Volume 18 - Issue 5 - May 2005

Surgical Pearls »

How To Salvage A Failed First MPJ Implant

By Graham A. Hamilton, DPM | 27198 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 | 7955 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 | 9716 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



Feature »

How To Detect And Treat Running Injuries

By Brian Fullem, DPM | 25037 reads | 0 comments

   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



Feature »

Exploring New Advances In Internal Fixation

By Gerard V. Yu, DPM, Theresa L. Schinke, DPM, Amanda Meszaros, DPM, and Naohiro Shibuya, DPM | 11759 reads | 0 comments

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



Feature »

Chronic Plantar Fasciitis: Is Cryosurgery The Answer?

By Lawrence Fallat, DPM | 39510 reads | 0 comments

   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 Read the full story »

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