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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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  • May 2005 | Volume 18 - Issue 5
    By John H. McCord, DPM
    1,725 reads | 0 comments | 09/03/08
       I tried to apply a soft fiberglass cast to the leg of a screaming 4-month-old baby boy last week. It was toward the end of a very busy day and, in most cases, a screaming baby would not be an opportunity I would seek. In this case, the child’s screaming was music to my ears.    The baby boy was one of my curveballs. A curveball is a category of patient that presents with particularly difficult foot problems or health problems. This baby was referred to me by Isaac Pope, MD, my most reliable source of “curveballs.”    Isaac is a pediat... continue reading
    When it comes to osteomyelitis (as shown above), there are a variety of imaging techniques one can use to help confirm the diagnosis, according to Thomas Zgonis, DPM. (Photo courtesy of Robert Snyder, DPM)
    Clinical Editor: Lawrence Karlock, DPM
    9,924 reads | 0 comments | 09/03/08
       When is advanced imaging necessary for guiding one’s decision-making on the treatment of a lower-extremity wound? How reliable are radiographs when clinicians suspect osteomyelitis? Should you employ magnetic resonance imaging? Does nuclear medicine imaging have particular value in managing wounds? Our expert panelists tackle these questions and more in the following discussion.    Q: What role do you see advanced imaging playing in the management of foot and ankle wounds?    A: Molly Judge, DPM, says advanced imaging is unnecessa... continue reading

    9,525 reads | 0 comments | 09/03/08
       The debate that continues about the DPM/MD or DPM/DO dual degree is understandable, as demonstrated by Duane Dumm, DPM (see pg. 14, “Dual Degrees May Not Benefit DPMs,” March issue). Change is difficult. Change is suspect. Change is resisted. However, in podiatric medicine, change is a function of rapid growth with dimensions of practice that many take for granted and perhaps others do not fully realize.    First, dual degrees are not simply programs designed to benefit the DPM. While there certainly is a benefit to the podiatric physician, the ultimate ... continue reading
    Any changes in training, running shoe model or overuse prior to the injury may provide important clues to determining the cause of the injury and making the proper diagnosis.
    By Brian Fullem, DPM
    25,411 reads | 0 comments | 09/03/08
       Many runners will consult a podiatrist for their initial physician visit for lower extremity injuries. Diagnosing and treating the most common running injuries requires finding the cause of the injury and going beyond simply treating the symptoms. Injured runners will often show up in the office with a bag full of old running shoes, a training log and a self-diagnosis. In my practice, runners tend to be the most well-informed patients and simply advising these patients to refrain from running could lead to them seeing another doctor.    When seeing a runner ... continue reading
    A 58-year-old patient with longstanding diabetes and a previous history of ulceration and neuropathy presented with increasing redness and swelling to his right foot (as shown above).
    By Suhad A. Hadi, DPM
    20,371 reads | 0 comments | 09/03/08
       Diabetic neuropathy is a major risk factor in patients with diabetes. However, a larger impending threat to patients with neuropathy is the risk of developing Charcot arthropathy and ultimately an ulcer that causes deformity or joint instability. In patients with diabetic neuropathy, Charcot arthropathy alone results in an increased risk of ulceration and/or amputation.1 The subsequent deformities one sees with Charcot, predominantly the rocker bottom deformity, are due to the loss of structural joint integrity.    The subsequent deformities one ... continue reading
    Here is an intraoperative photo of a completed Austin bunionectomy, which is fixated with a Kompressor screw that provides enhanced rigid internal compression fixation across the plantar arm of the osteotomy.
    By Gerard V. Yu, DPM, Theresa L. Schinke, DPM, Amanda Meszaros, DPM, and Naohiro Shibuya, DPM
    11,952 reads | 0 comments | 09/03/08
    Prior to the broad adoption of the principles and techniques of the AO/ASIF group, cerclage wires, K-wires and Steinmann pins as well as a variety of staples were the more common internal fixation devices employed for stabilizing fractures, osteotomies and fusions. Rigid internal compression fixation techniques eventually became more commonplace and the application of these techniques to foot and ankle surgery has led to clinical advances with improved surgical outcomes. As technology advances and we increase our knowledge of bone healing from a variety of perspectives, newer designs in inte... continue reading
    Note the preoperative dorsal spurring in the above photos.
    By Babak Baravarian, DPM
    11,512 reads | 0 comments | 09/03/08
       As I get more in tune with patient care, I find that the simple cases such as hallux limitus are more difficult than I initially thought because they are often more complicated and involved than the original examination might show. I have come to this conclusion after being burned by a couple of trouble cases and learning what to look for as a result.    A typical patient is a 47-year-old female with chronic pain in the great toe. She has trouble in dress shoes and has mild limitation of shoegear. The patient reports having mild pain when playing golf and th... continue reading
    Locating the exact area of heel pain is paramount to the success of cryosurgery. The circle represents the area of greatest pain with palpation.
    By Lawrence Fallat, DPM
    40,074 reads | 0 comments | 09/03/08
       Cryosurgery is the specialized field of using extremely low temperatures (controlled by a handheld probe) to destroy pathological tissue. This technique has been used for decades to treat malignant tumors of the prostate, liver and other organs.1-3 Cryosurgery is also gaining acceptance in dermatology, plastic surgery, urology and pain management.4-6 Now clinicians are using this technology to help manage common foot and ankle conditions.7-9    I have been performing cryosurgery for ... continue reading
    Aircast has improved its line of Pneumatic Walking Braces. The company says the more ergonomic design will encourage compliance.

    4,004 reads | 0 comments | 09/03/08
    Brace Yourself    For injured patients who need supportive and comfortable braces, clinicians may want to give an established product line another look.    The Aircast line of pneumatic walking braces, including the XP Walker™ (extra pneumatic), FP Walker™ (foam pneumatic) and SP Walker™ (short pneumatic), have been improved. The improved braces were unveiled recently at the annual meeting of the American Academy of Orthopaedic Surgeons.    In order to provide enhanced support and protection,... continue reading
    By John V. Guiliana, DPM, MS
    2,771 reads | 0 comments | 09/03/08
       Well-trained and efficient employees are crucial to the success of any business. Often a shortcoming, staff development is something that podiatric practitioners need to take seriously, building an integrated training process into their business plan. Without an adequate plan to train employees, doctors often feel as though the practice is inefficient and that they are constantly taking corrective measures.    In many medical practices, staff training is often inadequate. What often winds up happening is having a new employee simply observe and work side by ... continue reading