Volume 19 - Issue 6 - May 2006
Plantar fasciitis is often inaccurately referred to as “heel spur syndrome.” Clinicians should no longer use this terminology. Most of the time, the presence or absence of a plantar calcaneal spur has no effect on symptoms or treatment. The term fasciitis may also be a misnomer. Lemont studied the pathology of 50 patients who underwent fascial release surgery.1 The findings did not show any evidence of inflammatory cells within the fascia. The common finding was degeneration of the tissue. The inflammation appears to be in the underlying intrinsic musculature so perhaps the corr
Arthrodesis of the great toe joint has been described for the repair of just about every problem affecting the great toe joint, including hallux valgus, hallux varus, hallux limitus/rigidus, osteoarthritis, rheumatoid arthritis and salvage of failed surgeries of the first ray.
Many foot surgeons view the great toe joint fusion as a salvage procedure and will not consider it for primary repair of hallux valgus or hallux rigidus. One of the reasons for doing any type of fusion surgery is to stabilize an unstable or hypermobile joint.
With that said, the great toe joint fusion can be benefi
Podiatric surgeons commonly perform an extraarticular calcaneal osteotomy on hindfoot deformities of the foot and ankle.1 One would typically perform this powerful osteotomy in conjunction with other procedures. Complications with the percutaneous calcaneal displacement osteotomy are rare.2-4
This is in contrast to the customary lateral approach of a calcaneal osteotomy as the surgeon may see complications that include wound dehiscence, sural nerve damage, sural neuritis, delayed union, non-union, infection and invasion of the medial neurovascular structures.2-6
Continuing Education »
The recognition and characterization of soft tissue tumors is central to the practice of podiatric medicine. In many instances, clinicians of the lower extremity serve as the frontline physicians when it comes to the identification of such tumors. Given the inverse relationship between the amount of time prior to diagnosis and patient survival rates, the role of podiatrists may be of paramount importance.
Depending upon one’s depth of experience and comfort level, some clinicians might limit their role to clinical recognition and ordering preliminary imaging studies. Others may go a step
Treatment Dilemmas »
With over 50 different surgical procedures in the literature relating to bunion surgery, there is a great deal of debate as to the best surgical procedure. Some consider a minimum incision technique to be ideal while others believe an open and more extensive correction is the best.
For years, I have pondered the best surgical procedure for hallux valgus correction and have tried many of the procedures. I have come to some conclusions that have dramatically changed my practice and resulted in far better outcomes related to hallux valgus correction.
First and foremost, I have to state that th
Technology In Practice »
Many people suffer from tendinosis or similar tendon aliments that involve tissue scarring. In seeking relief for their pain and discomfort, patients may try a variety of conservative modalities ranging from bracing to injections. If conservative methods fail, there is another option before one considers the possibility of an invasive surgical procedure.
The Topaz Microdebrider (Arthrocare) enables clinicians to perform microdebridement of soft tissue, such as tendons, in the foot and ankle. Essentially, the device uses radiofrequency energy to cause microscopic “trauma” to the scar tissu
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