Shoes Research Articles

Reconstruction of extreme post-burn scar contracture of the ankle using a thoracodorsal artery perforator flap: a case report

Post-burn scar contracture associated with deep second-degree or higher burns in the joint area can lead to joint immobility and may cause chronic ulcers, substantially impacting patients’ quality of life. Surgical intervention is necessary, with local flaps or skin grafts being the first option. In extreme cases, free flap transfer may be required to address large defects that occur after contracture release. This study presents a successful case of reconstruction using free flap transfer in a patient with severe post-burn scar contracture, which resulted in a club-like deformed ankle with a nonfunctional joint. Despite the extreme deformity and nonfunctioning joint, we utilized a thoracodorsal artery perforator flap to stably cover the newly fused joint in a neutral position. After reconstruction, the patient was able to wear shoes and ambulate. This case highlights the potential of free flap transfer even in the most challenging situations where joint function is severely compromised.

Design and development of fused deposition modeling (FDM) 3D-Printed Orthotic Insole by using gyroid structure

The orthotic insole is a device that is placed between the bottom of the foot and the sole of the shoe. It bears the body weight and directly influences the biomechanics of the foot and the body. These insoles are used to minimize the stress by reducing plantar pressure between support points hence minimizing the pressure. Such customized insoles have usually been produced by either handmade or subtractive methods. Fused deposition modeling (FDM) has opened innovative ways for the manufacture of orthotic insoles. In recent studies, no specific computer-aided design (CAD) tools are available to design and manufacture the insole, which is the primary focus. This work aims to evaluate established CAD techniques for designing and fabricating insoles utilizing different manufacturing processes. The evaluation is based on a prior analysis of the possibilities for functionalizing insole materials and structures. In this study, multiple software tools are utilized for designing custom insoles, considering pressure points and a three-dimensional (3D) foot scan of an individual. The research highlights how the implementation of software enables a significant level of customization by integrating pressure mapping data into the insole design process. A novel CAD approach for designing an orthotic insole has been provided in this work. Soft poly-lactic acid (PLA) is used to fabricate an insole using FDM technology. The gyroid and solid samples were evaluated following ASTM standards. When compared to the solid construction, the gyroid structure has a high specific energy absorption capability, which is used to create the orthotic insole. The results of the experiment suggest that the selection of the structure for customized insole design is significantly affected by the infill density parameter.

Effects of custom insoles for symptomatic hallux valgus: protocol for a sham-controlled randomised trial

IntroductionHallux valgus (HV) is one of the most prevalent forefoot deformities, and its frequency increases with age, reaching nearly 23% in adulthood (females are usually more affected). Studies on customised...

Acquired Hallux Varus Deformity Correction: Pivotless Distraction Technique.

Acquired hallux varus deformity secondary to postburn contracture is a rare condition. It causes cosmetic disfigurement, pain, and inability to wear a shoe. Soft-tissue procedures and tendon transfers have been described for correction; however, these may require multiple operations and the outcome may be poor. We report a 6-year-old neglected case of hallux varus deformity secondary to burn contracture successfully managed by contracture release with pivotless distraction technique using a biplanar distractor and skin grafting with Z-plasty in the same procedure. The deformity was corrected to a lesser extent and with good functional outcomes. The scar was excised and Z-plasty was performed. The medial joint capsule was released. We used gradual differential distraction with monitoring on sequential radiographs. Pain-free flexion of 45° and extension of 40° were achieved and the patient was able to wear shoes after 4 weeks postoperatively. Hallux varus is a multidimensional deformity. A severe and rigid deformity might not respond well to tendon transfers in a single stage. Our described technique can be used to correct rigid hallux varus deformity with preservation of joint function.

Investigation of the Effectiveness of Plantar Pressure Redistribution of Customized Insole Structure Designed Based on Plantar Structure

Although both fabricated insoles and customized insoles were designed with varied function components, current knowledge approved that customized insoles worked much better. However, how the customized insoles achieved a better performance in term of load re-distribution was still lacking quantitative assessment. The aim was to determine whether the customized insole structure based on a novel customization procedure proposed in this study performs better than the prefabricated insoles in terms of plantar pressure re-distribution efficiency. This study included ten healthy subjects, each wearing four types of insoles accordingly (control insoles; arch support insoles; orthotic insoles; customized insoles), and plantar pressure was collected in a walking state. The custom insoles are made by determining the subject’s plantar surface and key plantar points, then following the customization procedure to finish them. The plantar area was divided into eight zones and then a pressure transfer algorithm was used to gain insight into the plantar pressure. Compared to the control group insoles, the arch support of the customized insoles reduced pressure in the hallux region and transferred pressure from the M4-5 to the MH and LH regions, while the metatarsal pad enhanced the pressure transfer in the mid-foot, and the anterior-posterior height difference of the insole plays a role in pressure transfer. Furthermore, the customized insoles performed close to the professional orthotic insoles. Design strategy with accurate insole’s component location and reasonably plantar surface matching, our customized insole demonstrated advantages such as a better loading redistribution and significant pressure relieving on the forefoot.

Present Pasts of Colonial Modernity: Embroideries by Lucie Kamuswekera

Present Pasts of Colonial Modernity: Embroideries by Lucie Kamuswekera

ID: 219222 Peripheral Nerve Stimulation for Refractory Plantar Fibromatosis Pain: A Case Report and Literature Review

41-year-old man was referred by orthopedics to the outpatient pain clinic with history of chronic bilateral plantar heel pain and a diagnosis of plantar fibromatosis following diagnostic ultrasound evaluation. He had failed numerous non-operative treatments including shoe wear modification, orthoses, physical therapy, acupuncture, shock wave therapy, ultrasound guided corticosteroid injection, and percutaneous needle tenotomy. Upon initial consultation, the patient endorsed a 5-year history of bilateral medial plantar heel pain, provoked with weight bearing activities. He denied paresthesias and weakness. Given his refractory symptoms joint the decision was made to proceed with a diagnostic block of his more symptomatic side with goal to pursue bilateral percutaneous 60-day peripheral nerve stimulator placement if he experienced a favorable response. Diagnostic target was the left tibial nerve just proximal to the medial malleolus and prior to its division into plantar and calcaneal branches. Diagnostic injectate consisted of 2cc 1% lidocaine and 5mg of dexamethasone for a total volume of 2.5cc. Patient rated his pain 8/10 prior to injection and 0/10 following. He subsequently underwent placement of dual peripheral nerve stimulators targeting the bilateral tibial nerves with implantation 5cm proximal to the medial malleoli. At 60 day follow up, the device was explanted. The patient was no longer tender with palpation of either foot. He reported 50% reduction compared to pre-operative pain, significant improvement in his quality of life and physical functioning, and a reduction in oral analgesic regimen. The patient is currently awaiting permanent stimulator placement.

Effects of customized insoles with medial wedges on lower extremity kinematics and ultrasonographic findings in plantar fasciitis persons

The customized insole is widely recommended as an effective intervention for pain reduction and foot function improvement in plantar fasciitis persons. However, it is unclear whether the additional correction of medial wedges could change the kinematics from the only insole. The objectives of this study were thus to compare customized insoles with and without medial wedges on lower extremity kinematics during gait and to determine the short-term effects of the customized insole with medial wedges on pain intensity, foot function, and ultrasonographic findings in plantar fasciitis persons. A within-subject, randomized, crossover design within motion analysis research laboratory was conducted among 35 persons with plantar fasciitis. Main outcome measures included joint motions of the lower extremity and multi-segment foot, pain intensity, foot function, and ultrasonographic findings. The customized insole with medial wedges produced less knee motion in the transverse plane and hallux motion in all planes during the propulsive phase than that without medial wedges (all p < 0.05). After the 3-month follow-up, the insoles with medial wedges decreased pain intensity and increased foot function. Abnormal ultrasonographic findings also decreased significantly after the 3-month treatment of insoles with medial wedges. Customized insoles with medial wedges seem superior to those without medial wedges on both multi-segment foot motion and knee motion during propulsion. Positive outcomes from this study supported the use of customized insoles with medial wedges as an effective conservative treatment in patients with plantar fasciitis.Trial registration: TCTR20210928006 (28/09/2021).

Is there an association between plantar fasciitis and knee osteoarthritis?

Knee osteoarthritis (OA) and plantar fasciitis share similar risk factors including ageing, occupation, obesity, and inappropriate shoe wear. However, the association between knee OA and heel pain caused by plantar fasciitis has received limited attention to date. We aimed to assess the prevalence of plantar fasciitis using ultrasound in patients with knee OA and to identify factors associated with plantar fasciitis in these patients. We conducted a cross-sectional study including patients with Knee OA, fulfiling the European League Against Rheumatism criteria. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and the Lequesne indexes were used to evaluate pain and function of the knees. The Manchester Foot Pain and Disability Index (MFPDI) was used to estimate foot pain and disability. Each patient underwent a physical examination, plain radiographs of the knees and the heels, and an ultrasound examination of both heels to find signs of plantar fasciitis. Statistical analysis was performed using SPSS. We included 40 knee OA patients, with a mean age of 59.85±9.65years [32-74] and a male-to-female ratio of 0.17. The mean WOMAC was 34.03±19.9 [4-75]. The mean Lequesne for knees was 9.62±4.57 [3-16.5]. Among our patients, 52% (n=21) experienced heel pain. The heel pain was severe in 19% (n=4). The mean MFPDI was 4.67±4.16 [0-8]. Limited ankle dorsiflexion and plantar flexion were noted in 47% of patients (n=17) each. High and low arch deformities were seen in 23% (n=9) and 40% (n=16) of patients. Ultrasound revealed a thickened plantar fascia in 62% (n=25). An abnormal hypoechoic plantar fascia was noted in 47% (n=19), with the loss of normal fibrillar architecture in 12 cases (30%). No Doppler signal was exhibited. Patients with plantar fasciitis had significantly limited dorsiflexion (n=2 (13%) versus n=15 (60%), p=0.004) and plantar flexion (n=3 (20%) versus n=14 (56%), p=0.026). The range of supination was also less important in the plantar fasciitis group (17.73±4.1 vs. 12.8±6.46, p=0.027). The low arch was statistically more present in patients with plantar fasciitis (G1: 36% [n=9] vs. G0: 0% [n=0], p=0.015). However, the high arch deformity was statistically more present in patients without plantar fasciitis (G1: 28% [n=7] vs. G0: 60% [n=9], p=0.046). Multivariate analysis showed that the risk factor for plantar fasciitis in knee OA patients was limited dorsiflexion (OR=3.889, 95% CI [0.017-0.987], p=0.049). In conclusion, our work showed that plantar fasciitis is frequent in knee OA patients, with reduced ankle dorsiflexion being the main risk factor for plantar fasciitis in these patients.

CLINICO- RADIOLOGICAL OUTCOME OF IDIOPATHIC CONGENITAL TALIPES EQUINOVARUS FOLLOWING PONSETI TECHNIQUE

Introduction: Idiopathic clubfoot or congenital talipes equinovarus is the most common orthopedic congenital deformity. Club foot affects roughly one in every 1000 live births, and it is bilateral in about half of the cases. The four components of a congenital club foot are cavus, adduction, varus, and equinus. The treatment's purpose is to address four abnormalities and keep them corrected so that the patient can have a functional, pain-free plantigrade foot. Aims: To identify the minimum set of outcomes that should be collected in clinical practice and reported in research related to the care of children with idiopathic congenital talipes equinovarus (CTEV). Materials and Methods: The present study was a Observational study. This Study was conducted from 03/08/2005 to 02/08/2007 at Ramakrishna Mission Seva Pratishthan, Vivekananda Institute of Medical Sciences. Total 37 patients were included in this study. Result: we found that a relatively low clinical outcome as compared to ndings by other authors who have reported excellent treatment outcomes that have ranged from 82.4% to 97% and In this study 62.6% of the patients reported no pain, an evidence of good functional outcomes associated with the Ponseti conservative method of treatment compared to the surgical soft tissue release. Conclusion: The functional outcomes are equally good with the majority of patients reporting no pain, being able to wear shoes of their liking and having no limitation during walking or running. This is a sign of an improved life style and quality of life and correlates with good patient and caregiver satisfaction.

Long-term vertical stability of horseshoe osteotomy for the correction of large vertical excess of the maxilla, a retrospective assessment in 15 patients

IntroductionVertical stability after a Le Fort I (LF1) osteotomy with substantial upward movement can be compromised by the position and the volume of the inferior turbinate. A horseshoe (HS) osteotomy represents then an alternative as it preserves the hard palate and the intranasal volume. The aim of this study was to assess the vertical stability of the maxilla after HS osteotomy. Materials and methodsPatients who underwent a HS osteotomy for the correction of long-face syndrome were retrospectively analyzed. The vertical stability was assessed on lateral cephalograms performed preoperatively (T0), immediately postoperatively (T1), and at the last follow-up (T2) by studying points C (the distal cusp of the first maxillary molar), point P (the prosthion, the lowest edge of the maxillary alveolus of the central incisor), and point I (the upper central incisor edge) in a coordinate system. Postoperative complications and aesthetics of the smile were also investigated. ResultsFifteen patients were included (7 females, 8 males, mean age 25.5 ± 9.8 yeras). The mean impaction ranged from 5 mm on point P to 6.1 mm on point C, with a maximal movement of 9.5 mm. A non-significant relapse of 0.8 ± 1.7, 0.6 ± 0.8, and 0.5 ± 1.8 mm was observed after a mean 20.7 months on point C, P, and I respectively. Smile parameters were significantly improved by the procedure, mainly regarding the correction of the gum smile. ConclusionHS osteotomy represents a good alternative to total LF1 osteotomy for substantial maxillary upward movement in long face syndrome deformities.

Ovarian Inguinal Hernia in 1-Month-Old Girl with Horseshoe Kidney

Herniation of the ovaries is a rare congenital anomaly that may be complicated by strangulation, torsion, and infertility. Female pelvic structures such as the ovaries, fallopian tubes, ligaments, and uterus can rarely enter inside a hernial sac. The Aim of this review was to emphasise the fact that early intervention can save ovary from complication and infertility of the patient. A systematic search was conducted from literature published up to 2013 using the Google Scholar™ databases along with the references of the full-text articles retrieved. Papers on observational studies and case reports concerning ovaries in the inguinal canal were considered eligible for inclusion in the review. Seventeen papers comprising 24 patients (mean age45.5) were evaluated. A left-sided hernia was noted in 18 cases (75%) whereas 4 patients had a right-sided hernia(25%).This case is unique in its existence because of age of presentation (0ne Month) and comormids of horse shoe kidney. Ovarian inguinal hernias can present as early as on day one of birth. Thorough history and examination followed by investigations can lead to prompt and adequate treatment. In women of reproductive age, repair of the hernia with the intent to preserve fertility is of critical importance.

A STUDY ON PREVALENCE OF IDIOPATHIC FLATFOOT IN ADOLESCENTS OF NORTH EAST INDIA

Introduction: “Pes planus” commonly known as “atfoot” is characterised by sagging of medial longitudinal arch with secondary hind foot valgus, forefoot abduction and supination relative to hind foot. Idiopathic type of atfoot is physiological and there is a lack of clear consensus about the maximum limit of age for its persistence. Assessment of medial longitudinal arch can be done either on clinical grounds or based on radiological evidences. Foot prints can be easily obtained with simple ink print method. They are simple, fast, inexpensive and non-invasive way to assess the arches of foot. The present study was conducted over a Materials and methods: period one year under Department of Orthopaedics, Assam Medical College &amp; Hospital. In this community based cross sectional study, 800 school going children of age group 10 to 15 years were included. Bilateral footprints of all children were taken using simple ink print method. Results and Observations: The Staheli's PAI value ≥ +2SD from the mean was regarded as threshold index for atfoot in either feet. The cut off in left foot was PAI value ≥1.29 and for right foot it was ≥1.18 to dene atfoot. Number of children with normal foot was 704 (88%) compared to 72 children (9%) with atfoot. 3% of children had high arched foot. There is a signicant c Discussion and conclusion: orrelation in terms of persistence of atfoot in adolescents with obesity, faulty shoe wearing practices and children belonging to higher socio-economic groups. Though exible atfoot is self correctable but proper cut off age by which it resolves is still a matter of debate

‘I have to like it’: Working-class awareness among workers at a Bata shoe factory

The working class has been interpreted within various disciplines and conceptual frameworks, some pointing to the gap between the depiction of the working class as a potentially active social force in the neoliberal deregulated global market and its portrayal as a suffering class of the marginal and excluded. In this text, I move behind this dichotomy to explore the everyday experiences of working-class men and women. Based on ethnographic research at the Bata shoe factory in the Czech Republic, I examine the meanings factory workers attach to their working classness. I investigate their sense of place in society in general. I argue that class matters in the workers’ perceptions of the self. On the one hand, the workers adopt the awareness of subalternity in relation to the educational and further the labor field that ranks them among the lowest positions. On the other hand, they take individual pride in their endurance of the hard work that shoemaking is believed to be. The committed work and emphasis on collectivity turn the microorganism of the factory into a place of mutual discipline, where the praised collectivity functions also as a tool for enhancing work effectivity, also in the interest of the management. By pointing to the concrete dimensions in which they balance the feelings of pride and shame, belonging, and symbolic displacement, I contribute to the sociological understanding of contemporary working classness.

WORK STUDY (MOTION AND TIME STUDY) IN THE GENERAL ESTABLISHMENT FOR LEATHER INDUSTRIES (AS AN APPLIED MODEL)

The study of work has a direct relationship to productivity and is usually used to increase the amount of production with a limited amount of resources without resorting to additional investments except in some cases and on a small scale. Studying work as one of the methods that lead to raising productivity, as the principles of work study were applied to one of the industrial facilities, specifically in (the leather shoes factory in the eastern Karadat) - Factory No. (1) of the General Establishment for Leather Industries, and a study of movement and time was conducted on a linear basis Separation and sewing of shoe model (701) women's textile shoes, and there were several savings and differences between the current method of work and the proposed method. Removing bottlenecks and not removing the basic processes for manufacturing the product with the most important recommendations.

Intelligent Braking System Using Electromagnetic Actuators

The accident prevention has been one of the leading areas of research today. Our paper is designed to prevent accidents due to loss of control, drunken driving, and rash driving, using circuitry aided by a microcontroller kit. This paper focuses on a system known as 'Intelligent braking system' (IBS) which employ several sensors to respond when emergency conditions occur. In our work, braking distance and the distance of the obstacle are taken into consideration along with the speed of the vehicle. The sensor detects speed of movement of the vehicle and the ultrasonic sensor senses the distance of the object in front of vehicle. These sensors provide real- time inputs to the microcontroller program. Using sensor, the system will sense the speed of the vehicle and with the microcontroller, it will calculate the distance required to bring the vehicle to a complete stop for that speed. An intelligent mechatronic system includes an ultrasonic wave emitter provided on the front portion of a car producing and emitting ultrasonic waves frontward in a predetermined distance. An ultrasonic receiver is also placed on the front portion of the car operatively receiving a reflective ultrasonic wave signal. The reflected wave (detected pulse) gives the distance between the obstacle and the vehicle and RPM counter gives speed of vehicle. The reflected wave gives the distance between the obstacle and the vehicle. Then a microcontroller is used to detect the pulses and apply brakes to the vehicle the breaking motors is incorporated to activate the brakes thereby achieving automatic breaking procedures. The system helps in conjunction with the driver judgment if the driver doesn’t sense the obstacle and applies the brake at the right time then the microcontroller initiates braking motor to apply the brakes automatically. Our future work deals with incorporating real time brake shoe wear system to provide enhanced feature for the intelligent braking system. • By looking at safety in terms of avoiding accidents in the first place. • And then protecting occupants when a crash is unavoidable. • We can prevent more accidents, save more lives, and reduce insurance and medical costs to society. Key Words: Braking system, Ultrasonic Sensor, Arduinoboard, Intelligent Mechatronic system, RPM counter, Microcontroller.

Assessment of food security, living condition, personal hygiene health determinants and relations among Almajiri students in Sokoto metropolis, Nigeria

Almajiri are students’ is an ancient Islamic system of teaching. This paper assesses food security, personal hygiene, living condition, and violence in Almajiri. Survey using questionnaire and descriptive statistics, and x2 at p &lt; 0.05 were used. Most schools were donated (66.7%), and minority (33.3%) were self-owned. Schools were built with zinc (33.3%), mud (33.3%), and modern tools (33.3%). There are urinals in all the schools (100.0%), overcrowding (100.0%), 66.7% have windows and doors, (33.3%) have no windows and doors. 66.% of the schools have mats for sitting, 33.3% have chairs. Risks found at schools are: open defecation (33.3%), and nearby water (66.7%). Majority of students stay for 4 months before returning home (66.7%), and significant portion of them return after graduation (33.3%). Pertaining personal hygiene 66.7% of the students’ wear shoes, 33.3% do not wear; 66.7% have cleaned clothes, 33.3% dirty clothes, there was no water at 66.7% of the schools, 33.3% have water. 66.7% wash hands after toilet, none wash hands before eating. On food security for Almajiri, 66.7% eat once, 33.3% eat twice daily. They eat Tuwo (33.3%), Gari (33.3%), and unspecified food (33.3%); source of food includes begging (33.3%), external labor (33.3%), and home (33.3%). Types of violence encountered are: weapon use (33.3%), fight (33.3%), and flogging (33.3%). Majority (66.7%) of students like western education, and (33.3%) replied no. All students are feeling their condition psychologically; some are at SS1 (33.3%), JSSI (33.3%), and (33.3%) never attend western school. Poor health determinants exist in Almajiri students in Sokoto.

Prevalence of Low Back Pain in Women Wearing High Heels Residing in Khanewal, Pakistan

Purpose: Low back pain is not much prevalent among women wearing high heels but in certain cases it is the cause of disability, absence from work and also affects the quality of life. The objective of the study was to determine the prevalence of low back pain among the women of Khanewal wearing high heels. Methodology: A cross sectional survey was used. Data was collected from Khanewal from 1st October to 31st December 2019. The sample size was 250 women ranging between 20 to 40 years. Inclusion criteria include age between 20 to 35 years, height of heel 2 – 10 cm, duration of wearing of high heel shoes &gt; 3 hours per day, frequency of wearing high heel shoes &gt; 3 times / week. Exclusion criteria consisted of previous history of any accident or injury to the back, fracture of the vertebrae, any spinal pathology, any systemic disease, women who left wearing heels, women wearing heels occasionally. Data was collected by convenient sampling technique, through the use of oswestry low back pain disability questionaire.Study was completed in 3 months after the approval of synopsis. Data entry and analysis were done using computer software SPSS 21. Findings: Among 250 women with the mean age of 27 years, 208(83.2%) female lie in minimum disability sore and 42(16.8%) females lie in moderate disability score. The study concluded that there is relatively low prevalence of low back pain among the women wearing high heels. Recommendations: The duration of study was short, so in future more time is required for this study. Sample was only conducted in Khanewal, therefore more cities should be selected for target population to collect sample in future.

The Pope’s New Clothes

The Pope’s New Clothes

The effect of different inflated air insole in the foot plantar pressure

Exercise promotes health in people with diabetes. Weight-bearing activities increase the risk of foot ulcers. Air-pressure shoes may relieve high plantar pressure. Nevertheless, no study has investigated whether air-pressure shoes affect the plantar foot. A repeated measures study design, with five healthy subjects were tested with three inner air pressures (80, 160, and 240 mmHg) and 20 minutes of walking to examine their effects on peak plantar pressure (PPP). PPP after walking was measured from the forefoot in the big toe (T1), first metatarsal head (M1), and second metatarsal head (M2). We used a one-way ANOVA to analyze the results. We found that after walking for 20 min, inner air pressure significantly affected plantar pressure in the M1 and M2 (P = 0.008 and 0.006, respectively). Regarding the inner air pressure effect, there was a significant difference in the M1 head between 80 and 240 mmHg (274.2 ± 35.6 kPa vs. 689.4 ± 106.3 kPa, P = 0.002) at 20 minutes of walking duration. Moreover, there was a significant difference in the M2 head between 80 mmHg and 240 mmHg (250.6 ± 30.1 kPa vs. 572.4 ± 87.3 kPa, P = 0.002) and 160 and 240 mmHg (396.6 ± 35.3.7 kPa vs. 572.4 ± 87.3 kPa, P = 0.050). This finding is significant because the higher inner air pressure shoes can increase plantar pressure compared to 80 mmHg inner air pressure. This study suggests that individuals who are at high risk of developing foot ulcers should wear shoes with an inner air insole (80 mmHg).