Podiatrists often design custom inserts to change a patient’s mechanics in some way to help their lower extremity problems. Sometimes that correction is direct, such as offloading a sore area with a horseshoe-shaped blue pad. Sometimes the correction is indirect, like the white metatarsal pad to help center the foot. For instance, I had a recent patient for whom I made three adjustments to a pair of over-the-counter (OTC), drugstore-style insoles.

Throughout the COVID-19 pandemic, the use of telehealth visits has skyrocketed in an attempt to limit the spread of the virus. And due to its popularity, the continued use of telehealth is expected. However, while telehealth can be effective in many areas, there are limitations when it comes to characterizing changes in physical function such as gait. Methods traditionally used to quantify physical function and gait require trained personnel and often specialized equipment that is found within the clinic or laboratory setting.

Subtalar instability remains a topic of debate, and its precise cause is still unknown. The mechanism of injury and clinical symptoms of ankle and subtalar instabilities largely overlap, resulting in many cases of isolated or combined subtalar instability that are often misdiagnosed. Neglecting the subtalar instability may lead to failure of conservative or surgical treatment and result in chronic ankle instability. Understanding the accurate anatomy and biomechanics of the subtalar joint, their interplay, and the contributions of the different subtalar soft tissue structures is fundamental to correctly diagnose and manage subtalar instability.

Ankle Charcot deformity can occur after midfoot Charcot reconstruction, especially when patients present with hindfoot varus or pre-existing ankle instability. The osseous reconstruction consisting of midfoot intramedullary beaming and adjunctive procedures such as subtalar joint fusion influences the biomechanics of the ankle joint. In patients with preoperative hindfoot varus or ankle instability, the frontal plane deformity at the subtalar joint could predispose to excessive forces through the collateral ligaments of the ankle joint complex.

 

The CFPM can post a job posting to reach the chiropody/podiatry community. This service is FREE for all CFPM members and $150 for non-members (for a 30 day posting).