Volume 18 - Issue 11 - November 2005
Continuing Education »
Calcaneal fractures continue to be one of the most complicated injuries of the lower extremity. Satisfactory outcomes are difficult to achieve and require extensive experience and understanding in treating the injury. Calcaneal fractures are much like pilon fractures of the distal tibia in that they are severe soft tissue injuries complicated by fracture of the heel bone. The importance of the soft tissue envelope cannot be overstated.
There continues to be a wide range of treatment strategies despite the significant ongoing research on this injury. Cast
Editor's Perspective »
There is no doubt that podiatrists see quite a bit of heel pain. Plantar fasciitis accounts for 11 to 15 percent of all foot symptoms in adults, according to an article published in the New England Journal of Medicine last year. As Stephen Barrett, DPM, points out in his cover story, “A Guide To Neurogenic Etiologies” (see page 36), projected estimates indicate that greater than two million patients per year are diagnosed with heel pain in the United States.
However, despite the prevalence of this condition, there are complex anatomical consid
Surgical Pearls »
One of the most documented postoperative complications of distal metatarsal osteotomies is adhesive capsulodesis that limits dorsiflexion of the first metatarsophalangeal joint (MPJ). When faced with such a post-op complication, one may be able to use a proven cartilage preservation procedure that maintains, if not improves, the first MPJ range of motion.
Austin and Leventon first described the Austin bunionectomy in 1962 and the original procedure has undergone many modifications over the years.1 Each modification has different indications and
Technology In Practice »
Doctors are turning to Biofreeze to manage the pain associated with a variety of ailments affecting the lower extremities. Available in a gel, roll-on or no-touch natural Cryospray™, the product provides a pain relief period that generally lasts 30 percent longer than conventional gels, according to its manufacturer, Performance Health, Inc.
Biofreeze works through cryotherapy. In essence, it decreases blood flow and confuses nerve endings. This in turn numbs the affected area and results in a decrease in inflammation. The formula contains Ilex, an he
Treatment Dilemmas »
It is not uncommon to see one patient every day on my practice schedule who has pain and inflammation of the second metatarsophalangeal joint (MPJ). While there are cases that involve a hammertoe associated with metatarsophalangeal joint pain, what are the options for treating patients who have pain in the second metatarsophalangeal joint but do not have a hammertoe deformity?
When it comes to cases of so-called “capsulitis of the second MPJ,” we try all kinds of different therapy with little consideration of a proper diagnosis and diagnostic testing.
Wound Care Q&A »
In a follow-up column to the previous discussion of lower extremity traumatic wounds (see “Essential Insights On Managing Traumatic Wounds,” page 32, September issue), the panelists discuss key principles in treating open fracture wounds in the forefoot and toes. They also share their thoughts on the use of plastic surgery techniques and advanced wound closure modalities. Without further delay, here is what the panelists had to say.
Q: How do you manage simple open fracture wounds in the forefoot/toes?
A: A. Douglas Spital
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