Volume 15 - Issue 5 - May 2002

Feature »

How To Manage Difficult Patients

By John V. Guiliana, DPM, MS, Hal Ornstein, DPM, and Lynn Homisak, PMAC | 8259 reads | 0 comments

Is there a particular patient or two you dread seeing in your office? If a vote took place among physicians as to what kind of patient provokes the most distress in healthcare providers, we would bet many providers would answer “patients who fail to comply.” In fact, providers often react with anger and frustration when patients ignore their professional recommendations.
Aside from the potential legal ramifications, a patient’s lack of compliance often triggers feelings that our professional opinion is devalued and may even cause us to begin to question our own self-worth. When our own



Feature »

A Closer Look At Endoscopic Plantar Fasciotomy

By Stephen L. Barrett, DPM | 41902 reads | 0 comments

Prior to the development of the first endoscopic foot surgery, there was a strong desire not only to find a better, less invasive method to treat recalcitrant mechanical plantar fasciitis surgically but also to develop a more universally consistent surgical approach to what has been labeled an “endemic problem.” Indeed, the standard of care regarding the surgical management of the heel pain has radically changed since the introduction of the endoscopic plantar fasciotomy (EPF).
In 1990, there was an almost universal perception within the podiatric community that the spur was the primary c



Forum »

Emphasizing The Concerns Of Podiatry Students

By Megan Lawton | 4252 reads | 0 comments

I have always loved sports and knew I wanted to be able to treat athletes’ anomalies medically. I participated in many sports up through college. Whether I was playing volleyball, fastpitch games or doing a triathlon, I found that athlete anomalies typically involved the foot and ankle. I found the podiatry profession fit my life. Not only could I treat athletes and others, I could incorporate surgery into some treatments.
After I decided to pursue podiatry as a career, I started thinking about my future. I’m not alone. As the podiatric profession continues to evolve, students often wond



Feature »

Distal Tibia: Is It The Best Source For Bone Graft?

By Jesse Burks, DPM, MS | 9053 reads | 0 comments

Numerous primary and revisional surgical procedures mandate using either osseous autografts or allografts. Although allografts continue to increase in popularity, most podiatric surgeons will agree that autografts offer distinct advantages in healing and are preferable when possible. In comparison to autogenous grafts, allografts help facilitate an absence of donor site morbidity, unlimited supply and decreased surgical time. However, autografts provide numerous benefits such as host compatibility, viable precursor cells and superior immunologic properties.1,2
As with any surgical procedure



News and Trends »

Is Arthrodesis The Answer For First MPJ Arthritis?

By Brian McCurdy, Associate Editor | 7201 reads | 0 comments

What is the best treatment approach for seniors who have painful arthritis in the first MPJ? Arthrodesis may provide significant pain relief for these patients, according to the results of a recent 29-patient study presented at the annual meeting of the American College of Foot and Ankle Surgeons (ACFAS).
A retrospective analysis revealed that 100 percent of 19 patients who responded to a survey said they were satisfied with the results of the arthrodesis, which involves fusing arthritic bones to inhibit motion and eliminate the arthritis. These patients also noted they would undergo the proc



Surgical Pearls »

How To Test And Treat Exertional Compartment Syndrome

By Richard Braver, DPM | 41409 reads | 2 comments

When patients experience intense pain, a burning sensation, tightness and/or numbness in the lower extremities during exercise activity, and the pain usually resolves quickly once the patients stop the activity, you may be looking at exertional compartment syndrome (ECS). ECS is certainly one of the more confounding conditions as differentiating between the various leg pains can be difficult.
Parasthesia to the anterior leg, ankle or between the first and second metatarsal is indicative of anterior leg compartment involvement. In addition, weakness of ankle dorsiflexion or a drop foot also in



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