13 LETTER: TRANSVERSE ARCH IMPORTANCE OVERSTATED 17 HIGHLIGHTS FROM SAWC FALL 2020 VIRTUAL 23 FROM THE LITERATURE 27 MISSIVES FROM THE 3D FRONT LINES 43 LER PEDIATRICS: COACHING TOWARD COGNITIVE ABILITIES 49 PATIENT GUIDANCE: THREE EASY STEPS TO ELIMINATING HEEL PAIN T 800.556.5572 10300 North Enterprise Drive I Mequon, WI 53092 I U.S.A. drcomfort.com I Copyright © 2019 by DJO, LLC I MKT00-8854 Rev A BALANCE. if any, which may be appropriate for you. @drcomfort Dr.Comfort Individual results may vary. Neither DJO Global, Inc. normedical, any of its subsidiaries legal, or any dispense other type medical of professional advice. The advice. contents Rather, of please this sheet consult do not constitute your healthcare professional for information on the courses of treatment, Our new Stability Outsole combines a dual density midsole on the medial side, an EVA and rubber bottom and a wider outsole to aid stability and support. Now available on Roger and Ruth, our newest men’s and women’s athleisure shoe. dr.comfort.com OM19-MKT00-8854-RevA-DRC-Roger-Ruth-LER-Spread-Print-Ad_r3.indd 1 7/8/19 1:43 PM T 800.556.5572 10300 North Enterprise Drive I Mequon, WI 53092 I U.S.A. drcomfort.com I Copyright © 2019 by DJO, LLC I MKT00-8854 Rev A BALANCE. if any, which may be appropriate for you. @drcomfort Dr.Comfort Individual results may vary. Neither DJO Global, Inc. normedical, any of its subsidiaries legal, or any dispense other type medical of professional advice. The advice. contents Rather, of please this sheet consult do not constitute your healthcare professional for information on the courses of treatment, Our new Stability Outsole combines a dual density midsole on the medial side, an EVA and rubber bottom and a wider outsole to aid stability and support. Now available on Roger and Ruth, our newest men’s and women’s athleisure shoe. dr.comfort.com OM19-MKT00-8854-RevA-DRC-Roger-Ruth-LER-Spread-Print-Ad_r3.indd 1 7/8/19 1:43 PM WHAT WE CREATE HERE GETS PEOPLE HERE DEDICATION. INNOVATION. INSPIRATION Join us in creating the best custom orthotics in the business CALL US TO GET STARTED WITH FOOTMAXX 1.800.779.3668 Ler Sept 2.indd 1 9/18/20 11:01 AM November 2020 contents VOLUME 12 NUMBER 11 LERMAGAZINE.COM EDITORIAL APPRECIATION COVER STORY POSTCARDS FROM MAIN STREET 9 2020: THE YEAR THAT WAS! 2020 may be in the rearview 27 MISSIVES FROM THE 3D mirror, but we would be remiss FRONT LINES if we didn’t thank all those who 3D printing has been making helped us through what was, countless inroads into everyday arguably, the most trying year work routines. Here, O&P we as a country have gone through. But we’re still professionals from around the standing thanks to all mentioned here. 33 CLINICAL APPLICATIONS country share their use of 3D OF CUSTOM 3D PRINTED technology. By Janice T. Radak, Editor, and Rich Dubin, IMPLANTS IN COMPLEX Publisher LOWER EXTREMITY By Janice T. Radak & Friends RECONSTRUCTION Four cases of complex lower extremity reconstruction LETTER TO THE EDITOR – failed total ankle arthroplasty, talus avascular LER PEDIATRICS 13 TRANSVERSE ARCH necrosis, ballistic trauma, and nonunion of a tibial osteotomy – showcase how 3D printing technology 43 CAN’T VS DOESN’T IMPORTANCE OVERSTATED allows for innovative solutions. UNDERSTAND: COACHING Responding to a September 2020 LER article on the TOWARD COGNITIVE ABILITIES importance of the transverse arch, this author notes By Rishin J. Kadakia, MD, Colleen M. Wixted, Successful patient care requires missing sources that offer counter evidence. Nicholas B. Allen, Andrew E. Hanselman, MD, and Samuel B. Adams, MD good communication. This By Kevin A. Kirby, DPM author, an expert in dealing with patients of all ages on the Autism HIGHLIGHTS FROM SAWC Spectrum, offers insights for meeting patients where they are. AD INDEX 17 • Hematoma Algorithm May Improve Outcomes By Eric Chessen, MS 57 GET CONTACT INFO FOR ALL OF • Gellable Fiber Dressing in Chronic OUR ADVERTISERS Venous Leg Ulcers PATIENT GUIDANCE • Measuring Topical Oxygen Therapy NEW & NOTEWORTHY Result with NIRS 49 THREE EASY STEPS TO ELIMINATING HEEL PAIN 58 PRODUCTS, ASSOCIATION A take-home primer for patients NEWS & MARKET UPDATES FROM THE LITERATURE with plantar fasciitis. • Low Energy Increases Fall Risk in CROSSWORD PUZZLE 21 By Paul J. Betschart, DPM, Older Adults FACFAS 62 TEST YOUR KNOWLEDGE OF • Don’t Try This for Ankle Stability INFORMATION FROM THIS • 3D Printed Insoles Offer New Hope ISSUE for Patients with Diabetes The views and opinions expressed in this issue are those of the authors and do not necessarily reflect the official policy or position of Lower Extremity Review. “My patients keep thanking me… for relieving their foot problems with PediFix® Medical Footcare Products” “I save valuable time not having to make palliative pads and get excellent results with the PediFix line,” adds another specialist. Your patients will express their gratitude too, for the instant and long-lasting pain relief you’ll provide with Conservative Care Footcare Products from PediFix. Don’t be fooled by imitations. Our proven designs, Congrats exclusive materials and old-world craftsmanship combine to provide you and your patients with durable to Rich devices that really work. 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Please send me: ☐ Free Catalog ☐ Free Product Sample PRODUCT NAME / # ___________________________________________________________________________________ For a free catalog, product sample My Name ________________________________________________________________________ or more information, Practice/Clinic Name ____________________________________________________________ Call: 1-800-424-5561 or 845-277-2850 Address __________________________________________________________________________ FAX: 1-800-431-7801 or 845-277-2851 City ________________________________________State ______ Zip _____________________ Phone ____________________________________________________________________________ E-mail: [email protected] Fax _______________________________________________________________________________ To order, contact your favorite PediFix supplier: Email ____________________________________________________________________________ McKesson In our practice, we see approximately ___________ (#) patients each week. Henry Schein My favorite supplier is ____________________________________________ Gill Podiatry I prefer: to Dispense to Prescribe Patient Direct Order Call for more ☐ ☐ ☐ Mail to: PediFix, Dept. LER819, 301 Fields Lane, Brewster, NY 10509 Fax to: 845-277-2851 Please provide all information requested. Allow 2 weeks for delivery. © 2019 PediFix, Inc. LER819 This offer is for healthcare professionals only. 19113-Quote Ad LER819.indd 1 7/24/19 11:33 AM Lower Extremity Review Mission Showcasing evidence and expertise across multiple medical disciplines to build, preserve, and restore function of the lower extremity from pediatrics to geriatrics. EDITORIAL PILLARS • Biomechanics matter • Injury prevention is possible • Diabetic foot ulcers can be prevented • Collaborative care leads to better outcomes Richard Dubin Publisher and Chief Executive Officer [email protected] | 518.221.4042 EDITORIAL ADVISORY BOARD STAFF David G. Armstrong, DPM, MD, PhD Stefania Fatone, PhD, BPO Bijan Najafi, PhD Professor of Surgery and Director, Professor, Physical Medicine & Professor of Surgery Editor Southwestern Academic Limb Salvage Rehabilitation Director, interdisciplinary Consortium on Alliance (SALSA), Keck School of Northwestern University Advanced Motion Performance (iCAMP) Janice T. Radak | [email protected] Medicine of the University of Southern California, Los Angeles, California Chicago, Illinois Director, Clinical Research in Vascular Surgery Associate Editor Timothy E. Hewett, PhD Windy Cole, DPM Baylor College of Medicine Director, Biomechanics Laboratories & Laura Fonda Hochnadel | [email protected] Medical Director, Wound Care Center, Houston, Texas University Hospitals Ahuja Medical Sports Medicine Research Center Consulting Editor Center Mayo Clinic Antonio Robustelli, MSc, SCS Adjunct Professor/Director Wound Care Minneapolis, Minnesota Sports Performance Consultant John Baranowski | [email protected] Research Applied Sport Scientist/Technologist Geza Kogler, PhD, CO Kent State University College of Podiatric Strength & Conditioning Specialist Graphic Design/Production and Medicine Program Director Salerno, Italy Website Development Cleveland, Ohio MS Prosthetics and Orthotics Anthony Palmeri | PopStart Web Dev Kennesaw State Unversity, Clinical Jarrod Shapiro, DPM Robert Conenello, DPM Biomechanics Laboratory [email protected] Vice Chair, Department of Podiatric Orangetown Podiatry Kennesaw, Georgia Medicine, Surgery & Biomechanics Clinical Director, NJ Special Olympics Associate Professor of Podiatric Operations Coordinator Robert S. Lin, CPO NYPD Honorary Surgeon Medicine, Surgery & Biomechanics Managing Partner, Adaptive Prosthetics Melissa Rosenthal-Dubin | [email protected] Greater