Volume 17 - Issue 3 - March 2004
Surgical Pearls »
Hallux limitus/rigidus is defined as a degenerative arthrosis of the first metatarsophalangeal joint (MTPJ) which is characterized by a decrease in the MTPJ range of motion and an eventual lack of motion.1 Treatment for this condition is a frequently discussed topic at podiatric conferences. When it comes to the stages of osteoarthritis in the MTPJ, one may consider performing joint preservation or joint destructive procedures.
Joint preservation procedures include cheilectomy procedures, soft tissue correction and distal/proximal osteotomies as indicated for osseous correction. Wi
Wound Care Q&A »
In a follow-up to the last Q&A column on preventing post-op wounds (see page 16, January issue), our expert panelists have reconvened to discuss the treatment of post-op wounds. They explore treatment approaches to a variety of wounds, ranging from the post-op dehiscence and infected wounds to exposed internal fixation and fracture blisters. Without further delay, here are their thoughts.
Q: How do you typically manage the post-op wound dehiscence? What types of wound products do you suggest?
A: Ronald G. Ray, DPM, PT, says you should first remove any loose suture material and debr
Repetitive stress is a major contributing factor to the rise of most foot problems. In the high-risk diabetic foot clinics at the Southern Arizona Veterans Affairs Medical Center, the most common of these severe complications is the diabetic foot wound. The prime etiology of diabetic foot ulcers is the combination of neuropathy and repetitive moderate stress (walking).
Diabetic foot wounds often lead to a host of other maladies including sepsis, amputation and premature death. It has also been shown that people undergoing amputation have higher healthcare costs.1,2
When it comes
Crush injuries of the foot are serious and can be difficult to manage. These complex injuries often involve soft tissue and osseous structures. Potentially devastating complications and long term sequelae can occur if these injuries are underestimated or mismanaged.1 Compartment syndrome is a serious complication that can occur with these types of injuries. Due to the high morbidity associated with crush injuries, prompt and meticulous care is essential.2
Omer and Pomerantz reported 50 percent of their patients who sustained crush injuries of the foot had residual pain
The fantasy of retirement is one which many people occasionally turn to in order to get through the difficult stretches of a workday. The warm, sandy beaches of the mind are crowded with reclining metal chairs and the residue of tropical drinks that have no name, fishing poles bent in the direction of luckless mahi-mahi, and thousands of flip-flopped feet, attached to dozing, lotioned bodies.
The reality of retirement, however, can knock the taste of salty air right out of your mouth. There are no true statistics that can tell how many of us are financially underprepared for our winter year
Yes, the authors say skin flaps can be a viable option if conservative wound care fails. They emphasize that flaps can provide a unique match to the soft tissue properties of weightbearing areas and facilitate healing in wounds with exposed bone and tendon.
By Gary P. Jolly, DPM, and Thomas Zgonis, DPM
Historically, the treatment of chronic foot wounds has centered around aggressive debridement, pressure reduction and, lately, the application of wound healing accelerators such as various growth factors. More recently, the use of reconstructive procedures has been gaining support a