December 1, 2016 | | JFAS | Contact Us

News From ACFAS

View Board Candidate Profiles Online
Profiles and position statements of the five candidates nominated for the ACFAS Board of Directors are now posted at Voting opens December 12, and each eligible voting member will receive an email with a unique link to the election website. After logging in, members will first see the candidate biographies and position statements, followed by the actual ballot. Eligible voters without a valid email address will receive instructions on how to log in to the election website and vote by U.S. mail. There will be no paper ballots.

Two three-year terms and one two-year term will be filled by election. The ballot appearance is prescribed in the bylaws. Eligible voters may cast one, two or three votes on their ballot. Regular member classes eligible to vote are Fellows, Associates, Emeritus (formerly Senior) and Life Members.
Share Facebook  LinkedIn  Twitter  | Web Link
Residency Directors Forum Returns to Annual Scientific Conference
The Residency Directors Forum is returning in 2017 and is jam-packed with take-home information to help build on every residency program’s foundation. This year’s Forum, held in advance of the 75th Anniversary Scientific Conference on Sunday, February 26, 2017 from 1:30–5:30pm and cohosted by the Council of Teaching Hospitals (COTH), will provide updates from COTH, AACPM and CPME as well as the Boards (ABFAS and ABPM). Discussion will also include:
  • updates from PRR on the new 2.0 version of its database
  • dos and don’ts of social media for residents
  • program assessment tools and what changes may be in store for residency programs in the future
For the first time, residency program codirectors, faculty and administrators are invited to attend, with up to two attendees per program. Registration closes on February 10, 2017. Space is limited, so don’t delay!

Visit for the complete schedule and registration form.
Share Facebook  LinkedIn  Twitter  | Web Link
Need Money? Support Available for Posters/Manuscripts at ACFAS 75
Are you a resident or postgraduate fellow who plans to present a poster or manuscript at the ACFAS 75th Anniversary Scientific Conference, February 27–March 2 in Las Vegas? Could you use some extra money to apply toward your travel costs? The ACFAS Regional Divisions can help!

If your poster or manuscript is accepted for presentation at the conference and you would like to receive funding from your local Division, complete an application for support. Poster submitters are potentially eligible for $250, and manuscript presenters are potentially eligible for $500. Complete rules for acceptance and provision of funds are listed in the application form.

Please submit the completed form directly to your Division's president (names and email addresses are available on the form) by February 10, 2017. Each Division will determine the amount of support it can provide based on the number of submissions received and will contact you directly with next steps.

The ACFAS Regional Divisions are happy to continue this annual tradition of supporting the next generation of researchers in their parts of the country.
Share Facebook  LinkedIn  Twitter  | Web Link
Readers Weigh in on Work-Related Injuries
The November poll in This Week @ ACFAS asked readers which occupational foot and ankle injuries they treat most frequently. Fifty-five percent of respondents treat sprains from slips, trips and falls most often, while 45 percent said they most frequently treat crushed, broken or punctured toes, feet and/or ankles. Chemical burns, frostbite and electrical shocks to feet received no responses.

Thank you to everyone who shared their input, and watch for the December poll on year-end elective surgery. View poll results throughout the month at
Share Facebook  LinkedIn  Twitter  | Web Link

Foot and Ankle Surgery

Cross-Cultural Adaptation, Reliability and Validity of the Japanese Version of the Cumberland Ankle Instability Tool
A recent study assessed the validity and reliability of a Japanese version of the Cumberland Ankle Instability Tool (CAIT). The CAIT questionnaire was cross-culturally adapted into Japanese. The psychometric properties evaluated in the questionnaire were measured for criteria validity, internal consistency and test-retest reliability in 111 collegiate athletes. Researchers also determined the cutoff score for discriminating between individuals with and without chronic ankle instability. The correlation between the Japanese CAIT and the Karlsson score was significant. The questionnaire had a high internal consistency (Cronbach’s alpha = 0.833) and reliability (intraclass correlation coefficient = 0.826). The cutoff score was 25.

From the article of the same title
Disability and Rehabilitation (01/01/2017) Vol. 39, No. 1, P. 50-58 Kunugi, Shun; Masunari, Akihiko; Noh, Byungjoo; et al.
Share Facebook  LinkedIn  Twitter  | Web Link - May Require Paid Subscription

Effect of Calcaneus Fracture Gap Without Step-Off on Stress Distribution Across the Subtalar Joint
Calcaneal fracture models have shown altered contact characteristics when a step-off is created in the posterior facet articular surface, but previous models have not characterized calcaneal fracture gaps without step-off. Researchers determined the peak pressure, area of contact and centroid of pressure of the posterior facet of the subtalar joint in six cadavers. A calcaneal fracture was created to simulate a Sanders type II fracture. The contact characteristics were determined for the anatomically reduced fracture as well as fracture gap displacements of two, three and five millimeters without a step-off of the articular surface. Peak pressure on the medial fragment was significantly less with a five-millimeter gap compared with the two- or three-millimeter gap or the reduced fracture. The peak pressure on the lateral fragment was significantly increased with a five-millimeter gap. Contact area significantly changed with increased gap.

From the article of the same title
Foot & Ankle International (11/16) Barrick, Brett; Joyce, Donald A.; Werner, Frederick W.
Share Facebook  LinkedIn  Twitter  | Web Link - May Require Paid Subscription

Increased Mortality After Lower-Extremity Fractures in Patients <65 Years of Age
Researchers examined the association between mortality and lower-extremity fractures in adults of all ages. During the study, 2,081 women and 1,486 men were treated for a lower-extremity fracture. After a mean follow-up of five years, 42 percent of the women and 32 percent of the men had died. The standardized mortality ratio was 1.9 for women and 2.6 for men. Mortality increased in patients more than 65 years after fractures of the hip, femoral diaphysis and knee. Mortality increased in patients under 65 after fractures at all sites. The SMR ranged from 2.1 (ankle) and 6.7 (hip) in patients under 65 years and between 0.6 (leg) and 2.2 (hip) in patients more than 65 years.

From the article of the same title
Acta Orthopaedica Belgica (12/16) Vol. 87, No. 6, P. 622-625 Somersalo, Axel; Paloneva, Juha; Kautiainen, Hannu
Share Facebook  LinkedIn  Twitter  | Web Link

Practice Management

Staying Connected to Patients Beyond the Office Visit
Healthcare professionals can leverage automated phone calls, text messages and emails to stay connected with patients and better track patient health between appointments. According to a study from West Corp., 66 percent of Americans have received a voicemail, text or email from their healthcare provider, with a third of those respondents saying the digital communication makes them feel more likely to visit the provider again. However, many physicians have not collected updated patient information and are unable to contact their patients through their preferred channels. Once the right information is obtained, providers can use targeted communications to improve care. For example, Louisiana-based Ochsner Health Systems implemented an automated phone notification program to encourage its patients to schedule a colonoscopy or upper endoscopy. Patients responding to the automated message would immediately be connected with scheduling staff. Similar automated communication methods can be used to remind patients of upcoming appointments or as a follow-up to see if patients have questions about their care. Automation frees up staff for other duties, and calls made in the evening are more likely to be answered than calls during office hours. “Closing the gaps in healthcare does not require large-scale interoperability between technology platforms, but by being able to communicate with the patient,” says Chuck Hayes, vice president for TeleVox Software. “You can achieve fantastic results and do that today.”

From the article of the same title
Medical Economics (11/14/16) Shryock, Todd
Share Facebook  LinkedIn  Twitter  | Web Link

To Attract New Patients, Think Like a Patient
As more patients turn to the Internet for help in making their health decisions, providers must broaden their sphere of physician-patient communication to include digital platforms. The patient experience begins before an appointment is made, so a practice’s website and online presence provide an important first impression. A well-designed and responsive website serves as a gateway for new patients, and an active presence on social media can help build a practice’s brand and reputation among current and potential patients. Providers should leverage social media to improve patient engagement, promote healthy habits and increase awareness about general conditions and disease prevention. Practices should also consider their patients’ communication preferences and use a combination of email, face-to-face, social media and phone calls to connect with patients. It is important to ask patients for feedback on practice services and to evolve as patients’ needs change. By encouraging regular and open communication, practices can build more positive relationships with patients.

From the article of the same title
Physicians Practice (11/20/16) Chauhan, Manish Kumar
Share Facebook  LinkedIn  Twitter  | Web Link - May Require Free Registration

Working Smarter, Not Harder: Helping Clinicians Optimize Use of EHRs
Physicians spend at least two hours during the office day working with electronic health records (EHRs) and an additional one to two hours after work, cutting into time for diagnosis and treatment. The time spent on documentation can be dramatically reduced by incorporating EHRs into the workflow in a manner that supports rather than detracts from the patient-physician encounter. Current EHRs come with a variety of functions that are often overlooked but can help physicians improve care and save time. Many systems offer features, such as favorites lists, which allow prescribers to skip manually entering dosing instructions and prescription quantities for electronic prescriptions. As an increasing number of medications require prior authorization before they can be dispensed, electronic prior authorization can decrease the turnaround time of a PA request dramatically. Physicians can also leverage EHR templates to standardize visit documentation and to reduce time spent on documentation during the patient encounter. Establishing predefined care alerts within the EHR will help avoid alert fatigue and create a customized guide for patient care depending on the physician’s specialty or patient mix. If a physician is part of an accountable care organization, alerts can remind providers about standards of care and other clinical requirements.

From the article of the same title
HealthTechZone (11/18/16) Schueth, Tony
Share Facebook  LinkedIn  Twitter  | Web Link

Health Policy and Reimbursement

ACA Repeal Without Replacement Could Spur Insurer Exodus
President-Elect Donald Trump’s administration and Congressional Republicans could immediately repeal parts of the Affordable Care Act once Trump is inaugurated in January, with a replacement package possibly taking more than a year to craft. Some ACA proponents and insurers warn that an immediate repeal combined with administrative actions to undermine the law may prompt health plans to abandon individual insurance markets in 2018. Republican lawmakers and Trump's transition team reportedly are discussing aspects of the law to abolish first, including premium subsidies and the individual mandate. The Senate Republican Policy Committee also says regulatory changes could start on the first day of Trump's presidency. If ACA's individual mandate and subsidies are abolished while the pre-existing condition provision is preserved, the individual insurance market would quickly collapse, according to Washington state's insurance commissioner Mike Kreidler. "I would not be surprised by a stampede to exit the market for fear of uncertainty and the strong potential for adverse selection,” says Kreidler. Unless lawmakers extend the individual mandate, insurers are unlikely to be willing to offer plans in 2018 because the consumer pool would skew sicker.

From the article of the same title
Modern Healthcare (11/17/16) Meyer, Harris
Share Facebook  LinkedIn  Twitter  | Web Link

AMA Implements Policies to Support Well-Being of Physicians-in-Training
The American Medical Association (AMA) has adopted new policies to support the medical and mental health of physician trainees during their medical schooling or residencies and fellowships. Many physicians-in-training do not receive treatment for physical or mental health issues due to concerns about confidentiality and potential impacts on their career. “With a high number of medical students and residents experiencing depression, burnout and suicide, and too many physicians overlooking their own health needs, we must do everything we can to reduce the barriers and stigmas that keep them from receiving care,” says AMA board member Omar Z. Maniya. The policy requires state medical boards to avoid asking about an applicant’s mental health history and to focus only on present mental health or addiction issues. Additionally, state boards should recognize “safe haven” nonreporting, which enables trainees to apply for licenses without disclosing whether they are receiving treatment for mental illnesses. AMA also calls for the creation of screening programs for mental health awareness and suicide prevention in medical schools.

From the article of the same title
Healio (11/18/2016)
Share Facebook  LinkedIn  Twitter  | Web Link

CMS Seeks to Block Supplemental Medicaid Payments to Providers
The U.S. Centers for Medicare and Medicaid Services (CMS) want to cut funding for pass-through payments, which are paid to Medicaid managed care plans as supplements to the base capitation rate. These payments are passed to providers who treat a disproportionate share of Medicaid or uninsured patients with costly cases. The agency seeks to end the supplemental funding because the payments are not directly related to contracted services. CMS estimates at least 16 states have paid an average of $3.3 billion in pass-through payments annually, with eight paying approximately $105 million.

From the article of the same title
Modern Healthcare (11/21/16) Dickson, Virgil
Share Facebook  LinkedIn  Twitter  | Web Link

Medicine, Drugs and Devices

Local Doctors Pioneer Procedure for Foot Pain Relief
Podiatrist Beth Gusenoff and plastic surgeon Jeffrey Gusenoff of the University of Pittsburgh Medical Center are testing a new procedure for fat pad atrophy using liposuction. The initial study included 30 people with fat pad atrophy who were nonsmokers and did not have diabetes or inflammatory conditions. A small amount of fat was removed by liposuction from the abdomen, hips or flank and injected into the bottom of the foot. Patients were able to walk immediately following the procedure. Researchers noted a risk of bruising in the foot and at the liposuction site, but the study’s participants have not required any prescription narcotics or antibiotics. Participants’ pain reduction and activity levels are evaluated every few months. The study will continue with a multicenter trial.

From the article of the same title
CBS Pittsburgh (11/21/16) Simbra, Maria
Share Facebook  LinkedIn  Twitter  | Web Link

The Prosthetic of the Future
Surgeons at Brigham and Women’s Faulkner Hospital have performed a unique amputation surgery on Jim Ewing, a mountain climber who shattered an ankle and suffered severe nerve damage in a climbing accident. Ewing is poised to become the first recipient of a limb designed at the Massachusetts Institute of Technology Media Lab and controlled by Ewing’s own brain waves. The amputation surgery, dubbed “the Ewing Amputation,” laced together tendons at the end of Ewing’s leg to preserve the neurological connections and allow him to tense and relax the muscles in his lower leg as if his foot was still attached. In the coming year, the surgical team plans to embed wireless sensors to prepare Ewing for a prototype of a specialized prosthetic foot and ankle he will be able to control with his brain. “Traditionally, amputation has often been seen as a failure, the surgical equivalent of throwing in the towel to the ravages of trauma, disease or just plain bad luck,” says Dr. Matthew Carty, the lead surgeon on Ewing's case. “By reinventing the way that amputations are performed, we hope to elevate them to another form of limb salvage, one designed to restore as much function as possible.”

From the article of the same title
Boston Globe (11/21/16) Moskowitz, Eric
Share Facebook  LinkedIn  Twitter  | Web Link

‘Spicy’ Injection Could Take Sting Out of Foot Pain
The U.S. Food and Drug Administration (FDA) has given fast track designation to CNTX-4975, an injectable pain reliever. CNTX-4975 contains a synthetic form of capsaicin, which is the active ingredient in chili peppers that make them spicy. If approved, the drug would be used to treat Morton's neuroma.

From the article of the same title
Pain News Network (11/21/16) Anson, Pat
Share Facebook  LinkedIn  Twitter  | Web Link


This Week @ ACFAS
Content Reviewers

Mark A. Birmingham, DPM, FACFAS

Daniel C. Jupiter, PhD

Gregory P. Still, DPM, FACFAS

Jakob C. Thorud, DPM, MS, AACFAS

Contact Us

For more information on ACFAS and This Week @ ACFAS, contact:

American College of
Foot and Ankle Surgeons
8725 W. Higgins Rd.
Suite 555
Chicago, IL 60631
P: (773) 693-9300
F: (773) 693-9304
E: ThisWeek

Visit Us: Friend us on Facebook Follow us on Twitter Link us in on LinkedIn

This Week @ ACFAS is a weekly executive summary of noteworthy articles distributed to ACFAS members. Portions of This Week are derived from a wide variety of news sources. Unless specifically stated otherwise, the content does not necessarily reflect the views of ACFAS and does not imply endorsement of any view, product or service by ACFAS.

Some publication websites may require user registration or subscription before access is granted to the links following the articles. If an article is unavailable online, a link is provided to that publication's homepage.

Copyright © 2016 American College of Foot and Ankle Surgeons

To change your email address, please click here. If you wish to unsubscribe, click here.

Abstract News © Copyright 2016 INFORMATION, INC.
Powered by Information, Inc.