Volume 17 - Issue 5 - May 2004

Feature »

A New Approach To Adult-Acquired Flatfoot

By Douglas H. Richie Jr., DPM | 44095 reads | 0 comments

Ask experienced DPMs what pathology has seen the most dramatic increase in prevalence over the last 20 years and, aside from plantar heel pain, they will tell you it is posterior tibial tendon dysfunction (PTTD). Currently, most authorities have dropped the description PTTD in favor of “adult-acquired flatfoot.” This is due to increased recognition of the fact that a rupture or attenuation of the posterior tibial tendon cannot itself lead to the deformity and disability that one sees in older adults with progressive flatfoot deformity.
Significant ligamentous rupture occurs as the flatfoo

Diagnostic Dilemmas »

Managing Chronic Pain After An Ankle Sprain

By Babak Baravarian, DPM | 26701 reads | 0 comments

A patient presents to the office with a history of an ankle sprain that occurred eight months ago. The patient was playing tennis and rolled his ankle during the match. He had to immediately stop and felt a snap in the lateral ankle. For the next week, he wore a lace-up ankle brace and iced the ankle.
He was able to walk on the ankle the day after the injury but had continued pain in the ankle that did not resolve for one month. At the one-month point, his doctor suggested the ankle was painful from the sprain and suggested a course of physical therapy.
The patient performed all of the phy

Forum »

Fitting Podiatry Around Your Life

By Lara M. Allman, DPM | 1764 reads | 0 comments

I have been in private practice for five and a half years now. I have acquired three offices and I see patients from multiple nursing homes. Like most new practitioners, I had spent numerous hours the first few years figuring out how to “run” a practice. I was eager to build my practice and apply what I had worked so hard for over the last several years in school and residency.
During my first year out of residency, I spent a lot of time on marketing and trying to figure out the coding and billing. I spent my free time lecturing, visiting offices and going to just about every hospital f

New Products »

Suspending Patients' Pain

4281 reads | 0 comments

Looking for something to support the orthotic you’re already using?
Look no further than the Arch Suspender, which has lifting straps that provide adjustable support for the talonavicular joint and/or calcaneal cuboid joint. The product supports the custom Richie Brace® orthotic.

While applying ankle tape to the medial arch and leg has provided temporary relief for posterior tibial tendon dysfunction (PTTD), the Arch Suspender’s adjustable strapping provides “maximum support and comfort,” according to patent holder Douglas Richie, DPM.
He says you can apply the Arch

News and Trends »

Study Sheds New Light On Therapeutic Footwear For Patients With Diabetes

By Brian McCurdy, Associate Editor | 9530 reads | 0 comments

While there has been a plethora of studies in recent years that have tackled therapeutic footwear for people with diabetes, a new study reveals a dramatically lower rate of foot ulcers among those who wear therapeutic footwear and insoles. The study, which was published recently in Diabetes Care, found that 33 percent of patients who wore their own shoes had new foot lesions while approximately four percent of those who wore therapeutic footwear and insoles experienced new ulcers.
The study, which was conducted in India, tracked 241 patients with diabetes who either had previous foot u

Surgical Pearls »

Learning From Failed Talonavicular Fusions

By Jesse B. Burks, DPM | 10731 reads | 0 comments

Isolated fusions of the rearfoot have long been a choice of many podiatric foot and ankle surgeons for conditions such as coalitions, arthrosis and symptomatic flatfoot deformities. Persuasive arguments can be made for fusion of the calcaneocuboid, subtalar or talonavicular joints, especially when it comes to deformities such as the symptomatic flatfoot. While each of these procedures provide certain benefits for surgeons, they can present their own unique intraoperative and postoperative challenges as well.
With this in mind, I would like to share my thoughts as to why my talonavicular (TN)

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