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When A Patient Has Hallux Limitus On One Foot And Hallux Rigidus On The Other

Larry Huppin DPM | 927 reads | 0 comments | 02/03/2017

I had a colleague call with a question regarding an orthotic prescription for a patient with functional hallux limitus affecting one foot and a rather severe hallux rigidus affecting the other. The right foot had less than 5 degrees of dorsiflexion available at the first MPJ while the left foot had full range of motion and just a little dorsal exostosis.

The orthotic for the foot with hallux limitus is fairly straightforward. In this situation, we want to design the device to enhance motion in the first MPJ and decrease compression within that joint.

Keys To Addressing MRSA In The Diabetic Foot

Suhad Hadi, DPM, FACFAS, and Randy Garr, DPM | 38,304 reads | 0 comments | 02/27/2013

As diabetic infections continue to evolve and become more resistant to antibiotics, having a comprehensive treatment plan for methicillin resistant Staphylococcus aureus (MRSA) is crucial. These authors present a guide to current antibiotic options and offer two illuminating case studies of patients with diabetes and MRSA.

Emerging Insights On Ex-Fix Offloading For Diabetic Foot Ulcers

William P. Grant, DPM, FACFAS, Lisa M. Grant, and Bryan R. Barbato, BS | 12,500 reads | 0 comments | 03/25/2013

It is well understood that unremitting pressure is a major etiologic factor in both the creation and persistence of diabetic foot ulcers. Sensory neuropathy in combination with autonomic and motor neuropathy readily produces foot deformities with bony prominences and skin lacking normal protective sensibility. Further complicating the problem, alteration in tendon morphology and its function produces increased plantar pressures as well as temporal alteration in the phasic gait cycle that can destroy the protective barrier of the skin beneath the foot.

When A Diabetic Foot Ulcer Is Complicated With Tophaceous Gout

David M. Davidson, DPM | 17,717 reads | 0 comments | 03/26/2013

In an interesting case study, this author discusses the diagnostic workup and multidisciplinary efforts to resolve a longstanding combination of a diabetic foot ulcer and tophaceous gout.

Can The Medical Home Model Reinvent Outpatient Diabetic Foot Care?

By Thomas Belken, DPM | 7,829 reads | 0 comments | 12/19/2012

There are certain protocols/algorithms that physicians follow within the hospital setting. When a patient with diabetes comes into the emergency department with an infected ulcer, a cascade of events takes place: lab tests, X-rays, wound cultures, blood cultures and consults to the appropriate specialists. Medicine, infectious disease, vascular, endocrinology and podiatry personnel usually comprise the “team” that assembles to take care of this patient while he or she is in-house.

What Is A ‘Normal’ Foot?

Kevin A. Kirby, DPM | 8,274 reads | 3 comments | 03/23/2015

Podiatrists commonly use the terms “normal” and “abnormal” to describe foot structure and foot function. We might look at a set of plain film radiographs and note that one foot has a hallux valgus angle that we call “normal” while the contralateral foot has a hallux valgus angle that we call “abnormal.” We might also do gait examinations in our office and tell one patient that his gait appears normal while in another patient, we may say that her gait appears abnormal.

What You Should Know About Nutritional Deficiency And Diabetic Peripheral Neuropathy

Robert Smith, DPM, MSc, RPh, CPed | 9,699 reads | 0 comments | 02/24/2016

In a thorough review of the relationship between nutrition and diabetic peripheral neuropathy, this author discusses key vitamin deficiencies, the impact of oxidative stress in patients with diabetes, and the need for close postoperative nutrition monitoring in those who have bariatric surgery.

The Emerging Role Of Alpha-Lipoic Acid For Diabetic Neuropathy

Kevin Ragothaman, BS, and David Shofler, DPM, MSHS | 23,690 reads | 0 comments | 06/22/2015

A Closer Look At Preserving Foot Function With A Transmetatarsal Amputation

Cherreen Tawancy, DPM, Tammer Elmarsafi, DPM, Caitlin Garwood, DPM, and John Steinberg, DPM, FACFAS | 4,807 reads | 0 comments | 11/20/2015

For patients with diabetes and neuropathy, partial first ray amputations can lead to less than optimal results. With this in mind, these authors discuss emerging insights from the literature and offer a compelling case study that illustrates the key considerations in choosing between partial amputations and more proximal procedures.

Assessing And Treating The Subtle Cavus Foot Deformity

H. John Visser, DPM, FACFAS, Asiya Ansari, DPM, and Sarah Thompson, DPM | 12,221 reads | 0 comments | 05/27/2015

Given the various conditions associated with the subtle cavus foot, it is important to be able to recognize the deformity in order to prevent related symptom recurrence and potential failure of surgical procedures. Accordingly, these authors present a guide to evaluation as well as conservative and surgical treatment options.