Surgical Pearls

The PathFormer cable is connected to a pair of monitoring electrodes on the patient’s skin. The operator presses and holds down the actuating button until the cutter automatically pulls away from the nail after creating a microconduit.
By Andreas Boker, MD; Clinical Editor: Jesse Burks, DPM
24,162 reads | 0 comments | 11/03/2007

The fully keratinized, thick multilayered structure of the nail plate presents a formidable barrier to nail bed access. This limits the options for treatment of nail diseases such as onychomycosis and subungual hematoma from nail trauma. Until recently, clinicians considered nail removal as an option for formal repair of the nail bed for subungual hematomas involving large regions of the nail bed.1

Penetration enhancing formulations have aided the delivery of molecules to the nail bed through the impermeable nail plate.2 Researchers have used a carbon diox

| Continue reading
One should then evaluate the entire construction and use one suction tube to complete the seal among the three wounds.
By Luis Leal, DPM
19,322 reads | 0 comments | 09/03/2007

Vacuum Assisted Closure (VAC) is one of our greatest tools in managing large as well as deep wounds. It crosses multiple surgical disciplines and is applicable to virtually all anatomical sites. This technology has revolutionized limb salvage surgery and has prevented untold numbers of amputations. There is an exciting growth curve with the use of this technology. Surgeons can modify the technology to aid in the closure of a multitude of wound scenarios.

In the course of utilizing VAC therapy (KCI), one must be cognizant of adjacent tissue and protect it from the deleterious effects of negat

| Continue reading
By Gordon Zernich, CP, Tomas Dowell, CPO/LPO, Gary M. Rothenberg, DPM, FACFAS, and Michael M. Cohen, DPM, FACFAS
40,397 reads | 0 comments | 07/03/2007
By Devon Glazer, DPM
6,713 reads | 0 comments | 05/03/2007
By Anthony Weinert, DPM, Ali Elkhalil, DPM, and Ahmad Farah, DPM
9,187 reads | 0 comments | 03/03/2007

      Practitioners have described various osteotomies for the proximal hallux. However, the Akin closing wedge osteotomy is currently the most common procedure. Podiatric surgeons commonly employ the transverse plane closing wedge osteotomy for the correction of hallux abductus interphalangous deformity. One may also use this as an additional procedure for the correction of hallux abductovalgus deformity.       Akin noted that one should perform the closing base wedge osteotomy at the proximal one-third of the proximal hallux and orient it in the transverse p

| Continue reading
By Kerry Zang, DPM
18,365 reads | 0 comments | 01/03/2007

      One of the most common conditions that the foot and ankle surgeon will encounter is the hammertoe deformity. Surgeons have used multiple procedures for more than 60 years to deal with this condition. These have included amputation of the digit, arthrodesis of the interphalangeal joints, soft tissue releases, arthroplasty (removal of bone, partial or complete), tendon transfers, implants and/or a combination of the above. The most popular procedure during this time has been the arthroplasty with resection of the head of the proximal phalanx.       However,

| Continue reading
By Dave Nielson, DPM, FAPWCA and Guy Pupp, DPM, FACFAS
13,861 reads | 0 comments | 11/03/2006

     While the concept of infections has been studied for many years, our current understanding of infections is based upon studies and observations of planktonic bacteria. This is free floating bacteria that cause diseases such as pneumonia, sepsis, urinary tract infections, gas gangrene and many other examples. These types of infections often respond well to antibiotics and resolve without recurrence.      However, there are several infections that occur out of the typical sequence of planktonic bacterial infections. These infections occur postoperatively aft

| Continue reading
By Richard O. Lundeen, DPM
14,546 reads | 0 comments | 09/03/2006

   Foot and ankle surgeons have no shortage of choices when it comes to selecting instruments for surgical procedures. Our surgical team has found success in using the Koby line of instruments (OsteoMed) for the treatment of various conditions.    For the last four years, surgeons have found success using Koby instruments for three procedures commonly performed in the foot and ankle. Koby instruments are designed to perform the partial plantar fasciotomy for heel spur syndrome, intermetatarsal ligament decompression of neuroma and release of the gastrocnemius

| Continue reading
By Daniel K. Lee, DPM, and Gregory E. Tilley, DPM
19,784 reads | 0 comments | 07/03/2006

   There have been many surgical treatment modalities described in the podiatric and orthopedic literature for the correction of hallux limitus.1-5 Since the Regnauld procedure was introduced in 1968, surgeons have used it in the treatment of a pathologically long proximal phalanx and hallux limitus.6 However, since its development, this procedure has been characterized as a technically challenging procedure for the treatment of hallux limitus with or without moderate degenerative arthritis.7-10    In 1995, Kissel, et. al., and

| Continue reading
By Don Green, DPM and Peter S. Kim, DPM
162,715 reads | 0 comments | 05/03/2006

The etiology of heel pain is quite varied. First described by Wood in 1812, the most common cause is thought to be plantar fasciitis. This is typically marked by focal tenderness to any component of the aponeurosis but most frequently at the proximal medial insertion of the plantar aponeurosis.1 Many symptomatic patients with plantar fasciitis demonstrate plantar heel spurs (traction enthesopathies) of the os calcis. One may best appreciate this shelf of exostosis on the lateral and lateral oblique views of standard radiographic studies.2 On rare occasions, fracture of

| Continue reading