Many risk factors have been identified to be associated with ingrown toenail. Internal pressure by the distal phalanx of the hallux and the second toe and external compression from the shoes has been proposed as a reason for the pathology. The main objective of the study was to analyze the existence of a correlation between the presence of pathological hallux interphalangeal angle (HIA) and risk of ingrown hallux nail. One hundred and sixty-five subjects (312 ft) were enrolled in a cross-sectional, analytical and observational case–control study. A radiographic computerized system was used to measure HIA in both groups. The angle was considered as the sum of three angles, obliquity, asymmetry and joint deviation. The mean HIA in case group subjects (patients with hallux ingrown nail) was significantly higher than that obtained in control group subjects (17.39 ± 6.0° versus 13.47 ± 4.6°, p = .036). A total of 73.71 and 46.79 % of feet presented an angle equal or greater than 13.47° in the onychocryptosis and control group, respectively. The results show a correlation between the variables analysed. The presence of an HIA greater or equal than 14.5° may be a predisposing factor for developing onychocryptosis of the hallux. Clinicians treating individuals with pathology in hallux might use a baseline cutoff of HIA equal than 13.5°.

Recent studies support the theory that ill-fitting shoes are an important source of pain and may lead to foot malformations in the medium term. Taking as reference the ideal allowance considered in the literature, the purpose of this study was to verify the outdoor footwear fit in a population of schoolchildren of southern Spain. Five hundred and five children within the range of 3–12 years of age participated in this study. Using a measuring instrument designed and validated for this purpose, maximum foot length, width and height were obtained from the longest foot. These measurements were compared with the inner length, width and height of the footwear. An adequate toe allowance of 5–15 mm in length and 10 mm in width were estimated. Inner footwear length was shorter than foot length in 33.3% of the schoolchildren. Based on the allowance established, it was observed that the footwear of the schoolchildren was too short and too narrow in 72.5 and 66.7% of the cases, respectively. Only one third of the participants analysed had well-fitted footwear. The results show that it is necessary to raise awareness among parents and teachers about the importance of replacing, periodically, the footwear of children in primary education. Manufacturers should adapt the lasts considering the use of 90th percentiles instead of mean values obtained from the growth curves of schoolchildren’s feet.

The Surgical Safety Checklist (SSC) is a tool developed by the World Health Alliance for Patient Safety, to assist health professionals in improving patient safety during surgery. Numerous specialties have incorporated this into their clinical practice. The purpose of this study is to adapt and implement this tool within the field of podiatric surgery and to evaluate its impact upon safety standards and post-surgical complications. An analytical, observational, longitudinal study has been performed retrospectively. The implementation of the Surgical Safety Checklist in podiatric surgery took place over a 10-month period. The sample is made up from the medical histories of patients who were operated on (n = 134) in the University of Seville’s podiatric clinic. The sample was divided into three groups: those prior to the implementation process (65 subjects), those after the implementation process: without the SSC (35 subjects) and those with the SSC (34 subjects). The safety standards included in the tool were analysed in conjunction with the results and post-operative complications. An improvement was seen in compliance with the Prophylaxis Protocol and the correct completion of the Informed Consent (p = 0.00), as well as a statistically significant relationship between the correct use of antibiotic prophylaxis and the use of the Surgical Safety Checklist (p = 0.049). The results demonstrate a reduction in the number of post-operative days (p = 0.012). No cases of surgery being performed in the wrong place were found in this study. The Surgical Safety Checklist allows us to improve compliance with the safety protocols recommended by the scientific community, and consequently to reduce the incidence of complications related to surgery and to improve patient safety during elective podiatric surgery.

Background: Several studies have shown the relationship between poor footwear fit and the risk of feet deformities. The available evidence seems to show that the development of hallux valgus deformity in the feet of schoolchildren may be related to the use of shoes that are poorly fitting in length. The objective of this cross-sectional study was to analyze the relationship between poor footwear fit in length and risk of developing hallux valgus. Methods: Using an instrument that was designed and calibrated for this purpose, maximum foot length was obtained and compared to the inner length of the shoe in 187 schoolchildren. Hallux valgus angle (HVA) was measured on weight-bearing podogram image obtained from the longest foot in 188 schoolchildren. Results: By default, the footwear was poorly fitting in length (too short or close-fitting) in 38.5% of the schoolchildren, with boys having the worst footwear fit; though no significant differences stood out. (p = 0.276). Regarding the HVA, no significant differences were recorded according to age or gender (p = 0.573). A strong correlation was observed between too-short footwear and the increase in HVA in 10-year-old boys (r = 0.817; p = 0.025) and in 9-year-old girls (r = 0.705; p = 0.005). Conclusions: Inadequate footwear fit in length may be a predisposing extrinsic risk factor for the development of hallux valgus in schoolchildren of both sexes. Results of the present study demonstrate the need to adapt the sizes of footwear to the rapid increase in foot-length that occur at puberty to avoid the risk of developing hallux valgus, especially at the ages of onset pubertal foot growth.