Volume 21 - Issue 1 - January 2008

Diabetes Watch »

Essential Questions For Surgical Intervention Of Diabetic Foot Infections

By Andy Meyr, DPM | 13661 reads | 0 comments

     Dedicating oneself to the side of limb salvage in the fight against diabetic foot disease is a demanding and personally challenging enterprise. In the face of infection, it often seems as though all variables are against the surgeon and the patient as they both struggle against the possibilities of proximal amputation and limb loss. In fact, it often appears as though the only constant is the unpredictability of the disease progression.

     However, expert knowledge in lower extremity anatomy is one of the most valuable tools that one can have in this fi



Wound Care Q&A »

Expert Insights On Treating The Wounded Charcot Foot

Clinical Editor: Lawrence Karlock, DPM | 14959 reads | 0 comments

     Treating a wound on a Charcot foot can be a challenge. Our expert panelists discuss the diagnosis of acute Charcot, the management of Charcot and Charcot-related wounds, indications for exostectomy and keys to facilitating a return to weightbearing.

     Q: How do you diagnose an acute Charcot foot? Do you use any ancillary testing?

     A: Most of the time, Geoffrey Habershaw, DPM, diagnoses acute Charcot by combining the patient’s history and physical with simple tests.
     Dr. Habershaw, Lawrence Lavery, DP



Surgical Pearls »

Pertinent Insights On Treating Lapidus Nonunions

By Graham A. Hamilton, DPM | 12051 reads | 0 comments

     Nonunion is a well-documented potential complication of the Lapidus arthrodesis. It reportedly occurs anywhere from 3.3 percent to 12 percent of the time, and is a very challenging problem to fix.1-7

     Granted, a strict definition of nonunion and timeline for classifying a nonunion varies from one surgeon to another. However, for the purpose of this discussion, nonunion has both clinical and radiographic definitions. Nonunions involve the failure of bone healing at the fusion site after six months, broken hardware or both. A clinical nonunio



Feature »

How To Differentiate Soft Tissue Neoplasms

By Francis Rottier, DPM | 31758 reads | 0 comments

     Soft tissue neoplasms of the lower extremity present a significant treatment challenge to the treating physician. Although most neoplasms of the lower extremity prove to be benign, the potential for malignancy does exist. The ability to appropriately diagnose and treat soft tissue neoplasms may be the difference between life and death for the patient presenting with a soft tissue tumor of the lower extremity.

     Accordingly, let us take a closer look at appropriate evaluation and diagnostic techniques that will aid the physician in making an accurate dia



Feature »

A Guide To Hybrid Screw Fixation In Lesser Metatarsal Surgery

By Michael Salcedo, DPM, and Michael Motyer, DPM | 19046 reads | 0 comments

     During the past five years, there has been a large influx of non-traditional bone screws on the orthopedic market for small bone fixation of the foot. Some of these designs have been effective at providing long-term surgical fracture stability with reduced osteotomy fixation morbidity. Additionally, these bone screw designs have found their way into a variety of applications in hindfoot surgery with headless screws, locking plate screws and cannulated self-tapping screws.

     When trying to assess the technology available in small fragment fixation, it



Feature »

Current Insights On Bracing For Hindfoot Osteoarthritis

By Lawrence Huppin, DPM | 24471 reads | 0 comments

     Foot orthoses (FOs) have been a standard treatment in podiatric clinics for decades. Until a decade ago, however, it was rare for American podiatrists to dispense ankle foot orthoses (AFOs) of any kind.

     In 1996, the Richie Brace was introduced and it was the first ankle brace to incorporate a custom functional foot orthosis (FFO). Two years later, the Arizona Brace, the first gauntlet AFO to incorporate a polypropylene shell, arrived on the market and was soon widely used within the podiatric profession. Read the full story »