Volume 18 - Issue 9 - September 2005

Surgical Pearls »

When Is It Appropriate For Arthrodiastasis Of The First MPJ?

By Peter M. Wilusz, DPM, and Guy R. Pupp, DPM | 14227 reads | 0 comments

   Multiple etiologies exist for painful conditions that involve the first metatarsophalangeal joint (MPJ). Hallux abducto valgus and hallux limitus are the most common pathologies of the first MPJ podiatrists see in most foot and ankle clinics. Other causes may include rheumatoid arthritis, trauma, connective tissue disorders, infection, iatrogenic and metabolic disorders. Historically, treatment has been geared to realigning structural abnormalities of bone as they affect the joint.1

   Unfortunately, very little literature discusses specific treat



Technology In Practice »

Will Infrared Technology Render Plaster Casting Obsolete?

By Robi Garthwait, Contributing Editor | 5377 reads | 0 comments

   Considering the prevalence of orthotic therapy in podiatric care today, it only seemed like a matter of time before a technologically advanced option arrived on the scene. With the introduction of the PedAlign system, podiatrists may have an alternative to the traditional time-consuming and often messy method of plaster casting.

   The PedAlign technology employs an infrared optical scanning device that quickly captures and digitizes a foot’s image. This image, along with a doctor’s prescription, is electronically transmitted to a laborator



Wound Care Q&A »

Essential Insights On Managing Traumatic Wounds

Clinical Editor: Lawrence Karlock, DPM | 9119 reads | 0 comments

   Traumatic injuries in the lower extremity can be particularly difficult to manage and treat. Not only is it difficult to assess the degree of the damage caused by these injuries, prompt evaluation and treatment is essential given the risks of infection and amputation. With that said, our expert panelists review their treatment protocols.

   Q: What are the basic guidelines/philosophies in treating lower extremity traumatic wounds?

   A: Jordan Grossman, DPM, emphasizes precise evaluation of the clinical and radiographic presentation.



Treatment Dilemmas »

How To Address Osteochondral Lesions

By Justin Franson, DPM, and Babak Baravarian, DPM | 42015 reads | 0 comments

   An athletic, 35 year-old male presents to the office four months after suffering an ankle sprain while playing soccer. In spite of a period of immobilization and a course of physical therapy, he has had continued pain and stiffness localized to the ankle joint. He has been wearing a lace-up ankle brace, icing the ankle and taking OTC NSAIDs.

   A physical examination reveals mild tenderness upon palpation to the ankle joint line but there is no significant pain along the medial or lateral collateral ligaments. He has a negative anterior drawer. Routine X-ra



Feature »

How To Reduce Claim Denials

By Anthony Poggio, DPM | 49311 reads | 0 comments

   Getting a denial for claims is, at best, upsetting for both the doctor and staff. Often, the doctor sees this in a negative light. If the dollar amount in question is small, he or she may totally disregard it, believing it is “not worth it” to appeal. When repeated problems involving specific CPT or ICD-9 codes occur, DPMs sometimes select alternative coding choices, which may not be the best option either.

   Instead of looking at a claim denial as a defeat, try to look at it as an educational opportunity. Unless one understands the reason for the deni



Continuing Education »

A Guide To Offloading The Diabetic Foot

By Nick Martin, DPM, Tim Oldani, DPM, and Matthew J. Claxton, DPM | 26023 reads | 0 comments

   Increased plantar foot pressure is a leading cause of ulceration in the diabetic population.1 Healing these ulcers requires adequate blood supply, control of infection, excellent wound care and offloading or pressure redistribution of the ulcerative area.2-16 Out of all these factors, offloading presents a particularly unique challenge in treating chronic wounds. As diabetic foot care has evolved over the years, podiatrists have used numerous approaches including complete bed rest, cutout felt pads and total contact casting to offload these wounds.3