Volume 20 - Issue 11 - November 2007
The world of orthotic therapy and foot biomechanics was somewhat shaken in 2006 when a randomized study found that “customized and prefabricated orthoses used in the trial (had) similar effectiveness in the treatment of plantar fasciitis.”1 Of course, there was a great deal more to this study than the one sentence but it sure stimulated discussion within podiatry and orthopedic surgery concerning the value of custom orthoses in comparison to prefabricated devices.
There are actually four relatively recent trials that compare prefabricated and custom orthoses relativ
Continuing Education »
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There may be a tendency to leap to a plantar fasciitis diagnosis when patients present with heel pain. However, this author emphasizes the importance of a thorough differential diagnosis. accordingly, he offers diagnostic insights on a variety of potential causes ranging from calcaneal spur fractures and neurogenic heel pain to systemic etiologies.
News and Trends »
Given that patients with diabetes can face extensive treatments due to the risk of complications, adherence to treatment regimens may be a problem due to a perceived decline in their quality of life.
A new study finds that although end-stage complications have the greatest effect on quality of life, comprehensive treatments affect quality of life to the degree that some patients were willing to forego years of healthy living to avoid treatments.
In the study, which was recently published in Diabetes Care, researchers interviewed 701 patients with diabetes a
Diabetes Watch »
While various researchers have implicated the equinus deformity as a major deforming force in a host of foot and ankle pathologies, the exact definition of equinus remains unclear.1-4 However, Root states that “the minimal range of ankle joint dorsiflexion that is necessary for normal locomotion is 10 degrees.”5 Subsequent studies report that the ankle joint range of motion for asymptomatic patients ranges from 0 to 13.1 degrees with the knee extended and from 5 to 22.3 degrees with the knee flexed.6-9
The implication from these studies and
Wound Care Q&A »
Important questions arise when traumatic wounds occur in the lower extremity. Accordingly, our expert panelists address key considerations in the initial evaluation and when one should consider an amputation. They also explore the use of soft tissue coverage, skin substitutes and topical dressings with traumatic wounds.
Q: What protocol/triage steps do you utilize in the initial evaluation of a traumatic wound?
A: For a patient with extreme pain and a traumatic wound that requires immediate surgical debridement, Molly Judge, DPM, says pain management and a
Surgical Pearls »
The fully keratinized, thick multilayered structure of the nail plate presents a formidable barrier to nail bed access. This limits the options for treatment of nail diseases such as onychomycosis and subungual hematoma from nail trauma. Until recently, clinicians considered nail removal as an option for formal repair of the nail bed for subungual hematomas involving large regions of the nail bed.1
Penetration enhancing formulations have aided the delivery of molecules to the nail bed through the impermeable nail plate.2 Researchers have used a carbon diox