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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., Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería), Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

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., Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería), Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

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., Sección Deptal. de Radiología, Rehabilitación y Fisioterapia (Enfermería), Fac. de Enfermería, Fisioterapia y Podología, TRUE, pub

El Neuroma de Morton consiste en una fibrosis perineural del nervio plantar digital con un amplio espectro de factores etiológicos como los traumatismos crónicos, la pronación o el atrapamiento que sufre el nervio con el borde anterior del ligamento transverso intermetatarsiano profundo. El diagnóstico debe basarse fundamentalmente en la clínica, siendo de interés los signos de Mulder y Tinel. En caso de duda podemos ayudarnos de la ecografía o la resonancia magnética indistintamente. El tratamiento ortopodológico consiste en una pieza retrocapital y un calzado más amplio. La ablación por radiofrecuencia y las ondas de choque extracorpóreas pueden considerarse como otras líneas de tratamiento aunque la evidencia científica que tenemos de las mismas es escasa; así como las inyecciones localizadas de alcohol, que ecoguiadas pueden reducir significativamente el dolor del paciente. El tratamiento conservador mejor descrito es la infiltración de corticoesteroides, que debe realizarse dorsal, ecoguiada y asociada a un anestésico; sin embargo su efectividad se reduce a los tres meses y un porcentaje significativo de los pacientes recidiva en los siguientes años. Respecto al tratamiento quirúrgico, la neurectomía presenta mayor reflejo en la literatura en comparación con la descompresión endoscópica, refiriendo resultados similares tanto el abordaje dorsal como el plantar si bien es cierto que se observan diferentes efectos adversos en función del abordaje empleado., The Morton Neuroma is a perineural fibrosis with a wide range of etiological factors such as chronic trauma, pronation or nerve entrapment by the anterior edge of the deep transverse metatarsal ligament. Diagnosis should be based in clinical examination, where Mulder and Tinel signs could be helpful. If the diagnosis is still uncertain, we could employ ultrasonography or magnetic resonance equally. Orthesic treatment consists on inserts to reduce pressure beneath the metatarsal heads and widen footwear. Radiofrequency ablation and extracorporeal shock wave therapy could be considered as different treatment lines however the scientific evidence reported is limited. Alcohol injections combined with ultrasonography are also a conservative treatment widely used which have proved relieving significantly pain. The conservative treatment best described is the corticoid injection, which should be performed dorsal, ultrasound guided and with an anesthetic; nevertheless its effectiveness decreases after three months and a significative percentage relapses within the next few years. When it comes to surgical treatment, neurectomy it is the most widely used in published literature compared with endoscopic decompression, referring similar results either dorsal or plantar approach, while it is true the complications vary depending the approach employed.