Pan Metatarsal Head Resection for Diabetic Forefoot Ulcers

NewsBot · Jun 20, 2012

Members do not see these Ads. Sign Up.
Clinical Efficacy of the Pan Metatarsal Head Resection as a Curative Procedure in Patients With Diabetes Mellitus and Neuropathic Forefoot Wounds
David G. Armstrong, Joseph L. Fiorito, Brian J. Leykum, Joseph L. Mills
Foot Ankle Spec June 19, 2012

Objective. To evaluate the safety and efficacy of the pan metatarsal head resection (PMHR) compared with nonsurgical management of wounds in the forefoot in people with diabetes.

Methods. The authors evaluated 92 patients with diabetes (66.3% male), with ulcers classified as University of Texas grade 1A or 2A at the plantar aspect of the forefoot using a case-control model. Cases were patients treated with multiple metatarsal head resections for multiple metatarsal head wounds, and controls received standard nonsurgical care. Both groups received standard off-loading and wound care. Outcomes included time to healing, reulceration, infection, and amputation.

Results. Patients in the surgery group (SG) healed significantly faster than those in the standard therapy group (ST; 84.2 ± 39.9 days for the ST vs 60.1 ± 27.9 days for the SG; P = .003) and had fewer recurrent ulcers (39.1% for the ST vs 15.2% for the SG; P = .02; odds ratio [OR] = 3.6; 95% confidence interval [CI] = 1.3-9.7) and infections during 1 year of follow-up (64.5% for the ST vs 35.5% for the SG; P = .047; OR = 2.4; 95% CI = 1.0-6.0). There was no significant difference in the proportion of patients receiving an incident amputation in the follow-up period (13.0% for the ST vs 6.5% for the SG; P = .5).

Conclusion. The results of this study suggest that the PMHR may be associated with shorter times to healing and lower morbidity compared with standard care alone in patients without digital gangrene and with multiple plantar forefoot ulcers.
Click to expand...

NewsBot · Jul 14, 2016

Mini-Invasive floating metatarsal osteotomy for resistant or recurrent neuropathic plantar metatarsal head ulcers.
Tamir E et al
J Orthop Surg Res. 2016 Jul 11;11(1):78.

BACKGROUND:
Patients with peripheral neuropathy and pressure under a relatively plantar deviated metatarsal head frequently develop plantar foot ulcers. When conservative management with orthotics and shoes does not cure the ulcer, surgical metatarsal osteotomy may be indicated to relieve the pressure and enable the ulcer to heal. The purpose of this study is to evaluate the use of a mini-invasive floating metatarsal osteotomy in treating recalcitrant ulcers or recurrent ulcers plantar to the metatarsal heads in patients with diabetes mellitus (DM) related neuropathy.
METHODS:
Computerized medical files of patients with diabetic neuropathy treated with an osteotomy during 2013 and 2014 were retrospectively reviewed. There were 20 osteotomies performed on 17 patients (mean age 58 years). The patients had a diagnosis of DM for a mean of 17 years. All ulcers were University of Texas grade 1A; mean ulcer age was 19 months.
RESULTS:
After 17/20 operations, the ulcer completely resolved after 6 weeks and did not recur after a mean follow-up of 11.5 months. One patient developed an early post-operative infection with osteomyelitis at the osteotomy site (proximal shaft of the fifth metatarsal) that needed debridement and IV antibiotics. In the other 19 cases, the surgical wound healed within 1 week. Asymptomatic radiological non-union developed in six cases (30 %).
CONCLUSIONS:
Mini-invasive floating metatarsal osteotomy can cure resistant and recurrent University of Texas grade 1A ulcerations plantar to the metatarsal heads in neuropathic patients.
Click to expand...

NewsBot · Mar 9, 2017

Comparison of Metatarsal Head Resection Versus Conservative Care in Treatment of Neuropathic Diabetic Foot Ulcers
Alireza Kalantar Motamedi, MD, Mohammad Ansari, MD'Correspondence information about the author MD Mohammad AnsariEmail the author MD Mohammad Ansari
JFAS; Article in Press

Complications from diabetic foot ulcers often lead to increased patient morbidity. Much debate still ensues concerning surgical versus conservative management of neuropathic diabetic foot ulcerations. The present study assessed and compared the efficacy of metatarsal head resection and medical approach in the treatment of neuropathic diabetic foot ulcers located at the plantar surface of metatarsal heads. In a retrospective cohort study, 24 consecutive neuropathic diabetic foot ulcers in the lower area of the metatarsal heads that had undergone metatarsal head resection were included as the operative group. For the control group, we included 25 similar ulcers that were scheduled for medical therapy. With respect to postoperative complications, wound healing occurred earlier in the operative group, and the recurrence rate was inversely greater in the medical treatment group. Also, the hospitalization rate was significantly greater in the medical treatment group. Overall, the long-term complication rate was lower in the operative than in the medical treatment group. Also, the infection rate was greater in the medical treatment group than in the operative group. Comparing early and late clinical outcomes of metatarsal head resection surgery and medical treatment showed complete superiority for the surgical approach, and metatarsal head resection is more completely cost beneficial than the medical approach.
Click to expand...

NewsBot · May 7, 2017

Outcomes after foot surgery in people with a diabetic foot ulcer and a 12-month follow-up.
Lenselink E, Holloway S, Eefting D.
J Wound Care. 2017 May 2;26(5):218-227. doi: 10.12968/jowc.2017.26.5.218.

OBJECTIVE:
The aim of this study was to retrospectively measure the outcomes of foot-sparing surgery at one year follow-up for patients with diabetic foot ulcers (DFUs). We assessed wound healing and the need for further surgery in relation to the variables that influence healing.
METHOD:
Data were retrospectively collected by reviewing the electronic files of patients attending the Wound Expert Clinic (WEC). Outcomes of surgical debridement, toe, ray and transmetatarsal amputations were assessed.
RESULTS:
A total of 129 cases in 121 patients were identified for inclusion. The results demonstrated that complete wound healing was reached in 52% (61/117) of the patients within 12 months. The need for additional surgery or for major amputation was 56% (n=72/129) and 30% (n=39/129) respectively. The need for an additional procedure was particularly high after surgical debridement (75%, 33/44) and transmetatarsal amputation (64%, 7/11). Risk factors for non-healing or for a major amputation were: infection (p=0.01), ischaemia (p=0.01), a history of peripheral arterial occlusive disease (p<0.01) and smoking (p=0.01). Additional findings were that not all patients underwent vascular assessment and in half of the patients there was a delay in undergoing revascularisation.
CONCLUSION:
The results of the study reveal some areas for improvement including timely revascularisation and performance of multiple debridement procedures if needed in order to save a limb.
Click to expand...

NewsBot · Nov 8, 2017

Minimally Invasive Distal Metatarsal Diaphyseal Osteotomy (DMDO) for Chronic Plantar Diabetic Foot Ulcers
Carlo Biz, MD, Stefano Gastaldo, MD, Miki Dalmau-Pastor, PhD, PT, DPM, ...
Foot & Ankle International November 7, 2017

Background:
The aims of this prospective study were first to evaluate the safety and effectiveness of minimally invasive distal metatarsal diaphyseal osteotomies (DMDOs) for treating a consecutive series of diabetic patients with chronic plantar diabetic foot ulcers (CPDFUs) and second to assess their clinical-functional and radiographic outcomes.

Methods:
A consecutive series of patients affected by diabetes mellitus with CPDFUs, not responsive to previous nonoperative management, underwent DMDO. The CPDFUs were evaluated using the University of Texas Diabetic Wound Classification System (UTDWC). Demographic parameters, Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS) scores, healing times, and complications were recorded. Maestro et al criteria and bone callus formation were analyzed radiologically. Statistical analysis was carried out (P < .05). Thirty consecutive enrolled patients with a mean age of 66.7 (range, 53-75) years presented 35 CPDFUs with a mean diameter of 16.3 mm and a mean duration of 10.3 months. The most frequent grade of the UTDWC was IIIB (42.9%).

Results:
All ulcers recovered with a mean healing time of 7.9 ± 4.0 (range, 4-17) weeks. AOFAS scores improved significantly from 55.3 to 81.4 points (P < .001). At a mean follow-up of 25.3 months (range, 18-71), no cases of ulcer recurrence were recorded, while a major complication or a wound infection required longer healing time.

Conclusion:
Minimally invasive DMDO was a safe and effective method in promoting CPDFU healing, regardless of the grade of severity, by the reduction of the high plantar pressure under the metatarsal heads. This technique improved functional and radiographic outcomes with few complications.
Click to expand...

NewsBot · Dec 22, 2018

Metatarsal Osteotomies for Treating Neuropathic Diabetic Foot Ulcers: A Meta-analysis.
Yammine et al
Foot Ankle Spec. 2018 Dec 19

Diabetic foot ulcers (DFUs) are usually treated with conservative management based on debridement, topical agents, and nonsurgical off-loading; however, the recurrence rate following such standard care is reported to be high. In the case of recalcitrant or recurrent ulcers, a surgical off-loading technique such as the metatarsal osteotomy (MO) is indicated. Thus, the aim of this study is to conduct a meta-analysis evaluating the efficacy of MO in treating DFUs. Four relevant studies were identified, including 119 patients with 129 DFUs; all wounds were refractory to a previous conservative treatment of a mean duration of 10.9 ± 4.2 months. With a mean follow-up period of 18.2 ± 5.7 months, the weighted pooled rates were as follows: 98.7% for ulcer healing (in a mean time to heal of 6.5 ± 1.2 weeks), 4.3% for ulcer recurrence, 10.3% for ulcer transfer, 3.7% for infection, and 3.4% for nonunion. These findings were found to be noticeably better than those reported in the literature following standard care, whether associated or not to nonsurgical off-loading methods and that for all the studied outcomes. Knowing the dismal natural history of recalcitrant DFUs treated conservatively, the results of the MO techniques seems to offer a promising alternative in terms of ulcer healing and ulcer complications. In addition to complicated wounds, the indications for MO could include noncomplicated ulcers with healing delay.
Click to expand...

NewsBot · Dec 27, 2018

Complications associated with the approach to metatarsal head resection in diabetic foot osteomyelitis
Aroa Tardáguila‐García Irene Sanz‐Corbalán Raúl J. Molines‐Barroso Francisco J. Álvaro‐Afonso Yolanda García‐Álvarez José L. Lázaro‐Martínez
Int Wound Jnl: 26 December 2018

The aim of this study was to evaluate the recovery time and the development of complications in the dorsal and plantar approach to metatarsal head resections (MHR) in patients with diabetic foot ulcers complicated by osteomyelitis. A retrospective study was carried out involving 108 patients who underwent MHRs for the treatment of diabetic foot osteomyelitis. Two cohorts were defined: dorsal approach with incision closed with sutures and plantar approach with ulcer healed using conservative treatment. The main outcomes were the weeks until healing and complications related to the approaches. Fifty‐three patients (49.1%) underwent a plantar approach and 55 (50.9%) a dorsal approach. Both approaches rendered similar healing times. However, the patients undergoing a dorsal approach developed more post‐surgical complications than patients treated through a plantar approach. The dorsal approach intervention was performed on smaller and shallower ulcers; however, more complications developed at follow up using this approach than through a plantar approach for MHR complicated with osteomyelitis.
Click to expand...

NewsBot · Nov 25, 2019

Surgical Offloading Techniques Should be Used More Often and Earlier in Treating Forefoot Diabetic Ulcers: An Evidence-Based Review
Kaissar Yammine MD, MPH, PhD, Chahine Assi, MD
International Journal of Lower Extremity Wounds November 20, 2019

Conservative treatment is the basis for diabetic foot ulcer (DFU) management, whereas surgical treatment is usually reserved for patients with failed, recurrent, or nonresponsive infected wounds. However, many reports demonstrated good to excellent results following surgery. Evidence synthesis on surgical offloading techniques and clear guidelines regarding the timing of surgery are lacking. The present study aimed to investigate the evidence behind surgical offloading techniques and propose a cutoff time for surgical indication following failed conservative treatment of neuropathic diabetic forefoot ulcers. Electronic databases were searched from inception to identify the best evidence level articles related to non-vascular surgical treatment of DFUs, such as metatarsal head resection, resection arthroplasty, metatarsal osteotomy, Achilles tendon lengthening, gastrocnemius recession, and flexor tenotomy, that have been employed for managing DFUs. Based on the highest level of evidence available, surgery was found to generate better values than standard conservative care for all outcomes except for the transfer rate. In particular, surgical bony offloading procedures demonstrated significantly better outcomes than standard conservative nonsurgical care in terms of higher healing rates, shorter healing durations, and lower recurrence rates. Moreover, 96% of DFUs healed in <1 month following surgical bony offloading, whereas 68% of ulcers healed within 3 months after standard care. The findings could challenge the classical guidelines of DFU management. This evidence-based review indicates that surgical offloading could be used more often and be proposed earlier during the course of ulcer management. The results imply that a period of 12 weeks could be considered a reasonable cutoff value to consider surgical treatment for patients with nonhealing DFUs.
Click to expand...

NewsBot · Dec 14, 2019

Assessment of Outcomes of a Metatarsal Bone Ostectomy for Chronic Plantar Ulcers: A Preliminary Study.
Chiu WK et al
Ann Plast Surg. 2020 Jan;84(1S Suppl 1):S112-S115

BACKGROUND:
Clinical management of chronic plantar ulcers is a difficult issue in medical practice. Pressure overloading is a problem that needs to be resolved. Herein, we report a surgical method to reduce plantar pressure: a dorsal approach to a metatarsal ostectomy.

METHODS:
From March 2011 to October 2016, 16 patients suffering from chronic plantar ulcers underwent ostectomy procedures at Taipei Wan-Fang Municipal Hospital (Taipei Medical University). A bone segment about 0.5 to 1 cm long was removed via a dorsal foot approach. The plantar wound was treated with debridement only or was simultaneously covered with a skin graft. In total, 16 patients with an average age of 57.81 (SD, 11.6) years (12 males and 4 females) were included; 15 patients (93.75%) had a diagnosis of type 2 diabetes for a mean of 20.66 years (range, 5-30 years). The mean glycated hemoglobin was 9.14 g/dL (range, 5.2-13.2 g/dL). The mean plantar wound size was 5.72 cm. Four patients (25%) needed to receive a skin graft with a mean skin graft size of 8.13 cm.

RESULTS:
The mean follow-up time was 15.2 months. The plantar wounds completely healed in 14 patients (87.5%) in an average of 2.14 months. No plantar ulcer was complicated with recurrence, but transfer ulcers developed in 2 patients (12.5%) at an average of 7.5 months postoperatively.

CONCLUSIONS:
Metatarsal ostectomy surgery via a dorsal foot approach is an efficient way to reduce pressure overloading of chronic plantar wounds. Our study provides an alternative method to treat this difficult problem with a high wound healing rate and less recurrence.
Click to expand...

NewsBot · Jun 10, 2020

Determinants of Success After Metatarsal Head Resection for the Treatment of Neuropathic Diabetic Foot Ulcers
Alireza Kalantar Motamedi, MD & Mohammad Ansari Kalantar Motamedi, MD
JFAS: June 09, 2020

Metatarsal head resection (MHR) is an effective option for the treatment of nonhealing neuropathic diabetic foot ulcers. The present study aimed to identify factors that predict treatment success for neuropathic diabetic foot ulcers undergoing metatarsal head resection. In this prospective interventional case series, 30 consecutive diabetic patients with documented nonischemic neuropathic plantar diabetic foot ulcers beneath the metatarsal head who underwent MHR were included. The study endpoint was demographic indicators of early and late postoperative outcomes. Patients were followed up for 1 to 66 months (mean 37.6 months). Except for 1 patient, all subjects’ wounds (96.6%) healed after metatarsal head resection within an average of 35 days. One of the operated patients (3.4%) suffered short-term complications; long-term complications occurred in 23.3% of the patients. One patient (3.4%) experienced ulcer recurrence, 3 patients (10%) developed wound infection, and transfer lesions occurred in 3 other patients (10%) during the follow-up period. Using 3 estimators including ordinary least squares (OLS), White's heteroscedastic standard errors, and bootstrapping procedure, we could not find any statistically significant demographic feature related to ulcer healing. Using regression modeling, we could not find any evidence for a role of age, sex, weight, height, BMI, duration of ulcer until MHR, and duration of diabetes mellitus (years since diabetes diagnosis) affecting the outcome of MHR. Hence, demographic features, duration of ulcer until MHR, and years with diabetes did not affect the outcome of MHR. In conclusion, the authors believe that MHR will have a high rate of success for neuropathic wound healing in this specific subset of patients regardless of demographic features, as long as there is no ischemia to impair healing by secondary intention.
Click to expand...

NewsBot · Sep 4, 2020

Meta-analysis of the outcomes of metatarsal head resection for the treatment of neuropathic diabetic foot ulcers.
Prof. Kaissar Yammine, Dr. Nadim Kheir, and Prof. Chahine Assi
Advances in Wound Care:1 Sep 2020

Significance: Diabetic foot ulcers (DFUs) are associated with high morbidity, mortality, and health costs. Standard care (SC) associated with nonsurgical offloading is the mainstay treatment for DFUs, but it has high recurrence and infection rates. Metatarsal head resection (MHR) has been proposed as an effective surgical offloading technique for the treatment of plantar neuropathic DFUs, but with no evidence synthesis yet. Recent Advances: Based on PRISMA guidelines, a meta-analysis was conducted to assess the efficacy of MHR. Four electronic databases were searched for. Eleven studies met the inclusion criteria with a total of 477 patients (494 feet and 593 neuropathic forefoot ulcers). The studies included 3 retrospective comparative studies and 8 case-series. Critical Issues: Meta-analytical results of comparative studies on recent non-infected DFUs showed MHR having significantly better rates of healing, time to healing, ulcer recurrence, and infection than SC. Failure to heal, recurrence, and infection rates were 4 times higher in the SC group than in the MHR group, and the amputation rate was two times higher in the SC group than in the MHR group. The outcomes of the meta-analysis of case-series on chronic and recalcitrant ulcers treated with MHR were similar. Future Directions: Considering the natural history of DFUs treated conservatively and the satisfactory outcomes with a significantly low complication rate of MHR, physicians should consider the use of MHR more often and include this technique in the early management of DFUs.
Click to expand...

NewsBot · Dec 7, 2020

Metatarsal Head Resection Versus a Removable Mechanical Device for Offloading of the Neuropathic Diabetic Plantar Forefoot Ulcer
Ahmed H Elbarbary et al
Int J Low Extrem Wounds. 2020 Nov 23

Although surgical offloading seems a more permanent solution for prevention and treatment of neuropathic plantar diabetic forefoot ulcers (DFUs), the evidence for this assumption is weak and needs further studies to be established. The aim of this retrospective study is to compare the healing efficacy, associated morbidity, and recurrence rates of surgical versus removable knee-high offloading for neuropathic plantar (DFUs) healing. From January 2016 to January 2018, 70 neuropathic plantar forefoot DFUs were nonrandomly assigned to either removable knee-high cam-walker (n = 35), or metatarsal head, or accessory bone resection (n = 35). The primary endpoints were the frequency and rate of complete healing, and the rate of ulcer area reduction within 4 months. The secondary endpoints were 4 months morbidity and ulcer recurrence within 12 months. After 4 months, complete healing was significantly inferior with cam-walker compared with surgical offloading; 24 (67.6%) versus 31 patients (88.6%), respectively, P = .015. Ulcer area reduction was 2.4 cm2 (66.7%) versus 2.6 cm2 (83.9%), P = .001, in the mechanical versus the surgical groups, respectively. The mean healing time was 3.6 ± 2.1 versus 2.8 ± 0.6 months in the mechanical versus the surgical groups, respectively, P = .012. Morbidity and recurrence show nonsignificant differences between both groups. Ulcer recurrence was noted in 5/35 (14.3%) versus 2/35 (5.7%), in mechanical versus surgical groups, respectively, P = .23. Therefore, metatarsal head/accessory bone resection offered improved healing efficacy but similar morbidity and recurrence to the removable cam-walker.
Click to expand...

NewsBot · Jun 3, 2021

Analysis of Plantar Pressure Pattern after Metatarsal Head Resection. Can Plantar Pressure Predict Diabetic Foot Reulceration?
Marta García-Madrid et al
J Clin Med. 2021 May 24;10(11):2260

To evaluate the metatarsal head that was associated with the highest plantar pressure after metatarsal head resection (MHR) and the relations with reulceration at one year, a prospective was conducted with a total of sixty-five patients with diabetes who suffered from the first MHR and with an inactive ulcer at the moment of inclusion. Peak plantar pressure and pressure time integral were recorded at five specific locations in the forefoot: first, second, third, fourth, and fifth metatarsal heads. The highest value of the four remaining metatarsals was selected. After resection of the first metatarsal head, there is a displacement of the pressure beneath the second metatarsal head (p < 0.001). Following the resection of the minor metatarsal bones, there was a medial displacement of the plantar pressure. In this way, plantar pressure was displaced under the first metatarsal head following resection of the second or third head (p = 0.001) and under the central heads after resection of the fourth or fifth metatarsal head (p < 0.009 and p < 0.001 respectively). During the one-year follow-up, patients who underwent a metatarsal head resection in the first and second metatarsal heads suffered transfer lesion in the location with the highest pressure. Patients who underwent a minor metatarsal head resection (second-fifth metatarsal heads) showed a medial transference of pressure. Additionally, following the resection of the first metatarsal head there was a transference of pressure beneath the second metatarsal head. Increase of pressure was found to be a predictor of reulceration in cases of resection of the first and second metatarsal heads.
Click to expand...

NewsBot · Aug 2, 2021

Analysis of Plantar Pressure Pattern after Metatarsal Head Resection. Can Plantar Pressure Predict Diabetic Foot Reulceration?
Marta García-Madrid et al
J. Clin. Med. 2021, 10(11), 2260

To evaluate the metatarsal head that was associated with the highest plantar pressure after metatarsal head resection (MHR) and the relations with reulceration at one year, a prospective was conducted with a total of sixty-five patients with diabetes who suffered from the first MHR and with an inactive ulcer at the moment of inclusion. Peak plantar pressure and pressure time integral were recorded at five specific locations in the forefoot: first, second, third, fourth, and fifth metatarsal heads. The highest value of the four remaining metatarsals was selected. After resection of the first metatarsal head, there is a displacement of the pressure beneath the second metatarsal head (p < 0.001). Following the resection of the minor metatarsal bones, there was a medial displacement of the plantar pressure. In this way, plantar pressure was displaced under the first metatarsal head following resection of the second or third head (p = 0.001) and under the central heads after resection of the fourth or fifth metatarsal head (p < 0.009 and p < 0.001 respectively). During the one-year follow-up, patients who underwent a metatarsal head resection in the first and second metatarsal heads suffered transfer lesion in the location with the highest pressure. Patients who underwent a minor metatarsal head resection (second–fifth metatarsal heads) showed a medial transference of pressure. Additionally, following the resection of the first metatarsal head there was a transference of pressure beneath the second metatarsal head. Increase of pressure was found to be a predictor of reulceration in cases of resection of the first and second metatarsal heads.
Click to expand...

NewsBot · Sep 19, 2022

Radiographic Bone Healing in Minimally Invasive Floating Metatarsal Osteotomy for Neuropathic Plantar Metatarsal Head Ulcers - A Retrospective Cohort Study
Eran Tamir et al
Int J Low Extrem Wounds. 2022 Sep 14;15347346221126004

Minimally invasive floating metatarsal osteotomy is an option for treating neuropathic ulcers under the metatarsal heads. This study presents the radiographic results of the floating metatarsal osteotomy. We reviewed files and radiographs at least 4 months after a floating metatarsal osteotomy in patients with diabetic neuropathy. In 71 osteotomies in 54 patients with late onset diabetes (mean age 61 ± 9, mean HbA1c 7.9 ± 1.9%), the primary ulcer healed within 3.5 ± 1.4 weeks. Of 66 osteotomies where radiographs were available 10 had non-union (15%, all asymptomatic), 15 (23%) had hypertrophic callus formation and 41 (62%) had normal union. One patient developed an ulcer under the hypertrophic callus. This necessitated callus resection. Asymptomatic non-union may happen in 15% of floating osteotomies, but the osteotomies appear to be relatively safe and effective for neuropathic plantar metatarsal head ulcers. Hypertropic callus causing local re-ulceration is rare and can be managed surgically.
Click to expand...

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

NewsBot The Admin that posts the news.

Abdominal pain with lower leg discrepancy

Limb Length Discrepancy After Total Hip Joint Replacement Surgery Treated With Heel Lifts

Participant eligibility criteria used in plantar heel pain research

The walk of Japanese children develops differently from children in other countries

Long term impact of the COVID-19 pandemic on the education of Podiatry students

Limb Length Discrepancy

Establishment of Japan’s First “Podiatry Medicine Center” in a University Hospital

Share This Page