Volume 18 - Issue 6 - June 2005

Feature »

Point-Counterpoint: Nerve Decompression In Diabetic Patients: Should It Be Done?

By Stephen L. Barrett, DPM, Patrick DeHeer, DPM, and Stephen Offutt, DPM | 10468 reads | 0 comments

   Yes. This author discusses the etiology of diabetic peripheral neuropathy, cites reports of efficacy for peripheral nerve decompression in the literature and shares insights from his experience in performing the procedure.

By Stephen L. Barrett, DPM

   Mainstream medical education is still teaching that the symptoms of diabetic peripheral neuropathy are progressive and irreversible. There is adequate and overwhelming basic and clinical medical science that contradicts this dogma.1-5 Indeed, one wonders how many additional outcome studies



Feature »

NSAIDs: Where Do We Go From Here?

By Anthony R. Iorio, DPM, MPH | 6937 reads | 0 comments

   Nonsteroidal antiinflammatory drugs (NSAIDs) are among the most widely used medications today. Considering their well-documented efficacy in managing fever, mild to moderate pain and, at higher doses, inflammation, such widespread use is generally appropriate. In 1997, over 74 million NSAID prescriptions were dispensed in the United States, representing approximately 4.5 percent of all prescriptions. In addition, nonprescription NSAIDs such as aspirin and ibuprofen contribute significantly to the use of this class of medications. It is estimated that 1 to 2 percent of the Nor



Feature »

Current Concepts In Medial Column Hypermobility

By Neal M. Blitz, DPM | 33644 reads | 0 comments

   The impact of medial column hypermobility on foot function and deformity development has gained significant attention in the past few decades.1 It has been associated with pes planus, metatarsus primus adductus, hallux valgus, midfoot arthritis, metatarsalgia, plantar plate injury and lesser metatarsal stress fractures. Dudley Morton, an anatomist, introduced the concept of hypermobility.2 The so-called “Morton’s foot” includes hypermobility, equinus and a short first metatarsal.3

   While the existence of hypermobility



Continuing Education »

How To Treat Lesser MPJ Disorders

By Vincent J. Muscarella, DPM | 14817 reads | 0 comments

   Podiatric physicians routinely see disorders of the forefoot, especially the lesser metatarsophalangeal joints (MPJs). In fact, they are often the presenting complaint of the patient or the reason for the medical referral. Lesser MPJ disorders can also occur as a result of preexisting conditions such as trauma, infection, faulty biomechanics and previous podiatric surgery.

   Unfortunately, the term metatarsalgia has been used as a catch-all term to describe a condition without a true etiology. This can be very frustrating to both the patient and the doctor



Editor's Perspective »

Seeking Insight Through A Variety Of Perspectives

By Jeff Hall, Executive Editor | 1393 reads | 0 comments

   Every June, we start thinking about next year. We actively seek out suggestions from our Editorial Advisory Board and other key contributors on the latest topics that would make for solid feature articles. We sit in on lectures during the Western Podiatric Medical Congress and subsequently approach the lecturers about converting their talks into future articles. It is all part of the process in developing the right editorial mix of innovative approaches and practical insights for both common conditions and other dilemmas one may see in practice.

   Last year



Forum »

Rethinking The Notion Of Dual Degrees

By John H. McCord, DPM | 3373 reads | 0 comments

   I consider myself a general podiatrist. I took a PSR-12 residency, which was the gold standard for post-graduate podiatric training in the 1970s. Now a PSR-12 will hardly get you a license. Podiatry has evolved during the past 30 years and hopefully I have evolved with the profession.

   I am a Diplomate of the American Board of Podiatric Surgery but don’t consider myself a surgical specialist in podiatry. In a small town, you do everything.

   This morning, we had a lady with a fractured ankle, a 10-year-old with a Salter I fracture of



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