Podiatry Today Current Issue

Waveform Electrostimulation: Can It Be Another Option For Painful Peripheral Neuropathy?

admin — Wed, 03 Sep 2008 17:01:38 -0400

According to the Centers for Disease Control and Prevention (CDC), approximately 7 percent of the population in the United States has diabetes mellitus. Approximately 30 percent of patients with diabetes over the age of 40 have some kind of impaired sensation of the foot. Sensorimotor neuropathy is the primary risk factor for developing a diabetic foot ulcer, which leads to 85 percent of diabetic lower extremity amputations.¹
Sensory neuropathy causes paresthesia and loss of protective sensation, which can lead to ulcerations and lower extremity amputations. Motor n

When A Patient Has An Unusual Growth On A Toe

admin — Wed, 03 Sep 2008 17:01:38 -0400

A 43-year-old African-American male presents to the office with an irritated fourth toe with no known trauma to the toe. There is a horny projection of skin coming from the posterior nail fold with a nail-like structure at the tip. It has been present for the past two years and had recently become larger.

The lesion is asymptomatic except for physical inconveniences.
The patient reports that the toe is painful only in shoes. The patient works as a custodian and spends a lot of time on his feet. He has recent onset diabetes of three years but has not been to a podiatrist in the

How To Address Key Biomechanical Issues With Second MPJ Injuries

admin — Wed, 03 Sep 2008 17:01:38 -0400

Injuries to the second metatarsophalangeal joint (MPJ) can be challenging to treat. Our expert panelists discuss predisposing factors to injury and review pertinent biomechanical considerations. They also discuss conservative treatment options, including variations of orthotic therapy and modifications that they have employed in clinical practice.

Q: What are the predisposing factors (gender, foot type, activity, etc.) that are associated with injuries to the second MPJ?
A: Second MPJ injuries may have a variety of etiological causes, accordi

A Closer Look At Locking Plates In Podiatric Surgery

admin — Wed, 03 Sep 2008 17:01:38 -0400

Using plates and screws for bone fixation is a standard and successful technique. However, any fixation with plates and screws involves some amount of additional trauma and insult to the osseous blood supply of fracture fragments. These disturbances increase the risk of delayed union and infection.¹
Indeed, reconstructive and trauma procedures of the foot and ankle present unique challenges for foot and ankle surgeons. As these cases grow in complexity, certain principles prevail in ensuring predictable and successful outcomes. These principles emphasize the protection of

Managing Pediatric Metatarsus Adductus: Should You Treat It?

admin — Wed, 03 Sep 2008 17:01:38 -0400

Yes, this author advocates early treatment for moderate to severe metatarsus adductus, and semi-rigid or rigid deformity. He cites problematic compensatory effects from residual deformities and a documented association between metatarsus adductus and hallux abducto valgus deformity.

Metatarsus adductus is a transverse plane congenital deformity with adduction of the forefoot at the tarsometatarsal joint. It has a reported incidence of one per 1,000 live births. However, it has been acknowledged that this may reflect only the severe cases and the true incidence may be

What You Should Know About Malignant Melanoma

admin — Wed, 03 Sep 2008 17:01:38 -0400

In an article published in the New England Journal of Medicine (NEJM) in 2006, the author gives an account of a 53-year-old female patient who received treatment from a podiatrist for a plantar wart for two years. She underwent electrocoagulation therapy without histological examination.
Her lesion grew and she eventually sought the care of the NEJM author, who biopsied the lesion and noticed enlarged inguinal lymph nodes. The biopsy revealed amelanotic melanoma exceeding 6 mm in thickness (Clark’s level IV). Despite excision of the lesion and involved l

Study Says NPWT More Effective Than Moist Dressings For DFUs

admin — Wed, 03 Sep 2008 17:01:39 -0400

Negative pressure wound therapy (NPWT) is more effective than advanced moist wound therapy in facilitating the closure of diabetic foot ulcers and reducing secondary amputations. These are the findings of researchers who recently published the largest randomized, multicenter, controlled trial on NPWT.
In the study, which was published in Diabetes Care, researchers randomized 169 patients to VAC Therapy (KCI) and 166 patients to advanced moist wound therapy (primarily hydrogels and alginates). Patients had stage 2 or 3 (as per the Wagner scale) calcaneal, dorsal or plan

Defusing The Myths About Investing In Medical Office Real Estate

admin — Wed, 03 Sep 2008 17:01:39 -0400

It is always amazing to me how many physicians do not buy their own real estate in the first couple of years of practice. I have heard physicians say it is too expensive, they just want to rent, they are too busy to look into the area or they do not know much about real estate. Working too hard and not having enough time to research this area are poor excuses.
Real estate is the number one long-term, wealth-building vehicle available to all physicians. Look around at your most growing areas. New medical office buildings and projects are sprouting up everywhere. read more

How Core Muscles Can Affect The Lower Extremity

admin — Wed, 03 Sep 2008 17:01:39 -0400

Occasionally, a podiatrist may encounter an athletic patient who does not improve with traditional treatment. We tend to focus on the injured area and may overlook weakness of the core muscles, which may contribute to foot or leg pain. The core muscles are extremely important in lower extremity muscle function.
The core muscles include the stomach muscles (the rectus abdominus, transverse abdominus, external and internal obliques and erector spinae) and the hip abductors (the gluteus medius and gluteus minimus).
If the core muscles are weak, particularly the gluteal muscl

Wound Debridement: Are Adjunct Therapies Cost Effective?

admin — Wed, 03 Sep 2008 17:01:39 -0400

Please click here for the full Continuing Medical Education article:

http://www.naccme.com/program/n-208/

There is a variety of debridement options ranging from sharp debridement and mechanical debridement to enzymatic debridement. In recent years, physicians have also seen the emergence of ultrasound debridement and the use of a hydro scalpel. Accordingly, this author evaluates the various debridement methods and assesses their cost effectiveness.