Strengthening the relationship between intractable plantar keratosis and human papillomavirus.

The aim of the study was to determine the presence of human papillomavirus (HPV) in patients with intractable plantar keratosis (IPK) by comparing the histopathological findings of biopsies. A prospective, observational, and concordance study was carried out. Three different specimens were taken from each IPK. A first punch was sent for histopathological examination, and a second punch and a superficial skin scraping were both sent for HPV  polymerase chain reaction (PCR) and type determination. A total of 51 patients were included. From the histopathological examination, it was determined that 35 (68.6%) samples were diagnosed as warts and 16 (31.3%) as keratosis. However, the presence of HPV was confirmed by PCR in 49 (96.1%) and in 42 (82.4%) samples obtained by punch and superficial scraping, respectively. In the 49 PCR-positive samples, the most common HPV types were HPV1, HPV2, HPV27, HPV57, and HPV65, accounting for 81.6% of the samples. In conclusion, this study demonstrates that HPV infection and IPK lesions are very closely related. Although we cannot confirm that HPV is the cause of the development of IPK, the high prevalence of HPV observed in these lesions calls for a change to the procedures for managing IPK.

The resting calcaneal stance position (RCSP): an old dog, with new tricks.

The objective of this study was to establish the accuracy of the resting calcaneal stance position (RCSP) for the assessment of flat foot (FF) in children, aligned to the validity of the foot posture index (FPI). The RCSP cut-off point was explored, in context of both FF prevalence and the relationship between FF and body weight. A total of 205 healthy children, aged 5 to 10 years, participated in a cross-sectional study. Correlation was performed between RCSP and FPI. ROC curve technique was calculated to assess differentiation between groups. A score equal to or greater than 7 on the FPI was used as the 'gold standard' for analysis. The correlation between FPI and RCSP was significant (r = 0.63; p < 0.01). The discrimination score on the ROC curve (6 points/degrees) shows that the model can be used to identify FF through RCSP, with a sensitivity of 67% and specificity of 85% returned.  Conclusion: The results of this study indicate the role of RCSP for simple, accessible and quick screening of paediatric FF. This is especially pertinent for non-podiatric healthcare professional without specialised paediatric foot knowledge. What is Known: • Most children develop a normal arch quickly, and flat feet usually resolve on their own between 2 and 6 years of age. • The measurement used to diagnose flat foot in children must be accurate, consistent, and valid to characterize the standard foot position. The Resting Calcaneal Stance Position (RCSP) is another widely used measure to evaluate the position of the flat foot in children. What is New: • The RCSP cut-off point 6 shows a sensitivity of 67% and a specificity of 85% thanks to the FPI as the Gold standard. • The RCSP is useful for health professionals who are not specialised in pediatric foot health. The RCSP is useful to detect flat foot in children.

Effect of using a kinetic wedge during the hallux dorsiflexion resistance test in asymptomatic individuals.

BACKGROUND: The hallux dorsiflexion resistance test is a frequently employed clinical maneuver for assessing the initiation of the windlass mechanism This maneuver involves dorsiflexion of the phalanx of the hallux, thereby evaluating plantarflexion of the first metatarsal, elevation of the medial longitudinal arch, and supination of the rearfoot. The windlass mechanism plays a crucial role in gait, and orthopedic devices, such as a kinetic wedge, which aims to facilitate its activation by increasing the hallux dorsiflexion. Although it is believed that facilitating the windlass mechanism with the kinetic wedge should be directly correlated with a decrease in hallux dorsiflexion resistance, its effects have yet to be characterized. Thus, this study aimed to determine the influence of a kinetic wedge on hallux dorsiflexion resistance in asymptomatic individuals. METHODS: The sample comprised thirty participants (14 women and 16 men). A digital force gauge measured the force required to perform the hallux dorsiflexion resistance test during two conditions: barefoot and with a kinetic wedge. The Wilcoxon signed-rank test was used to compare the hallux dorsiflexion resistance between conditions. RESULTS: A statistically significant reduction in force (10.54 ± 3.16N vs. 19.62 ± 5.18N, p < 0.001) was observed when using the kinetic wedge compared to the barefoot condition during the hallux dorsiflexion resistance test. CONCLUSION: The use of a kinetic wedge reduces the required force for performing the passive hallux dorsiflexion resistance test in asymptomatic individuals. Future studies should determine to what extent the kinetic wedge can attenuate the required force to dorsiflex the hallux in individuals with musculoskeletal disorders such as plantar fasciopathy and functional hallux limitus.

The effect of varus rearfoot wedges on hallux dorsiflexion resistance.

BACKGROUND: The first metatarsophalangeal joint (MTPJ), which includes the first metatarsal and proximal phalanx, plays a crucial role in gait and impacts the windlass mechanism. Disruptions to this mechanism are implicated in various foot pathologies. Jack's Test serves as a valuable tool for clinicians to assess the functionality of the MTPJ. Varus rearfoot wedges (VRFWs) are a common treatment employed in the management of lower limb pathologies. The impact of VRFWs on the resistance of the first MTPJ during Jack´s Test is currently unknown. This study aimed to measure the influence of VRFWs on the resistance of the first MTPJ during Jack´s Test. The secondary objective was to validate a new measurement method using a digital force gauge. METHODS: Thirty participants (17 women and 13 men) were enrolled. A digital force gauge measured the weight-bearing force needed for Jack's Test, thereby evaluating the effects of VRFWs of different angulations. The Kolmogorov-Smirnov test confirmed that the data followed a normal distribution (p > 0.05). The nonparametric Friedman test (p < 0.001) showed that there were significant differences among all VRFWs, while the Wilcoxon test (p < 0.001) showed that there were differences between barefoot conditions and 3°, 5°, and 8° VRFWs. RESULTS: The use of 8° VRFWs yielded a statistically significant reduction in the passive dorsiflexion force of hallux during Jack's Test (12.51 N ± 4.12, p < 0.001). CONCLUSIONS: The use of VRFWs has been observed to reduce dorsiflexion resistance in the proximal phalanx of the first MTPJ during Jack's Test. Additionally, the digital force gauge was proven to be a valid tool for conducting Jack's Test, thus offering a reliable measurement method.

Polymer Optical Fiber Plantar Pressure Sensors: Design and Validation.

The proper measurement of plantar pressure during gait is critical for the clinical diagnosis of foot problems. Force platforms and wearable devices have been developed to study gait patterns during walking or running. However, these devices are often expensive, cumbersome, or have boundary constraints that limit the participant's motions. Recent advancements in the quality of plastic optical fiber (POF) have made it possible to manufacture a low-cost bend sensor with a novel design for use in plantar pressure monitoring. An intensity-based POF bend sensor is not only lightweight, non-invasive, and easy to construct, but it also produces a signal that requires almost no processing. In this work, we have designed, fabricated, and characterized a novel intensity POF sensor to detect the force applied by the human foot and measure the gait pattern. The sensors were put through a series of dynamic and static tests to determine their measurement range, sensitivity, and linearity, and their response was compared to that of two different commercial force sensors, including piezo resistive sensors and a clinical force platform. The results suggest that this novel POF bend sensor can be used in a wide range of applications, given its low cost and non-invasive nature. Feedback walking monitoring for ulcer prevention or sports performance could be just one of those applications.

Kinematic Effect on the Navicular Bone with the Use of Rearfoot Varus Wedge.

BACKGROUND: The rearfoot varus wedge (RVW) is a common treatment for foot pain and valgus deformity. There is research on its effects in the calcaneus, but there is little research on the navicular. More research is needed with the use of RVW due to the relationship that exists between the position of the navicular and the risk of suffering an injury. OBJECTIVES: this study sought to understand how RVW can influence the kinematics of the navicular bone, measuring their movement with the 6 SpaceFastrak system. METHODS: a total of 60 subjects participated in the study. Two sensors were used to measure the movement of the calcaneus and navicular using RVWs as compared in the barefoot position in a static way. RESULTS: there were statistically significant differences, the use of RVWs caused changes in the navicular bone, with subjects reaching the maximum varus movement with the use of RVW 7 mm of 1.35 ± 2.41° (p < 0.001), the maximum plantar movement flexion with the use of RVW 10 mm of 3.93 ± 4.44° (p < 0.001). CONCLUSIONS: when RVWs were placed under the calcaneus bone, the navicular bone response was in varus movement too; thus, the use of rearfoot varus wedge can influence the movement of the navicular bone.

Effects of Novel Inverted Rocker Orthoses for First Metatarsophalangeal Joint on Gastrocnemius Muscle Electromyographic Activity during Running: A Cross-Sectional Pilot Study.

BACKGROUND: The mobility of the first metatarsophalangeal joint (I MPTJ) has been related to the proper windlass mechanism and the triceps surae during the heel-off phase of running gait; the orthopedic treatment of the I MPTJ restriction has been made with typical Morton extension orthoses (TMEO). Nowadays it is unclear what effects TMEO or the novel inverted rocker orthoses (NIRO) have on the EMG activity of triceps surae during running. OBJECTIVE: To compare the TMEO effects versus NIRO on EMG triceps surae on medialis and lateralis gastrocnemius activity during running. STUDY DESIGN: A cross-sectional pilot study. METHODS: 21 healthy, recreational runners were enrolled in the present research (mean age 31.41 ± 4.33) to run on a treadmill at 9 km/h using aleatory NIRO of 6 mm, NIRO of 8 mm, TMEO of 6 mm, TMEO of 8 mm, and sports shoes only (SO), while the muscular EMG of medial and lateral gastrocnemius activity during 30 s was recorded. Statistical intraclass correlation coefficient (ICC) to test reliability was calculated and the Wilcoxon test of all five different situations were tested. RESULTS: The reliability of values was almost perfect. Data showed that the gastrocnemius lateralis increased its EMG activity between SO vs. NIRO-8 mm (22.27 ± 2.51 vs. 25.96 ± 4.68 mV, p < 0.05) and SO vs. TMEO-6mm (22.27 ± 2.51 vs. 24.72 ± 5.08 mV, p < 0.05). Regarding gastrocnemius medialis, values showed an EMG notable increase in activity between SO vs. NIRO-6mm (22.93 ± 2.1 vs. 26.44 ± 3.63, p < 0.001), vs. NIRO-8mm (28.89 ± 3.6, p < 0.001), and vs. TMEO-6mm (25.12 ± 3.51, p < 0.05). CONCLUSIONS: Both TMEO and NIRO have shown an increased EMG of the lateralis and medialis gastrocnemius muscles activity during a full running cycle gait. Clinicians should take into account the present evidence when they want to treat I MTPJ restriction with orthoses, and consider the inherent triceps surae muscular cost relative to running economy.

Heel Height as an Etiology of Hallux Abductus Valgus Development: An electromagnetic Static and Dynamic First Metatarsophalangeal Joint Study.

Background: Hallux abductus valgus (HAV) is a forefoot condition produced by extrinsic and intrinsic factors. Shoes with a high heel height and a typical narrow tip toe box can induce deviations in both the proximal phalanx of the hallux (PPH) and the first metatarsal (IMTT) bones. Nevertheless, the isolated role of heel height remains unclear in the development of HAV pathology. Objectives: The goal was to determine if the heel height increase of shoes without a narrow box toe could augment the PPH and IMTT deviation in frontal, sagittal, and transverse planes toward the first metatarsophalangeal joint (MPJ) and the first metatarsocuneiform joint (MCJ), respectively, during static and dynamic conditions in relation to precursor movements of HAV. Methods: Women with an average age of 25.10 ± 4.67 years were recruited in this cross-sectional study to assess the three planes of motion of PPH and IMTT while wearing high heels with heights at 3, 6, 9 cm and unshod conditions via sandals. The measurements used an electromagnetic goniometer device with sensors placed on medial aspects of the PPH and IMTT bones under static and dynamic conditions. Results: Wearing shoes with a 6 cm heel in dynamic condition may increase the PPH valgus and abduction deviation from 3.15 ± 0.10° to 3.46 ± 0.05° (p < 0.05) and from 1.35 ± 0.28° to 1.69 ± 0.30° (p < 0.001), respectively. In addition, a PPH abduction increase from 1.01 ± 0.36° to 1.31 ± 0.46° (p < 0.05) after wearing shoes with a 6 cm heel height was observed under static conditions. Conclusions: Wearing shoes with a heel height of 6 cm without a narrow box toe interference may produce PPH abduction and valgus deviations related to HAV formation.

Ultrasonography Features of the Plantar Fascia Complex in Patients with Chronic Non-Insertional Achilles Tendinopathy: A Case-Control Study.

PURPOSE: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy (AT). METHODS: An observational case-control study. A total sample of 143 individuals from 18 to 55 years was evaluated by USI in the study. The sample was divided into two groups: A group composed of the chronic non-insertional AT (n = 71) and B group comprised by healthy subjects (n = 72). The PF thicknesses at insertion on the calcaneus, midfoot, rearfoot and CFP were evaluated by USI. RESULTS: the CFP and PF at the calcaneus thickness showed statistically significant differences (P < 0.01) with a decrease for the tendinopathy group with respect to the control group. For the PF midfoot and forefoot thickness, no significant differences (P > 0.05) were observed between groups. CONCLUSION: The thickness of the PF at the insertion and the CPF is reduced in patients with AT measured by USI.

Effectiveness of Eccentric Exercise and a Vibration or Cryotherapy Program in Enhancing Rectus Abdominis Muscle Thickness and Inter-Rectus Distance in Patients with Chronic Mid-Portion Achilles Tendinopathy: A Randomized Clinical Trial.

Purpose: Abdominal muscles are key in maintaining body stability and balance and an improvement in the functioning of these muscles could influence the rehabilitation process in lower limb pathologies such as Achilles Tendinopathy (AT). The aim was to explore whether calf eccentric exercise (EE) with vibration training was more effective at causing adaptation to the rectus anterior (RA) thickness and inter-rectus distance (IRD) than calf EE with cryotherapy. Methods: The investigation was a single-blinded, randomized, controlled clinical trial (NCT03515148). Sixty-one individuals diagnosed with mid-portion AT were recruited and divided in two groups: group A (n = 30) followed an EE with vibration program and group B (n = 31) an EE program with cryotherapy, for 12-weeks. RA muscle thickness and IRD were measured in maximal isometric contraction and at rest as an indication of superficial abdominal muscle activation. Results: IRD measures showed a significant (P < 0.05) decrease at baseline, 4 and at 12-weeks in both groups, but no significant differences were observed between the intervention groups. RA thickness was significantly increased (P < 0.05) in measures at baseline, 4 and 12-weeks showed a significant increase in maximal isometric contraction and at rest in favor of the EE vibration program group. Conclusions: The present study showed a RA thickness increase in both groups in favor of the EE vibration program with respect to cryotherapy added to EE in short and mid term in maximal isometric contraction and at rest in subjects with chronic mid-portion AT. IRD was decreased in both groups without between-groups differences.

Gender Differences among Nurses in Managing Arterial Puncture-Related Pain: A Multicenter Cross-Sectional Study.

There is evidence that healthcare can be executed differentially depending on the gender of patients, researchers, and clinicians. The aim was to analyze the possible existence of nursing gender differences in pain management produced by arterial puncture for blood gas analysis. A cross-sectional, multicenter study designed was conducted in Castilla-la Mancha (Spain). Variables of interest were collected from nurses in the public health system of a European region through a questionnaire. Data were collected for four months; the primary outcome was the use of any intervention to reduce pain and the explanatory variable was the nurse's gender. Bivariate analysis was carried out to assess associations between gender and pain-reducing interventions and a multivariate model was created with those factors that were relevant using logistic regression. A significantly higher proportion of men reported using some form of intervention (45% vs. 30%) and had more specific training (45.9% vs. 32.4%). The adjusted probability of using pain-reducing interventions by men was 71% higher than women. Thus, we found gender differences in the management of pain caused by arterial punctures performed by nurses as the main healthcare providers.

Effects of Myofascial Release Technique along with Cognitive Behavior Therapy in University Students with Chronic Neck Pain and Forward Head Posture: A Randomized Clinical Trial.

The purpose of this randomized controlled trial was to evaluate the effectiveness of the Myofascial Release Technique (MRT) along with Cognitive Behavioral Therapy (CBT) on pain, craniovertebral angle (CVA), and neck disability in university students with chronic neck pain and forward head posture. A total of sixty-six eligible participants with chronic neck pain and forward head posture were randomized into the Myofascial Release Therapy (MRT) group (n = 33) and MRT and Cognitive Behavior Therapy (CBT) group (n = 33). Clinical outcomes included neck pain measured using the numerical pain rating scale, neck disability measured through the neck disability index, and forward head posture measured through the cranial vertebral angle. The outcomes were assessed at baseline and the four and eight weeks after the intervention. Both groups showed significant improvement in pain intensity, CVA, and neck disability after the intervention. However, the CBT group demonstrated greater improvements than the MRT group. The difference in outcomes between the groups was statistically significant. Myofascial Release Therapy combined with CBT is an effective treatment method for patients with chronic neck pain and forward head posture.

Biomechanical Effect on Jack's Test on Barefoot Position, Regular Socks, and Biomechanics Socks.

The proper dorsal flexion movement of the first metatarsophalangeal joint (MTPJ) is crucial for an accurate gait. Restricted movement can disrupt the windlass mechanism, and Jack's test is a tool to assess such alterations. Although running socks are commonly used, their influence on the windlass mechanism remains unclear. Therefore, the aim of this study was to measure the resistance to passive dorsal flexion of the first metatarsophalangeal joint (MTPJ) under three different conditions: barefoot, wearing regular socks, and wearing biomechanical socks, using a digital force gauge. METHODS: The research involved a sample size of 30 subjects (14 men and 16 women), and Jack's test was conducted using a digital force gauge and a lever system. Three conditions were measured, barefoot, with a regular sock, and with the biomechanical socks. RESULTS: Statistically significant differences were observed when using biomechanical socks with orthopedic corrections during Jack's test, as measured with the digital force gauge (13.33 N ± 3.54, p < 0.001). CONCLUSIONS: The utilization of biomechanical socks with a kinetic wedge, reinforced mesh in the medial longitudinal arch, and padding in the heel area results in a reduction of the force required, measured in newtons, to perform dorsal flexion of the first metatarsophalangeal joint (MTPJ) during Jack's test compared to being barefoot or wearing regular socks.

Pilates versus Zumba training effects on postural control under conflicting sensory conditions in postmenopausal women.

The current study aimed to compare the effects of Pilates versus Zumba training on postural performance in middle-aged postmenopausal women. Fifty-seven eligible women, aged between 50 and 60 years, were randomized into three groups: Zumba (ZG) group, Pilates (PG) group or control (CG) group. Postural control was assessed using a force platform under 4 sensory manipulation conditions: on firm and foam surfaces with eyes opened (EO) and closed (EC). Our results showed more marked adaptations in favor of ZG concerning postural performance compared to PG. For the PG, postural control was significantly improved only in simple postural conditions on the firm surface with EO (p < 0.1) and EC (p < 0.05) conditions. However, postural control of the ZG significantly improved in both the simple and complex postural conditions, even under conflicting sensory situations (firm surface/EO (p < 0.001; 95 % CI: [1.34, 4.46]), EC (p < 0.001; 95 % CI: [2.13, 5.24])); foam surface/EO (p < 0.01; 95 % CI: [0.70, 8.57]), EC (p < 0.01; 95 % CI: [0.65, 8.52])). In conclusion, Zumba training seems to be more effective and a better strategy to promote postural control in daily living activities and autonomy in postmenopausal women than Pilates training. These findings are useful for public health practitioners in designing physical interventions for balance disorders.

Validation of the Barthel Index as a Predictor of In-Hospital Mortality among COVID-19 Patients.

In order to predict the high mortality due to COVID-19, simple, useful and remote instruments are required. To assess the validity of the baseline Barthel Index score as a predictor of in-hospital mortality among COVID-19 patients, a validation study of a clinical prediction tool in a cohort of patients with COVID-19 was conducted. The primary variable was mortality and the Barthel Index was the main explanatory variable. Demographic, clinical and laboratory variables were collected. Other mortality predictor scores were also assessed: Pneumonia Severity Index, CURB-65 and A-DROP. The Receiver Operating Characteristic Area under the Curve (ROC AUC), sensitivity and specificity were calculated for both the Barthel Index and the other predictor scores. An analysis of the association between the main variables was conducted, adjusting by means of three multivariate models. Three hundred and twelve patients were studied. Mortality was 16.4%. A mortality Odds Ratio (OR) of 5.95 was associated with patients with a Barthel Index ≤ 90. The model number 3 was developed to predict in-hospital mortality before COVID-19 infection occurs. It exhibits an OR of 3.44, a ROC AUC of 0.792, a sensitivity of 74.5% and a specificity of 73.9%. The Baseline Barthel Index proved useful in our population as a predictor of in-hospital mortality due to COVID-19.

Effects of Low-Dye Tape on Arch Height and Its Impact on the Medial Gastrocnemius Electromyographic Activity in Structurally Differentiable Foot Types: A Cross-Sectional Observational Study.

BACKGROUND: Low-Dye tape (LDT) is a short-term treatment for plantar fasciitis, where external stabilization by means of the tape improves kinetics, kinematics, pain level, and electromyography (EMG). PURPOSE: The purpose of this study was to compare the EMG of the medial gastrocnemius (MG) and changes in arch height (AH) based on the type of foot. METHODS: A total of 30 subjects participated in this study; they walked on a treadmill barefoot and when taped, where the average activity and changes in AH were measured over a 30 s period. The statistical intraclass correlation coefficient (ICC) to test for reliability was calculated, and the Wilcoxon test was determined for measures of EMG and AH. RESULTS: The reliability of the values of EMG was almost perfect. The data show that there was an increase in height in the comparison of the moment pre-baseline walking and post-taped walking on neutral feet (5.61 ± 0.46 vs. 5.77 ± 0.39 cm, p < 0.05), on pronated feet (5.67 ± 0.57 vs. 6.01 ± 0.53 cm, p < 0.001) and on supinated feet (5.97 ± 0.36 vs. 6.28 ± 0.27 cm, p < 0.05). In the MG, EMG activity decreased significantly in the taped condition compared to the baseline condition in neutral subjects (0.0081 ± 0.016 vs. 0.076 ± 0.016 mV, p < 0.05) and in pronated subjects (0.081 ± 0.022 vs. 0.068 ± 0.025 mV, p < 0.05). CONCLUSIONS: It was demonstrated that with the use of LDT, there was an improvement in the average activity in the MG in pronated and neutral feet. All foot types improved in arch height with the use of tape.

Innovative Medial Cushioning Orthoses Affect Peroneus Longus Electromyographic Activity during Running.

Background: Over-supination processes of the foot and ankle involving peroneus longus (PL) damage during running sports have been treated conservatively with passive control tools, such as tapes, braces, or external ankle supports, but the effect of orthoses with typical lateral wedging orthoses (TLWO) on the muscular activity of PL during running remains unclear. Here we investigate the effects of innovative medial cushioning orthoses (IMCO) on PL activity during the full running gait cycle. In addition, we wished to ascertain the effects of innovative medial cushioning orthoses (IMCO) on PL activity during running. Methods: Thirty-one healthy recreational runners (mean age 34.5 ± 3.33) with neutral foot posture index scores, were selected to participate in the present study. They ran on a treadmill at 9 km/h wearing seven different orthoses (NRS, IMCO 3 mm, IMCO 6 mm, IMCO 9 mm, TLWO 3 mm, TLWO 6 mm and TLWO 9 mm), randomly performed on the same day while electromyographic activity of the PL muscle was recorded. Statistical intraclass correlation coefficient (ICC) to test reliability was carried out and the Wilcoxon test with Bonferroni's correction was developed to analyze the differences between the conditions. Results: the reliability of all assessments showed data higher than 0.81, that is, "almost perfect reliability"; all EMG PL values wearing either TLWO or IMCO showed a statistically significant reduction versus NRS during the fully analyzed running gait cycle; the highest difference was set on NRS 23.08 ± 6.67 to TLWO 9 mm 17.77 ± 4.794 (p < 0.001). Conclusions: Muscular EMG activity of the PL during the full running gait cycle decreases when wearing either TLWO or IMCO relative to NRS; therefore, these orthoses could be prescribed to treat the strain and overload pathologies of PL. In addition, IMCO­as it less thick, compared with TLWO­can be used when aiming to achieve better running economy.

Management of post-surgical infection of onychocryptosis with topical application of hyaluronic acid versus antibacterial ointments.

Introduction: The prevention and cure of postoperative infections has been a source of study over the years and is currently being studied. In this bibliographic review, a comparison between the different products used for the prevention and treatment of postsurgical infections has been procured, likewise, being able to determine which would be the best option for the treatment of post-surgical infections. In this bibliographic review we focus on Onychocryptosis because it is an emerging problem today. Many surgeries are performed to fix this condition, which increases the risk of infections. Material: databases, including PubMed and Cochrane Library, as well as websites of international organizations, were searched up to January 2021. The search included studies and trials in humans on the use of hyaluronic acid and antibacterial ointments in various conditions or diseases. Results: 18 articles were analyzed individually, which included randomized studies of Hyaluronic Acid, various antibiotics and honey, and variables used topically. 3 articles were also selected to explain onychocryptosis and postoperative infections. Conclusion: Despite being able to determine which antibiotic would be the best, and whether hyaluronic acid can be used for the prevention and/or cure of post-surgical infections, this review emphasizes that there is still a need for more specific studies on its use of these variables, both in post-surgical infections in general and in post-surgical onychocryptosis infections.

Changes in the Kinematics of Midfoot and Rearfoot Joints with the Use of Lateral Wedge Insoles.

The lateral wedge insole (LWI) is a typical orthopedic treatment for medial knee osteoarthritis pain, chronic ankle instability, and peroneal tendon disorders. It is still unknown what the effects are in the most important joints of the foot when using LWIs as a treatment for knee and ankle pathologies. Objectives: The aim of this study was to determine the influence of LWIs on the position of the midfoot and rearfoot joints by measuring the changes using a tracking device. Methods: The study was carried out with a total of 69 subjects. Movement measurements for the midfoot were made on the navicular bone, and for the rearfoot on the calcaneus bone. The Polhemus system was used, with two motion sensors fixed to each bone. Subjects were compared by having them use LWIs versus being barefoot. Results: There were statistically significant differences in the varus movement when wearing a 4 mm LWI (1.23 ± 2.08°, p < 0.001) versus the barefoot condition (0.35 ± 0.95°), and in the plantarflexion movement when wearing a 4 mm LWI (3.02 ± 4.58°, p < 0.001) versus the barefoot condition (0.68 ± 1.34°), in the midfoot. There were also statistically significant differences in the valgus movement when wearing a 7 mm LWI (1.74 ± 2.61°, p < 0.001) versus the barefoot condition (0.40 ± 0.90°), and in the plantar flexion movement when wearing a 4 mm LWI (2.88 ± 4.31°, p < 0.001) versus the barefoot condition (0.35 ± 0.90°), in the rearfoot. Conclusions: In the navicular bone, a varus, an abduction, and plantar flexion movements were generated. In the calcaneus, a valgus, an adduction, and plantar flexion movements were generated with the use of LWIs.