Volume 15 - Issue 7 - July 2002
There is a tendency for people to fear the unknown. Unfortunately, stereotypes abound about the incapability of the podiatric profession. It is up to everyone involved in the field directly or indirectly not to perpetuate this way of thinking.
Bias towards podiatry is a double-edged sword. On one side, the laypeople are constantly questioning the profession.
Surgical Pearls »
Metatarsalgia may develop from osseous, neurological, vascular or dermal etiologies. The causes are numerous and commonly involve a cavus foot structure, a long second metatarsal, short first metatarsal, hypermobile first ray, iatrogenic pain from forefoot surgery or manifest from a rheumatology-induced systemic disease. When symptoms persist, you may see callus lesions develop under the affected metatarsal. Keep in mind that these lesions can lead to stress fractures and compensation-induced pains in the lower extremity and back.
About four of 1,000 people will develop a leg ulcer during their lives, but the prevalence of leg ulcers rises dramatically with age, increasing to about 1 percent in people over the age of 60 and 2 percent in people over the age of 80. In the U.S., about 3 million people suffer from leg ulceration, costing an annual $4 billion in treatment costs and losses of over 2 million days from work.
In general, diagnosing the cause of leg and foot wounds requires examining the wound, the extremity and the patient. Let’s start by taking a look at venous problems.
Any disease state that leads to ven
Unfortunately, it doesn’t always work out and the staffer you thought to be perfect for your team winds up bringing down your practice in some significant way. It is when you recognize that you must fire the employee that the real work of managing your office truly begins. Indeed, with the increasingly litigious nature of our era, firing staffers has become a problematic process, fraught with many legal and ethical landmines.
“We all know how to terminate someone,” notes Hal Ornstein, DPM, who has a private practice in Howell, N.J. “It’s not hard to say ‘You’re fired.’ The id
Is the term “overuse injuries” really appropriate? After all, many so-called “overuse” injuries of the lower extremity are unilateral. In most cases, the right foot is used just as much as the left foot so the term becomes illogical. Perhaps stress failure phenomena would be a more accurate description of these injuries. Some examples of mechanisms leading to stress failure problems include repetitive motion, repetitive loading and repetitive impact.
Your patients might encounter repetitive motion injuries in endurance sports like swimming or sports such as cross-country running or b
The wound is in constant evolution. Changes arise and you need to be able to respond accordingly in your treatment course. Indeed, understanding the biochemical dynamics of wound healing is vital for proper product selection (see “Understanding The Phases Of Wound Healing” on page 42). The challenge to the practitioner is to have the knowledge base with which to sort through the thousands of topical agents and dressings available today.
Insights On Topical Agents With Collagen
Let’s start out with a discussion of the biologic topical agents that contain collagen. Collagen hastens wou
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