John Vanore - Academia.edu (original) (raw)

Papers by John Vanore

Journal of Foot and Ankle Surgery

Journal of Foot & Ankle Surgery, 2000

Foot ulcerations, infections, and Charcot neuropathic osteoarthropathy are three serious foot com... more Foot ulcerations, infections, and Charcot neuropathic osteoarthropathy are three serious foot complications of diabetes mellitus that can too frequently lead to gangrene and lower limb amputation. Consequently, foot disorders are one of the leading causes of hospitalization for persons with diabetes and can account for expenditures in the billions of dollars annually in the U.S. alone. Although not all foot complications can be prevented, dramatic reductions in their frequency have been obtained through the implementation of a multidisciplinary team approach to patient management. Using this concept, the authors present a Clinical Practice Guideline for diabetic foot disorders based on currently available evidence. The underlying pathophysiology and treatment of diabetic foot ulcers, infections, and the diabetic Charcot foot are thoroughly reviewed. Although these guidelines cannot and should not dictate the standard of care for all affected patients, they are intended to provide ev...

It was developed by a panel of ACFAS physician volunteers based on consensus of current clinical ... more It was developed by a panel of ACFAS physician volunteers based on consensus of current clinical practice and review of the clinical literature. It provides information and accepted approaches to treatment and/or diagnosis. It is not intended to be a fixed protocol, as some patients may require more or less treatment or different means of diagnosis. Patient care and treatment should always be based on a clinician's independent medical judgment, given an individual patient's clinical circumstances.

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 2009

Forefoot pain is a common presenting complaint seen by foot and ankle surgeons. Patients often de... more Forefoot pain is a common presenting complaint seen by foot and ankle surgeons. Patients often describe their pain in a vague and encompassing manner. The purpose of this clinical practice guideline is to review the varied pathologies that comprise the differential diagnosis of forefoot pain, with the exclusion of disorders of the first ray. The pathologies in the differential diagnosis range from acquired orthopedic deformities (eg, hammertoes, digital deformities) to overuse problems and traumatic injuries. These clinical problems, encountered daily by the foot and ankle surgeon, typically involve the lesser toes and metatarsals and their respective joints. Presented in this document are current practice guidelines for the diagnosis and treatment of hammertoe (digital deformities) (Pathway 2); central metatarsalgia (Pathway 3); Morton’s neuroma (Pathway 4); tailor’s bunion (Pathway 5); and trauma (Pathway 6). Digital Deformities (Pathway 2)

Trauma to the toes, lesser metatarsals, and their respective joints involves various mechanisms a... more Trauma to the toes, lesser metatarsals, and their respective joints involves various mechanisms and injury types (1, 2). These include a history of both direct and indirect trauma. Patients may exhibit symptoms acutely at the time of trauma or at a later onset. Symptoms include pain, swelling, discoloration, loss of joint motion, and difficulty standing and/or walking. An accurate history of the inciting traumatic event should be elicited.

Forefoot pain is a common presenting complaint seen by foot and ankle surgeons. Patients often de... more Forefoot pain is a common presenting complaint seen by foot and ankle surgeons. Patients often describe their pain in a vague and encompassing manner. The purpose of this clinical practice guideline is to review the varied pathologies that comprise the differential diagnosis of forefoot pain, with the exclusion of disorders of the first ray. The pathologies in the differential diagnosis range from acquired orthopedic deformities (eg, hammertoes, digital deformities) to overuse problems and traumatic injuries. These clinical problems, encountered daily by the foot and ankle surgeon, typically involve the lesser toes and metatarsals and their respective joints. Presented in this document are current practice guidelines for the diagnosis and treatment of hammertoe (digital deformities) (Pathway 2); central metatarsalgia (Pathway 3); Morton’s neuroma (Pathway 4); tailor’s bunion (Pathway 5); and trauma (Pathway 6).

The Journal of Foot and Ankle Surgery Official Publication of the American College of Foot and Ankle Surgeons, 2009

This clinical practice guideline (CPG) is based upon consensus of current clinical practice and r... more This clinical practice guideline (CPG) is based upon consensus of current clinical practice and review of the clinical literature. The guideline was developed by the Clinical Practice Guideline Forefoot Disorders Panel of the American College of Foot and Ankle Surgeons. The guideline and references annotate each node of the corresponding pathways.

The Journal of Foot and Ankle Surgery, 2005

The Journal of Foot and Ankle Surgery, 2003

The Journal of Foot and Ankle Surgery, 2010

Heel pain, whether plantar or posterior, is predominantly a mechanical pathology although an arra... more Heel pain, whether plantar or posterior, is predominantly a mechanical pathology although an array of diverse pathologies including neurologic, arthritic, traumatic, neoplastic, infectious, or vascular etiologies must be considered. This clinical practice guideline (CPG) is a revision of the original 2001 document developed by the American College of Foot and Ankle Surgeons (ACFAS) heel pain committee.

The Journal of Foot and Ankle Surgery, 2005

Flatfoot versus a normal foot (Fig 1) is readily apparent with clinical evaluation. The appearanc... more Flatfoot versus a normal foot (Fig 1) is readily apparent with clinical evaluation. The appearance of the foot, both on and off weightbearing, will help define its deformed or compensated condition. Physical examination reveals 1 or more of the following characteristics: depression of the medial longitudinal arch, everted or valgus heel in relaxed stance, and abduction of the forefoot relative to the rearfoot (Figs 2 and 3). Areas of tenderness may be localized with careful palpation of the foot, ankle, and leg; particular attention should be paid to the posterior tibial tendon, lateral rearfoot, and plantar fascia. Range of motion evaluation differentiates the flexible from rigid flatfoot and identifies the degree of abnormal motion that may be present. Flexibility can also be assessed by using the Hubscher maneuver (Jack test) to determine if the deformity is reducible (22, 23). Manual muscle testing and the single heel-rise test assess muscle strength and tendon function (24). Additionally, the double heel-rise test determines reducibility of rearfoot valgus (Figs 1 and 3). Gait observation may show an increased angle of gait, delayed or absent supination of the foot, or decreased propulsion. Footwear patterns also can provide valuable information. Extrapedal manifestations may include genu valgum, shin splits, short tendo-Achilles with calf tenderness,

The Journal of Foot and Ankle Surgery, 2006

Journal of Foot & Ankle Surgery, 2005

Journal of Foot and Ankle Surgery

Journal of Foot & Ankle Surgery, 2000

Foot ulcerations, infections, and Charcot neuropathic osteoarthropathy are three serious foot com... more Foot ulcerations, infections, and Charcot neuropathic osteoarthropathy are three serious foot complications of diabetes mellitus that can too frequently lead to gangrene and lower limb amputation. Consequently, foot disorders are one of the leading causes of hospitalization for persons with diabetes and can account for expenditures in the billions of dollars annually in the U.S. alone. Although not all foot complications can be prevented, dramatic reductions in their frequency have been obtained through the implementation of a multidisciplinary team approach to patient management. Using this concept, the authors present a Clinical Practice Guideline for diabetic foot disorders based on currently available evidence. The underlying pathophysiology and treatment of diabetic foot ulcers, infections, and the diabetic Charcot foot are thoroughly reviewed. Although these guidelines cannot and should not dictate the standard of care for all affected patients, they are intended to provide ev...

It was developed by a panel of ACFAS physician volunteers based on consensus of current clinical ... more It was developed by a panel of ACFAS physician volunteers based on consensus of current clinical practice and review of the clinical literature. It provides information and accepted approaches to treatment and/or diagnosis. It is not intended to be a fixed protocol, as some patients may require more or less treatment or different means of diagnosis. Patient care and treatment should always be based on a clinician's independent medical judgment, given an individual patient's clinical circumstances.

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons, 2009

Forefoot pain is a common presenting complaint seen by foot and ankle surgeons. Patients often de... more Forefoot pain is a common presenting complaint seen by foot and ankle surgeons. Patients often describe their pain in a vague and encompassing manner. The purpose of this clinical practice guideline is to review the varied pathologies that comprise the differential diagnosis of forefoot pain, with the exclusion of disorders of the first ray. The pathologies in the differential diagnosis range from acquired orthopedic deformities (eg, hammertoes, digital deformities) to overuse problems and traumatic injuries. These clinical problems, encountered daily by the foot and ankle surgeon, typically involve the lesser toes and metatarsals and their respective joints. Presented in this document are current practice guidelines for the diagnosis and treatment of hammertoe (digital deformities) (Pathway 2); central metatarsalgia (Pathway 3); Morton’s neuroma (Pathway 4); tailor’s bunion (Pathway 5); and trauma (Pathway 6). Digital Deformities (Pathway 2)

Trauma to the toes, lesser metatarsals, and their respective joints involves various mechanisms a... more Trauma to the toes, lesser metatarsals, and their respective joints involves various mechanisms and injury types (1, 2). These include a history of both direct and indirect trauma. Patients may exhibit symptoms acutely at the time of trauma or at a later onset. Symptoms include pain, swelling, discoloration, loss of joint motion, and difficulty standing and/or walking. An accurate history of the inciting traumatic event should be elicited.

Forefoot pain is a common presenting complaint seen by foot and ankle surgeons. Patients often de... more Forefoot pain is a common presenting complaint seen by foot and ankle surgeons. Patients often describe their pain in a vague and encompassing manner. The purpose of this clinical practice guideline is to review the varied pathologies that comprise the differential diagnosis of forefoot pain, with the exclusion of disorders of the first ray. The pathologies in the differential diagnosis range from acquired orthopedic deformities (eg, hammertoes, digital deformities) to overuse problems and traumatic injuries. These clinical problems, encountered daily by the foot and ankle surgeon, typically involve the lesser toes and metatarsals and their respective joints. Presented in this document are current practice guidelines for the diagnosis and treatment of hammertoe (digital deformities) (Pathway 2); central metatarsalgia (Pathway 3); Morton’s neuroma (Pathway 4); tailor’s bunion (Pathway 5); and trauma (Pathway 6).

The Journal of Foot and Ankle Surgery Official Publication of the American College of Foot and Ankle Surgeons, 2009

This clinical practice guideline (CPG) is based upon consensus of current clinical practice and r... more This clinical practice guideline (CPG) is based upon consensus of current clinical practice and review of the clinical literature. The guideline was developed by the Clinical Practice Guideline Forefoot Disorders Panel of the American College of Foot and Ankle Surgeons. The guideline and references annotate each node of the corresponding pathways.

The Journal of Foot and Ankle Surgery, 2005

The Journal of Foot and Ankle Surgery, 2003

The Journal of Foot and Ankle Surgery, 2010

Heel pain, whether plantar or posterior, is predominantly a mechanical pathology although an arra... more Heel pain, whether plantar or posterior, is predominantly a mechanical pathology although an array of diverse pathologies including neurologic, arthritic, traumatic, neoplastic, infectious, or vascular etiologies must be considered. This clinical practice guideline (CPG) is a revision of the original 2001 document developed by the American College of Foot and Ankle Surgeons (ACFAS) heel pain committee.

The Journal of Foot and Ankle Surgery, 2005

Flatfoot versus a normal foot (Fig 1) is readily apparent with clinical evaluation. The appearanc... more Flatfoot versus a normal foot (Fig 1) is readily apparent with clinical evaluation. The appearance of the foot, both on and off weightbearing, will help define its deformed or compensated condition. Physical examination reveals 1 or more of the following characteristics: depression of the medial longitudinal arch, everted or valgus heel in relaxed stance, and abduction of the forefoot relative to the rearfoot (Figs 2 and 3). Areas of tenderness may be localized with careful palpation of the foot, ankle, and leg; particular attention should be paid to the posterior tibial tendon, lateral rearfoot, and plantar fascia. Range of motion evaluation differentiates the flexible from rigid flatfoot and identifies the degree of abnormal motion that may be present. Flexibility can also be assessed by using the Hubscher maneuver (Jack test) to determine if the deformity is reducible (22, 23). Manual muscle testing and the single heel-rise test assess muscle strength and tendon function (24). Additionally, the double heel-rise test determines reducibility of rearfoot valgus (Figs 1 and 3). Gait observation may show an increased angle of gait, delayed or absent supination of the foot, or decreased propulsion. Footwear patterns also can provide valuable information. Extrapedal manifestations may include genu valgum, shin splits, short tendo-Achilles with calf tenderness,

The Journal of Foot and Ankle Surgery, 2006

Journal of Foot & Ankle Surgery, 2005