Volume 16 - Issue 9 - September 2003

Point-Counterpoint »

Is the Keller Bunionectomy Outdated?

By Mark Hofbauer, DPM, and Steven Kravitz, DPM | 28407 reads | 0 comments

Yes, Mark Hofbauer, DPM, cites the limited indications of the procedure. He says the first MPJ fusion is a better option for hallux abductovalgus patients as it provides enhanced stability and biomechanical effects.

For the past 10 to 15 years, there has been a great debate over whether the Keller bunionectomy has become an outdated procedure. Proponents on both sides have been able to make solid arguments. The Keller bunionectomy began to get a black eye years ago when surgeons stretched the indications for its use. This was due in part because it was an easy, quick procedure to perform. A



Feature »

Playing To Win At The Insurance Game

By Neal Frankel, DPM | 5907 reads | 0 comments

Who would have thought that when we finally went into practice after years of podiatry school and residency, we would be more dependent on third party payers for our existence than our patients? In fact, recent studies have indicated that, on the average, we spend one-half to one full hour per patient on paperwork and insurance matters. For many podiatrists to whom I have spoken, the “hassle factor” of trying to get paid from insurance companies seems to be the primary reason many of them are not happy with private practice.
Keep in mind this is a game of sorts. The insurers want to keep



Editor's Perspective »

Are Eight Schools Too Many For Podiatry?

By Jeff Hall, Editor-in-Chief | 3233 reads | 0 comments

Three years ago, enrollments at podiatry schools were in serious decline and it was deemed a crisis situation. It got to the point where some even suggested reducing the number of podiatry schools from seven to six or perhaps five. However, experienced educators noted that enrollment trends are very cyclical and, sure enough, there have been positive increases in enrollment the last two years.
According to the American Association of Colleges of Podiatric Medicine (AACPM), the total first year enrollment at the six AACPM schools improved to 461 in 2003, a 15 percent increase from two years



Feature »

Exploring New Advances In Digital Arthrodesis

By Gerard V. Yu, DPM, Andrew Vincent, DPM, and Wissam Khoury, DPM | 16008 reads | 0 comments

Over the years, a multitude of techniques have been described and employed for digital arthrodesis, ranging from arthroplasty and arthrodesis to flexor tendon transfer and lesser digital implants. Each procedure has a place in surgical correction of digital deformities. Digital arthrodesis, in particular, provides permanent and reliable correction of deformities and is considered by the senior author to be a favored technique, especially when it comes to managing digital deformities of a biomechanical etiology.
Two fundamental techniques, the end-to-end arthrodesis and the peg-in-hole arthro



Continuing Education »

Identifying Skin Malignancies On The Distal Lower Extremity

By James Q. Del Rosso, DO, FAOCD | 4778 reads | 0 comments

Cutaneous malignancies and benign neoplasms simulating malignancy commonly affect the distal lower extremity, including the foot. One may see a variety of malignancy categories such as epithelial tumors, adnexal neoplasms, melanoytic neoplasms, vascular neoplasms and soft tissue tumors. Histologic confirmation of diagnosis is essentially mandatory, warranting the need to send all tissue specimens, including biopsy, incisional and excisional specimens, for pathology examination.
In some cases, the pathologist may incorporate immunohistochemical stains to differentiate specific tumor types. D



Feature »

Key Insights On Orthotic Materials

Moderator: Robert Phillips, DPM Panelists: William Olson, DPM, Douglas Richie Jr., DPM, Paul Scherer, DPM and Christopher E. Smith, DPM | 19647 reads | 0 comments

In order to help bring orthotic therapy into sharper focus, some of the top thinkers on biomechanics share their insights on various orthotic materials. They discuss the importance of addressing the patient’s specific activity and pathology in arriving at an appropriate orthotic prescription, and offer their views and experiences on the efficacy of various orthotic materials. Without further delay, here’s what they had to say to questions posed by Robert Phillips, DPM.

Q: What type of feet do you feel almost always need rigid orthotics? What type of feet should never be put into a



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