DPM Blogs

Can Metformin Use Increase The Risk Of Diabetic Neuropathy?

Allen Jacobs DPM FACFAS
3/1/10 | 6195 reads | 1 comments
Metformin (Glucophage, Bristol-Myers Squibb) is a commonly utilized biguanide agent for the treatment of diabetes. Increasingly, it appears that metformin may paradoxically increase the risk of neuropathy in the patient with diabetes. Therefore, when you see a patient with diabetes who is taking metformin, greater surveillance may be necessary for the presence of sensory, autonomic and motor neuropathy. Read More.

Recognizing The Potential Impact Of Stress With Skin Conditions

Tracey Vlahovic DPM
2/25/10 | 2182 reads | 0 comments
How many times has a new or established patient presented to you with a new onset skin rash that was acute and angry in nature? As you are digging deeper with your patient interview, you find that a large stress (or stressors) has occurred in that person’s life. Sources of stress may include unemployment, divorce, a new baby, etc. Read More.

Is The Closing Base Wedge Osteotomy Extinct?

Patrick DeHeer DPM FACFAS
2/22/10 | 4262 reads | 2 comments
The closing base wedge osteotomy (CBWO) has long been a favorite for the severe bunion deformity in podiatric surgical history, especially throughout the 1970s and 1980s. Has the once sacred procedure become extinct? Is this procedure still a viable option for the severe bunion deformity? Do the potential complications move this procedure to the back of the bus when it comes to treating the severe bunion deformity? In my opinion, the answer to all of these questions is yes. Read More.

Can An Electrical Stimulation Device Be Part Of A ‘Pacemaker’ In Neuropathic Patients?

David G. Armstrong DPM PhD MD
2/16/10 | 2100 reads | 0 comments
For patients with diabetic and motor neuropathy, an electrical stimulation device, combined with pressure monitoring and thermometry, may be able to act as a “pacemaker” to stimulate the foot. At the Southern Arizona Limb Salvage Alliance (SALSA), we have become increasingly interested in the Walkaide system (Hanger Orthopaedics) and its potential future as a delivery system for extracorporeal nerve and muscle stimulation. The device uses electrical stimulation to improve walking in patients with post-stroke footdrop, according to the company. Read More.

When a Child Presents With An Underlapping Toe

Ron Raducanu DPM FACFAS
2/16/10 | 3501 reads | 1 comments
Sometimes you have to think outside of the box. This is especially the case when it comes to possible surgical intervention in the pediatric population. Even the simplest procedure can test your skills and experience. Recently, a very pleasant family brought in their two and a half year-old daughter so she could be evaluated for “walking problems.“ I eventually diagnosed these walking problems as a severe metatarsus adductus. I decided to attempt conservative management with a custom-molded orthotic with a medial flange. This initially helped the toddler. Read More.

Where Can The Foot And Ankle Surgeon Go For Continuing Education On Biomechanics?

Doug Richie Jr. DPM FACFAS
2/8/10 | 2779 reads | 0 comments
The last time I checked, there were no lectures devoted to biomechanics at the upcoming American College of Foot and Ankle Surgeons (ACFAS) Scientific Conference in Las Vegas (Feb. 22 to 26). I continue to be amazed that our profession would stage a conference that advertises “cutting edge clinical and practice management topics,” and ignores the vital role that biomechanics plays in foot and ankle surgery. Our counterparts at the American Orthopaedic Foot and Ankle Society (AOFAS) devote almost one-third of the lectures at its annual meeting to biomechanics topics. Read More.

Failure To Biopsy: When Alleged ‘Wound Care Specialists’ Fall Short Of The Standard Of Care

Molly Judge DPM FACFAS
2/8/10 | 4083 reads | 7 comments
I do not know about you but I continue to find myself wondering who are these so-called wound care specialists who undertake management of wounds but are nowhere to be found when bad wounds take a turn for the worse. Read More.

A Closer Look At The Three-Knot Layered Krackow Achilles Repair

Neal Blitz DPM FACFAS
2/5/10 | 7393 reads | 0 comments
When it comes to repairing the ruptured Achilles tendon, there are a variety of methods ranging from wide-open exposures with grafting to percutaneous approaches. All of these options have their advantages and disadvantages. However, the most common is a straightforward open approach in which the surgeon re-approximates the tendon in an end-to-end fashion. Read More.

Does Saying ‘I Am Sorry’ Make Malpractice Lawsuits Go Away?

Kathleen Satterfield DPM FACFAOM
2/3/10 | 2370 reads | 0 comments
Does making a medical mistake mean never having to say you are sorry? No, it is just the opposite. Apparently, it is all about saying you are sorry. That is what my surgical mentor taught me and it definitely worked. One time I made a serious mistake and I approached the patient and his family and said those simple words, “I am sorry.” They found no fault. We worked through the problem together and solved it. All was forgiven and they appreciated my sincere efforts. Read More.