Volume 16 - Issue 1 - January 2003
Surgical Pearls »
The advantages of lesser proximal interphalangeal joint arthrodesis in hammertoe surgery are numerous and well known. Arthrodesis is indicated in patients who have compromised intrinsic muscle function and are lacking both digital and metatarsophalangeal joint stability. Indeed, digital arthrodesis has always been an excellent procedure to consider if you fear reoccurrence of the hammertoe deformity due to biomechanical factors.
Through the years, surgeons have employed several methods and devices to facilitate fusion across the lesser proximal interphalangeal joints (PIPJ) for stable hammer
Technology In Practice »
Proper diagnosis and treatment of foot ulcerations is essential to preventing lower extremity amputations. With this in mind, Footlogic offers its PressureStat device. An alternative to the traditional optical pedobarograph, the PressureStat gives you a quick and effective way to identify plantar pressure abnormalities associated with diabetes. A 1999 study in Diabetic Medicine showed that the PressureStat performed well in correctly identifying all high pressure areas in patients versus other pressure data techniques in assessing and preventing diabetic foot ulcers.1
Wound Care Q&A »
As Aristidis Veves, MD and Thanh Dinh, DPM, point out, it is well-known that the chronic diabetic foot ulcer is stuck in the inflammation phase of the wound healing cycle. Research studies have shown that non-healing wounds may have specific biochemical imbalances, notes Liza Ovington, PhD. In particular, non-healing wounds have been shown to have excessively high levels of proteolytic enzymes such as matrix metalloproteases (MMPs).
While these enzymes are necessary in various aspects of the healing process, such as cellular migration, debridement and phagocytosis, Dr. Ovington notes that hi
While the great majority of hallux valgus deformities can be accommodated with a wide toe-box shoe, secondary deformities, such as painful hammer digit syndrome and metatarsalgia, coupled with patient demands, often drive the need for operative intervention. In addition, some individuals are averse to wearing any type of special shoes and wish to have the deformity corrected rather than accommodated.
When an operation is indicated in your opinion and in concert with the patient’s wishes, the goals for the ideal hallux valgus operation are as follows:
• joint congruity with full, pain-fre
Continuing Education »
In our profession, we do not receive extensive training in medical nutrition and its link to wound healing and the prevention of infections. Most podiatric and medical school curriculums devote only a limited amount of time to nutritional instruction for their students. Granted, podiatrists are aware of the nutritional requirements for the diabetic patients. Preoperatively, we usually work alongside an internist or primary care physician to help these patients balance their insulin and glucose levels during and after the foot surgeries.
While several large orthotic laboratories have offered AFOs for over 20 years, the increasing demand for the devices has become a significant phenomenon in the podiatric field. Why have podiatrists turned to AFOs more and more in recent years? There are three key reasons that have caused this shift in treatment.
First, there has been a meteoric rise in the number of patients who have challenging foot and ankle pathologies. Two of these pathologies, adult acquired flatfoot secondary to posterior tibial tendon insufficiency and diabetic Charcot’s arthropathy, have disappointing treatment re
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