Volume 15 - Issue 12 - December 2002

Diabetes Watch »

What You Should Know About Using NIV Studies

By Dana Giacalone, DPM, and Khurram Khan, DPM | 13707 reads | 0 comments

When it comes to peripheral vascular disease, you can use many modalities to detect and evaluate this disease. Arteriography is the gold standard and provides excellent anatomic detail, but it is invasive and requires ionizing radiation and administration of contrast. It also provides very limited physiologic or functional information.
Indeed, it’s important to be aware of the role of noninvasive testing measures (see “When NIV Studies Are Warranted”). After all, Pellerito, et. al., pointed out it’s advantageous to use noninvasive vascular (NIV) evaluation prior to angiography in ord



Orthotics Q&A »

Ski Boot Orthotics: Plowing Through The Options

Clinical Editor: Howard Dananberg, DPM | 23199 reads | 0 comments

As December arrives, patients who enjoy winter sports begin to think about skiing. Ski boot technology has come a long way in recent years, with many comfort features added to complement the performance the boots are designed to provide. Patients will often ask your opinion as to what they need and how they can enhance their skiing. With this in mind, our expert panelists offer their opinions.

Q: What are the most interesting advances now available in ski boots for the upcoming season?
A:
In the past five years, ski boots have moved in a few directions, according to Ben Wax, CPe



Feature »

Expert Insights On Detecting Lisfranc's Injuries

By David Caldarella, DPM, and Celeste Borchers, DPM | 25422 reads | 0 comments

Lisfranc’s injuries, as found at the tarsometatarsal joint, are rare, according to the literature. Only 1 percent of all fractures are found at the tarsometatarsal articulation with an incidence of one per 55,000 people per year.1 These injuries are two to four times more likely to occur among young to middle-aged men as opposed to female patients.1-3 Overall, though, the injury is still a rare phenomenon. Aitken and Poulson reviewed 82,500 fractures over a 15-year period and found only 16 cases of Lisfranc’s fractures.4
But are these injuries as rare as



Feature »

CE: When Should You Perform Callus Distraction?

By Michael S. Downey, DPM | 12513 reads | 1 comments

The current use of callus distraction techniques in foot, ankle and lower leg surgery is constantly growing. The limits of callus distraction techniques appear to be those imposed by surgical access and fixation. As techniques and technology continue to improve, even more indications for callus distraction will evolve.
Callus distraction, also commonly referred to as distraction osteogenesis or callostasis, is the lengthening of a bone by manipulation of the bone callus during the healing process. Gavriel A. Ilizarov, a Russian-born physician, is credited with popularizing limb lengtheni



Feature »

What Are The Best Modalities For Charcot's Foot?

By Guy R. Pupp, DPM, David T. Savage, DPM, MS, and Mark B. Hellmann, DPM, MS | 21453 reads | 0 comments

Neuropathic osteoarthropathy is a debilitating condition that affects diabetic patients with peripheral neuropathy. This distinct pathologic entity, commonly known as Charcot’s arthropathy or Charcot’s joint disease, is characterized by pathologic fractures, joint dislocation and deformity, resulting in a foot at high risk for ulceration and amputation in severe cases.
Armstrong, et. al., found the prevalence of Charcot’s arthropathy ranges between 0.16 percent in the general diabetic population of patients to 13 percent of patients presenting to a high-risk diabetic foot clinic.1<



Feature »

How To Detect And Treat Chronic Compartment Syndrome

By Michael M. Cohen, DPM | 42142 reads | 0 comments

Certainly, one of the greatest challenges practitioners face is properly evaluating exercise-induced leg pain. All too commonly pigeonholed under the term shin splints, chronic (or exertional) compartment syndrome (ECS) is a unique disorder whose term specifies its clinical and pathological features. Those who treat the condition recognize the list of differentials can be exhausting and an accurate diagnosis is essential to providing proper treatment.
Compartment syndromes are either acute or chronic. The acute form first described by Volkman in 1881, is irreversible and may be initiated by



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