Volume 20 - Issue 3 - March 2007

Feature »

A Guide To Surgical Offloading In The Neuropathic Foot

By Rachel Grieder, DPM, Sean McMurray, DPM, and Matthew J. Claxton, DPM | 10562 reads | 0 comments

      The neuropathic foot presents unique challenges when treating and preventing chronic wounds. One of the most difficult challenges is offloading the neuropathic foot without compromising function or causing a transfer of pressure that leads to further ulceration. When performing a limb salvage procedure, the goal is to provide the patient with a stable, plantargrade foot while still allowing for ambulation.1

      In choosing the appropriate procedure to offload the foot, it is important to consider minimal bone resection versus a partial pedal



Feature »

Honey-Based Dressings: Can They Have An Impact For Diabetic Foot Ulcers?

By Wendy Tyrrell MEd, DPodM, MChS, and Rose A. Cooper, PhD | 23260 reads | 0 comments

     Honey is an ancient wound remedy that is reappearing in clinical practice in developed countries. The availability of licensed wound care products in Europe, New Zealand and Australia is prompting healthcare practitioners in conventional medicine to consider the use of honey within their treatment armamentarium. Ulcer remedies such as honey are necessary as the prevalence of diabetes rises.

     The American Diabetes Association has estimated that about 7 percent of the population had diabetes.1 It is an increasing problem that has serious impl



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How To Address Predislocation Syndrome Of Lesser MPJs

By William D. Fishco, DPM, FACFAS | 56430 reads | 1 comments

     Metatarsalgia is a diagnostic term used to describe pain in the ball of the foot. Gerard V. Yu, DPM, eloquently described and illustrated predislocation syndrome in 1995. What Dr. Yu described was a clinical syndrome characterized by focal pain under a lesser metatarsophalangeal joint (MPJ), most often affecting the second toe joint.1

     Subjective symptoms reported by those afflicted with this syndrome would be described as a “grape-like” swelling under the affected toe joint, and a feeling as if there were a stone bruise on the ball of



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Secrets To Facilitating Patient Adherence

By Kathleen Satterfield, DPM | 4677 reads | 0 comments

     The basic question is really “How do you get someone to do something that they do not especially want to do?” The fictional Tom Sawyer was the classic king of this skill but as physicians, we are trying to do something a bit more complicated than getting someone to paint a fence. We are trying to get our patients to adhere to the instructions of given treatment regimens, such as taking a confusing regimen of pharmaceuticals or staying off an injured foot.

     Although the word “non-compliance” is not in the title of this article, be assured that



Feature »

How To Maximize Patient Outcomes With DME

By William N. McCann, DPM | 20567 reads | 0 comments

      The use of durable medical equipment (DME) has grown to become a part of almost every podiatric practice over the last half-century. In fact, podiatrists have led the field in this important area of patient treatment through our use of orthotic devices.

      With our extensive background and training in biomechanics, our understanding of diabetes and its complications in the lower extremities as well as a need to provide patients with immediate immobilization, it is no wonder that DME is one of the more important offerings that we can extend to those we



Continuing Education »

Assessing Debridement Options For Diabetic Wounds

By Eric H. Espensen, DPM | 23000 reads | 0 comments

      Diabetic wounds are a common occurrence in wound care centers and private practice. With the escalating rate of diabetes, more and more patients are developing wounds that require care. Wound care for diabetic wounds routinely includes debridement. The term debridement comes from the French desbrider, meaning “to unbridle,” and was probably first used as a medical term by surgeons working in war zones. The medical personnel and surgeons likely recognized that contaminated wounds had a better chance of healing if one surgically removed the damaged tissue to revea



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