Volume 19 - Issue 1 - January 2006

News and Trends »

Can Microcirculation Changes Predict Non-Healing Ulcers?

By Brian McCurdy, Associate Editor | 15342 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 | 8838 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



Forum »

How To Convey A Difficult Diagnosis To A Patient

By John H. McCord, DPM | 3731 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



Feature »

How To Address Nail Bed Injuries

By D. Scot Malay, DPM, MSCE | 178385 reads | 2 comments

   Injuries involving the toe nail bed and adjacent tissues are very common. Acute injuries to these structures are frequently caused by dropping a heavy object on the toe or by stubbing the toe into a solid object. Less common mechanisms of acute injury include nail bed lacerations and puncture wounds. Chronic nail trauma is usually caused by repetitive mechanical pressure associated with hammertoe or claw toe deformities aggravated by weightbearing and shoe gear contact. This can also lead to toe nail and bed hyperkeratosis and nail plate dystrophy.

   Failu



Feature »

Conquering Medial Tibial Stress Syndrome

By John T. Hester, DPM, MSPT | 128928 reads | 3 comments

   Tibial stress injuries have become an increasingly frequent reason for visits to sports medicine offices and clinics over the past decade. Unfortunately, these patients often leave the office with a diagnosis of shin splints. This nonspecific “diagnosis” has little clinical usefulness in light of the present day understanding of exercise-induced leg pain and, specifically, tibial stress injuries. The term “shin splints” merely describes a symptom of tibial stress injury and has little clinical or diagnostic value.

   Researchers have proposed many



Feature »

Point-Counterpoint: Is External Fixation The Best Option For Calcaneal Fractures?

By Gary Peter Jolly, DPM, FACFAS, and Michael M. Cohen, DPM, FACFAS | 12746 reads | 0 comments

Yes. This author emphasizes the use of external fixation and ligamentotaxis for treating calcaneal fractures, citing key benefits including earlier post-op weightbearing.

By Gary Peter Jolly, DPM, FACFAS

   Intraarticular calcaneal fractures have long been recognized as a devastating injury but, fortunately, they constitute only 2 percent of all fractures. While there is universal agreement on the severity of their impact, there has been anything but a consensus on how practitioners should manage these fractures.

   The history of the treatment of



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