Volume 19 - Issue 1 - January 2006

Feature »

Conquering Medial Tibial Stress Syndrome

By John T. Hester, DPM, MSPT | 131726 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 | 12921 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



Feature »

How To Resolve Conflict With Difficult Patients

By John V. Guiliana, DPM, MS | 32925 reads | 2 comments

   Out of the many challenges that business owners face day to day, human conflict is the one that most people lack the skill to handle appropriately. However, learning how to deal with interpersonal conflicts caused by “difficult people” will help enhance patient satisfaction and ultimately improve the productivity of your practice.

   We perceive the “difficult person” in many different ways. He or she may be arrogant, demanding, unrealistic or condescending. Usually, the difficult person is someone who is working from the negative side of his or her



Continuing Education »

Key Insights On Writing Orthotic Prescriptions

By Lawrence Huppin, DPM, and Paul Scherer, DPM | 21168 reads | 0 comments

   When it comes to an effective prescription for custom foot orthoses, podiatrists must consider the dysfunction of that particular patient’s foot in order to achieve a satisfactory clinical outcome. Addressing the specific needs of the pathology producing the dysfunction as well as the symptoms the patient is experiencing makes the difference between treatment success and failure.

   Dispensing the same prescription orthotic for posterior tibial dysfunction and plantar fasciitis will not produce the same successful outcomes as a colleague who prescribes p



Editor's Perspective »

Combination Therapy: Should We See It More In Podiatric Clinical Trials?

By Jeff Hall, Executive Editor | 2217 reads | 0 comments

   Given the ongoing emphasis toward incorporating more evidence-based medicine (EBM) in podiatry, there has been a noticeable increase of published clinical trials in the peer-reviewed podiatry literature. For example, in the November/December 2005 issue of the Journal of the American Podiatric Medical Association (JAPMA), six out of the eight original articles are clinical trials.

   While these developments are certainly encouraging, there does seem to be a lack of published clinical trials involving combination therapy — the combination of one or



Surgical Pearls »

Taking A Novel Approach To Hammertoe Surgery

By John A. DeBello, DPM, Kordai I. DeCoteau, DPM, and Eric Beatty, DPM | 19693 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