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

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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What You Should Know About Biofilms And Chronic Wounds

Here one can see a biofilm infection in the sinus tarsi/tarsal canal that is associated with an arthroereisis device.This photo shows resection of osseous tissue from the sinus tarsi/tarsal canal to eliminate biofilm contamination.Here one can see bone removal from the sinus tarsi.As shown above, the surgeon would insert antibiotic impregnated polymethylmethacrylate that is designed to act as an arthroereisis device.The PMMA arthroereisis device demonstrates the limitation of subtalar joint eversion.Here one can see the inversion of the subtalar joint with the PMMA arthroereisis device.
VOLUME: 21 PUBLICATION DATE: Jul 01 2008
Issue Number: 
7

Biofilms reportedly cause an estimated 1 million nosocomial infections each year in the United States.1 Surgically, these microorganisms may cause abscesses, prosthetic failure and osteomyelitis. These complications may require surgical excision of the infected prosthesis and underlying soft tissue along with reconstruction of the affected part.
Understanding the nature of biofilms through research and clinical experience is key to providing the appropriate treatment. Moreover, such treatment and prevention may even lead to the eradication of serious, chronic illnesse

The Ins And Outs Of Forming A Multispecialty Practice

VOLUME: 15 PUBLICATION DATE: Apr 01 2002
Issue Number: 
4

The winds of change have blown through the medical community with a vengeance in the last 25 years. Managed care has turned medicine upside down. Dramatically lower fees and higher overhead expenses have made us work doubly hard just to maintain some level of consistency in our practice. Just as we have seen in the hospital community, economic necessity has made some strange bedfellows.
Hospitals and outpatient centers, who previously may have been formidable competitors, have now become partners. Some specialty groups, such as anesthesiologists, vascular surgeons and primary care practition

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How To Perform An Isolated Subtalar Joint Arthrodesis

This preoperative lateral photo demonstrates an overpronated hindfoot. Note the lateral process in the floor of the sinus tarsi.Here one can see a postoperative lateral photo demonstrating a realigned hindfoot with subtalar arthrodesis.This postoperative view shows an improved talonavicular relationship by subtalar realignment arthrodesis.
VOLUME: 21 PUBLICATION DATE: Jun 01 2008
Issue Number: 
6

Isolated arthrodesis procedures for the hindfoot are an interesting and sometimes controversial topic for foot and ankle surgeons. Historically, when it came to most major rearfoot deformities and joint conditions, surgeons utilized the triple arthrodesis versus any isolated joint fusions of this complex. The thinking was that the subtalar, calcaneocuboid and talonavicular joints all function together to allow pronation and supination of the entire foot, so if one joint needed fusion, they all needed fusion.
The trend during the past decade or two has been more toward preservi

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How To Prescribe Orthotics For Runners

Here is a polypropylene functional foot orthosis with an EVA rearfoot post. The author notes that one of the great advantages of polypropylene is its ability to conform to curves of the foot very tightly. This combination functional foot orthosis is comprised of a 1/8 polypropylene shell with EVA arch fill and a bottom cover. This type of orthosis allows for increased shock absorption. Here is a polypropylene functional orthosis with an intrinsic accommodation for a navicular prominence Here you can see a reverse Morton’s extension made out of korex to off-weightbear the first ray. Here is a slot accommodation that was made in order to off-weightbear a prominent metatarsal head.
VOLUME: 15 PUBLICATION DATE: Aug 01 2002
Issue Number: 
8

Most competitive runners do not like being restricted in their regimens. As we all know, these patients are very anxious to resume their running activity. However, they do look to foot and ankle specialists for help in reducing the inflammation, preventing and/or recuperating from lower extremity injuries. In order to write effective orthotic prescriptions for these patients, be sure to pay attention to cast correction, materials and additional bells and whistles.
The ability of the orthosis to control abnormal or excessive motion of the foot is more dependent on the size of the device and th

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Six Ways To Achieve Practice Excellence

VOLUME: 15 PUBLICATION DATE: Jun 01 2002
Issue Number: 
6

Do enough people know about your practice? Do enough primary care doctors know about your practice? Are you getting enough referrals or are most of them going to the DPM two blocks over? Several DPMs and a podiatric assistant say you have to be skilled in patient empathy, excel at staff relations and be a savvy marketer, among other things, if you want to build and sustain a thriving podiatric practice.
1. Emphasize empathy and pay close attention to patient needs. Jim Ritchlin, DPM, takes notes on his patients’ lives, not just on their foot conditions, which he keeps in their medica

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A Closer Look At Motor Neuropathy In Patients With Diabetes

Here one can see a foot with hallux valgus deformity. The author notes that the deformity is one possible manifestation of motor neuropathy in patients with diabetes. (Photo courtesy of Michael Cohen, DPM)This radiograph shows a Charcot foot. Researchers have suggested that diabetic motor neuropathy may represent a sentinel event in the evolution of Charcot’s joint disease. (Photo courtesy of Michael Downey, DPM)
VOLUME: 21 PUBLICATION DATE: Sep 01 2008
Issue Number: 
9

Although commonly present in the patient with diabetes mellitus, motor neuropathy frequently goes undetected. Less dramatic in presentation than sensory neuropathy, the presence of motor deficit secondary to diabetic neuropathy is frequently not evaluated during examination and subsequently goes unrecognized. There is also not a great deal of literature regarding the effects of diabetes on motor function in the lower extremity. As a result, the effects of motor neuropathy on the foot and ankle frequently go unappreciated.
Motor neuropathy in diabetes is common. A recent electrophysiologic stu

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When You Have To Fire An Employee

VOLUME: 15 PUBLICATION DATE: Jul 01 2002
Issue Number: 
7

Unfortunately, it doesn’t always work out and the staffer you thought to be perfect for your team winds up bringing down your practice in some significant way. It is when you recognize that you must fire the employee that the real work of managing your office truly begins. Indeed, with the increasingly litigious nature of our era, firing staffers has become a problematic process, fraught with many legal and ethical landmines.
“We all know how to terminate someone,” notes Hal Ornstein, DPM, who has a private practice in Howell, N.J. “It’s not hard to say ‘You’re fired.’ The id

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What You Should Know About Wound Healing And Hyalofill

A 76-year-old insulin-dependent male with diabetes presented with an ulceration under his big toe (see above photo). He has a long-term history of peripheral vascular disease and previously had an amputation of the fifth toe on the same foot. Here we see the same ulcer two weeks after the author treated it with debridement, Hyalofill, Aquacel and offloading via a Camwalker boot. Here we see the healed ulcer of the 76-year-old insulin-dependent diabetic male, six weeks after the author began treatment.
VOLUME: 15 PUBLICATION DATE: Apr 01 2002
Issue Number: 
4

The last decade has seen a tremendous evolution in the field of advanced wound management, both as a discipline and in regard to the development of wound healing therapies. New dressings, human skin equivalents, and barometric intervention all compete for utilization in the wound healing process. While each of these options is a viable intervention, there still needs to be more recognition of how wound biology and histo-cellular function affect wound healing.
Indeed, understanding the process of healing wounds is essential for the clinician dedicated to wound medicine. Often, it is stated th

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A Closer Look At The Research On Bilayered Living Cell Therapy

This plantar midfoot wound failed to close after the placement of a split thickness skin graft.Here one can see Apligraf applied to the wound base and secured with skin staples.This photo shows the application of nonadherent gauze and foam dressing over Apligraf to secure it to the wound.At one month, one can see progressive epithelialization and peripheral wound contracture.At two months, the aforementioned patient has achieved complete epithelialization of the wound bed.Here one can see a problematic postoperative diabetic wound after the resolution of infection.Here one can see the application of Apligraf after wound bed debridement.The aforementioned wound demonstrates complete epithelialization six weeks after the application of Apligraf.
VOLUME: 21 PUBLICATION DATE: Jul 01 2008
Issue Number: 
7

   

Diabetic foot ulcers are among the many complications encountered with poorly controlled diabetes mellitus. Approximately 15 percent of all patients with diabetes will experience an ulcer in their lifetimes.1,2 Additionally, 85 percent of all nontraumatic lower extremity amputations are preceded by a preventable ulceration.3,4

   Diabetic foot ulcerations pose a considerable economic burden. In 1995, Medicare spent $1.5 billion on diabetic lower extremity ulcers.5 One retrospective analysis found that foot ulc

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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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