Point-Counterpoint »
Hallux Valgus: Is Hypermobility A Cause Or Effect?
Cause.
While this author concedes there is no universal definition of hypermobility and a lack of evidence-based medicine to support hypermobility as a cause or effect of hallux valgus, he cites some research and clinical experience that suggest hypermobility as a possible factor in bunion formation.
By Gary M. Rothenberg, DPM, FACFAS
Does hypermobility cause bunions or did the bunion result in hypermobility? The question is admittedly difficult to answer, mostly because we cannot universally agree on a definition of hypermobility.
Point-Counterpoint »
Is High Pressure Better Than Low Pressure For NPWT?
Yes.
These authors say high pressure NPWT can positively affect edematous wounds or unstable wounds, and works well with hydrophilic dressings or barrier dressings.
By Quan Ngo, MBBS(Hons), and Anand Deva, BSc(Med), MBBS(Hons), MS, FRACS
Over a decade ago, Fleischmann, Morykwas and their respective colleagues first introduced negative pressure wound therapy (NPWT).1,2 Their early work confirmed the effectiveness of NPWT in enhancing healing in both human and animal models.
Point-Counterpoint »
Is Total Ankle Replacement More Effective Than Ankle Arthrodesis?
Yes.
With advances in the design of newer generation ankle implants, an improved understanding of the biomechanics involved with this procedure and a reduced risk of long-term complications, this author says total ankle replacement is increasingly becoming the procedure of choice for properly selected patients with end-stage arthritis.
By Lawrence A. DiDomenico, DPM, FACFAS
Point-Counterpoint »
Is The Weil Osteotomy Overused By DPMs?
Yes.
Although the Weil osteotomy provides an excellent surgical option for primary central ray pathologies, this author says it is not appropriate for most central metatarsal pathologies due to biomechanical factors and it is prone to complications.
By Patrick A. DeHeer, DPM, FACFAS
Point-Counterpoint »
Laser Care For Onychomycosis: Can It Be Effective?
Yes. In reviewing the early study findings and his own experience as a patient, this author says lasers have potential in the treatment of onychomycosis.
By John Mozena, DPM
Onychomycosis is one of the most commonly diagnosed foot problems that podiatrists treat. Two to 3 percent of the population is known to have onychomycosis and this incidence increases to 15 percent for those between the ages of 40 to 60.1
Point-Counterpoint »
Asymptomatic Flatfoot In Kids: Should You Treat It?
Yes. Ron Raducanu, DPM, FACFAS notes that orthotic treatment may help correct pediatric flatfoot and potentially prevent related biomechanical dilemmas as children move into adulthood.
There continues to be quite a bit of controversy surrounding the treatment of pediatric flatfoot with custom orthotics. Given the continued emphasis on evidence-based medicine, this controversy is largely fueled by the lack of any empiric data to support the use of custom orthotics as a means to prevent future podiatric abnormalities or symptoms.
Point-Counterpoint »
Is Low-Energy ESWT Better Than High-Energy ESWT For Plantar Fasciitis?
Yes. Lowell Weil Jr., DPM, MBA, FACFAS cites emerging research on low-energy ESWT and says it can be a cost-effective treatment for plantar fasciitis and other conditions.
When musculoskeletal extracorporeal shockwave (ESWT) was introduced in the United States with its first FDA approval in 2000, there was a great deal of controversy and posturing among manufacturers of ESWT technologies. Each company was determined to create an exclusive market for itself at the expense of its competition.
Point-Counterpoint »
Os Trigonum: Should You Treat It Surgically?
Yes. Christopher Corwin, DPM says surgical excision, when properly indicated, addresses the cause of os trigonum pain, offers a lower risk of recurrence and facilitates a quick recovery and return to activity.
Point-Counterpoint »
Bunion Surgery: Should You Perform A Lateral Release?
Yes. Neal Blitz, DPM says the lateral release is a common component of bunion surgery as it aids in bunion correction and assists with reduction of the intermetatarsal angle when surgeons combine this procedure with structural realignment of the first metatarsal.
Point-Counterpoint »
Is Foam More Effective Than Gauze With Negative Pressure Wound Therapy?
Yes. Lee C. Rogers, DPM cites the evidence from negative pressure wound therapy (NPWT) trials and says the characteristics of NPWT foam facilitate the development of granulation tissue and improved healing in diabetic foot ulcers.
There is no question that negative pressure wound therapy (NPWT) is a valuable modality in facilitating wound closure. In particular, the use of foam dressings with NPWT has demonstrated success in reducing wound surface size and accelerating the formation of granulation tissue.
