Pododermatitis is common in penguins kept under human care. Substrate optimization plays an important role in prevention and treatment; however, there is limited information on biomechanical properties of commonly used substrates on penguin feet. The objectives were to test the ability of different substrates to decrease weight loading on the central metatarsal pad of penguin feet in an ex vivo model using feet with and without bumblefoot harvested from two Magellanic penguin (Spheniscus magellanicus) cadavers. Penguin feet were attached to a digital force gauge mounted onto a stand for compression testing at 2.5 and 5 kg. Forces at the central metatarsal pad were measured in triplicate using small force sensors. Tested substrates included five granular surfaces (sand, wet sand, pea gravel, wet pea gravel, and crushed ice), three compliant surfaces (short-leaf Astroturf, long-leaf Astroturf, and neoprene), and three firm surfaces (tile, rubber drainage mat, and 3M Safety-Walk Wet Area Matting). Data were analyzed using linear mixed models. There were multifaceted effects of applied pressures, substrate surfaces, and pododermatitis on central metatarsal measured pressures. In general, doubling compression forces resulted in higher measured pressures in all firm and compliant surfaces but not in granular surfaces. Firm surfaces were associated with higher recorded plantar pressures at 2.5 kg, but different significance groupings emerged at 5 kg with a high-, medium-, and low-pressure cluster of surfaces. Pododermatitis lesions resulted in significant alterations in statistical significance clustering among substrate surfaces and unique substrate behaviors. The results of this study could help in making recommendations pertaining to foot health for penguin exhibits.

Tumoral calcinosis is a rare disorder defined as the development of periarticular calcified masses, typically surrounding large joints, although they may occur in the foot. We present a case of a patient with systemic tumoral calcinosis with lesions in both shoulders and wrists and a relatively large lesion in the right foot presenting with foot pain.

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The increase in competitive sports practice among children and lack of ionizing radiation have resulted in a higher demand for MRI examinations. MRI of the children skeleton has some particularities that can lead orthopedists, pediatricians, and radiologists to diagnostic errors. The foot and ankle have several bones with abundant radiolucent and high signal intensity cartilage in several ossification centers, apophysis and physis, that can make this interpretation even harder. The present revision aims to show, how to differentiate between normal developmental findings and anatomic variants from pathologic conditions, whether mechanical, inflammatory, infectious, or neoplastic.

BACKGROUND: Foot problems are common in the general adult population. Whereas older people experience foot problems because of multiple chronic diseases, younger people often have musculoskeletal foot problems related to overuse. Symptoms and severity may differ depending on the anatomical location of the problem, such as forefoot and rearfoot problems. We aimed to compare the differences in spatiotemporal gait characteristics, balance, and pain in musculoskeletal forefoot and rearfoot problems.
METHODS: Twenty-six patients with forefoot (14 participants) and rearfoot (12 participants) problems participated in this prospective study. Spatiotemporal gait characteristics (velocity, cadence, step time, step length, step-extremity ratio, stride length, base support, percentage of swing phase, percentage of stance phase, swing time, and stance time) were evaluated using an electronic walkway, and balance assessment was made using a balance check screener and trainer. The visual analog scale foot and ankle was used to determine patient pain levels. The Mann-Whitney U test was used to determine differences between groups.
RESULTS: There were no significant differences between groups regarding spatiotemporal gait characteristics (P > .05). The eyes closed normal stability and eyes open perturbed stability scores were lower in patients with rearfoot problems (P < .05). Pain intensity evaluated with the visual analog scale foot and ankle was higher in patients with rearfoot problems (P < .05).
CONCLUSIONS: Pain levels and balance deficits in this study were higher in patients with rearfoot problems. The balance evaluation and possible effects of pain management on balance should be considered, especially in patients with rearfoot problems, in aspects of treatment.

Foot and ankle disorders are common during pregnancy, driven by significant physiological changes including weight distribution, hormonal fluctuations, and fluid balance. These changes often result in conditions such as varicose veins, thrombophlebitis, deep vein thrombosis (DVT), edema, overpronation, ankle sprains, metatarsalgia, stress fractures, ligament tears, synovitis, tendon tears, tenosynovitis, paratenonitis, plantar fasciitis, and Morton\'s neuroma. This paper emphasizes the diagnostic utility of ultrasound for these conditions, given its safety, non-invasiveness, and real-time imaging capabilities without ionizing radiation. Ultrasound is particularly effective for diagnosing venous disorders like varicose veins and thrombophlebitis, leveraging Doppler ultrasound to assess vein structure and function. It is also instrumental in identifying DVT, detecting vein dilation, reflux, and thrombosis. For conditions such as edema, ultrasound helps differentiate physiological from pathological causes, ensuring accurate diagnosis and management. In cases of musculoskeletal issues like overpronation, ankle sprains, ligament tears, and tendon pathologies, ultrasound provides detailed images of soft tissues, allowing for precise diagnosis and effective treatment planning. It is equally useful for detecting metatarsalgia, plantar fasciitis, and Morton\'s neuroma, offering insights into soft tissue abnormalities and guiding therapeutic interventions. Ultrasound\'s role extends to diagnosing foreign bodies in the foot and ankle, where it demonstrates high sensitivity and specificity. The accessibility and cost-effectiveness of ultrasound make it an invaluable tool in various healthcare settings, ensuring timely and accurate diagnosis and management of foot and ankle disorders during pregnancy, ultimately enhancing patient outcomes and quality of life.

UNASSIGNED: The Swiss Claw Health Project (SCHP) started on 1 January 2019 and will last a total of 8 years. The main goals of the SCHP are (a) digital recording of claw health data of cattle in Switzerland by 100 professional claw trimmers, (b) development of claw health programs, (c) improvement of cattle claw health in Switzerland, (d) development of breeding values for claw health and (e) reduction of antibiotic use to control claw health problems.
METHODS: Data was collected digitally by 45 hoof trimmers who had previously successfully completed the training program for diagnosis and digital documentation in accordance with the ICAR Claw Health Atlas. The national animal health database was further developed for data storage. Livestock farms with unfavorable claw health were offered an on farm analysis with subsequent annual support visits.
RESULTS: A total of 1155 cattle owners joined the project by the end of the 5th project year. The claw health data of 149753 claw trimmings at cow-level was recorded, and 176 individual visits and analyses of farms with claw health issues were carried out. A health program for mechanical and metabolism-related claw disorders was developed and successfully established. Biosecurity measures during claw trimming were analyzed, and a brochure with recommendations for claw trimmers was developed. Risk factors for the occurrence of digital dermatitis in dairy herds were identified. The prevalence of alarm lesions (painful lesions) decreased significantly and continuously in the participating farms over the project years 2 to 4.
CONCLUSIONS: The scientific project support proved to be extremely useful, as the progress of the project was continuously monitored, and new issues could be addressed promptly. Digitally recorded findings during herd hoof trimming are essential for monitoring and improving claw health.
CONCLUSIONS: This description and critical assessment of the SKGP procedure can be used by other consortia planning a similar project.
UNASSIGNED: Das Schweizer Klauengesundheitsprojekt (SKGP) begann am 1.1.2019 und dauert 8 Jahre. Die Hauptziele des SKGP sind (a) die digitale Erhebung von Klauengesundheitsdaten bei Rindern in der Schweiz im Rahmen der Klauenpflege durch 100 gewerbsmäßig arbeitende Klauenpfleger, (b) die Erarbeitung von Klauengesundheitskonzepten, (c) die Verbesserung der Klauengesundheit bei Rindern in der Schweiz, (d) die Erarbeitung von Zuchtwerten für Klauengesundheit und (e) die Reduktion des Einsatzes von Antibiotika zur Bekämpfung von Klauengesundheitsproblemen.
METHODS: Die Datenerhebung erfolgte digital durch 45 Klauenpfleger, welche vorgängig das Fortbildungsprogramm zur Befundung und digitalen Dokumentation gemäß ICAR Atlas der Klauengesundheit erfolgreich abgeschlossen hatten. Für die Datenspeicherung wurde die nationale Tiergesundheitsdatenbank weiterentwickelt. Tierhaltungsbetrieben mit ungünstiger Klauengesundheit wurde eine Betriebsanalyse mit anschließenden jährlichen Betreuungsbesuchen angeboten.
UNASSIGNED: Bis am Ende des 5. Projektjahres sind insgesamt 1155 Tierhalter dem Projekt beigetreten. Die Klauengesundheitsdaten von 149753 Klauenpflegen auf Tierebene wurden gespeichert und 176 Besuche und Analysen von Betrieben mit Klauengesundheitsproblemen durchgeführt. Ein Gesundheitskonzept für mechanisch-metabolisch assoziierte Klauenprobleme wurde erarbeitet und erfolgreich etabliert. Die Biosicherheitsmaßnahmen anlässlich der Klauenpflege wurden analysiert und eine Broschüre mit Empfehlungen für Klauenpfleger erarbeitet. Risikofaktoren für das Vorkommen von Dermatitis Digitalis in Milchviehbetrieben wurden identifiziert. Die Prävalenz von Alarmerkrankungen ist in den Projektjahren 2 bis 4 bei den beteiligten Betrieben signifikant gesunken.
UNASSIGNED: Die wissenschaftliche Projektbegleitung erwies sich als äußerst sinnvoll, da der Projektfortschritt kontinuierlich verfolgt und neue Fragestellungen zeitnah angegangen werden konnten. Digital erfasste Befunde während der Betriebsklauenpflege sind essenziell für die Überwachung und Verbesserung der Klauengesundheit.
UNASSIGNED: Die Beschreibung und kritische Beurteilung der Vorgehensweise kann von anderen Konsortien, welche ein ähnliches Projekt planen, genutzt werden.

BACKGROUND: Foot pain can be a significant burden for patients. Custom foot orthoses (CFOs) have been a mainstay in podiatry treatment for foot pain management and improving foot function. However, little is known about podiatrists\' experience of prescribing CFOs or patient experience of using foot orthoses (FOs), including CFOs, for foot pain.
METHODS: A focus group (FG) discussion with three FOs users (Female = 2 and Male = 1) was conducted in November 2022 within a private podiatry practice. This group represented non-experts from the general local population of individuals with existing or previous foot pain who have personally experienced using either over-the-counter FOs or CFOs. An online FG discussion with five musculoskeletal (MSK) specialist podiatrists (Female = 2 and Male = 3) was also conducted in December 2022. This group represented podiatrists with specialist knowledge in foot biomechanics and clinical experience in CFO provision. The FG discussions were recorded and lasted 49 and 57 min respectively. Transcribed data was manually coded, and a thematic analysis was undertaken to identify patterns within the collected data.
RESULTS: The participants in the patient FG detailed mixed experiences of the prescription process and CFOs received, with reports of limited involvement/input in their prescription, the need for frequent adjustments and high costs. The impact on footwear choices, replicability and transferability of CFOs into different types of shoes and technologies to aid design were also highlighted. In the podiatrist FG, lack of confidence in design and manufacture processes, prescription form language, relationship and communication building with manufacturers, variability in the CFOs issued and the need for better student education in CFO provision emerged as key themes.
CONCLUSIONS: Patients and podiatrists shared similar views on CFO provision, namely poor communication with manufacturers leading to dissatisfaction with the CFOs prescribed causing negative impacts on patient experiences. Podiatrists called for greater education at registration level to increase new graduate podiatrist knowledge in CFO design and manufacture and better collaboration with manufacturing companies.

BACKGROUND: Verrucous carcinoma (VC) was first described in 1948 by Dr. Ackerman. It is a low-grade cutaneous squamous carcinoma that usually develops in the oral cavity, the anogenital region, and the plantar surface of the foot. Clinically, there is low suspicion for malignancy given the slow growth of VC lesions and their wart-like appearance. Diagnosis can be difficult because of the benign histological appearance with well-differentiated cells and absence of dysplasia. Surgical excision is the only satisfactory form of treatment for plantar VC; however, this becomes difficult given its benign clinical appearance and the pathologic misinterpretation of the lesion as a benign hyperplasia. While there are case reports and retrospective studies of patients with plantar VC in the literature, we present the largest case series of plantar VC within North America, with recurrence despite negative margins.
METHODS: We report on all the plantar VC excised between 2014-2023. We report six cases of VC, their treatment, and their outcomes.
RESULTS: Six patients obtained a diagnosis of plantar VC by incisional biopsy. All patients underwent excision of their lesions and had negative margins reported on the final pathology. All patients developed nonhealing wounds at the site of their lesion excision; therefore, biopsies were performed to confirm a recurrence. All patients had a recurrence of VC at the initial site. All patients underwent re-excision of the lesions. Despite negative margins again on final pathology, all patients had a subsequent second recurrence. Ultimately, all patients underwent an amputation as definitive management. Each patient had an average of 3 operations. There were 4 different surgeons and different pathologists reporting their findings.
CONCLUSIONS: Our experience with plantar VC suggests that an aggressive approach to surgical management is needed. Furthermore, management is optimized with the combined expertise of an experienced dermatopathologist and surgeon. Despite negative margins and repeated excisions, VC lesions recur and invade local tissues to the extent that only amputation of the involved foot has resulted in cure.

We used finite element analysis to study the mechanical stress distribution of a new intramedullary implant used for proximal interphalangeal joint (PIPJ) arthrodesis (PIPJA) to surgically correct the claw-hammer toe deformity that affects 20% of the population. After geometric reconstruction of the foot skeleton from claw toe images of a 36-year-old male patient, two implants were positioned, in the virtual model, one neutral implant (NI) and another one 10° angled (10°AI) within the PIPJ of the second through fourth HT during the toe-off phase of gait and results were compared to those derived for the non-surgical foot (NSF). A PIPJA was performed on the second toe using a NI reduced tensile stress at the proximal phalanx (PP) (45.83 MPa) compared to the NSF (59.44 MPa; p < 0.001). When using the 10°AI, the tensile stress was much higher at PP and middle phalanges (MP) of the same toe, measuring 147.58 and 160.58 MPa, respectively, versus 59.44 and 74.95 MPa at corresponding joints in the NSF (all p < 0.001). Similar results were found for compressive stresses. The NI reduced compressive stress at the second PP (-65.12 MPa) compared to the NSF (-113.23 MPa) and the 10°AI (-142 MPa) (all p < 0.001). The von Mises stresses within the implant were also significantly lower when using NI versus 10°AI (p < 0.001). Therefore, we do not recommend performing a PIPJA using the 10°AI due to the increase in stress concentration primarily at the second PP and MP, which could promote implant breakage.