Historically, surgeons have utilized circular and monolateral external fixation for the management of complicated high-energy orthopedic trauma and reconstruction of congenital or posttraumatic deformities through the Ilizarov and deBastiani principles of callotasis and distraction osteogenesis.1-3
Demonstrating success in bone healing and deformity correction in limbs that would have otherwise... Read More.
Dedicating oneself to the side of limb salvage in the fight against diabetic foot disease is a demanding and personally challenging enterprise. In the face of infection, it often seems as though all variables are against the surgeon and the patient as they both struggle against the possibilities of proximal amputation and limb loss. In fact, it often appears as though the only... Read More.
In reading many of the recent articles in podiatry publications, we will need to expand our vocabularies to include various new phrases. These phrases will include pay for performance, evidence-based medicine or evidence based treatment plans, and evidence-based treatment guidelines. Electronic medical records (EMR) and electronic health records (EHR) will be linked to evidence-based guidelines... Read More.
Podiatrists commonly encounter and treat skin and skin-structure infections (SSSIs), ranging from cellulitis to more complicated surgical site infections and infected diabetic foot ulcers. Aerobic gram-positive cocci, such as Staphylococcus aureus and streptococci, are the most common causative agents of skin infections.1
While the treatment of simple and superficial infections is relatively... Read More.
By Paul J. Kim, DPM, Clinical Editor: John S. Steinberg, DPM
While various researchers have implicated the equinus deformity as a major deforming force in a host of foot and ankle pathologies, the exact definition of equinus remains unclear.1-4 However, Root states that “the minimal range of ankle joint dorsiflexion that is necessary for normal locomotion is 10 degrees.”5 Subsequent studies report that the ankle joint range of motion for asymptomatic... Read More.
When managing patients in the acute phase of Charcot neuroarthropathy, the hallmark of treatment is immobilization and non-weightbearing of the affected foot until the destructive nature of this stage disappears and the coalescence stage begins. In the past decade, researchers have hypothesized that using bisphosphonates in acute Charcot patients can decrease pathological fractures and permanent... Read More.
Unfortunately, all too often, we shy away from valuable history and background information regarding the overall health of the patient. Many of us ask about diseases such as diabetes and some will routinely inquire about alcohol and smoking history. However, few of us spend the necessary time to truly evaluate and integrate historical data such as lipid profiles, etc.
For example, peripheral... Read More.
By Eric M. Feit, DPM, FACFAS and Alona Kashanian, DPM
It is typically easier to heal a diabetic foot ulcer than it is to prevent recurrence. Once you’ve healed the ulcer, the next challenge is to minimize pressure at the site of the old ulceration or the site of a boney prominence. If the patient has never had an ulcer but has a high risk for ulceration, then employing pressure off devices is essential for prevention.
Obviously, the large majority... Read More.
Over 16 million people in the United States have diabetes and this number is growing by the hour. Diabetes is now the fifth leading cause of death in this country.1 By understanding the pathophysiology of diabetes and the environmental factors which contribute to this disease, we can have a better focus on the scope and nature of the threat to our patient population with diabetes.
With this in... Read More.
According to the Centers for Disease Control and Prevention (CDC), approximately 7 percent of the population in the United States has diabetes mellitus. Approximately 30 percent of patients with diabetes over the age of 40 have some kind of impaired sensation of the foot. Sensorimotor neuropathy is the primary risk factor for developing a diabetic foot ulcer, which leads to 85 percent of diabetic... Read More.