Volume 17 - Issue 7 - July 2004
Diabetes Watch »
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
Diagnostic Dilemmas »
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
New Products »
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
News and Trends »
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 »
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 »
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.