Volume 18 - Issue 5 - May 2005

Diagnostic Dilemmas »

When Sesamoid Pain Complicates Hallux Limitus Cases

By Babak Baravarian, DPM | 11027 reads | 0 comments

   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



New Products »

New Products

3851 reads | 0 comments

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,



News and Trends »

Will Medicare Slash Reimbursement In 2006?

By Brian McCurdy, Associate Editor | 5070 reads | 0 comments

   Congressional legislation has been able to hold off cuts in Medicare reimbursement for the last several years. However, the relief may have been only temporary. If Congress does not take further action beyond the temporary 2004-05 legislative fix, physicians may see a reduction in Medicare reimbursement in 2006.

   Without a legislative remedy, podiatrists will see a 5.2 percent reduction in Medicare payments next year, notes Julie K. Letwat, JD, MPH, the Director of Health Policy and Practice Advocacy for the American College of Foot and Ankle Surgeons (ACF



Surgical Pearls »

How To Salvage A Failed First MPJ Implant

By Graham A. Hamilton, DPM | 26536 reads | 0 comments

   A challenging problem for any podiatric surgeon is surgically managing cases in which a silicone elastomer implant in the first metatarsophalangeal joint (MPJ) has failed. When patients initially present with this problem, they will complain of pain, deformity or both at either the first or lesser metatarsophalangeal joints.

   The cause of the pain or deformity can be multifactorial. The possible causes may include: chronic synovitis and swelling around the implant; chronic skin fistulas; implant breakage or fragmentation; severe periarticular bony subside



Technology In Practice »

How The KobyGard System Provides A Surgical Solution

By Robi Garthwait, Contributing Editor | 7803 reads | 0 comments

   Chronic plantar fasciitis and Morton’s neuroma are two persistent conditions that podiatrists frequently see among their patients. However, practitioners are seeing results with a surgical system that succeeds when conservative treatments fail to alleviate these conditions.

   The KobyGard System (OsteoMed) enables surgeons to isolate and cut both the transverse metatarsal ligament and plantar fascia through a small incision. The system is comprised of a variety of instruments including a tissue locator, a ligament separator, a fascia separat



Wound Care Q&A »

Roundtable Insights On Imaging For Foot And Ankle Wounds

Clinical Editor: Lawrence Karlock, DPM | 9506 reads | 0 comments

   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



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