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regions to prevent these regions from the onset and recurrence of DFU, which is done by encouraging effective pressure off-loading. 28 , 33 , 34 Nevertheless, the efficacy and feasibility of these techniques are rarely studied in clinical practice
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Department of Surgery, EOC, Service of Orthopaedics and Traumatology, Lugano, Switzerland
Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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for foot problems ( 60 , 61 ). This finding is of high clinical relevance and questions the real efficacy of the conservative treatments used for the management of plantar fasciitis. In fact, an improvement reported after a hypothetically effective
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clinical efficacy and clinical effectiveness of LIPUS therapy in the foot and ankle exist. A clinical efficacy study investigating the use of LIPUS therapy in a particular area, such as delayed unions in 5th metatarsal fractures, may utilize a double
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useful modicum of osteo-inductive potential, in addition to its osteo-conductive properties. 14 In foot and ankle surgery, there are a good number of clinical studies documenting the efficacy and safety of allograft usage in primary arthrodesis and
Department of Surgery, Universidad de La Laguna, Tenerife, Spain
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University of Basel, Basel, Switzerland
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Department of Orthopedic and Rehabilitation, University of Iowa, Iowa, USA
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Department of Surgery, Universidad de La Laguna, Tenerife, Spain
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Department of Surgery, Universidad de Sevilla, Sevilla, Spain
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-term studies to determine its long-term efficacy ( 73 ). Bipolar allograft Designed with the idea of replacing the ankle joint with a fresh total allograft (fixed to the distal tibia and talus with screws), it is a novel and complex procedure. Clinical
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prospective, randomized, double-blinded study compared two calf-stretching regimens for PF and it was confirmed that Achilles stretching alone was an effective treatment. 53 Several Level-I and Level-II clinical studies demonstrate the efficacy of home
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provided encouraging results. In particular, most recent studies have focused on the efficacy and safety of subtalar arthoereisis, a surgical alternative considered minimally invasive and safer than soft-tissue and bony procedures (osteotomies and
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prognostic variables are proposed (see Table 1 ). Table 1. Prognostic factors and their relationship to clinical outcome Better outcome Undetermined Worst outcome Young 14 Low grade 20 Low activity level 1 , 14 , 17
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locking or catching of the ankle. Often, recurrent sprains and unbalanced loading of the entire foot go along with the ankle problem. A thorough clinical examination of the patient focussing on the location of tenderness and swelling of the ankle
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United States, 6 approximately £650 million annually in the UK and > €10 billion annually in Europe. 2 Optimal management of patients with DFUs includes clinical awareness, adequate blood glucose control, periodic foot inspection, custom
