Volume 16 - Issue 4 - April 2003

Feature »

Essential Treatment Tips For Flexible Flatfoot

By Richard O. Lundeen, DPM, and Stephen M. Offutt, DPM, MS | 18430 reads | 0 comments

The treatment of symptomatic flexible pes planovalgus is a topic that stirs up considerable controversy among practitioners. This is especially true in the pediatric arena where there is a common belief that the child will “grow out of it.” For many foot specialists who see the damaging effects of excessive pronation among adults, the realization is all too obvious that much of this pathology can be curbed if it is addressed in childhood. Shockingly, some even deny the existence of the condition.
Etiological factors of flexible pes planovalgus fall into two broad categories: pediatric an



Feature »

How To Hire An Associate

By Robert Smith, Contributing Editor | 7967 reads | 0 comments

Hiring an associate can be a time-consuming, involved process—if it is done properly. As with any major professional decision, you must take great care and consideration in order to make the right move at the right time with the right person. Making a rushed or uninformed decision can result in excess costs and wasted time, not to mention the potential damage done to relationships with patients.
Do you really need an associate? There are a number of key considerations in determining whether to bring an associate on board.
• Do you need more time off? Bringing an associate on board



Feature »

Current Concepts In External Fixation

By Thomas Zgonis, DPM, Gary P. Jolly, DPM and Peter Blume, DPM | 17940 reads | 0 comments

While external fixation will not replace internal fixation in the surgical toolbox, it does offer a number of specific advantages. Using external fixation has become routine for initial reduction and stabilization of comminuted long bone fractures, and is often used in conjunction with a few judiciously placed lag screws. In the presence of compromised soft tissue, external fixation becomes essential.
Unlike internal fixation, which becomes a fixed, static construct once you apply it, external fixation can be quite dynamic in certain forms. It is common during postoperative periods to adjust



Editor's Perspective »

Unlocking The Door To A National Scope Of Practice

By Jeff Hall, Editor-in-Chief | 4473 reads | 0 comments

Is it time for a national scope of practice in podiatry? Individual state laws prevail for now, but disparities between them raise eyebrows, not to mention the legal challenges. Are politics getting in the way of DPMs being able to provide complete podiatric care for patients or is the lack of universal training a far greater obstacle?
Let’s get to the wish list first. Some advocate broad parameters of what constitutes lower extremity care for a national scope of practice. One podiatrist says it should be the widest currently defined state law that encompasses care in the lower extremity



Forum »

Raising Expectations By Reforming Residency Programs

By John H. McCord, DPM | 2790 reads | 0 comments

I was pleased to learn the Council on Podiatric Medical Education (CPME) has declared a moratorium on one-year podiatric residency training programs that will take effect in 2008. Twelve months is simply not enough time to prepare young DPMs for the complexity and demands of our profession. I should know. I was a “12-month wonder.”
The residency training in podiatry has come 180 degrees since I graduated from podiatry school in 1974. At that time, the top students competed for the few good training programs. In 2003, it’s the opposite. Good residency programs are competing for the top s



Diabetes Watch »

A Guide To Effective Forefoot Salvage Procedures

By Eric M. Feit, DPM, and Mary M. Peters, DPM | 11806 reads | 0 comments

It is believed that 15 percent of diabetics will develop a foot or leg ulceration at some point during the course of their disease and that 50 percent will recur within 18 months.1 Approximately 80 percent of diabetic ulcers occur plantarly due to abnormal pressures. Most of these ulcers can be treated with sharp debridement, offloading devices and local wound care.2-4 Once you’ve achieved ulcer healing, utilizing custom orthotics with extra depth shoes will often prevent recurrence and reduce the needed frequency of pre-ulcerative keratoma debridements.
Unfortunately



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