Podiatry Today Current Issue

Minimal Incision Surgery: Can It Have An Impact In Diabetic Limb Salvage?

admin — Mon, 23 Feb 2009 12:47:49 -0500

For patients with diabetes and rigid forefoot deformities, traditional surgical procedures and prolonged offloading periods have a high risk of potential complications. Accordingly, these authors offer perspectives and step-by-step pearls on the use of percutaneous surgery and minimal incision surgery procedures.

The direct and indirect costs of foot ulcerations, infections and amputations as a result of diabetes are staggering.^1-4 Despite advances in disease management, wound healing, infection control and limb salvage techniques, diabetes will continue to ri

Keys To Selecting Footwear For Patients With Diabetes

admin — Mon, 23 Feb 2009 13:13:24 -0500

For patients with diabetes, proper footwear is a critical part of the equation for preventing or reducing the risk of lower extremity complications. Accordingly, this author offers pertinent pointers and key nuances in ensuring the proper fit of therapeutic shoes.

The number of people diagnosed with diabetes has doubled since 1996, according to the Centers for Disease Control and Prevention (CDC).¹ In 2009, approximately 4 million people with diabetes mellitus will develop a foot ulcer.¹ The ramifications of this fact are enormous and the effe

Essential Insights On Detecting The Etiology Of Peripheral Neuropathy

admin — Thu, 26 Feb 2009 09:49:29 -0500

Peripheral neuropathy can be triggered by disparate causes such as diabetes, alcoholism, certain chemotherapy medications and HIV. Given the importance of identifying the correct etiology in order to facilitate appropriate treatment, these authors discuss pertinent clues in the patient history and physical exam, and share perspectives on helpful diagnostic testing.

In podiatric practice, we commonly see peripheral neuropathy, the primary factor leading to ulceration, which can subsequently lead to infection and ultimately amputation. Neuropathy may also lead to Ch

What You Should Know About Emerging Techniques In Revascularization

admin — Thu, 26 Feb 2009 10:37:59 -0500

Given the challenges of managing chronic wounds in patients with peripheral arterial disease, these authors offer a review of current concepts in revascularization and how these procedures may facilitate improved wound healing.

Perfusion is the most fundamental requirement to heal a wound. According to current estimates, peripheral arterial disease (PAD) affects over 12 million people in the United States and more than half are asymptomatic.^1,2

As PAD progresses to advanced stages such as non-healing wounds or critical

What The Literature Reveals About Diabetic Foot Osteomyelitis

admin — Thu, 26 Feb 2009 11:16:32 -0500

Given that osteomyelitis in the diabetic foot can lead to complications such as limb loss, ensuring a proper diagnosis and timely treatment is vital. Accordingly, this author surveys the literature to review pertinent classification systems, the merits of different imaging techniques and current thoughts on the debate over conservative therapy versus surgical treatment.

The worldwide incidence of diabetes has reached nearly epidemic proportions. With this increased incidence, there has been a significant rise in the comorbidities commonly associated with the disea

March 2009

admin — Thu, 26 Feb 2009 11:30:22 -0500

Study Examines Shoelace Patterns On Running Shoes

By Brian McCurdy, Senior Editor

Before hitting the track, runners must take various factors into account to streamline their performance. A recent study in the Journal of Sports Medicine explores how different shoelace patterns can affect the biomechanics of runners.

According to the study, researchers evaluated 20 experienced runners and the influence of shoelace tightness and the number of laced eyelets upon foot pronation during contact, tibial acceleration and plantar pressure di

How Depression And Anxiety Affect Patient Adherence

admin — Thu, 26 Feb 2009 11:42:11 -0500

We have all bemoaned non-adherent patients with out-of-control blood sugars who nod agreeably and then ignore everything we say. Not surprisingly, their wounds heal poorly and discouragement sets in with these patients. Their behavior appears to defy logic until we look at how prevalent depression and anxiety disorders are among patents with diabetes and how these disorders affect healing. The picture begins to make even more sense when we consider the effect of prolonged hyperglycemia on the brain.

Extensive studies have established a strong link between

Tarsal Tunnel Syndrome: Can A Minimally Invasive Release Be Advantageous?

admin — Thu, 26 Feb 2009 12:43:52 -0500

Compression neuropathies of the posterior tibial nerve and its branches are a fairly common group of disorders, which are often misdiagnosed.^1,2 In order to diagnose lesions of these nerves accurately, one must maintain a fairly high index of suspicion of their presentation. Relying on abnormal findings via electromyography and nerve conduction velocity testing is risky because the incidence of false negatives is quite high.^2,3

In contrast, pressure specific sensory testing may produce false positive results. Although the classical

Has Intraoperative Nerve Testing Reinvented Our Approach To Tarsal Tunnel And Nerve Surgery?

admin — Thu, 26 Feb 2009 12:52:52 -0500

Nerve surgery, especially tarsal tunnel surgery, has been very difficult to perform. More often than not, it is a poorly used treatment in foot and ankle care. Often, the diagnosis is difficult to make and surgical treatment may not result in the best outcomes if physicians have not emphasized careful patient selection.

To date, the most common workup for tarsal tunnel and other peripheral nerve problems has been a nerve conduction test (NCV) with or without an electromyelogram (EMG). Both of these tests have shown moderately good potential in the upper

New Implant Offers Viable Alternative For Hammertoe Surgery

admin — Thu, 26 Feb 2009 12:56:33 -0500

For podiatric surgeons looking to reduce complications, improve outcomes and facilitate less postoperative pain for patients, a new implant may prove to be more beneficial than K-wire fixation in correcting hammertoe deformities.

One may use the Smart Toe™ memory implant to help correct hammertoe deformities in toes two through five, according to MMI-USA, the manufacturer of the implant. The Smart Toe offers an implant comprised of a special alloy with shape memory properties called NiTinol. The company notes that these properties resist potential rotat