There is a lack of scientific evidence about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical manifestations are not thoroughly understood; classically, the virus manifests itself at the pulmonary level but can manifest at other levels. To the best of our knowledge, systematic reviews and non-systematic reviews about COVID-19 symptoms in the feet have not been published. The aim of this review of reviews was to analyze and synthesize the published reviews on manifestations of COVID-19 at the foot level. Methods: a review of reviews was conducted; the eligibility criteria included studies published in English or Spanish, involving children and adults with COVID-19, and reporting foot manifestations. PubMed, SciELO, Science Direct, Cochrane Database of Systematic Review, and Google Scholar were analyzed. Two authors independently performed the screening and quality assessment of the studies with AMSTAR 1, and finally, nine reviews were analyzed (one systematic and eight narratives studies). The main clinical manifestations at the foot level in patients with COVID-19 were vascular (edema, exanthems, chilblains, ischemia, and distal necrosis), dermatological (vesicular, maculopapular, papulosquamous, urticarial skin breakouts, and recurrent herpes), and neurological (muscular weakness in lower limbs, paresis, areflexias, ataxia, and difficulty walking). Erythema pernio or “COVID toes” was shown as the most characteristic lesion of this disease, especially in asymptomatic children and young people, so this typical manifestation may be considered important in patients who are positive for COVID-19. This finding does not allow for strong conclusions due to the scarce literature and methodological quality in this regard. Future studies are necessary.

BackgroundThe 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.MethodsAn 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.ResultsAn 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.ConclusionsThe 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.

BackgroundMany 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.MethodsOne 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.ResultsThe 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.ConclusionsThe 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°.

Plasma cellular osteomyelitis is a chronic and recurrent non purulent bone inflammatory entity charactererized by abundance of plasma cells in the lesional bone. Is a recurrent, unifocal or multifocal disorder, which has an unknown etiology with clinical and radiographic features that may make it impossible to distinguish from other non-suppurative sclerosing osteomyelitis. This rare condition usually occurs in metaphysis of a long bone of children or young adults. We report a case of PCO in a 64-year-old woman with intermittent diffused pain in the hallux of the left foot after several nail avulsions and two surgical procedures on the distal phalanx. The histological study of the bone sample showed reactive sclerotic bone with plasma cells compatible with PCO. In spite of its infectious origin, as in the present case the causal agent is not always identified. Owing to rarity of entity, a clinical diagnosis is usually not considered and a histopathological examination is essential to establish of a definitive diagnosis.

The use of platelet gel for the treatment of onychocryptosis by single nonincisional matricectomy can guarantee good hemostasis, with a significant reduction in bleeding, but does not produce a clinically significant reduction in cicatrization time.