34-2 Foot Drop

© 2023 by Data Trace Publishing Company. All rights reserved. Reproduction or translation of any part of this work beyond that permitted by Section 107 or 108 of the United States Copyright Law without the permission of the copyright owner is unlawful. No portion(s) of the work(s) may be reproduced without written consent from Data Trace Publishing Company. Permission to reproduce copies of articles for non-commercial use may be obtained for a fee of $22 per copy from the Copyright Clearance Center, 222 Rose wood Drive, Danvers, MA 01923, 978-750-8400, www.copyright.com.

The ideas and opinions expressed in Foot and Ankle Quarterly are those of the authors and do not necessarily reflect those of the Editor or the Publisher. Publication of an advertisement or other product mentioned in Foot and Ankle Quarterly should not be construed as an endorsement of the product of the manufacturer’s claims. Readers are encouraged to contact the manufacturer with any questions about the features or limitations of the products mentioned. The Publisher does not assume any responsibility for any injury and/or damage to any persons or property arising out of or related to any use of the material contained in this periodical. The reader is advised to check the appropriate medical literature and the product information currently provided by the manufacturer of each device or of each drug to be administered to verify the dosage, the method and duration of administration, or contraindications. It is the responsibility of the treating physician or other healthcare professionals, relying on independent experience and knowledge of the patient, to determine drug dosages and the best treatment for the patient.

Disclosure

Data Trace Publishing Company Continuing Education Mission Statement

Data Trace Publishing Company is committed to providing high-quality print and internet-based enduring continuing education programs, including lectures, feature articles, and condensations and commentaries on current clinical podiatric topics and medical risk management topics which lead to improved delivery of patient care and help reduce the potential for medical errors. These programs are provided to meet the educational needs of the podiatric medical profession and thereby enhance the quality of patient care.

Program Objectives

Foot and Ankle Quarterly (FAQ) is a unique program designed to help today’s podiatric physician manage an ever-increasing flow of information. After completing the Foot and Ankle Quarterly, Volume 34 program, the learner should be better able to: develop and refine a perspective on current treatment recommendations, updates, and advances pertinent to podiatric practice; evaluate the implications of the learned information as it pertains to the diagnosis and treatment of podiatric disorders and societal issues and barriers, and; apply current trends, standards, and best practices into learner’s own practice.

Data Trace Publishing Company Continuing Education Accreditation Statement

Data Trace Publishing Company is approved by the Council on Podiatric Medical Education (CPME) as a provider of continuing education in podiatric medicine. Data Trace Publishing Company has approved this activity for a maximum of 6 continuing education contact hours (CECHs). Physicians should claim only the contact hours commensurate with the extent of their participation in the activity.

Estimated time to complete activity: 6 hours
Date of release: August 31, 2023
Expiration Date: August 31, 2026 (unless further validated and extended by provider). For amended dates of activity expiration, please see FAQ Activity Effective Dates at www.datatrace.com).

Commercial Interests

No commercial interest provided financial support for this continuing education activity.

CECH Note

Participants of Volume 34, Issue 2 will receive a maximum of 6 CECHs for a correctly-completed CME Answer Form. In order to qualify for CECHs, a score of 70% or more must be achieved on the written examination material. Any participant who does not pass the first time may take the exam one additional time (within 90 days of receipt of results). One retake test may be taken for a fee of $15. You will be responsible for notifying your state of the number of contact hours you have received.

Participants are required to complete a course evaluation for use in developing future issues and to meet the unique educational needs of podiatric physicians.

FINANCIAL DISCLOSURE INFORMATION

It is the policy of Data Trace Publishing Company to ensure balance, independence, objectivity, and scientific rigor in all of its educational programs. All faculty, presenters, speakers, authors, and reviewers participating in any programs provided by Data Trace Publishing Company are expected to disclose any relevant financial relationships with CPME-defined commercial interests to the program audience. “Relevant financial relationships” are financial relationships of the individual (including those of the individual’s spouse or partner) in any amount occurring within the past 12 months that create a conflict of interest. A commercial interest is any organization manufacturing, producing, marketing, re-selling, or distributing healthcare goods or services consumed by or used on patients. The CPME mandates that the content of accredited activities be objective and independent of commercial bias. The intent of this policy is that readers may form their own judgements about the presentations, using independent review to resolve all identified conflicts of interest.

In addition to disclosing commercial relationships, faculty are advised of the following policies:

Each continuing education planner and author has submitted a Conflict of Interest Disclosure in order to identify relevant financial relationships and resolve conflicts.

Limitations on Data: Presenter will ensure, to the extent possible, meaningful disclosure of limitations on data (e.g., ongoing research, interim analyses, preliminary data, or unsupported opinion).

Discussion of Unapproved Uses: If unapproved (unlabeled) uses are discussed during the continuing education activity, the presenter will disclose when a product is not approved in the United States (and/or the nation where the activity takes place) for the use under discussion.

Data Trace Publishing Company has identified the option to disclose as follows:

The following authors have disclosed whether they or a member of their immediate family:

1. Will be receiving an honorarium for this activity
2. Within the past 12 months, had a financial or other significant relationship with a commercial organization that markets a product to which they will refer as speaker or author:
   1. Received monetary or other significant research support
   2. Are or had been a paid consultant
   3. Are or had been a full-time or part-time employee
   4. Are or had been a paid or unpaid member of an advisory or similar board
   5. Are or had been a member or on the Board of Trustees
   6. Other
3. Within the past 12 months, had a financial or other significant relationship with a commercial organization that markets a product to which they will refer as speaker or author, BUT will not be recommending any of their products over similar competitor products
4. Within the past 12 months, had a financial or other significant relationship with a commercial organization that markets a product to which they will refer as speaker or author, AND will be recommending one or more of their products over similar competitor products. Recommendation will be based on:
   1. Exclusively on data and/or clinical experience not generated by the manufacturer or derived from manufacturer-sponsored studies
   2. Data and/or clinical experience most of which were not generated by the manufacturer or derived from manufacturer-sponsored studies
   3. Data and/or clinical experience, most of which were generated by the manufacturer or derived from manufacturer-sponsored studies
   4. Exclusively on data and/or clinical experience generated by the manufacturer or derived from manufacturer or derived from manufacturer-sponsored studies
   14. Have no conflicts to disclose

Article Authors and Lecturers

• Julie Abboud (1. Data Trace Publishing Co.)
• Arwa El-Sayed (n.)
• Kittra T. Owens (n.)
• Asim A.Z. Raja (n.)
• Wynn Rajan (n.)
• Alexander T. Ruutiainen (n.)
• Steven Shannon (1. Data Trace Publishing Co.)
• Sarah A. Spizzirri (n.)
• Ronnell Upshur (n.)
• James P. Wilton (1. Data Trace Publishing Co.)
• Jacob Wynes (n.)
• Marija Ugrinich (1. Data Trace Publishing Co.)

 FAQ Journal Planning Committee

• Chrissy Wesolowski (n.)
• Lauren Molander (n.)
• Stephanie Wu, DPM, MSc (n.)

The content and opinions in this issue are strictly those of the authors, and do not represent the views of the United States Department of Veterans Affairs or the United States Government.

Foot and Ankle Quarterly
34-1 Contributors

Guest Editor

Marija Ugrinich, DPM, FACFAS
Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA; Co-Director, Prevention of Amputations of Veterans Everywhere (PAVE) Committee; Clinical Associate Adjunct Professor, Department of Surgery, Temple University School of Podiatric Medicine; Fellow, American College of Foot and Ankle Surgeons

Contributors

Julie Abboud, DPM, MS, FAENS
Private practice, Greenville, WI;  Fellow, President (2022-2023) and Faculty of Basic Peripheral Nerve Surgery Course, Association of Extremity Nerve Surgeons, San Antonio, TX; Member, American Society of Peripheral Nerve; Diplomate, American Board of Podiatric Medicine; Certified Wound Specialist, American Board of Wound Management

Arwa El-Sayed, DPM
Provider, University of Pennsylvania Lancaster General Health, Lancaster, PA

Kittra T. Owens, DPM, FACFAS, FACPM
Chief of Staff, Central Alabama Veterans Health Care System; Diplomate, American Board of Foot and Ankle Surgery; Diplomate, American Board of Podiatric Medicine; Assistant Professor, University of Nevada Las Vegas School of Medicine, Las Vegas, NV; Adjunct Professor, Temple University School of Podiatric Medicine, Philadelphia, PA

Asim A.Z. Raja, DPM
Section Chief, Podiatry Service, Department of Orthopedics and Rehabilitation, Womack Army Medical Center, Fort Bragg, NC

Wynn Rajan, DPT
Physical therapist, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA

Alexander T. Ruutiainen, MD
Service Chief of Diagnostic Radiology, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA

Steven Shannon, DPM, FACFAS
Attending Podiatric Physician, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA; Adjunct Associate Professor, Temple University School of Podiatric Medicine, Philadelphia, PA; Fellow, American College of Foot and Ankle Surgeons

Sarah A. Spizzirri, DPM, FACFAS
Private Practice, Christie Clinic, Department of Foot and Ankle Surgery, Champaign, IL; Fellow, American College of Foot and Ankle Surgeons; Associate, Association of Extremity Nerve Surgeons

Ronnell Upshur, CPO
Advanced Practitioner, Certified Prosthetist Orthotist, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA; Member, American Academy of Orthotists and Prosthetists

James P. Wilton, DPM
Cottage Hospital, Woodsville, NH; Valley Regional Hospital, Clarement, NH; Fellow, Vice Chair Board of Trustees, Director of Basic and Advanced Peripheral Nerve Surgery Course, Association of Extremity Nerve Surgeons, San Antonio, TX; Fellow, American College of Foot and Ankle Surgeons; Member, American Society of Peripheral Nerve; Surgical Missions Director, Fundación Padre Damien Guayaquil, Ecuador

Jacob Wynes, DPM, MS, FACFAS
Assistant Professor, Program Director, Limb Preservation Deformity Correction Fellowship, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD