Volume 21 - Issue 8 - August 2008
In the annual roundup of emerging advances in podiatry, this author talks to podiatrists to get their thoughts about new surgical devices, vascular assessment tools and intriguing diagnostic innovations.
Advances in technology have the potential to reshape and redefine commonly held thought processes and practices in podiatry. This year’s list includes a quicker option for assessing microvascular flow, an ankle arthrodesis locking plate and a diagnostic device that may facilitate earlier recognition of lower extremity melanomas.
With that said,
Hallux rigidus of the first metatarsophalangeal joint (MPJ) is the most common form of osteoarthritis of the foot.1 Hallux rigidus is defined as a progressive arthritic process of the first MPJ that causes pain, stiffness and enlargement of the joint.1
There are numerous surgical procedures to help address the pain and stiffness of this joint. These procedures include cheilectomy, osteotomies, resection arthroplasty, interpositional arthroplasty, hemiarthroplasty, total joint arthroplasty and arthrodesis.
There are 15 million people in the United States with diabetes mellitus, half of whom are undiagnosed. Diabetic foot ulcers (DFUs) occur in 12 percent of these individuals, accounting for 60 percent of lower extremity amputations and costing more than $1 billion annually.1
Diabetic foot ulcers have various mechanisms including:
• microneurovascular dysfunction with loss of the nociceptive reflex and an exacerbated inflammatory response;
• vasomotor dysfunction with arteriovenous shunting;
Continuing Education »
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Given the significant dilemma of peripheral arterial disease and its strong association with diabetic complications in the lower extremity, this author reviews pertinent diagnostic keys and assesses the current research on treatment options.
The Charcot syndrome is a devastating condition that can affect the feet or ankles of those with diabetes and peripheral neuropathy. The reports on the incidence and prevalence of Charcot foot vary widely, and range between 0.1 to 29 percent among people with diabetes. These studies indicate a trend for a higher frequency in those with peripheral neuropathy and in specialty clinics.1 The specialty clinic providers may have a higher clinical suspicion and may accordingly arrive at a diagnosis more rapidly and definitively.
The risk of amput
Diabetes Watch »
Lower extremity complications associated with diabetes present a special challenge to any physician contemplating surgical management. Prophylactic foot surgery can be described as a procedure to prevent ulceration or re-ulceration in patients with diabetes without significant vascular compromise. This concept is part of a larger classification system, which stratifies the risks associated with various types of foot surgery.1
Why and when would you consider prophylactic surgery? A history of previous ulceration and/or amputation is an impo
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