Héctor Pereiro-Buceta

Background and Objectives: Local anesthesia is essential in podiatry, ensuring painless procedures. Technological and pharmacological advances require us to stay updated on the safest and most effective techniques. Lidocaine and bupivacaine are common anesthetics in this field, with the choice of technique tailored to each procedure. To evaluate the effectiveness and safety of local anesthesia techniques in reducing pain in podiatric procedures. Materials and Methods: A systematic review followed PRISMA guidelines, searching for studies in PubMed, Scopus, and Web of Science published in the last 10 years in English and Spanish. Studies focused on local anesthesia in podiatry were included, excluding those unrelated or without validated results. Results: Of 485 initial studies, nine were selected that met all criteria. These studies demonstrated the efficacy and safety of various local anesthesia techniques, such as WALANT and ultrasound-guided peripheral nerve blocks, highlighting their effectiveness in pain control and patient satisfaction. Conclusions: Local anesthesia techniques are effective in reducing pain in podiatric procedures. The safety of these techniques is high, with few serious complications. Local anesthesia without a tourniquet and specific techniques, such as subparaneural injection, are effective for pain control. Individual patient factors and surgeon experience influence results.

Background and Objectives: The Reverdin–Isham osteotomy via minimal incision is a prominent option for the surgical treatment of hallux valgus, a foot deformity characterized by medial deviation of the first metatarsal and lateral deviation of the first toe. This technique is particularly indicated for cases with an elevated proximal articular angle, enabling effective correction and improved foot functionality. However, its efficacy has not been fully established in the scientific literature. Objective: The main objective of this analysis was to evaluate the correction of radiological angles (PASA, IMA, and HVA), the improvement in functionality according to the AOFAS scale, pain reduction, and patient satisfaction. Materials and Methods: A systematic review was conducted following the PRISMA guidelines in scientific databases such as PubMed, Scopus, and Web of Science, assessing publication biases and heterogeneity. Ten studies were included, covering 579 procedures in 500 patients, with an average follow-up of 33.8 months. Results: The results did not show significant improvements in the PASA (p = 0.14; CI [−1.52, 0.32]), not in the AIM (p = 0.05; CI [−2.63, 0.02]), although the meta-regression was statistically significant (p = 0.0022) with a ratio of 61.2%. It did show significant improvements in the AHV (p = 0.0009; CI [−3.14, −1.33]). An increase of 37.4 points in the AOFAS scale was revealed, and a 5.4-point reduction in pain. Patient satisfaction was high, with 89.3% of patients satisfied and 94.7% willing to undergo the procedure again. However, 20 major complications were reported, primarily recurrences. Conclusions: The Reverdin–Isham osteotomy is a safe and effective technique for treating mild-to-moderate hallux valgus. It offers significant improvements in foot functionality and pain reduction, with high patient satisfaction rates. Although recurrences remain the main complication, their low frequency reinforces the validity of the technique as a surgical option for specific deformities.

There are studies that show the better balance after dry needling in lumbar pain. However, the postural control effects after foot dry needling are unknown. Check if dry needling changes postural control. Eighteen subjects with flexor digitorum brevis (FDB) muscle Myofascial trigger point were evaluated pre- and post-deep dry needling. We measured stabilometric variables in a pre-post study. We have found significant differences in three stabilometric variables: surface with eyes closed (29.36-53.21 mm(2)) (p = 0.000), medium speed of the laterolateral displacement with eyes closed (1.42-1.64 mm/s) (p = 0.004), and medium speed of the anteroposterior displacement with eyes closed (1.30-1.53 mm/s) (p = 0.025). Dry needling therapy application in FDB muscle reduces standing postural control with eyes closed.

Background: The Rheumatoid Arthritis Foot Disease Activity Index (RADAI-F5) questionnaire, based on five questions, is used to assess the severity of rheumatoid arthritis disease in the foot. Nowadays, RADAI-F5 has been validated in different languages; however a Spanish version was lacking. Therefore, the purpose of this research was to translate and validate the Spanish version (RADAI-F5-es). Methods: A cross-cultural translation of the RADAI-F5 questionnaire was performed from English to Spanish. To validate its use, 50 subjects with rheumatoid arthritis who responded to the translated questionnaire two times in an interval of less than 3 months were selected in order to verify the psychometric properties. Results: Excellent agreement between the two versions according to the Cronbach’s α was shown. Five domains with regards to arthritis activity in foot joint tenderness and swelling, foot arthritis pain, general foot health and joint stiffness were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for joint stiffness on awakening and foot arthritis pain domains. There were no significant differences among any domains (p > 0.05). There were no statistically significant differences (p = 0.000) for the mean ± standard deviations (SD) between pre- and post-tests (98.09 ± 15.42) [93.75–102.43] and 97.96 ± 13.88 [94.5–101.86] points, respectively). Bland–Altman plots or clinically pertinent variations were not statistically significantly different. Conclusions: The RADAI-F5-es is considered a valid and strong tool with adequate repeatability in the Spanish community.

Based on the high prevalence of asthma in the population, and its relationship with various musculoskeletal and postural disorders, the aim of this study was to evaluate the plantar pressures in asthmatic patients compared to a control group. A case-control study involving 90 participants was conducted, consisting of 45 asthma patients and 45 healthy paired controls. Static plantar pressure data were recorded using a portable pressure sensor platform. Statistically significant differences were shown in the body weight on the left heel (p = 0.031), and the right forefoot maximum peak pressure was lower in the case group (p = 0.042). The findings of this study show alterations in static plantar pressures in asthmatic patients compared to healthy individuals. Specifically, the subjects with asthma showed less maximum pressure in the right forefoot and less weight on the left heel, which appear to be associated with the asthma disease.

Background: The effect of Leg-Length Discrepancy (LLD) on dynamic gait parameters has been extensively discussed. Podobarography is the study of foot-to-ground pressure distribution. It has been used to test plantar footprint deviations that could reveal pathology. Purpose: The aim of this study is to determine the effects of simulated LLD on dynamic gait parameters measured with a pressure platform in healthy subjects. Methods: Thirty-seven healthy subjects participated in observational cross-sectional research. A procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Support time, mean pressure, and peak pressure measures were registered on three trials for each foot and LLD level per session. An analysis of variance (ANOVA) test for repeated measures was performed to check for differences between the different simulated LLD levels. Results: The stance time of the short leg had no significant changes. The stance time of the long leg increased by 3.51% (p < 0.001), mean pressure of the short leg increased by 1.23% (p = 0.005), and decreased by 5.89% in the long leg (p < 0.001). Peak pressure of the short leg decreased by 2.58% (p = 0.031) and the long leg decreased by 12.11% (p < 0.001). Conclusions: This study demonstrates that increasing LLD causes an asymmetrical foot-loading pattern, with decreased mean and peak pressure on the longer limb, and consequently an overload on the short side. Furthermore, an increasing LLD causes increased stance time on the long leg.

Leg length discrepancy (LLD) may play a key role in exercise biomechanics. Although the Podoprint platform has been used in dynamic pressure studies, there are no data regarding the reliability and repeatability of dynamic measurements under simulated LLD conditions. To determine the intra and intersession repeatability and reliability of dynamic parameters of the Podoprint pressure platform under simulated LLD conditions. Observational cross-sectional study at a public university. Thirty-seven healthy volunteers participated in this study. LLD was simulated using ethyl vinyl acetate plantar lifts with heights of 5 mm, 10 mm, 15 mm and 20 mm located under the right shoe of each volunteer. The procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Stance time, mean pressure and peak pressure measurements were registered in three trials for each foot and each LLD level. Data were collected during two separate testing sessions, in order to establish intrasession and intersession reliability. The intraclass correlation coefficients (ICCs) for intrasession reliability ranged from 0.775 to 0.983 in the first session and from 0.860 to 0.985 in the second session. The ICCs for intersession reliability ranged from 0.909 to 0.990. Bland-Altman plots showed absence of systematic measurement errors. The results from this study indicate that the Podoprint platform is a reliable system for assessing dynamic parameters under simulated LLD conditions. Future studies should evaluate plantar pressures under LLD conditions, in association with exercise, biomechanics and musculoskeletal disorders.