Volume 19 - Issue 1 - January 2006

News and Trends »

Can Microcirculation Changes Predict Non-Healing Ulcers?

By Brian McCurdy, Associate Editor | 15133 reads | 0 comments

   Researchers of a recent study say assessing microcirculation changes may help predict whether diabetic foot ulcers will heal. The authors of the study, which was published in a recent issue of The Lancet, utilized medical hyperspectral imaging to perform these assessments and add that the new technology may help identify patients with diabetes who are at higher risk for foot ulcers.

   Researchers of the study examined 108 patients, including 51 patients with diabetic neuropathy, 36 with diabetes but no neuropathy and 21 control patients without diab



Diabetes Watch »

Reconciling Combination Therapy With EBM: Where Do We Go From Here?

By Kathleen Satterfield, DPM | 8678 reads | 0 comments

   One will not find combination therapies mentioned in evidence based medicine (EBM) journals or in research trials. In fact, one will rarely find combination therapies mentioned in many trade publications either. Purists often claim this concept presents a mixed message. How can one track performance and outcomes if he or she is using combination therapies? What component worked?

   Detractors sometimes call the practice of using combination therapy “the shotgun approach.” They say it does not denote much finesse and represents excess. Proponents weigh i



Surgical Pearls »

Taking A Novel Approach To Hammertoe Surgery

By John A. DeBello, DPM, Kordai I. DeCoteau, DPM, and Eric Beatty, DPM | 18963 reads | 0 comments

   Hammertoes may have an etiology that is either congenital or acquired. Pain and cosmetic appearance are the leading factors for patients wanting surgical intervention for hammertoe deformities. While there are a variety of approaches for hammertoe correction, we have found success with a novel approach that emphasizes the use of medial and lateral incisions.

   Typically, surgeons use dorsal linear, dorsal longitudinal semi-elliptical, dorsal transverse semi-elliptical, plantar longitudinal and medial/lateral incisions in hammertoe surgery.1 Howe



Wound Care Q&A »

Treating Lower Extremity Wounds In The Face Of Systemic Disease

Clinical Editor: Lawrence Karlock, DPM | 7446 reads | 0 comments

   Systemic diseases as varied as diabetes, renal failure and rheumatoid arthritis can affect the healing of lower extremity wounds. When it comes to treating chronic wounds, there is an array of testing one can employ to rule out systemic disease as a potential cause. There are also key warning signs that may indicate a possible malignancy. With these issues in mind, our multidisciplinary panel offered the following insights.

   Q: What are the most common systemic diseases that manifest themselves as lower extremity wounds?

   A: Dia



Treatment Dilemmas »

Key Insights For Diagnosing And Treating Tendinosis

By Babak Baravarian, DPM | 40935 reads | 0 comments

   Tendinosis is one of those diagnostic terms that took me a while to truly understand. People most often use this term in relation to the Achilles complex but tendinosis can be related to any tendon of the foot or ankle. In most cases, tendinosis is associated with the tendons about the ankle and the most commonly affected tendons are the Achilles, posterior tibial and peroneals.

   While tendinosis is a very simple concept to explain, it is a far more difficult concept to truly understand and treat. Essentially, tendinosis involves the fraying or scarring of



Forum »

How To Convey A Difficult Diagnosis To A Patient

By John H. McCord, DPM | 3669 reads | 0 comments

   Most aspects of being a small town podiatrist are easy and pleasant. My patients almost always leave feeling better than when they arrived. Most are grateful and express it with their thanks or occasionally by leaving a batch of freshly baked cookies. I arrive home most evenings with my emotional cup full to the brim. Tonight, I came home on empty.

   Earlier this week, a vivacious woman in her mid-30s came to the clinic for help with a mole on the sole of her foot. Her doctor had been concerned when she found it during a routine yearly physical. The lesion



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