Podiatry Today Current Issue

Essential Insights On Treating Diabetic Heel Ulcers

admin — Tue, 23 Feb 2010 11:56:00 -0500

Diabetic heel ulcers are particularly challenging to treat as a wide range of factors can affect potential healing. With this in mind, this author discusses the challenges of wound bed preparation, key considerations with offloading and the possible impact of peripheral arterial disease.

Despite a better understanding and the advent of preventive measures that have been developed to address heel ulcers, the problems we encounter due to complications of diabetes make treating this specific patient population more challenging.

Pertinent Pointers On Offloading Diabetic Foot Ulcerations

admin — Tue, 23 Feb 2010 12:35:40 -0500

Offloading plays a key role in the management of diabetic foot ulcerations. With this in mind, these authors review the literature and discuss a variety of modalities ranging from non-weightbearing options and therapeutic half-shoes to removable cast walkers and total contact casts.

The Charcot Foot: What You Need to Know

admin — Tue, 23 Feb 2010 13:02:37 -0500

Given the potential complications of Charcot foot in the diabetic population, these authors review the pathophysiology of the disease, discuss key diagnostic considerations and offer their perspectives on possible surgical treatments.

The Charcot foot poses quite a challenge in even the most organized centers. The outcomes are often poor and can lead to osteomyelitis, amputation and permanent disability. The diagnostic delay averages 29 weeks.¹ Even when appropriate diagnosis occurs early, there is no agreement on the best treatment approach.

When Is Amputation The Salvage Procedure?

admin — Tue, 23 Feb 2010 13:22:27 -0500

While there may be a perception of amputation as a failure in treatment, these authors maintain that amputation salvage procedures do play a role in limb preservation and can enhance the quality of life for patients with diabetes. They address the timing and decision-making with these procedures and review emerging advances in prosthetics.

How To Facilitate Adherence In High-Risk Patients

admin — Tue, 23 Feb 2010 13:31:35 -0500

Poorly managed diabetes can have devastating consequences and there are challenges in getting patients to do their part in following treatment regimens. With these things in mind, this author offers key insights into the psychology of non-adherent behavior and how to get patients back on the right path.

A Memorial Tribute To Gary P. Jolly, DPM (1948-2010)

admin — Tue, 23 Feb 2010 13:39:33 -0500

The true measure of a man is not necessarily what he has accumulated or received over the course of his life, but rather what he has given to others. Gary P. Jolly, DPM, FACFAS, set the bar pretty high. A top educator in the field, Dr. Jolly played an instrumental role in the training of many of the current thought leaders in podiatry. Never afraid to push the proverbial envelope, Dr. Jolly was widely regarded as one of the truly innovative minds of podiatric surgery.

March 2010

admin — Tue, 23 Feb 2010 13:47:46 -0500

CPME May Extend Residency Requirement To Three Years

By Brian McCurdy, Senior Editor

The Council on Podiatric Medical Education (CPME) is proposing longer residency requirements for podiatrists to qualify for advanced certification. The council advocates lengthening the residency duration from two years to three, according to CPME 320 documents posted on www.cpme.org/

When There Are Acute Changes In Mental Status In Patients With Diabetes

admin — Tue, 23 Feb 2010 14:02:32 -0500

As podiatric physicians in 2010, we are better trained than ever to manage patients’ problems. Even more importantly, we are well versed in making appropriate, well-timed referrals when needed. In the following case study, that particular acumen was critically important.

Calcaneal Autograft: Can It Facilitate Salvage Of A Failed First MPJ Implant?

admin — Tue, 23 Feb 2010 15:26:21 -0500

Surgical revision of a failed silicone prosthesis in the first metatarsophalangeal joint (MPJ) is a difficult dilemma that many foot and ankle surgeons increasingly encounter. While advocates of silicone and similar implants have alluded to their preliminary benefits, there is a scarcity of literature on how to salvage these failures, especially when they occur in younger, active patients.

Key Insights On Advanced Wound Care Treatments

admin — Tue, 23 Feb 2010 15:30:47 -0500

There are a variety of advanced treatment options that can help expedite wound healing. Accordingly, these expert panelists offer insights on the use of negative pressure wound therapy (NPWT) and growth factors, and the emergence of stem cell therapy.

Q: Do you have any pearls in prescribing NPWT?