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  • Editorial Correspondence

  • Jeff Hall, Executive Editor/VP-Special Projects, Podiatry Today
  • HMP Communications, 83 General Warren Blvd
    Suite 100, Malvern PA 19355
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  • September 2002 | Volume 15 - Issue 9

    5,531 reads | 0 comments | 09/03/02
    It was with great incredulity that I read the article by Dr. Barrett entitled “A Closer Look At Endoscopic Plantar Fasciotomy” (see the May issue, pg. 38). He writes: “Prior to the development of endoscopic foot surgery, there was a strong desire not only to find a better, less invasive method to treat … plantar fasciitis surgically … Indeed, the standard of care … has changed radically since the … EPF.” The inference here, of course, is that after EPF, that desire has been fulfilled and it is now the standard of care. The truth is that in the facilities where I perform surger... continue reading
    Athletes often injure their toes on artificial turf, as seen here. The condition known as turf toe often requires taping and a turf toe plate.
    By Richard T. Braver, DPM
    8,800 reads | 0 comments | 09/03/02
    High contact. High intensity. It’s no surprise that many injuries occur on the football field. An injury may occur as an athlete is blocking an opposing player or as he is being tackled by another player. Other injuries may occur when players either sprint downfield, make sharp cuts to avoid being tackled, or make other movements that involve much rotation in order to catch or deflect the football. Playing surfaces can also lead to injuries (see “Artificial Turf Vs. Natural Grass: Which Is Better?” on page 48). Certainly, the first metatarsal phalangeal joint is one of the most injured ... continue reading
    By Pamela M. Jensen, DPM
    6,840 reads | 0 comments | 09/03/02
    Diet and exercise are essential for blood sugar management and are subject of much frustration for the diabetic patient and the physician. With each visit to the physician’s office, the patient has to anticipate the stern lecture about exercising, controlling his or her diet, abstaining from sweets, and testing his or her sugars regularly or face the multitude of complications from diabetes. In addition, physicians may also give a patient a handout with the recommendations from the American Diabetes Association. But does this method work? King and Armstrong studied the effectiveness of thi... continue reading
    Here is a close-up view of moderate onychomycosis.
    By Aditya K. Gupta, MD, PhD, and Jennifer Ryder, HBSc
    11,127 reads | 0 comments | 09/03/02
    Onychomycosis is a common nail infection, which is often chronic, difficult to eradicate and tends to recur.1 Current therapeutic approaches include mechanical or chemical avulsion, topical therapy, oral therapy or a combination of one or more of these treatment modalities. Treatment of onychomycosis has improved greatly with the addition of broad-spectrum oral antifungal agents and topical nail lacquers. However, even with the therapeutic advances, onychomycosis continues to increase in prevalence, treatment is not always successful, and relapse and reinfection may occur even after... continue reading
    Here is a chronic tear of an Achilles tendon.
    By Babak Baravarian, DPM
    22,760 reads | 0 comments | 09/03/02
    Chronic posterior ankle pain is a very difficult problem for foot and ankle surgeons. Given the multiple potential tendinous and osseous causes of pain, doing a proper diagnostic workup is essential for proper care. With this in mind, let’s consider the following case of a 52-year-old Caucasian male who presents with chronic pain and weakness of the posterior ankle. A computer salesman with an avid love for golf and tennis, the patient plays tennis on the weekends and golf at least once a week for business. Approximately two months ago, while playing tennis, he began to feel pain in the ... continue reading
    By Steven D. Chinn, DPM, MS
    5,350 reads | 0 comments | 09/03/02
    All medical practices are essentially small enterprises, not very different from any of the Fortune 500 companies. Practices generate revenue by providing services or selling products. They also have expenses for staff, rent, equipment and insurance. There are also elements of marketing, finance, human resources, etc. Like all companies, podiatric practices are challenged by inefficiency and the desire to continue improving on their profit margins. When the typical private practitioner hears phrases such as “Quality Improvement,” “Total Quality Management (TQM)” or “Process Enhancem... continue reading
    Langer introduces the L.XCEL orthosis with computer-aided technology for 
custom orthotics.

    4,454 reads | 0 comments | 09/03/02
    Looking for a custom orthotic that will improve the gait of your patients? Look no further than the Langer L.XCEL orthotic line, which minimizes energy consumption and absorbs forces created by weight stress transmission during gait. According to Langer, the new orthoses are the result of computer-aided technology that is used to evaluate patient models and create custom orthotics from two proprietary materials: LangerFlex and LangerZorb. Langer notes the L.XCEL orthotics are made from either a plastic cast or foam impression, and are value-priced at $55. For an additional charge, patie... continue reading
    This photomicrograph of a type 1 diabetic primate was taken from the ulnar nerve in an area of no known site of anatomical entrapment.  Note the significant endoneurial and sub-epineurial edema.
    By Stephen L. Barrett, DPM
    9,127 reads | 0 comments | 09/03/02
    Statistics from the American Diabetes Association (ADA) reveal there were 86,000 amputations due to complications from diabetes mellitus in 2000. The ADA also points out that 50 to 70 percent of these patients will develop peripheral neuropathy sometime in the course of their disease.1 The most widely believed paradigm in mainstream medicine today is that loss of sensation in diabetic peripheral neuropathy is irreversible and the only treatment available is the achievement of euglycemic control and the ancillary use of medicines such as Elavil and Neurontin.2 Sadly, this... continue reading
    By Brian McCurdy, Associate Editor
    6,283 reads | 0 comments | 09/03/02
    Researchers at the Centers for Disease Control and Prevention (CDC) recently discovered the first reported case of vancomycin-resistant Staphylococcus aureus (VRSA) in the world. The organism was identified in a patient in Michigan, had not spread to anyone else and is susceptible to other antibiotics, according to the CDC Web site. The 40-year-old woman was treated on an outpatient basis, has complicated diabetes and peripheral vascular disease, and undergoes hemodialysis on a regular basis, according to Dr. David Johnson, Deputy Director and Chief Medical Executive of the Michigan D... continue reading
    By Jeff Hall, Editor-in-Chief
    5,201 reads | 0 comments | 09/03/02
    The pursuit of a better testing method for diabetic peripheral neuropathy has spurred the re-emergence of the Pressure Specified Sensory Device (PSSD) and accompanying debate over its potential utility. Yes, the NCV test and the Semmes-Weinstein monofilament allow you to test for the presence of neuropathy. However, in his article, “Restoring Sensation In Diabetic Patients” (see page 38), Stephen Barrett, DPM, says the monofilament does not “quantify or stage the level of peripheral neuropathy” and neither test enables you to assess “early stages of isolated peripheral nerve compres ... continue reading