Volume 18 - Issue 5 - May 2005
Diabetes Watch »
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
Diagnostic Dilemmas »
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 »
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 »
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 »
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 »
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
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