Background: Herniated intervertebral disc (HIVD) with radiculopathy and foot drop can lead to substantial functional impairment. Although both pharmacopuncture and motion-style acupuncture treatment (MSAT) have demonstrated therapeutic potential individually, evidence on their combined use remains limited. In this single-case report, we described the clinical course of a patient with HIVD with radiculopathy and foot drop who underwent a novel approach combining ultrasound (US)-guided Shinbaro 2 pharmacopuncture targeting multiple nerve roots with tibialis anterior muscle motion-style acupuncture treatment (TA MSAT). Case Presentation: A 40-year-old man with lower back pain (LBP), radiculopathy, and foot drop attributed to acute HIVD was treated with high-dose US-guided Shinbaro 2 pharmacopuncture and TA MSAT. Outcomes were measured using the Numeric Rating Scale (NRS) for LBP, L5, and S1 radiculopathy; Manual Muscle Testing (MMT) for dorsiflexion and great toe extension; the Oswestry Disability Index (ODI) for lumbar function; the EuroQol Five-Dimension (EQ-5D) Index for quality of life; and the Patient Global Impression of Change (PGIC) for satisfaction. After 14 weeks of treatment, NRS scores for LBP, L5, and S1 radiculopathy decreased from 5 to 1, 8 to 1, and 8 to 1, respectively. MMT grades for dorsiflexion and great toe extension improved from 3 to 5 and 2 to 5, respectively, indicating full functional recovery. ODI and EQ-5D scores improved from 62.22 to 6.67 and 0.344 to 1.0, respectively. The PGIC score was 1, indicating clinical improvement. Conclusions: Our integrative approach involving US-guided pharmacopuncture and TA MSAT demonstrates therapeutic potential for the management of acute HIVD.

Adult acquired flatfoot deformity (AAFD) results from the collapse of the medial longitudinal arch (MLA), often managed conservatively with foot orthoses. While 3D printing enables rapid and cost-effective production of insoles, the biomechanical impact of different printing materials remains unclear. This study combined material testing, finite element (FE) simulation, and compression testing to evaluate four materials commonly used for 3D-printed insoles: PLA (polylactic acid), resin, EVA (ethylene vinyl acetate), and TPU (thermoplastic polyurethane). Tensile tests provided material properties for FE modeling of balanced standing using a validated healthy foot model. Outcome measures included MLA deformation (navicular drop), plantar stress distribution, and von Mises stress within the insole. A commercial semi-custom insole was tested for comparison. PLA and resin exhibited high stiffness (2228 and 880 MPa) and reduced navicular drop by 55-60%, compared with <30% reductions by EVA and TPU. Plantar stress distribution shifted from forefoot and hindfoot toward the midfoot, with PLA increasing midfoot load share to 38%. Compression testing confirmed that PLA and resin exhibited greater arch support ability than the semi-custom insole within a 10 mm displacement threshold. Material stiffness strongly influenced the biomechanical performance of 3D-printed insoles. Within this static simulation baseline, PLA and resin provided superior arch stabilization and stress redistribution compared with EVA, TPU, and a semi-custom reference. These findings suggest that material choice is critical to optimizing 3D-printed orthotic support, providing a valuable biomechanical baseline to guide future orthotic designs for flatfoot.

Bariatric and metabolic surgery (BMS) can be associated with neurological complications, including common peroneal nerve palsy, which usually arises from a combination of rapid weight loss, a decrease in the fatty tissue that protects the nerve, and sustained postures, such as crossing the legs, which promote compression at the fibular neck. This complication is uncommon among patients undergoing BMS, occurring in less than 1% of all surgical procedures. We present a series of six clinical cases of foot drop syndrome, the clinical manifestation of peroneal nerve motor palsy, that occurred after BMS over the last 25 years of experience at our hospital. A description of the cases is provided, along with an analysis of potential triggering causes and different types of treatment.

Ganglion cysts around the knee are uncommon and rarely cause compressive neuropathy of the common peroneal nerve. When present, they may result in foot drop and sensory disturbances, making early recognition crucial. We report a male in his late 50s presenting with a swelling over the lateral aspect of the right proximal lower leg, progressive weakness of ankle dorsiflexion and sensory loss over the dorsum of the foot. Examination revealed a firm, fluctuant swelling posterolateral to the fibular neck. Ultrasound and MRI confirmed a multiloculated cystic lesion compressing the common peroneal nerve. Nerve conduction studies demonstrated conduction block across the fibular neck. The patient underwent surgical excision of the cyst, which was found intraoperatively to arise from the posterolateral joint line causing compression of the nerve. Postoperatively, recovery was uneventful. The patient at the 6 month follow-up showed complete neurological recovery.

Chronic stroke gait disorders involve impaired motor coordination. While high-intensity gait training (HIGT) is supported by current clinical practice guidelines, and Functional Electrical Stimulation (FES) to tibialis anterior addresses foot drop, extending FES to multiple muscles may improve functional outcomes.

Foot drop, characterized by weakness of ankle and toe dorsiflexion, is a clinical sign rather than a diagnosis and requires accurate neuroanatomic localization. Potential sites of injury include the L5 nerve root, lumbosacral plexus, sciatic nerve, and common fibular (peroneal) nerve. Because lesions at different levels can produce overlapping motor and sensory findings, incorrect localization may lead to inappropriate diagnostic testing or treatment. This narrative review presents an anatomical, clinical, and electrodiagnostic framework for localizing neurogenic foot drop, with particular emphasis on distinguishing L5 radiculopathy, common fibular neuropathy at the fibular head, fibular-division predominant sciatic neuropathy, and lumbosacral plexopathy. High yield examination findings include ankle inversion and hip abduction strength, while electrodiagnostic localization relies on strategically selected sensory and motor nerve conduction studies and needle electromyography of muscles representing competing anatomic levels. The short head of the biceps femoris is particularly useful for distinguishing a proximal fibular division sciatic lesion from a typical common fibular neuropathy at the fibular head. Ultrasound and magnetic resonance imaging provide complementary structural information when focal nerve pathology is suspected. Integrating examination, electrodiagnostic testing, and targeted imaging provides a systematic approach to localization and guides subsequent etiologic evaluation and management.

A 32-year-old male sustained a complex vertical shear pelvic fracture after a motor vehicle accident, associated with hemodynamic instability and a large Morel-Lavallée lesion involving the anterior pelvis and right thigh. Initial management included external fixation and percutaneous sacroiliac screw placement as part of damage-control orthopedics. Two weeks later, anterior subcutaneous internal fixation (INFIX) was performed to provide anterior pelvic stability while limiting further soft-tissue dissection. Postoperative imaging showed satisfactory reduction and implant positioning. The INFIX component was removed four months later after healing, with preserved pelvic stability. At 18 months, the patient was able to walk with a cane and had regained urinary continence, although bilateral foot drop persisted. This case highlights the role of soft-tissue condition in surgical decision-making for complex pelvic trauma.

A 35-year-old man presented with an 8-year history of left foot drop and a 5-year history of right hand weakness without sensory involvement. He underwent nerve conduction studies, imaging, and serologic testing. Treatment led to dramatic improvement, although continual maintenance treatment was required. In this case report, we outline the clinical presentation and reasoning at each step, which led to diagnosis and management of a treatable neuromuscular disorder.