Editor's Note - November 2019

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By Andrea Spridgen

While the average person may give little thought to the human foot, it is extremely complex with 26 bones, 33 joints, 20 muscles, and 57 ligaments that all must work in harmony for comfortable, effective, pain-free locomotion. However, those in O&P, particularly those who specialize in providing care for the issues that plague this deceptively simple part of our anatomy, are well aware of how complicated our feet can be.

Recognition of the complexity of the anatomy of feet and the care associated with them gives rise to the changes proposed in "The Evolution of Pedorthic Education." As the O&P profession has continued to progress, and greater emphasis has been placed on the continuum of care, it has become increasingly important that pedorthic professionals have a good understanding of foot pathologies for which their interventions are prescribed, as well as the ability to discuss these with other members of the healthcare team. This feature outlines some of the proposed changes, key among them an increase in educational level, that the experts we spoke with feel are essential to keep pedorthics credible and relevant in the healthcare landscape.

"Amputation Following Diabetic Foot Disease—To Be Feared or Welcomed?" reveals an interesting attitude in patients who have diabetes and related foot disease that can be helpful for clinicians to understand, both those who are working with patients with advanced foot disease likely to require amputation, and those working with patients on interventions to prevent it. While the patients' biggest fear was amputation, most who underwent amputation actually had improved quality of life following the procedure—particularly if they had limited mobility prior to amputation.

"Patterns, Algorithms, and Designs—Revisiting Rotary Deformities" describes how understanding some of the complexities of deformities in joint rotations has informed the development of algorithms for identifying patterns of deformity and designing successful foot orthotic and AFO interventions.

Finally, in Stepping Out, "Anterior Cavus and Pseudoequinus," Séamus Kennedy explains that one of the most seemingly simple delineations in foot type, between one with a high arch or a flat foot, is often more complex than it first appears.

I hope you enjoy this issue devoted to the challenges of foot and ankle care. Happy reading.