DPM Blogs

Why It Is Becoming More Common To Utilize Closed Reduction And Percutaneous Fixation

Lawrence Fallat DPM FACFAS
5/13/09 | 3143 reads | 1 comments
While preparing a lecture on closed reduction with percutaneous fixation techniques for calcaneal fractures, I was surprised to see how common this technique had become. In addition to using these techniques in the management of avulsion (beak) fractures of the superior posterior aspect of the calcaneus, surgeons are using them for Sanders II fractures. These are intra-articular joint depression injuries that are difficult to reduce even with open surgery. Some surgeons are even using arthroscopy to ensure accurate closed reduction of these fractures. Read More.

A Closer Look At Scope Of Practice Battles In South Carolina

Michelle L. Butterworth DPM FACFAS
5/6/09 | 4978 reads | 0 comments
While I enjoy living in South Carolina, I do not enjoy its limited scope of practice for podiatry. I did a four-year residency, which involved reconstructive rearfoot and ankle procedures, foot and ankle trauma, and limb salvage. I moved to South Carolina immediately after residency and have been here for 10 years now. I do not want to sound naïve. I knew the limitations of the state’s scope of practice before I moved and I chose to move to South Carolina regardless. I did however have high hopes — even though I knew it would be a tough battle — that our state law would eventually Read More.

Is Clinical Examination A Lost Art?

William Fishco DPM FACFAS
5/1/09 | 2918 reads | 1 comments
We live in a high-tech world. Medicine and surgery are not exempt. I personally think we are all prone to forget the basic tenets of diagnosis. Think way back to podiatry school when you learned the fundamentals (range of motion, manual muscle testing, gait exam, etc.) of examining the foot and ankle. Today, it is all about diagnostic ultrasound, MRIs, CTs, bone scans and other “hands-off” testing modalities. Certainly, these tests have their place in working up a difficult diagnosis but let us not forget the most important aspect of examination. It is not uncommon for me to see pa Read More.

Could Recent Discoveries In Research Eventually Lead To Genetic Therapy For Clubfoot?

Kathleen Satterfield DPM FACFAOM
5/1/09 | 3430 reads | 0 comments
Soon there will be a time when the next generation of cutting-edge podiatrists trained in rearfoot surgery will see children with clubfoot being treated non-surgically. I am not talking about those patients who are amenable to treatment via serial casting. I am talking about the bad boy deformities that require tendon releases and opening of joint capsules for repositioning. It was a previously unheard of thought — treatment science fiction really. However, researchers from the Washington University School of Medicine in St. Louis recently discovered a mutation in the gene responsible fo Read More.

Can Podiatrists Be The Premier Surgeons Of The Foot And Ankle Without An Understanding Of Current Biomechanics Research?

Doug Richie Jr. DPM FACFAS
4/21/09 | 3346 reads | 2 comments
I recently had the privilege of serving on the faculty of a seminar entitled “Biomechanics for the Foot and Ankle Surgeon,” which was recently held in Oakland, Ca. This conference was sponsored by the California School of Podiatric Medicine at Samuel Merritt University in association with the Prescription Foot Orthotic Laboratory Association (PFOLA). The content of this meeting was certainly the first of its kind in the podiatric profession. The purpose was to update the attendees on recent advances in knowledge in biomechanics, which would have direct application to improving outcome Read More.

Lecture Points To Emerging Bacterial Resistance To Silver

Allen Jacobs DPM FACFAS
4/17/09 | 3478 reads | 1 comments
At the recently concluded scientific sessions of the American Professional Wound Care Association (APWCA), Adrianne P.S. Smith, MD, presented evidence of evolving bacterial resistance to silver. Silver dressings are, of course, frequently utilized in wound care. It has been generally accepted that natural resistance to silver does not occur. However, Dr. Smith noted that silver resistance is being increasingly reported. The origins of this resistance include: plasmids with encoded genes for silver resistance; bacterial chromosomes; and selection when too low a dosage of silver exposure all Read More.

Medical Mission Trip: Facilitating Clubfoot Care In Haiti

Patrick DeHeer DPM FACFAS
4/10/09 | 4767 reads | 5 comments
I recently made my eighth trip to Haiti for an ongoing clubfoot project. It was my 15th medical mission trip overall. I first started going in 2002 and have been hooked every since. I love it and wish I could do it full time. I often have colleagues and friends ask about my trips so I thought I would do a brief travel log of my most recent trip. We are in the midst of trying to establish a clubfoot foot program for Haiti run by Haitians. “Parachute medicine,” in which one parachutes in a do a bunch of surgery, is of minimal value. I will discuss this in much more detail in my next blog Read More.

Modified SALSAstand Fixation/Offloading For TMAs And Fragile Flaps

David G. Armstrong DPM MD PhD
4/10/09 | 3189 reads | 0 comments
Many clinicians have offered means of offloading the posterior diabetic foot both with and without internal fixation. We offer a modification of a post technique described by Saul Trevino, MD. In this modified technique, we reinforce the posts with a posterior distal to proximal anterior hypotenuse, using the Hoffman II Modular Fixation System (Stryker Orthopaedics) in a patient with end-stage renal disease and a gangrenous forefoot. We were able to correct the patient’s equinovarus position with an Achilles tendon lengthening and external fixation. We believe this aggressive stabili Read More.