Volume 18 - Issue 11 - November 2005

News and Trends »

Nerve Decompression Study Offers Provocative Findings

By Brian McCurdy, Associate Editor | 12348 reads | 0 comments

   While previous studies have touted the benefits of peripheral nerve decompression for patients with neuropathy, a new study in the Journal of the American Podiatric Medical Association (JAPMA) reveals positive effects on sensation, neuropathic pain and patient balance. Authors of the study found that 87 percent of patients with numbness reported improved sensation and 92 percent who had preoperative balance problems had improved balance a year after undergoing the procedure.

   According to the study, which involved 60 patients with diabetic neuropat



Surgical Pearls »

Cartilage Preservation: Can It Maintain Post-Op Dorsiflexion?

By John Mozena, DPM, PC, and Tyler Marshall, DPM | 14056 reads | 0 comments

   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 »

A Closer Look At A Versatile Cryotherapy Solution For Pain

By Robi Garthwait, Contributing Editor | 6380 reads | 0 comments

   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 »

When Second MPJ Overload Occurs Without Hammertoe Deformity

By Babak Baravarian, DPM | 39057 reads | 0 comments

   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 »

How To Manage Traumatic Wounds Successfully

Clinical Editor: Lawrence Karlock, DPM | 20410 reads | 0 comments

   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



Feature »

A Guide To Neurogenic Etiologies Of Heel Pain

By Stephen L. Barrett, DPM, MBA | 59774 reads | 0 comments

   While heel pain is the most common condition podiatrists see in practice, heel pain can often be complex and occasionally difficult to treat.1 In recent years, we have seen the introduction of new treatments as logical conservative preludes to fasciotomy, including extracorporeal shockwave therapy, injection of the plantar fascia with autologous growth factors and coblation therapy.2

   Clinicians are able to employ some of these modalities, such as autologous growth factors, due to a better understanding of the true histological and ph