Volume 21 - Issue 3 - March 2008
Treatment Dilemmas »
Ankle arthritis has been the subject of much research and researchers have made a great deal of progress in this area in the past 50 years. In the past, physicians primarily treated post-traumatic arthritis, which accounts for much of the cause of ankle arthritis, with casting. This often caused malalignment and poor articular position, resulting in rapid arthritis of the hindfoot and ankle.
With the advent of internal fixation and external fixation advances, proper anatomic alignment of the hindfoot and ankle has resulted in a dramatic decrease in the rate of post-traumatic ar
Wound Care Q&A »
When it comes to patients with diabetes and lower extremity ulcers and complications, what does the evidence-based medicine say about high-risk patients and proactive prevention? These panelists examine risk factors for ulcerations, appropriate screening and offer their thoughts on what works and what does not work in terms of prevention.
Q: What does evidence-based medicine show in regard to who is at risk for limb loss and foot ulcerations?
A: Thomas Zgonis, DPM, says approximately 15 percent of patients with diabetes will experience a
Feature » MRSA
In the past few months, we have heard numerous reports in the news about a “new super bug” that is resistant to conventional antibiotics and is sweeping through high school sports locker rooms and classrooms. The alleged new super bug is methicillin resistant Staphylococcus aureus (MRSA) and, more specifically, community-acquired MRSA (CA-MRSA).
However, MRSA is not a new type of bacteria that has suddenly appeared in the community. The organism has actually been around for quite a few decades.
In 1941, all S. aureus isolates were suscept
Continuing Education »
Please click here for the full Continuing Medical Education article:
Given that ulcers are a common complication for patients with diabetes, it is important to understand the various ulcer grading systems and how they can aid in treatment. This author reviews common classification systems and how to apply them in a clinical setting.
The World Health Organization and the International Diabetes Federation have stated that up to 85 percent of diabetic lower extremity amputations are preventable. There are approximately 82,000 diabetes-related lower extremity amputations (LEA) annually at an estimated cost of over $11 billion.1,2 Eighty-five percent of amputations are preceded by a foot ulcer.3 Diabetic foot ulcers are caused by neuropathy, deformity and repetitive microtrauma.4 The treatment of diabetic foot ulcers may cost the United States healthcare system as much as $19 billion
The treatment of patients with diabetes and associated complications has been extensively studied. Over the past several decades, the treatment of foot and ankle ailments in patients with diabetes has dramatically shifted from conservative measures of “do not perform surgery” to the present day thinking that has taught us that diabetic feet are not very different from normal feet.
The most common misconception with diabetic foot ailments has been that the loss of limbs is due to severe vascular problems. However, with time, we have found that vascular issues in the
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