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  • Executive Editor/VP-Special Projects:
    Jeff Hall
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    Bonnie Shannon
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  • Editorial Correspondence

  • Jeff Hall, Executive Editor/VP-Special Projects, Podiatry Today
  • HMP Communications, 83 General Warren Blvd
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  • July 2004 | Volume 17 - Issue 7
    A 56-year-old Hispanic female with diabetes underwent an open partial first ray amputation and lower extremity angioplasties. No response was noticed three days after surgery even with good wound care.
    By Damieon Brown, DPM and Javier La Fontaine, DPM
    13,857 reads | 0 comments | 09/03/08
    Autonomic neuropathy may significantly affect the quality of life of patients with diabetes. Unfortunately, despite the common prevalence of this condition in this population, autonomic neuropathy is one of the least understood and recognized complications of diabetes. Not only is there a cloudy picture in regard to the pathogenesis of the condition, there are various clinical manifestations with no degree of consistency in which they may occur. With this in mind, let’s take a closer look at this potentially serious complication among people with diabetes. Autonomic neuropathy generally in... continue reading
    A 59-year-old female with type 2 diabetes presented with ankle instability secondary to Charcot neuroarthropathy of nine months duration. Note the severe destruction of the talus in her radiograph above.
    By Guy R. Pupp, DPM, and Peter M. Wilusz, DPM
    8,972 reads | 0 comments | 09/03/08
    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... continue reading
    Here one can see moderate hallux varus.
    By Justin Franson, DPM, and Babak Baravarian, DPM
    19,199 reads | 0 comments | 09/03/08
    Chances are, you have seen patients present to your office with pain after undergoing a bunion surgery, which you may or may not have performed. If you were the operating surgeon, it is easy enough to research the specific procedure that you performed. However, in many cases of hallux varus complications, the patients wind up in another surgeon’s office for reconstruction. Obtaining all the prior operative and post-op information will aid in tailoring the revisional surgery. With this in mind, let’s consider the following case. A 55-year-old female patient returns to the office for a fol... continue reading
    By John S. Steinberg, DPM, Khurram Khan, DPM, and Jonah Mullens
    20,204 reads | 0 comments | 09/03/08
    In clinical practice, two of the most common types of infected wounds podiatrists see are ulcerations and postoperative incision sites. In order to resolve these infections and ultimately close these wounds, one must have a strong understanding of the etiology of infected ulcerations and post-op infections, how to assess these wounds and how to select appropriate treatment options. ... continue reading
    A new instructional CD guides you in using Ethyl Chloride® Topical Anesthetic to minimize injection pain, according to Gebauer.

    3,202 reads | 0 comments | 09/03/08
    When treating diabetic patients who have neuropathic ulcers, it can be challenging to apply a wound care ointment with a wooden applicator or cotton swab due to pain tolerance issues. However, a new spray version of Panafil® may be able to address these concerns. Healthpoint, the manufacturer of Panafil Spray, says the spray is light so it doesn’t hurt a sensitive wound bed and facilitates easier access with tough to reach areas of irregularly-shaped wounds. The company also emphasizes that using the spray minimizes the potential for cross-contamination, a significant benefi... continue reading
    By Jeff Hall, Editor-in-Chief
    1,908 reads | 0 comments | 09/03/08
    Consider the dizzying array of choices one must make when a patient presents with a non-healing wound. In some cases, determining the etiology can be a daunting challenge. In their guest column for Diabetes Watch, Damieon Brown, DPM, and Javier La Fontaine, DPM, discuss the difficulties of detecting diabetic autonomic neuropathy and provide an illuminating case study that reflects the subsequent challenges of treating these patients for chronic wounds (see page 20). Within this month’s continuing education article, “How To Detect And Treat Infected Wounds” (see page 68), John S. Stei... continue reading
    Samuel Nava, Jr., DPM, says female runners comprise approximately 10 to 15 percent of his patients with neuromas.
    By Brian McCurdy, Associate Editor
    9,022 reads | 0 comments | 09/03/08
    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... continue reading
    Using a hemostat, one may see the bulbous, white and glistening nerve mass and dissect it.
    By Lynnelle R. Gabriel, DPM
    34,813 reads | 0 comments | 09/03/08
    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... continue reading
    Changes in the skin and its appendages can indicate a nutrient deficit. Note the dry skin.
    By Patricia Abu-Rumman, DPM, and Robert A. Menzies, BSc(Hons), MChS, SRCh
    16,509 reads | 0 comments | 09/03/08
    Wound healing is a complex process that depends upon the delicate balance of physical and spiritual well-being of the individual. In order to maintain this required balance for wound healing, clinicians must be aware of and evaluate five major conditions including: adequate perfusion, decreased bacterial load, protection from mechanical stress, sufficient nutrition and the patient’s psychosocial status. While one can evaluate the first three conditions through clinical examination techniques, laboratory assays and special studies, the nutritional status and psychosocial status of the patie... continue reading
    Clinical Editor: Lawrence Karlock, DPM
    10,045 reads | 0 comments | 09/03/08
    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. ... continue reading