Volume 17 - Issue 7 - July 2004

News and Trends »

Experts Share Their Insights On Treating Neuromas

By Brian McCurdy, Associate Editor | 8856 reads | 0 comments

Painful foot neuromas are a common dilemma among podiatric patients and the neuromas appear to be increasingly more prevalent among runners. Samuel Nava, Jr., DPM, a Fellow of the American College of Foot and Ankle Surgeons (ACFAS), estimates that approximately 10 to 15 percent of his patients with neuromas are female runners. He notes that female runners who wear more narrow shoes at work and subsequently go running on hard surfaces may be at a higher risk for developing neuromas.
Bruce Werber, DPM, a Fellow and Past President of ACFAS, says the majority of his neuroma patients are female bu



Surgical Pearls »

Should You Excise Morton's Neuroma?

By Lynnelle R. Gabriel, DPM | 34240 reads | 0 comments

Treating a Morton’s neuroma can be a delicate operation. There is currently much discussion and controversy over whether to remove an intermetatarsal neuroma or leave the nerve intact and release the deep transverse intermetatarsal ligament via a minimally invasive nerve decompression (MIND). There have not been enough studies to sway the majority of surgeons to leave the intermetatarsal neuroma and only release the ligament. Although I believe this is truly an entrapment of the nerve, I have found removing the neuroma has been quite successful.

The clinical signs and symptoms of a neurom



Wound Care Q&A »

Inside Insights For Offloading Diabetic Neuropathic Ulcers

Clinical Editor: Lawrence Karlock, DPM | 9684 reads | 0 comments

Offloading diabetic neuropathic ulcers comes with a unique set of treatment challenges. Some consider total contact casting the gold standard but whether it’s practical in a busy practice is highly debatable. Still, how can one arrive at a solution that will enhance patient compliance? With these issues in mind, our expert panelists share their thoughts and experiences with this topic.

Q: How do you initially offload the plantar diabetic neuropathic ulcer?
A:
Lawrence G. Karlock, DPM, says he is initially aggressive when it comes to offloading the plantar neuropathic ulceration.



Feature »

How To Assess And Manage Burn Injuries Of The Foot

By Alan J. Cantor, DPM, CWS, and Keith Burger, PA-C | 19952 reads | 0 comments

Burn injuries are among the most devastating wounds a clinician may be asked to treat. Burn medicine is a critical care, specialized field of medicine, surgery and rehabilitation, all of which are intertwined and interdependent for successful outcomes. Precise awareness of modern wound management, skin function, infectious disease issues and crisis decision capabilities are hallmarks of burn injury care.
Significantly, as more podiatrists become experts at wound management, many DPMs will find themselves becoming an integral part of the modern burn team.
In the United States, there are appr



Feature »

Assessing The Role And Impact Of Enzymatic Debridement

By Jonathan Moore, DPM and Pamela Jensen, DPM | 17563 reads | 0 comments

Over the last few decades, many technological advances have occurred in the field of wound healing, resulting in a variety of wound dressings, ointments, creams, debriding agents, growth factors and bioengineered skin grafts. While one does not have to be a wound care specialist to treat complicated wounds, it is important to have a basic knowledge of normal wound healing and the etiology of a chronic or nonhealing wound, an understanding of the wound products available, and the ability to adapt to an ever-changing wound.
Chronic, delayed or non-healing wounds demonstrate an impaired response



Feature »

External Fixation: Is It The Answer For Diabetic Limb Salvage?

By Guy R. Pupp, DPM, and Peter M. Wilusz, DPM | 8684 reads | 0 comments

There has been a six-fold increase in diabetes mellitus over the last four decades in the United States.1 Indeed, 798,000 new diabetic patients are diagnosed each year in the U.S.2,3 The statistics are particularly disturbing when it comes to lower extremity amputation among people with diabetes.
Lower extremity amputation among the diabetic population increased from 67,000 in 1994 to 140,000 in 2000.4 While amputation in the diabetic population is a viable option in the presence of significant peripheral arterial disease and gangrene, life expectancy after m



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