Volume 21 - Issue 7 - July 2008

Feature »

How To Address Vascular Complications With Lower Extremity Wounds

David E. Allie, MD | 24427 reads | 0 comments

Our contemporary knowledge and critical limb ischemia (CLI) tools have allowed us to dispel many myths regarding the endovascular treatments of lower extremity disease and CLI. These tools are not perfect but they have greatly improved over the last decade and certainly over the last two to three years. One of the biggest complaints I hear from podiatrists is “the surgeons and interventionalists in my area do not believe these things work.” Accordingly, let us take a closer look at some of these myths and the corresponding realities.

Myth: Most CLI patien



Diabetes Watch »

Assessing Vascular Surgery Options In Patients With PAD

Lauren A. Fisher, DPM, Hillarie L. Sizemore, DPM, and Khurram H. Khan, DPM | 12719 reads | 0 comments

Peripheral arterial disease (PAD) is a very common condition that affects 20 to 30 percent of patients over 50 years of age, equating to an estimated 10 million Americans. As the population ages, the incidence of PAD will likely increase dramatically.1
Intermittent claudication is a symptom among patients with PAD and one can use the presence of these symptoms as a diagnostic tool.2 True claudication is an aching or cramping within the muscles in the involved extremity that is exertion-related, relieved by rest and occurs at a relatively constant walking



Treatment Dilemmas »

How To Get Better Results With Bunion Surgery

Justin Franson, DPM, and Babak Baravarian, DPM | 34768 reads | 0 comments

Bunion surgery is perhaps the most common procedure we perform in podiatry. Since bunions come in all shapes and sizes, several different types of procedures have emerged along with various refinements over the years.
Accordingly, let us take a closer look at what makes these procedures work well. Conversely, we need to ask some tough questions.Why do some bunion surgeries fail? Why do some people seem to recover better than others? How can we minimize poor outcomes? Our group has been involved in many revision bunion surgeries so there is a certain level of failures and compl



Surgical Pearls »

Can Calcium Phosphate Bone Cement Aid In Hallux Valgus Repair?

Kerry Zang, DPM | 17905 reads | 0 comments

Over the years, hallux valgus repair has evolved from simple bunionectomies to complex and multiple osteotomies. The keys to a successful outcome are the realignment of the structural abnormalities and a stable postoperative environment.The former is important for proper function and the latter facilitates the healing process.
With this in mind, let us take a closer look at the potential benefits of utilizing calcium phosphate bone cement (OsteoVation, OsteoMed Corp.) for filling voids in metatarsal osteotomy-type bunionectomies to achieve a favorable surgica



Feature »

Secrets To Motivating Your Staff

Lynn Homisak, PRT | 5422 reads | 0 comments

Motivation does not always come wrapped in a dollar bill.Yet whenever the topic of “staff incentive” comes up, so does the topic of money. Even though I try to emphasize that it takes more than cold hard cash to incentivize staff, far too many physicians are unable to grasp this notion and keep reverting back to the bankroll in an effort to “buy” their staff ’s enthusiasm.
One survey, conducted by the late Kenneth Kovach, PhD, of the University of Maryland, found a significant disconnect between what employees actually want from a job and what man



Feature »

Point-Counterpoint: Extracellular Matrices: Are They Worth It?

Steven R. Kravitz, DPM, Khurram Khan, DPM, and Lawrence Harkless, DPM | 9884 reads | 0 comments

Yes. By Dr. Steven R. Kravitz, DPM. This author says podiatrists should consider extracellular matrix enhancement for chronic, complex wounds that do not respond to standard of care therapy.

Over the past 10 years, there have been paradigm shifts in intervention for chronic non-healing wounds. There has been an increased emphasis on moist wound healing,wound bed preparation and managing the wound microenvironment through bone factor enhancement, matrix metalloprotease (MMP) management and bioload reduction.
There has also been a new emphasis on e



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