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  • Executive Editor/VP-Special Projects:
    Jeff Hall
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  • Editorial Correspondence

  • Jeff Hall, Executive Editor/VP-Special Projects, Podiatry Today
  • HMP Communications, 83 General Warren Blvd
    Suite 100, Malvern PA 19355
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  • July 2005 | Volume 18 - Issue 7
    Older patients may not report pain due to the fear of further tests, the addition of supplemental medications or feeling intimidated by the knowledge and authority of the doctor.
    By Erwin Juda, DPM, R.Ph.
    11,968 reads | 0 comments | 09/03/08
       Pain management in the elderly remains one of the most challenging issues for the podiatric surgeon. As life expectancy continues to advance, more geriatric patients will undergo surgery. While these patients may undergo these procedures to help facilitate independence and a better quality of life, one must carefully weigh the risks and benefits of surgical intervention in this patient population.    Regardless of the success of the given surgical procedure, one may still encounter significant tissue damage and the subsequent release of pain and inflammator... continue reading
    Here is significant blanching of a Limberg flap following rotation. This blanching was not addressed at the time of surgery.
    By Tod Storm, DPM
    22,090 reads | 0 comments | 09/03/08
       The use of plastic surgery techniques has increased dramatically among podiatric surgeons over the past few years. The most useful techniques involve the use of skin grafts and local flaps, which can help solve some difficult wound closure problems. The increased usage of these techniques is partially due to the fact that some are relatively easy to learn and one can learn the basics at weekend workshops. However, as one might expect with any surgical procedure, complications can arise.    Fortunately, severe complications are infrequent but one must handle ... continue reading
    Dr. Wu says Axsain is “a low-risk alternative for symptomatic relief” of neuropathic pain.
    By Robi Garthwait, Contributing Editor
    6,758 reads | 0 comments | 09/03/08
       For patients suffering from neuropathic pain, quality of life can be a real issue. Traditional over-the-counter remedies have often not been enough to combat the effects of diabetic neuropathy or postherpetic neuralgia. However, with the introduction of Axsain™ (capsaicin 0.25%), doctors now have a new weapon in their armamentarium to fight pain.    Used alone or as an adjunctive therapy to supplement oral medications, Axsain contains three times as much capsaicin as other brands currently on the market. It works by depleting sensory nerves of t... continue reading
    Here one can see cellulitis on a patient’s right foot with localized signs of infection. Early aggressive surgical debridement is crucial to avoid subsequent proximal amputations.
    By Warren S. Joseph, DPM, Thomas Zgonis, DPM, and Thomas S. Roukis, DPM
    42,243 reads | 0 comments | 09/03/08
       Diabetic foot infections arising from ulcerations are the largest non-traumatic cause of lower extremity amputations. Contributing factors include peripheral neuropathy and vascular disease, rigid pedal deformities, local trauma and pressure, extensive soft tissue loss, multi-system failure, non-compliance and severe infection.    Over the decades, there have been a number of shifts in the way clinicians approach diabetic foot infections (DFIs). Throughout the ‘60s and into the ‘70s, clinicians felt most DFIs were, like other skin and skin structure inf... continue reading
    By Peter A. Blume, DPM, Kenneth L. Cornell, DPM, Bauer Sumpio, MD, and John Aruny, MD; and Mardon R. Day, DPM
    9,495 reads | 0 comments | 09/03/08
       Yes, these panelists say ischemia plays a significant role in chronic ulcerations and emphasize the importance of a thorough vascular workup in these patients. By Peter A. Blume, DPM, Kenneth L. Cornell, DPM, Bauer Sumpio, MD, and John Aruny, MD    Clinicians must consider numerous factors when evaluating and treating ulcerations of the foot. Ulceration in the foot most frequently occurs as a result of a combination of neuropathy, ischemia and trauma. Ulcerations that become chronic in nature frequently result in a lower extremity that is at an i... continue reading
    Here you can see a typical neuropathic forefoot ulcer before tendon lengthening (gastrocnemius-soleus and posterior tibial).
    By J. Monroe Laborde, MD, MS
    18,416 reads | 0 comments | 09/03/08
    The above X-ray of the right ankle of a 10-year-old boy shows lucency in the tibial metaphysis secondary to acute hematogenous osteomyelitis (AHO).
    By Michael Schreck, DPM
    26,668 reads | 0 comments | 09/03/08
       Although both acute hematogenous osteomyelitis (AHO) and chronic recurrent multifocal osteomyelitis (CRMO) are somewhat uncommon, differentiating between the two can be tricky. Having a strong grasp of the etiology and presentation of these conditions can go a long way toward preventing a delayed or inappropriate diagnosis, which could be harmful for pediatric patients.    Pediatric hematogenous osteomyelitis may occur secondary to a traumatic injury and/or an acquired illness or other immunosuppressive condition. Acute hematogenous osteomyelitis reportedly ... continue reading
    Here is a view of the ankle with arthritic changes of multiple joints. Such a presentation is typical of early rheumatoid changes.
    By Babak Baravarian, DPM
    10,464 reads | 0 comments | 09/03/08
       Forefoot issues related to rheumatoid arthritis (RA) are well noted with fusion of the great toe being a standard procedure in association with relocation or resection of the lesser metatarsophalangeal joints, and fusion of the proximal interphalangeal joints. Surgeons have also been successful in treating the rearfoot with fusion procedures once the arthritis is not tolerable with bracing and medication.    As a patient grows older, it is easier to address the issues of RA in the ankle. In the thin and fairly sedentary patient, ankle replacement is a good ... continue reading
    Here is an example of a MRSA infection with accompanying cellulitis. (Photo courtesy of Lawrence Karlock, DPM)
    By Jason R. Hanft, DPM, and Brigette Smith, DPM
    46,767 reads | 0 comments | 09/03/08
       Since every wound has the potential for infection, it is important to differentiate between infection and colonization.1 There is no textbook that depicts all the possible appearances of wounds that contain bacteria. Indeed, the potential of wounds to heal or become infected depends on many variables. Wound care specialists have a responsibility to become familiar with the these variables as well as develop a trained eye for the clinical appearance of a wound so they may render the appropriate treatment.    There is an enormous amount of informat... continue reading
    By John McCord, DPM
    3,758 reads | 0 comments | 09/03/08
       This is the time of my professional life when I planned to slow down with fewer clinic hours, less surgery and maybe a few more nursing home visits. It has not worked out that way. Three years ago, I hired an associate who had just completed a quality PSR-24 in a university hospital. The place was an advanced trauma center with a lot of emergency room activity to stimulate young podiatric residents.    He asked about my referral experience from our local emergency room. I received a handful of referrals and consults over the years, and just accepted that tr... continue reading