Research is an essential part of medicine when it comes to the ongoing improvement of patient care. Although podiatry is still very early into its development of consistent research contributions, research in diabetes has an impact in what we do daily. Research on topics such as diabetic neuropathy, vascular disease, wound care, the management of diabetes and offloading... Read More.
Peripheral arterial disease (PAD) is a significant risk factor for diabetic foot amputation. It is also an important marker for atherosclerosis in other organ systems and is associated with a fourfold increase in cardiovascular death.1 Current estimates suggest a 3 to 10 percent incidence of PAD in the general population but reportedly only 25 to 33 percent of these people are symptomatic. Of... Read More.
Diabetic neuropathies are a consequence of long-term hyperglycemia and occur in patients with type 2 diabetes, usually those who are 40 years of age or older. Diabetic neuropathy may occur regardless of whether a patient has insulin-dependent or non-insulin dependent diabetes. Bear in mind that diabetic neuropathy may have a variety of clinical characteristics. Patients may have a symmetric or... Read More.
By Kazu Suzuki, DPM, CWS; Clinical Editor: John S. Steinberg, DPM
Hyperbaric oxygen (HBO) chambers are currently located in over 750 facilities in the United States. New wound care centers are opening monthly across the country and most incorporate HBO chambers. Which foot and ankle conditions benefit from HBO treatment? Does clinical evidence support HBO treatments?
Patients undergoing HBO therapy enter a chamber filled... Read More.
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.