabilitación, México City, México.

Common peroneal nerve injury is present in 40% of knee dislocations, and foot drop is the principal complication. Posterior tibial tendon transfer is a viable solution to replace the function of the anterior tibial tendon (ATT) in the mid-foot. Several techniques for posterior tibial tendon transfer exist today, with variable results reported. Read More

Ann Med Surg (Lond) 2021 Jun 19;66:102407. Epub 2021 May 19.

Department of Neurosurgery, Tishreen University, Latakia, Syria.

A primary spinal Ewing sarcoma is extremely rare to be found. To the best of our knowledge, it is the first reported case for bilateral foot drop as a prodromal symptom of sacral Ewing sarcoma. The case, we are presenting, is of an 18-year-old athletic female, who was presented to the emergency department suffering from sudden severe low back pain radiated to the lower limbs, associated with bilateral foot drop and later urinary incontinence. Read More

Brain Nerve 2021 Jun;73(6):659-670

Department of Neurology, Chubu Rosai Hospital.

The most caudal part of the spinal cord shows special anatomical characteristics and it contains epiconus (L4-S2 segments), the conus medullaris (S3-S5 segments), and surrounding nerve roots. Lesions of the thoracolumbar junction cause epiconus or conus syndrome. Epiconus syndrome is characterized by segmental muscular weakness and atrophy of one or both lower extremities, often accompanied by foot drop. Read More

Phys Eng Sci Med 2021 Jun 14. Epub 2021 Jun 14.

Department of Mechanical Engineering, College of Engineering, University of Tehran, 1417466191, Tehran, Iran.

During landing, the lower limb joints work concertedly to reduce landing forces. Changing the biomechanics of one joint can alter landing strategies in other joints thus affecting the probability of injury. Therefore, understanding the mutual effects between the joints is crucial for the prevention of lower extremity injuries. Read More

Orthop Surg 2021 Jun 14. Epub 2021 Jun 14.

Department of Orthopaedic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Objective: To investigate the clinical effect of mouse nerve growth factor (mNGF) and methylcobalamin (MeCbl) for the treatment of lumbar disk herniation (LDH) with foot drop.

Methods: A total of 46 patients suffering from LDH with foot drop who underwent transforaminal lumbar interbody fusion (TLIF) surgery in our department from January 2015 to December 2017 were retrospectively analyzed. We divided these patients into two groups according to the different postoperative treatment which independently selected by patients after signing informed consent form: one group of 25 patients was treated with MeCbl alone (Group MeCbl), the other group of 21 patients was treated with a combination of mNGF and MeCbl (Group MeCbl+mNGF). Read More

J Clin Anesth 2021 Oct 4;73:110363. Epub 2021 Jun 4.

Clinic for Orthopedics Surgery and Traumatology, University Clinical Center of Serbia, Belgrade, Serbia; Medical School, University of Belgrade, Belgrade, Serbia.

Materials (Basel) 2021 May 31;14(11). Epub 2021 May 31.

Department of Mechanical Engineering, Inha University, 100 Inha-ro, Michuhol-gu, Incheon 22212, Korea.

The ankle joint of a powered ankle-foot orthosis (PAFO) is a prominent component, as it must withstand the dynamic loading conditions during its service time, while delivering all the functional requirements such as reducing the metabolic effort during walking, minimizing the stress on the user's joint, and improving the gait stability of the impaired subjects. More often, the life of an AFO is limited by the performance of its joint; hence, a careful design consideration and material selection are required to increase the AFO's service life. In the present work, a compact AFO joint was designed based on a worm gear mechanism with steel and brass counterparts due to the fact of its large torque transfer capability in a single stage, enabling a compact joint. Read More

Metabolites 2021 May 20;11(5). Epub 2021 May 20.

Department of Food Quality and Nutrition, Edmund Mach Foundation, Research and Innovation Centre, Via Edmund Mach 1, 38010 San Michele all'Adige, TN, Italy.

Depending on the vineyard location, cluster thinning (CT) may represent an effective tool to obtain the desired grape composition and wine quality. The effect of 20% cluster thinning on Ribolla Gialla ( L.) sparkling wine aroma, lipid compounds, and aromatic amino acid (AAA) metabolites composition was studied for three consecutive seasons in two vineyards located in the Friuli Venezia Giulia region, Italy. Read More

Clin Neurol Neurosurg 2021 Jul 23;206:106696. Epub 2021 May 23.

Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. Electronic address:

Objective: To evaluate the improvement of drop foot following lumbar decompression surgery and determine the prognostic factors that might influence the recovery of drop foot.

Summary And Background Date: Drop foot is a common but serious problem that can lead to deteriorate patient's daily activities. There are numerous studied regarding the prognostic factors for the recovery of drop foot. Read More

J Back Musculoskelet Rehabil 2021 May 14. Epub 2021 May 14.

Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey.

Background: Patellofemoral pain (PFP) is a common knee problem. The foot posture in a relaxed stance is reported as a distal factor of PFP. However, the effects of short foot exercise (SFE) on the knee and functional factors have not yet been investigated in patients with PFP. Read More

J Int Med Res 2021 May;49(5):3000605211005954

The Spine Centre of SE Georgia, Brunswick, GA, USA.

There are limited treatment options for patients with foot drop and associated lower back and/or leg pain. We present a case series of three patients who received permanent implantation of 10 kHz spinal cord stimulation (10 kHz SCS) devices. Following treatment, all patients reported sustained improvements in lower back and leg pain, foot mechanics and function which resulted in increased mobility and cessation of opioid use for pain management. Read More

Neurol Sci 2021 May 21. Epub 2021 May 21.

Dysimmune Neuropathies Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy.

Introduction: Electrophysiological diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) may be challenging. Thus, with the aim ofproviding some practical advice in electrophysiological approach to a patient with suspected CIDP, we analyzed electrophysiological data from 499 patients enrolled inthe Italian CIDP Database.

Methods: We calculated the rate of each demyelinating feature, the rate of demyelinating features per nerve, the diagnostic rate for upper andlower limb nerves, and, using a ROC curve analysis, the diagnostic accuracy of each couple of nerves and each demyelinating feature, for every CIDP subtype. Read More

Acta Ortop Mex 2020 Nov-Dec;34(6):371-375

Universidad San Pablo CEU, Madrid. España.

Introduction: The Drop foot is a condition that is usually handled with short orthosis, usually made of polypropylene. It has also been described as being treated with silicon orthosis, little studied but which seem to improve the kinematic pattern of gait and, given its comfort, be more accepted by patients. Our study describes the kinematic characteristics of gait and patient satisfaction when using a silicon foot ankle orthosis, and compares this pattern to the non-use of the orthosis, in patients with a drop foot. Read More

BMJ Case Rep 2021 May 19;14(5). Epub 2021 May 19.

Department of Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, Maryland, USA

We reported a unique case with the coexistence of classic and cutaneous polyarteritis nodosa (PAN), and microscopic polyangiitis (MPA) in hepatitis virus-associated vasculitis. A 77-year-old Asian man presented with extremity weakness and weight loss found to have bilateral foot drop and rash on his hands and legs. Labs reveal positive for hepatitis B core antibody and perinuclear-antineutrophil cytoplasmic antibody (p-ANCA), decreased C3 and C4 levels. Read More

Int J Surg Case Rep 2021 Apr 29;83:105928. Epub 2021 Apr 29.

Department of Orthopedic Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.

Background: Foot drop is defined as a weakness in the ankle and foot dorsiflexors. A disruption of the neural pathway starting from the motor prefrontal cortex and ending in the peroneal nerve can lead to foot drop. Foot drop due to lower motor neuron injury is well documented. Read More

J Bodyw Mov Ther 2021 Apr 21;26:501-504. Epub 2020 Nov 21.

Rehabilitation Research Center Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Background: Passive and hybrid passive ankle foot orthoses (AFOs) are often prescribed in post stroke drop foot; however, the effects of these AFOs on balance related parameters in these patients seem unclear. Accordingly, the aim of current study was to evaluate the role of the newly designed hybrid passive and Posterior Leaf Spring (PLS) AFOs on balance related parameters including: self-reported balance confidence (ABC), Timed Up and Go Test (TUG) and Berg Balance Scale (BBS) in post stroke drop foot patients.

Methods: Fifteen post stroke drop foot patients were recruited in current study. Read More

Reg Anesth Pain Med 2021 May 14. Epub 2021 May 14.

Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK

Background: The infiltration between the popliteal artery and the capsule of the knee (IPACK) block has been described as an alternative analgesic strategy for knee pain.

Objective: Our aim was to perform a narrative review to examine the place and value that the IPACK block has in comparison to and in conjunction with other regional anesthesia modalities.

Evidence Review: Following an extensive search of electronic databases, we included anatomical studies, letters, comparative observational studies, and non-randomized and randomized controlled trials that examined the IPACK block in relation to surgery on the knee under general or neuraxial anesthesia. Read More

J Clin Orthop Trauma 2021 Jul 19;18:20-24. Epub 2021 Apr 19.

Department of Orthopaedic Surgery, J. N. Medical College, Faculty of Medicine, AMU, Aligarh, UP, India.

Back Ground: Complex gap nonunion of tibia following open fractures and osteomyelitis with pathological fractures in children is a treatment challenge with unpredictable outcome. Treatment options available are bone transport bone grafting, induced membrane technique, allograft reconstruction and Huntington procedure (ipsilateral transposition of vascularized fibula). There is no consensus in the literature about which technique is optimal in the given situation. Read More

Cureus 2021 Apr 8;13(4):e14374. Epub 2021 Apr 8.

Physical Medicine and Rehabilitation, Montefiore Medical Center, Bronx, USA.

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus causing the coronavirus disease 2019 (COVID-19) pandemic is known to lead to the complicated sequelae of severe acute respiratory distress syndrome. Proning has been used as an adjunctive treatment to improve oxygenation in both ventilated and non-ventilated patients. Although patients respond well to this strategy, complications from this arise as well. Read More

PLoS One 2021 12;16(5):e0250965. Epub 2021 May 12.

Sciences and Technologies in Health Post-graduation Program, University of Brasília, Brasília, Federal District, Brazil.

Patellofemoral pain (PFP) is one of the most prevalent injuries in runners. Unfortunately, a substantial part of injured athletes do not recover fully from PFP in the long-term. Although previous studies have shown positive effects of gait retraining in this condition, retraining protocols often lack clinical applicability because they are time-consuming, costly for patients and require a treadmill. Read More

Case Rep Orthop 2021 22;2021:5544126. Epub 2021 Apr 22.

Department of Orthopaedic Surgery, Kochi Prefectural Hata Kenmin Hospital, 3-1 Yoshina, Yamana-cho, Sukumo, Kochi 788-0785, Japan.

Pyogenic facet joint infection (PFJI) is a relatively rare spinal infection. Clinical suspicion of this condition is a key for diagnosis. We report a case of PFJI which required decompression surgery for severe neurological dysfunction. Read More

Foot (Edinb) 2021 Jun 21;47:101778. Epub 2021 Jan 21.

Kırıkkale University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Kırıkkale, Turkey.

Background: Virtual reality exercises (VRE) offers functional, multipurpose usage with a motivational approach. This study aimed to compare VRE and short foot exercises (SFE) in individuals with flexible pes planus.

Methods: Forty participants with pes planus were assigned to the SFE group (n = 20) or VR exercise group (n = 20). Read More

J Exp Orthop 2021 May 6;8(1):36. Epub 2021 May 6.

Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 0368562, Japan.

Purpose: The purpose of this study was to examine the effect of simple core muscle training (CMT) program on trunk muscle strength and neuromuscular control among pediatric athletes.

Methods: Forty-nine male soccer players (mean age, 10.8 years) participated. Read More

Biomed Res Int 2020 21;2020:4809125. Epub 2020 Nov 21.

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China.

Methods: Randomized controlled trials on manual acupuncture treatment of DPN were retrieved from the Medline, Web of Science, PubMed, Cochrane Library, EMBASE, CNKI, WanFang, and VIP databases. Extracted research data were summarized in the tables, and methodological assessment was performed using the risk-of-bias assessment tool of Cochrane. Meta-analysis was performed by Revman 5. Read More

J Orthop Case Rep 2020 May-Jun;10(3):57-59

Department of Spine Services, Indian Spinal Injuries Centre, Delhi, India.

Introduction: Hydatid disease is caused by the parasite Echinococcus granulosus which is also known as the dog tapeworm. This disease is a relatively uncommon cause of spinal cord and dural compression.

Case Report: We came across a peculiar case in a 41-year-old male patient who presented to us with pus discharge from a surgical wound over lower back for 10 days. Read More

Turk J Ophthalmol 2021 04;51(2):127-130

Birjand University of Medical Sciences Valiasr Hospital, Department of Internal Medicine, Birjand, Iran

A 42-year-old man with undiagnosed Churg-Strauss syndrome (CSS) developed bilateral central retinal artery occlusion (CRAO). His medical history included bronchial asthma and irregular prednisolone usage but no atherosclerotic risk factors. At presentation, visual acuity (VA) was hand motion in the right eye and counting fingers in left eye. Read More

Medicine (Baltimore) 2021 May;100(18):e25812

Department of Neurology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Abstract: In this study, multiple-site, cross-sectional area (CSA) reference values were established for major peripheral nerves, including small branches, in the upper extremity of a healthy Asian population.This study included 107 prospectively recruited age-matched, healthy subjects with a mean age of 46 years (range, 24-75 years). All subjects underwent standardized nerve conduction studies for the median, ulnar, peroneal, posterior tibial, and sural nerves. Read More

JBJS Case Connect 2021 05 5;11(2). Epub 2021 May 5.

Singhealth Orthopaedic Residency, Department of Orthopedic Surgery, Changi General Hospital, Singapore, Singapore.

Case: A 63-year-old man underwent L2-S1 decompression and fusion for spinal stenosis. He developed urinary retention postoperatively requiring catheterization. He developed fever, purulence, and foot-drop 8 days postoperatively and underwent debridement with implant retention. Read More

Gait Posture 2021 Jun 15;87:177-183. Epub 2021 Apr 15.

National Rehabilitation Research Institute, National Rehabilitation Center, Seoul, South Korea. Electronic address:

Introduction: Ankle dysfunction in patients with stroke is a common but serious cause of balance and gait impairments. However, comprehensive paretic ankle training seldom exists. Thus, we investigated the effects of a bi-axial ankle muscle training program using visual feedback as a means to improve ankle strength and performance of functional activities in patients with stroke. Read More