Podiatry Today Current Issue

ACFAS Changes Dual APMA Membership Policy

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

In a change to a longstanding policy, the American College of Foot and Ankle Surgeons (ACFAS) recently lifted a requirement that renewing college members must maintain a membership in the American Podiatric Medical Association (APMA). The policy change only affects renewing members as new ACFAS members still must belong to APMA when they join the college.
In a letter sent to the college membership, ACFAS President Daniel Hatch, DPM, noted that the college has been contacted by those who cite a financial hardship of having to belong to two groups, or have professional differences with various

When A Pediatric Patient Has Severe Itching On Her Heels

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

A 4-year-old girl presented to the office with her mother, who was concerned about a skin problem affecting her heels. According to her mother, the patient’s symptoms were present for six months or more. The child’s symptoms included a severe itch that caused constant scratching, pain and cracking of the skin leading to bleeding.
Previous home treatment included the application of various over the counter creams including hydrocortisone, antifungals and hand lotions. These treatments did not help. She had no prior treatment by a physician for this problem.
Her past medical history was

Is External Fixation Overutilized In Managing Charcot In The Diabetic Foot?

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

Historically, surgeons have utilized circular and monolateral external fixation for the management of complicated high-energy orthopedic trauma and reconstruction of congenital or posttraumatic deformities through the Ilizarov and deBastiani principles of callotasis and distraction osteogenesis.^1-3
Demonstrating success in bone healing and deformity correction in limbs that would have otherwise left patients with permanent disabilities or necessitated limb amputation, external fixation has found its way into the treatment of Charcot foot, arguably one of the most challenging probl

How To Handle Difficult Post-Op Patients

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

Difficult patients are challenging enough but when the difficult patient is also a postoperative patient, the challenge becomes a medico-legal risk. Difficult patients are not difficult because they have special medical needs. They are difficult because they challenge our defenses, stretch our tolerance and patience, or demand much more of our time than we can give. However, it is possible to care for these challenging patients if you know how.
Taking on a difficult patient can spiral into a battle of wills and wits that you are destined to lose. That is why it is necessary to understand you

A Closer Look At Practice Management Aspects Of Treating Heel Pain

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

Heel pain is the single most common reason that patients seek out the care of podiatric physicians. Estimates state that more than 15 million Americans suffer with heel pain and emerging technologies for treatment have ballooned over the past seven years. However, many of these technologies are expensive and may not be covered by all insurance companies.
Therefore, it is incumbent upon the podiatric physician not only to know the practice guidelines of the American College of Foot and Ankle Surgeons (ACFAS) for the treatment of heel pain but also the financial considerations for patients wit

A Smart Doppler

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

When documenting a patient’s vascular condition, a new lightweight technology may be an option.

The Smartdop^® 30EX is a bidirectional portable Doppler with an integrated printer and large visual LCD display, according to the manufacturer Koven Technology. The company notes the product also has an automatic cuff inflator for quick, simple, accurate ankle brachial index (ABI) and tibial brachial index (TBI) testing.
With the Smartdop 30EX, the company says one can save up to 30 waveforms for later reference or print them out. Koven notes one can also download the optional Sm

Can A New Implant Lead To Easier Hammertoe Arthrodesis?

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

Patients having hammertoe arthrodesis have had to undergo fixation with K-wires that can cause complications including pin tract infection. However, a new implant may obviate the need for K-wires and provide adequate correction. The Smart Toe^™ Intramedullary Memory Implant was specifically developed for hammertoe arthrodesis and is composed of nitinol (Memometal^® Alloy Ti-Ni), according to the manufacturer MMI-USA, Inc. Since the implant is one piece, no connection is required. There is no post-op implant exposure and no disruption of healthy joints. The company sa

Navigating The Nuances Of Risk Management

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

I used to play a game called Risk with a group of friends during the early years of my practice. We would gather at somebody’s home or office, bring pizza and beer, and start the game. Risk is a game where you try to conquer the world with little plastic armies, using dice and strategy to gain continents and countries. As the night wore on and the beer and pizza were ingested or thrown at other players, our “risk” tolerance grew. A strategy I enjoyed was irritating another player by slinging insults about his profession and then conquering his countries. My friends/opponents returned th