Podiatry Today

Podiatry Today






CLINICAL EVENTS CALENDAR

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Non-Accredited Education

Managing the Diabetic Foot: A Clinical and Economic View Complimentary Archived Webcast
Non-Accredited


Understanding Collagen Dressings and their Benefit in Wound Care

Complimentary Archived Webcast
non-accredited

Feature

Key Insights For Treating Navicular Stress Fractures

VOLUME: 21 PUBLICATION DATE: Oct 01 2008
Issue Number: 
10 Oct 08

Stress fractures of the tarsal navicular are an uncommon injury in the general population. However, people who engage in ballistic sporting events or recreational activities are at an increased risk of such an injury. The recognition of this injury seemed to parallel an increased fitness craze in the population over the last 30 years. Since Towne, et al., originally described tarsal navicular stress fractures in 1970, they have increased in prevalence secondary to our increased awareness of the injury and the emergence of faster and more powerful athletes.1
The formation of a st

Current Concepts In Orthotic Therapy For Pes Cavus

VOLUME: 21 PUBLICATION DATE: Oct 01 2008
Issue Number: 
10 Oct 08

Despite the prevalence of pes cavus, questions abound about etiology, classifications and appropriate treatment. Accordingly, these authors sort through the various classification systems, offer insights on the pathomechanics and share their thoughts on the role of orthoses for managing symptoms of pes cavus.

Pes cavus occurs in about 8 to 15 percent of the population but it does not get nearly as much attention in the medical literature as its counterpart pes planus.1 Sixty percent of the population with cavus feet develop foot pain.2

Why does this chronical

Point-Counterpoint: Is Arthrodiastasis A Viable Option For Ankle Arthrosis

VOLUME: 21 PUBLICATION DATE: Oct 01 2008
Issue Number: 
10 Oct 08

Yes. By George Vito, DPM FACFAS. With appropriate experience, surgeons can help relieve symptoms of severe osteoarthritis of the ankle with this procedure and delay the need for a joint destructive procedure.

There are basically two major forms of osteoarthritis, both of which can be severely disabling. In primary osteoarthritis, the cause is generally unknown. In secondary osteoarthritis, the cause is generally traumatic in origin. Both forms present with similar clinical symptoms, which include pain, decreased range of motion and swelling.

Radiologically, there is a decrease in

How To Market Your Practice On The Internet

Bruce Werber, DPM, says patients like his practice’s Web site because they can present to the office with information and “have a better, more informed discussion with the doctor.”The best way to address HIPAA compliance is by working with a Web designer who can set you up with a secure e-mail network, including user authentication and data encryption.
VOLUME: 21 PUBLICATION DATE: Sep 01 2008
Issue Number: 
9

As we draw closer to the close of the century’s first decade, we see that technology is more ubiquitous than ever as it reaches into virtually every aspect of our lives and businesses. Nowhere is this more apparent or relevant than in medical practices, which have opened themselves to the Web in everything from billing to dispensing and prescriptions.
Marketing a practice on the Web is possibly the most widely used application of Internet technology. One essential reason justifies the creation and maintenance of a practice Web site: patients expect it.

“It is a critical part of running

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The Top Ten Innovations In Podiatric Care

Lee Rogers, DPM, says one study found that the OxyVu-1 system had a positive predictive value for wound healing of 93 percent among patients with diabetic foot wounds.While measuring TCPO2 is “dependent on many conditions and is time-consuming,” Dr. Rogers says the non-invasive SensiLase offers a quicker alternative to help predict wound healing.In regard to the LCP Anterior Ankle Arthrodesis Locking Plate (shown above), Lawrence DiDomenico, DPM, says the device emphasizes the protection of the soft tissue envelope and the importance of bone callus formation in uniting an arthrodesis site.Robert Frykberg, DPM, has used the RingFix for rearfoot fusions, ankle fusions, pilon fractures and other conditions. He praises the device’s ease of use and innovative design.Michael Downey, DPM, notes that the Evenup is for patients wearing Cam-walkers or cast boots on one extremity while wearing their own shoe on the other extremity.
VOLUME: 21 PUBLICATION DATE: Aug 01 2008
Issue Number: 
8

In the annual roundup of emerging advances in podiatry, this author talks to podiatrists to get their thoughts about new surgical devices, vascular assessment tools and intriguing diagnostic innovations.

     Advances in technology have the potential to reshape and redefine commonly held thought processes and practices in podiatry. This year’s list includes a quicker option for assessing microvascular flow, an ankle arthrodesis locking plate and a diagnostic device that may facilitate earlier recognition of lower extremity melanomas.

     With that said,

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Is There A Role For HBO In Limb Salvage?

Here one can see a non-healing ulceration in a male patient with peripheral vascular disease, diabetes and Charcot arthropathy. (Photos courtesy of Intermountain LDS Hyperbaric Medicine Department)In addition to the patient receiving a below the knee popliteal to dorsalis pedis artery bypass graft, physicians performed wound debridement and utilized Integra. They also utilized postoperative HBO and negative pressure wound therapy. (Photos courtesyThis photo shows a non-healing ulcer in a patient with diabetes. (Photos courtesy of James Holm, MD)The patient underwent debridement, moist wound care and HBO treatment. (Photos courtesy of James Holm, MD)Here one can see healing of the patient’s diabetic foot ulceration. (Photos courtesy of James Holm, MD)Here one can see an infected diabetic foot ulcer. (Photos courtesy of James Holm, MD)In regard to the patient’s diabetic foot ulcer, physicians debrided the wound, provided moist wound care and utilized HBO. Ultimately, the patient received a skin graft and healed. (Photos courtesy of James Holm, MD)
VOLUME: 21 PUBLICATION DATE: Aug 01 2008
Issue Number: 
8

   There are 15 million people in the United States with diabetes mellitus, half of whom are undiagnosed. Diabetic foot ulcers (DFUs) occur in 12 percent of these individuals, accounting for 60 percent of lower extremity amputations and costing more than $1 billion annually.1

   Diabetic foot ulcers have various mechanisms including:
   • microneurovascular dysfunction with loss of the nociceptive reflex and an exacerbated inflammatory response;
   • vasomotor dysfunction with arteriovenous shunting;
  

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Injectable Silicone: Can It Mitigate Plantar Pedal Pressure?

Here one can see a silicone injection. Physicians may inject modern purified silicone products approved by the FDA into the human body with minimal complications as long as they follow strict protocol.Here one can see infrared thermography demonstrating the effects of silicone injection for a patient who complains of plantar pain.This area of the foot is at risk for ulceration. The author cites a study that notes the efficacy of plantar silicone injections in reducing recognized risk factors associated with diabetic foot ulceration.
VOLUME: 21 PUBLICATION DATE: Sep 01 2008
Issue Number: 
9

Ambulation exposes the foot to a collaboration of focal pressure and repetitive stress, and ground reaction forces generated in response to weightbearing activities are the commonly responsible stressors.1
The portion of the foot in contact with the ground varies during the stance phase of gait. Accordingly, the site of ground reaction force application varies, generally progressing from the heel at first contact to the hallux at toe-off.2
These forces contain vertical, anteroposterior and mediolateral components. However, the vertical force is much greater than the o

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A Guide To First MPJ Head Resurfacing

These radiographs show end stage hallux rigidus in an active male patient.Surgical procedures to address hallux rigidus, as shown above, include cheilectomy, osteotomies, resection arthroplasty, interpositional arthroplasty, hemiarthroplasty, total joint arthroplasty and arthrodesis.The above radiographs depict the use of the HemiCAP implant to help address the patient’s end-stage hallux rigidus.Here one can see resurfacing of the damaged first metatarsal head with the HemiCAP implant. Note the satisfactory alignment of the joint.
VOLUME: 21 PUBLICATION DATE: Aug 01 2008
Issue Number: 
8

     Hallux rigidus of the first metatarsophalangeal joint (MPJ) is the most common form of osteoarthritis of the foot.1 Hallux rigidus is defined as a progressive arthritic process of the first MPJ that causes pain, stiffness and enlargement of the joint.1

     There are numerous surgical procedures to help address the pain and stiffness of this joint. These procedures include cheilectomy, osteotomies, resection arthroplasty, interpositional arthroplasty, hemiarthroplasty, total joint arthroplasty and arthrodesis.

    &nbsp

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A Guide To Early Intervention For The Charcot Foot

One can use the TempTouch (as shown above) to determine the skin temperature in a Charcot foot.One can create the instant total contact cast (iTCC) by simply rendering a removable cast walker irremovable with plaster, cohesive bandage or fiberglass.Here is a lateral radiograph of a foot with severe equinus deformity and a Charcot midfoot subluxation. Note the inverted calcaneal inclination angle (yellow lines).Here one can see an anteroposterior radiograph of a reconstructed Charcot foot with external fixation. Note that the bent wire (red arrow) provides compression across the tarsometatarsal joint (green arrow).
VOLUME: 21 PUBLICATION DATE: Aug 01 2008
Issue Number: 
8

     The Charcot syndrome is a devastating condition that can affect the feet or ankles of those with diabetes and peripheral neuropathy. The reports on the incidence and prevalence of Charcot foot vary widely, and range between 0.1 to 29 percent among people with diabetes. These studies indicate a trend for a higher frequency in those with peripheral neuropathy and in specialty clinics.1 The specialty clinic providers may have a higher clinical suspicion and may accordingly arrive at a diagnosis more rapidly and definitively.

     The risk of amput

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A Closer Look At Endoscopic Plantar Fasciotomy

According to Dr. Barrett (shown at right), more than 500,000 EPF procedures have been performed since the procedure received FDA approval in 1992. With the Pressure Specified Sensory Device (shown above), you can perform quanitative assessments of isolated peripheral nerves.
VOLUME: 15 PUBLICATION DATE: May 01 2002
Issue Number: 
5

Prior to the development of the first endoscopic foot surgery, there was a strong desire not only to find a better, less invasive method to treat recalcitrant mechanical plantar fasciitis surgically but also to develop a more universally consistent surgical approach to what has been labeled an “endemic problem.” Indeed, the standard of care regarding the surgical management of the heel pain has radically changed since the introduction of the endoscopic plantar fasciotomy (EPF).
In 1990, there was an almost universal perception within the podiatric community that the spur was the primary c

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CME Showcase


"Current Concepts In Healing Chronic Diabetic Foot Ulcerations"

A Complimentary On-Demand CE/CME Webcast

This activity is supported by an educational grant from Advanced Biohealing.
This activity is sponsored by the North American Center For Continuing Medical Education (NACCME).

To access this Webcast, visit www.naccme.com/program/n-550/

Current Concepts In Diagnosing And Treating MRSA In The Diabetic Foot

This activity is supported by an education grant from Pfizer.
This activity is sponsored by the North American Center of Continuing Medical Education (NACCME).

To access this activity, visit www.naccme.com/program/n-528/
MRSA And Diabetic Foot Wounds: Where Do We Go From Here?


Archived Accredited Webcast with Q&A

This activity is supported by an educational grant from Pfizer. This activity is sponsored by the North American Center For Continuing Medical Education (NACCME).
PERIPHERAL ARTERIAL DISEASE (PAD) AND CRITICAL LIMB ISCHEMIA (CLI):
Managing Vascular and Wound Healing Challenges with Current and Emerging Technologies

Archived Accredited Webcast with Q&A

This activity is supported by an educational grant from Baxter Healthcare Corporation.

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