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.

Data from dry bone samples, collected from anatomical or archaeological collections, can improve the knowledge regarding accessory foot bones, including prevalence, size, shape and laterality, that can be useful in disparate fields of research, from medicine to bioarcheology. In the present study, the prevalence of six accessory foot bones (os trigonum, calcaneus secundarium, accessory navicular bone, os vesalianum, os sustentaculum and os intermetatarseum) was assessed in a sample of 486 individuals (226 females, 260 males) from the Coimbra Identified Skeletal Collection (CISC). The most frequent accessory bones are os trigonum (9.9%; 48/485) and calcaneus secundarium (6.0%; 29/486), while the most uncommon is os sustentaculum (0.4%; 2/486). No sex differences were observed. All accessory bones occur more often unilaterally, with the exception of the accessory navicular bone that, in the majority of cases, occurs bilaterally. The unilateral expression of os trigonum, calcaneus secundarium and os vesalianum was mostly in the right foot. The co-occurrence of accessory foot bones was recorded in 1.7% of the individuals (8/486), and the combinations of os trigonum and calcaneus secundarium were the most frequently observed. This research emphasizes the relevance of conducting studies on reference skeletal collections in order to gain a comprehensive understanding of anatomical variations in the foot. This understanding is crucial for accurate diagnoses and successful treatment in clinical settings, as well as for establishing population comparison standards in the fields of bioarchaeology and forensic anthropology.

BACKGROUND: Angioleiomyoma is a benign soft-tissue tumor that arises from the smooth muscle cells in the tunica media of the blood vessels. Although the most common location for these neoplasms is the uterine wall, they can also originate from lower limbs. Altogether, these neoplasms account for 0.2% of all those located in the foot and ankle region. Signs and symptoms of foot angioleiomyoma can be a localized pain, swelling, and functional impairment. To date, only case reports and case series with small populations have been reported in the literature to describe the clinical picture of these neoplasms and the effectiveness of surgical treatment. In this study, we report our results of surgical treatment for angioleiomyomas of the foot.
METHODS: Thirteen cases suffering from angioleiomyoma of the foot underwent surgical resection in our institution between January of 2017 and January of 2022. For each case, we recorded preoperative and postoperative symptoms, and their preoperative and postoperative functional status according to both Musculoskeletal Tumor Society Score (MSTS) and American Orthopedic Foot and Ankle Society Score (AOFAS). Eventual complications and local recurrence were reported.
RESULTS: Each patient had at least mild pain before surgical treatment. The mean preoperative MSTS and AOFAS were 22.1 and 76.8, respectively. The mean tumor size was 17.7mm. Preoperatively, each patient underwent resection with wide margins. None had local recurrences or major complications at their latest follow-up. After surgery, the mean postoperative MSTS and AOFAS increased to 29.5 and 98.8, respectively. Each case had a marked increment of their functionality and a reduction of their pain after surgery.
CONCLUSIONS: Our results suggest that surgical approach with tumor resection should be considered a safe and reliable treatment for foot angioleiomyomas in light of the extremely low risk of local recurrence and because of the good postoperative pain relief and functional restoration that can be obtained after the treatment.

BACKGROUND: Access to clinical services for children with foot and ankle problems are important, but unravelling the complexity of practice and service delivery can be challenging. The pursuit and implementation of research evidence is critical for driving positive change in practice, but little is understood about the approaches to knowledge and research acquisition in children foot health.
OBJECTIVE: The aim of the study was to: (1) explore multi-professional habits of knowledge and research evidence acquisition in children\'s foot health; and (2) understand how clinicians integrate information for children and their families into their practice.
METHODS: This was a descriptive, cross-sectional online survey. Participants were included if they worked in the UK and had experience of working within paediatric services.
RESULTS: There were complete responses from 247 health professionals, representing physiotherapists (n = 160), podiatrists (n = 50), orthotists (n = 25), nurses and specialists in community public health nurses (health visitors) (n = 12). Three main themes were generated from the data: (1) Factors that influence knowledge and inform clinical practice. (2) The role of Professional Bodies in informing professional knowledge. (3) Health Professionals\' views on managing health information for parents and caregivers.
CONCLUSIONS: This work advances understanding of the value health professionals\' place in the development of materials for informing professional knowledge, as well as highlighting some of the challenges with translation of knowledge into clinical practice. The findings offer a national perspective of health professionals working on children\'s foot health and have highlighted that some of the most valued influences on clinical practice come from peer-to-peer networking.

From summer 2018 to summer 2019, several Thoroughbred racehorses held at the Miho Training Centre of the Japan Racing Association inadvertently ingested excessive amounts of sodium selenite, resulting in typical chronic selenium (Se) poisoning - the so-called alkali disease. The typical abnormality was a hoof wall disorder with a circumferentially deep ring and/or transverse hoof wall cracks parallel to the coronet on all feet and appearing after excessive ingestion. One affected Thoroughbred male was unique in that all the hooves had a rough surface with a very fragile hoof wall, but no wall rings or transverse cracking. This horse was euthanized because of dysstasia due to the permanent foot pain associated with hoof wall deformities in the front feet. To detect Se deposition in the hooves, we used energy-dispersive X-ray fluorescence (EDXRF) analysis to measure the Se signal intensity of each lesion. Characteristic Se-kα signals were emitted from the areas of histologically damaged hoof wall at 33.76 ± 11.78 (mean ± SD) counts per second (cps)/mm2. In contrast, the signal from the uninjured proximal hoof wall was 1.43 ± 0.14 cps/mm2 and that from the uninjured distal hoof wall was 1.51 ± 0.23 cps/mm2. The much greater Se deposition in the injured hoof walls suggests that their disintegration was caused by alkali disease. These results indicate that atypical hoof wall abnormalities due to alkali disease can be diagnosed by EDXRF analysis.

Zebu cattle (Bos indicus) is reported to be more resistant towards harmful environmental factors than taurine cattle (Bos taurus). A few hundred zebu cattle are kept in Switzerland and in contrast to the Swiss indigenous breeds, infectious hoof disease in zebu is not observed. Therefore, we compared the prevalence of three ruminant hoof pathogens in zebu and taurine cattle. These included Treponema spp., Fusobacterium necrophorum and Dichelobacter nodosus which are associated with bovine digital dermatitis (BDD), different bovine hoof diseases and ovine footrot, respectively. Interdigital swabs and punch biopsies from hind feet of slaughter animals were tested for the three pathogens by PCR. Sixty zebu from eight farms were compared to a convenience sample of 20 taurine cattle from 17 farms. Treponema spp. associated with BDD were not detected in zebu while 23 % of animals and 50 % of farms were positive for benign D. nodosus, with results indicating environmental contamination rather than colonization. Taurine cattle showed 35 % of animals and 41 % of farms positive for T. phagedenis while 90 % of animals and 94 % of farms were colonized by D. nodosus as indicated by a 500-fold higher bacterial load than in zebu. The difference in prevalence of the two pathogens between zebu and taurine cattle was highly significant. F. necrophorum was as well only detected in taurine cattle with values of 15 % of animals and 17.7 % of farms, being significantly different at the animal level. Furthermore, genetic analysis of Swiss zebu indicates high genomic diversity and clear separation from taurine cattle. This is the first evidence that zebu show resistance towards colonization by bacterial hoof pathogens in contrast to taurine cattle.

METHODS: Bizarre parosteal osteocartilaginous proliferation (BPOP) is rare, especially in the foot. To the best of our knowledge, multifocal BPOP has yet to be reported. We are reporting a case of a 40-year-old woman who presented with 4 bumps over her midfoot and toes. After staging studies, we excised the lesions, and histopathology confirmed BPOP. No local recurrence was observed at the end of the 2-year follow-up.
CONCLUSIONS: BPOP should be considered in the differential diagnosis of multiple foot bumps, whether synchronous or metachronous, which may present multifocally in the foot.

Many studies have shown a strong correlation between Hindgut Acidosis (HGA) and the occurrence of laminitis in horses; therefore, the early diagnosis of HGA is essential. In this study, we investigated changes in the plasma concentrations of lipopolysaccharide-binding protein (LBP) and serum amyloid A (SAA) as inflammatory markers in horses with laminitis. Sixteen healthy male Arabian horses that had cecal cannulation without visible laminitis or general symptoms were randomly divided into two groups. The horses were fed two different diets in a forage-to-concentrate ratio. Blood samples were collected on Days 1, 10, and 20. The primary objective of this study was to analyze plasma levels of LBP and SAA. Cecal specimens were obtained from each equine subject on three designated days: days 1, 10, and 20. The second objective was to assess the levels of pH and volatile fatty acids (VFA) in the samples. Throughout the study period, horses fed a high-concentrate diet exhibited a significantly elevated average lameness grade on days 10 and 20 compared to the initial stage (P < 0.001). On day 20, a significant increase in the concentration of SAA was observed in horses fed a high-concentrate diet, in contrast to the initial stage of the study. LBP levels in the plasma were significantly elevated on days 10 and 20 in horses fed a high-concentrate diet. Based on our findings, it is recommended that the evaluation of plasma LBP concentrations is more effective than SAA for the early identification of HGA in horses fed a high-grain diet.

BACKGROUND: Cattle lameness is a significant welfare and economic problem facing the livestock industry. Published research has investigated foot trimming practices in dairy herds, but little is known about the practices in beef herds. Therefore, the objective of this study was to obtain information about the current practices of professional cattle foot trimmers concerning beef cattle within the UK.
METHODS: An online survey comprising 16 questions was created using the Joint Information Systems Committee platform. The survey was open for 3 months.
RESULTS: There was a significant difference (p < 0.05) between the proportions of dairy cattle and beef cattle receiving preventative foot trims. Digital dermatitis was the most commonly recorded cause of lameness when a lame beef animal was trimmed by the respondents, followed by white line disease. A thematic analysis of foot trimmers\' opinions of barriers to engagement on beef farms is presented, in addition to their opinions on veterinary involvement with beef lameness.
CONCLUSIONS: Distribution bias may have affected the results, as the survey was distributed online with support from the Cattle Hoof Care Standards Board and the National Association of Cattle Hoof Trimmers. The percentage of foot trimmers not affiliated with either professional body is not known.
CONCLUSIONS: Further research on the impact of lameness on suckler and finishing cattle, including investigations into preventative actions to reduce lameness in beef systems, is warranted.

BACKGROUND: The field of medical grade footwear is dynamic. Originally, a field where individual knowledge, expertise and skills determined the footwear and its outcomes, now becoming a more evidence-based and data-driven field with protocols and systems in place to create appropriate footwear. However, scientific evidence concerning medical grade footwear is still limited. Evidently, all stakeholders, from patients to pedorthists to rehabilitation physicians, will profit from a larger evidence-base in this field. A widely supported research agenda is an essential first step to advance and facilitate new knowledge.
METHODS: We formed a multidisciplinary team and followed the methodology from Dutch medical societies for the development of a research agenda on medical grade footwear. This consisted of seven steps: (1) inventory of relevant questions with users and professionals; (2) analyses of responses; (3) analyses of existing knowledge and evidence; (4) formulating research questions; (5) prioritising research questions by users and professionals; (6) finalising the research agenda and (7) implementing the research agenda.
RESULTS: In phase 1, 109 participants completed a survey, including 50% pedorthists, 6% rehabilitation physicians and 3% users. Participants provided 228 potential research questions. In phases 2-4, these were condensed to 65 research questions. In phase 5, 152 participants prioritised these 65 research questions, including 50% pedorthists, 13% rehabilitation physicians and 9% users. In phase 6, the final research agenda was created, with 26 research questions, categorised based on the International Classification of Functioning Disability and Health \'process description assistive devices\'. In phase 7, an implementation meeting was held with over 50 stakeholders (including users and professionals), resulting in seven applications for research projects based on one or more research questions from the research agenda.
CONCLUSIONS: This research agenda structures and guides knowledge development within the field of medical grade footwear in the Netherlands and elsewhere. We expect that this will help to stimulate the field to tackle the research questions prioritised and with that to advance scientific knowledge in this field.