Volume 19 - Issue 1 - January 2006

Editor's Perspective »

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

By Jeff Hall, Executive Editor | 2068 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 | 17719 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 | 7039 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 | 37758 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 | 3457 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 | 163899 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