Volume 19 - Issue 1 - January 2006

Feature »

How To Address Nail Bed Injuries

By D. Scot Malay, DPM, MSCE | 179399 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 | 129658 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 | 12784 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 | 32572 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 | 20854 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 | 2192 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