Current Insights On Perioperative Management Of Anticoagulation Therapy

Allen Jacobs DPM FACFAS
8/12/14 | 411 reads | 0 comments
Increasingly, the podiatric physician must perform surgery on patients receiving anticoagulant therapy. Decisions on the perioperative management of anticoagulation represent a balance among concerns regarding postoperative hematoma, excessive bleeding and patient safety with consideration of the reasons why the patient started on anticoagulant therapy. Read More.

Addressing Toe Web Space Infections In Patients With Diabetes

Allen Jacobs DPM FACFAS
7/11/14 | 527 reads | 1 comments
Toe web space infection can be associated with significant morbidity. Not infrequently, toe web space infections result in cellulitis. This may progress from initial tinea pedis and skin xerosis.1 One can appreciate the significance of preventing cellulitis, particularly in a patient with diabetes, by looking at a study predicting foot ulceration in VA patients.2 The study authors found that onychomycosis and tinea pedis are two of the top seven predictors of foot ulceration in this study population.2 Read More.

Why You Should Consider The Use Of Supplements In The Management Of Diabetic Neuropathy

Allen Jacobs DPM FACFAS
6/17/14 | 714 reads | 1 comments
Supplements have proven useful for improved management of diabetes and diabetes-related complications such as neuropathy, wounds, cardiovascular complications, renal complications and ophthalmic complications. Read More.

What I Learned From A Recent Malpractice Case On Warts

Allen Jacobs DPM FACFAS
4/17/14 | 1402 reads | 0 comments
I recently had the opportunity to participate as a defense expert in a malpractice case. The jury returned a verdict in favor of the defendant podiatrist, determining that the plaintiff was 75 percent responsible for damages and the defendant was 25 percent responsible. However, the case was in the commonwealth of Pennsylvania where, unless the jury finds the defendant podiatrist to be greater than 51 percent responsible, it is a defense verdict. Read More.

Back To Basics: Why The Proximal First Metatarsal Osteotomy Is Resurging

Allen Jacobs DPM FACFAS
3/21/14 | 2740 reads | 0 comments
In 1928, McMensor noted that "in medical literature, ideas are frequently presented, forgotten and presented again.”1 In recent years, we have seen a resurgence of interest in proximal first metatarsal osteotomy procedures for the correction of bunion deformities. Numerous orthopedic suppliers now provide specific fixation devices for proximal first metatarsal closing and opening wedge osteotomies. This has been an interesting phenomenon, considering the enthusiasm for the Lapidus type of bunion correction over recent years. Read More.

What I Told The Students About Navigating Corporate Conflicts Of Interest

Allen Jacobs DPM FACFAS
2/17/14 | 6383 reads | 0 comments
The New York State Podiatric Medical Association meeting this year included a two-day lecture series for junior and senior students at the podiatry colleges. The sessions were well attended. I was honored that the seminar committee asked me to present one of the sessions to the students. For my topic, I decided to lecture on managing conflicts of interest and corporate influence in podiatry education and practice. Consistent with my concerns, every student had already been outfitted with a bag featuring a corporate name, which was filled with products and advertisements. Read More.

Current Insights On Differentiating Vascular Pain From Neuropathic Pain

Allen Jacobs DPM FACFAS
1/13/14 | 5504 reads | 0 comments
Not infrequently we face patients who have diabetes or other comorbid conditions with which vascular disease and neuropathy are both associated. At times, differentiating vascular pain from neuropathic pain can be difficult. In a patient with diabetes, vascular pain secondary to loss of blood flow may result from ischemia, vasculitis, vasospasm or vascular compression. Neuropathic pain may result from diabetic neuropathy, nerve entrapment such as tarsal tunnel syndrome, or spinal compression syndrome. Read More.

Learning From The Wisdom Of James Ganley, DPM

Allen Jacobs DPM FACFAS
11/26/13 | 1778 reads | 3 comments
As a student at the Pennsylvania College of Podiatry, my classmates and myself had the privilege of studying orthopedics under the direction of James Ganley, DPM. Dr. Ganley was a friend of E. Dalton McGlamry, DPM, and in a manner similar to Dr. McGlamry set a standard of academic and a scientific excellence that far exceeded the podiatry profession in those days. He practiced in a smaller Pennsylvania town and published a good deal in various areas of lower extremity pathology, always maintaining a keen interest in pediatric orthopedics. Read More.

Performing Revision Surgery Following The Lapidus Bunionectomy

Allen Jacobs DPM FACFAS
11/8/13 | 2670 reads | 0 comments
As with any bunion procedure, the Lapidus procedure may be associated with a number of potential complications and sequelae. Excessive elevation of the first metatarsal following the Lapidus procedure may result in lesser metatarsalgia or hallux limitus. Excessive shortening following the Lapidus procedure may also result in lesser metatarsalgia, hallux hammertoe deformity and lesser digital deformities. Injury to the peroneus longus or anterior tibial tendons may also occur as one performs the surgery in proximity to the insertion of these tendons. Read More.