Volume 22 - Issue 5 - May 2009

Wound Care Q&A »

Current Insights On Treating Heel Pressure Ulcers

Clinical Editor: Kazu Suzuki, DPM, CWS | 47342 reads | 0 comments

   Heel pressure ulcers can be particularly challenging for podiatric physicians, given the risk of complications, offloading challenges and the compromised vascular status of high-risk patients. Accordingly, our expert panelists share their perspectives in providing wound care for these patients.

   Q: How do you dispense offloading devices for pressure ulcers of heels?

   A: Kazu Suzuki, DPM, CWS, considers factors such as the patient’s weight, sensory perception (neuropathy), activity level and mobility level, as well as skin perfusion pr



Diabetes Watch »

Understanding How The Achilles Tendon Affects Plantar Pressure

Eleanor Wilson, DPM | 13446 reads | 0 comments

   Approximately 23.6 million people in the United States have diabetes, according to the 2007 statistics from the American Diabetes Association.1 Many of these patients have an associated comorbidity of obesity and, all too often, Achilles tendon contracture.

   As we age, the tendon naturally tightens. However, diabetes exacerbates this tightening process as increased blood sugar levels deposit glucose in the collagen of the tendon, greatly reducing its elasticity. Obesity can also contribute to the tightening of the posterior muscle group, which i



News and Trends »

May 2009

Brian McCurdy, Senior Editor; Lauren Grant, Editorial Assistant | 9270 reads | 0 comments

Can Peppering Augment Injections For Plantar Fasciitis?

By Brian McCurdy, Senior Editor

   A new study in the Journal of the American Podiatric Medical Association (JAPMA) concludes that a peppering injection technique can boost the effect of corticosteroids and provide greater pain relief.

   The prospective, randomized, multicenter study consisted of 100 patients divided into four groups of equal sizes. Patients in group A received a 2 mL injection of autologous blood. Group B received 2 mL of lidocaine along with peppering injections.



Feature »

Key Insights On Tendon Transfers For Drop Foot

Lawrence DiDomenico, DPM, and Laurence Cane, DPM | 45020 reads | 0 comments

Given the complexity of drop foot and its impact on gait biomechanics, these authors offer a primer on the diagnostic workup, and share their thoughts on the potential merits of tendon transfer procedures.

   Drop foot and foot drop are interchangeable terms that illustrate an abnormal neuromuscular disorder, which affects the patient’s capacity to lift up the foot at the ankle. Drop foot is further characterized by failure to dorsiflex the foot or move the foot inward or outward at the ankle. Pain, weakness and numbness may be associated with a loss of function.



Feature »

A Guide To Biopsy Techniques For Skin Neoplasms

Tracey C. Vlahovic, DPM, FAPWCA | 23493 reads | 0 comments

General guidelines for obtaining biopsies of skin lesions are few and far between. These techniques are also often underutilized in podiatric practice. Accordingly, this author offers a helpful primer on when and how to perform punch, incisional and excisional biopsies.

   Why does a physician perform a skin biopsy? Often skin neoplasms and inflammatory conditions look alike and are clinically confusing. In these cases, a biopsy can facilitate a histopathologic diagnosis, which helps to support the treatment plan.1

   Obtaining a skin bi



Feature »

A Guide To The Differential Diagnosis Of Heel Pain

Bob Baravarian, DPM | 42713 reads | 0 comments

Although plantar fasciitis is the most common cause of heel pain, one should not overlook other possible etiologies. Accordingly, this author reviews pertinent keys to the patient history, physical exam and diagnostic testing that can help facilitate an accurate diagnosis.

   Plantar fasciitis is by far the most common cause of heel pain. Given the high number of cases reported per year, it is not uncommon for a doctor to diagnose a patient with plantar fasciitis without paying adequate attention to other potential causes of heel pain.

   It is