Volume 21 - Issue 6 - June 2008

Orthotics Q&A »

Pertinent Roundtable Insights On Indications For Orthotic Management

Guest Clinical Editor: Ronald Valmassy, DPM | 11296 reads | 0 comments

Choosing the most effective type of orthotic device for a given condition can be tricky as one must consider factors that include materials, potential modifications and cost.
Accordingly, the panelists discuss possible indications for OTC orthoses, conditions that are particularly challenging to treat with orthotics and the role of functional foot orthoses in managing bunion deformities.

Q: Are all prefabricated, over-the-counter (OTC) foot support systems essentially the same? Are there unique characteristics of any of the devices which makes them better s

Feature »

What You Should Know About Planal Dominance And Pronated Feet

By Edwin Harris, DPM

| 25484 reads | 0 comments

It is unfortunate that the terms pes planus and flatfoot are so ingrained in the medical literature because they concentrate attention on only one component of a very complex deformity. Smith and Ocampo described a classification for pes “pronatus” based on an earlier work by Borelli and Smith that identified the dominant plane of the deformity.1,2 Although it was originally designed for surgical procedure planning, it is equally ideal for non-surgical treatment.
Dating back to the 1970s, biomechanical theory of the pronation syndromes concentrated almost

Feature »

Emerging Concepts In Shockwave Therapy

By Lowell Weil, Jr., DPM, MBA | 10029 reads | 0 comments

When musculoskeletal extracorporeal shockwave therapy (ESWT) was first introduced in the United States with the first FDA approval in 2000, there was a great deal of controversy and posturing among manufacturers of ESWT technologies. Each company was determined to create an exclusive market for their product at the expense of the competition. One of the most common targets for criticism was the level of energy of the technology. Based on industry biases, high-energy ESWT was considered the most effective for the musculoskeletal system. Those devices that failed to reach high energy we

Sports Medicine »

Should You Cast Achilles Tendon Ruptures?

By Troy J. Boffeli, DPM | 30656 reads | 0 comments

Surgeons routinely make treatment decisions based on their training and experience. For example, we typically employ non-operative treatment of Achilles ruptures for the elderly. Surgical repair, on the other hand, is usually recommended for younger, active patients. The traditional teachings on the long-term outcome after Achilles rupture tend to lump conservative treatment of acute rupture with non-operative treatment of delayed presentation and neglected rupture. Surgeons learn that non-operative treatment results in slow healing, weakness, calf atrophy, re-rupture and loss of func

Feature »

How To Perform An Isolated Subtalar Joint Arthrodesis

By Douglas K. Blacklidge, DPM | 32956 reads | 0 comments

Isolated arthrodesis procedures for the hindfoot are an interesting and sometimes controversial topic for foot and ankle surgeons. Historically, when it came to most major rearfoot deformities and joint conditions, surgeons utilized the triple arthrodesis versus any isolated joint fusions of this complex. The thinking was that the subtalar, calcaneocuboid and talonavicular joints all function together to allow pronation and supination of the entire foot, so if one joint needed fusion, they all needed fusion.
The trend during the past decade or two has been more toward preservi

Technology In Practice »

Can The HyProCure Implant Provide The Answer For Hyperpronation?

By Robi Garthwait, Contributing Editor | 15393 reads | 3 comments

For DPMs dealing with the common condition of hyperpronation, the HyProCure Sinus Tarsi Implant may be one of the more intriguing treatment options to date.
Composed of medical grade titanium, the implant serves as an internal orthotic that essentially turns the negative space of the sinus tarsi into a positive space, according to the implant’s manufacturer Gramedica.
Gramedica says the HyProCure implant is stronger than bone and requires one small incision for insertion without the need for casting after the procedure. Paul Clint Jones, DPM, has su

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