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Podiatry Research and News

As with any branch of medicine and healthcare, research in podiatry and chiropody is constantly undertaken to improve treatment technqiues and increase the rate of successful pateint outcomes following podiatric proceedures. New podiatric instrumention and equipment is produced through research and development in order to aid diagnosis and improve patient treatment. Patient care pathways are established, which are particularly important when the patient has multiple conditions which may or may not be interelated to their podiatric condition or conditions.

Podiatric research and development is carried out by podiatrists within the NHS, private practice, universities and other educational institutions and by instrumentation and medical equipment manufacturers.

The effectiveness of new podiatric treatments and patient care pathways must be monitored in order to ascertain whether or not they are successful and cost effective. Ideally podiatric or medicinal research should take the form of a double blind trial. However, due to the particular method of treatment involved and / or the availability of suitable podiatry patients, research reports may often take the form of case study reviews. Results of new podiatric treatments may be published in a range of medical and scientific journals. Journals relevant to podiatry include:

In order to keep up to date with the latest developments podiatrists and heathcare professionals should regularly review research literature and publications.

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Antifungal Socks Helped Prevent Recurrence of Toenail Fungus

Recurrence of toenail funugus (onychomycosis) and athlete's foot (tinea pedis) can affect as many as 87% of poditary patients. People suffering from toenail fungus and athlete's foot are typcially treated using an orally adminstered drug such as itraconazole. It is thought that re-infection occurs because patients wear shoes and socks that are contaminated with fomites carrying the fungal infection.

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Foot Orthotics Research

A study to compare the success rate of customised foot orthotics and off-the-shelf foot orthotics. Funded by the American Podiatric Medical Association (APMA), the study will be focusing on patients with heel pain (plantar fasciitis).

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Journal of Foot and Ankle Research Receives over 3,200 Visits per Month

"[The] Journal of Foot and Ankle Research the official journal of the Australasian Podiatry Council and the Society of Chiropodists and Podiatrists (UK), is an open access, peer reviewed, online journal that encompasses all aspects of policy, organisation, delivery and clinical practice related to the assessment, diagnosis, prevention and management of foot and ankle disorders".

First conceived in 2004 and set up over the following 4 years, the Journal of Foot and Ankle Research published its first papers in July 2008. By April 2009 it had published 22 papers covering a wide range of subjects and research topics. The fact that JFAR is an on-line journal means that statistics about the visitors can easily be recorded. Web statistics from November 2008 to January 2009 show that the Journal of Foot and Ankle Research received an average of over 3,200 visits per month. Just under 55% of visits originated from Search Engines, 29% were from Referring Sites and 16% were direct traffic. One third of visitors were from the United States and just under a third were from the United Kingdom. There were 17.5% of visitors from Australia. Visitors also came from Europe, Canada, India and New Zealand.

The most accessed paper so far was written by Menz et al. and is titled "Plantar calcaneal spurs in older people: longitudinal traction or vertical compression?" Recent publications include:

The Journal of Foot and Ankle Research can be found at https://www.jfootankleres.com.
The Editors-in-Chief of JFAR are Hylton Menz (Musculoskeletal Research Centre, La Trobe University) and Michael Potter (University of Southampton).

Reference:
Potter, M. and Borthwick, A. (2009). Journal of Foot and Ankle Research - JFAR. Podiatry Now, 12, 5, May 2009.

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Breakthrough Podiatric Research


There are many areas of research within the field of podiatry. The primary aim of all the research is to improve treatment of conditions effecting the lower limbs. Research includes areas such as development of new materials and designs for prosthetic limbs and orthoses, analysis into how different conditions effect a patient's gait, developing new methods of podiatric sugery, improvemnents in wound care and increasing knowledge of conditions that effect the feet, knees and ankles.

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Important Researchers - Who's Who in Podiatry

Ronald Laxton

Ronald Laxton (1929-2008) qualified at the London Foot Hospital in 1947. After working in the army as a chiropodist, he set up a private podiatry practice. In 1969 he formed the Croydon Postgraduate Group and eventually the Podiatry Association (PA). Despite some opposition, Ronald Laxton was instrumental in ensuring that his ground breaking research into local anaesthesia (LA) and foot surgery were to become part of the mainstream healthcare profession. (French, 2009).

"I consider Ron to be the father of podiatry surgery, his courses on local anaesthesia paved the way for the development of podiatric surgery as well as podiatry".

Peter C Smith, Podiatry Association Founder Member (Smith, 2007)

References:
Smith, P.C.(2007). The first podiatry operating theatre. Podiatry Now, November 2007.
French, G. (2009). Obituary: Ronald Laxton 1929-2008. Podiatry Now, 12, 2, February 2009.

Mike O'Neil

In a series focusing on medical specialisms on the BBC website, Mike O'Neil talks about podiatry and the role of the podiatric surgeon.

Chiropodists and podiatrists deal with the assessment, diagnosis and treatment of the feet, ankles, knees and lower limb and are qualified to carry out nail surgery and to treat people with arthritis, diabetes and sports injuries. There is no difference between a chiropodist, and podiatrist. The latter is the term used by other English speaking countries for a chiropodist.

What is your job as a podiatrist?

I am a podiatric surgeon based at the Thames Valley Nuffield Hospital and the Princess Margaret Hospitals in Berkshire. I also work for the NHS at Newham General Hospital. My job is primarily looking after people with foot pain and other muscular skeletal problems associated with the way they walk and how the foot functions.

What is the most common conidtion that you encouter as a podiatric surgeon?

The most common condition I see is probably the correction of hammer toe deformities and bunions.

Hammer toes produce large corns and calluses either on the top or end of the toe causing problems when both walking and wearing any normal footwear.

The most common non-surgical feet problems that I see is heel pain (plantar fasciitis). This is where a ligament on the inside of the foot attaching to the heel bone becomes very inflamed, usually causing severe discomfort on arising from bed in the morning. It can also lead to pain developing on the inside of the arch and heel after standing for several hours. Treatments for these usually involve the production of a special insole called an orthotic device which helps to control and improve the foot function. It is also very important that I teach these patients how to help themselves through a rehabilitation programme involving stretching and strengthening exercises and helping them choose the correct footwear.

What is the most common podiatric proceedure?

The most common procedure is the surgical management of ingrowing toenails. These affect a very high percentage of the population at some time in their life.

What is the hardest thing about your job as a podiatric surgeon?

People with foot pain unfortunately nearly always have to get better while continuing to use the feet. Educating patients that some treatments require rest, either with the foot elevated or a change of footwear and activity levels, is sometimes very difficult, even for a short period.

What was your most satisfying podiatry case?

It is always nice when dealing with elite athletes when you help them recover from an injury and then see them achieving at the peak of their career. Podiatry also has the ability to give the immediate relief of foot pain to many patients presenting with corns, calluses or ingrowing toenails. However it is more satisfying when you see a patient that has been attending for regular podiatry chiropody treatment every month for the last five or six years undergoing a relatively simple procedure which results in them getting back to normal footwear and not requiring to attend for regular monthly treatments.

Why did you chose podiatric surgery as your speciality?

I enjoy working with people. And the complexity of foot mechanics makes the feet a very interesting and challenging part of the body to work with. I enjoy mixing the surgical practice with the muscular skeletal injuries that can be dealt with by non-surgical methods.

If you had your time again would you change your speciality?

No, I am passionate about feet.

How do you see the role of the podiatric surgeon developing in the future?

There are currently about 12,000 podiatrists in the UK, but only 150 Podiatric Surgeons, with less than 60 NHS Podiatric Surgical units. Foot pain is on the increase due both to people standing many hours in their jobs, wearing poor footwear. Also, increased sporting activities produce extra stresses and strains on the feet and lower limb. Hopefully one day every major hospital will have a department of surgical podiatry and podiatric biomechanics.