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We are an aging population. One can ascertain that with aging comes an increased incidence of comorbid conditions. With the vast majority of podiatric surgical cases being elective, documentation supporting the vascular system prior to surgery will protect the surgeon from postoperative complications associated with circulatory issues, or may help surgeons recognize an asymptomatic issue for appropriate intervention prior to surgery. Recognition of asymptomatic circulatory issues is of particular importance in the younger diabetic population prior to surgery.
11,295 reads | 0 comments | 05/03/2008
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41,388 reads | 0 comments | 03/03/2008
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Tarsal tunnel syndrome is an entrapment of the posterior tibial nerve or its branches within the tarsal tunnel.1 This syndrome is most frequently unilateral as opposed to carpal tunnel syndrome in the upper extremity, which is typically bilateral.2 Keck and Lam first described the term “tarsal tunnel syndrome” in 1962.3,4
Malaisé first described the clinical signs and symptoms of tarsal tunnel syndrome in 1918. Some of the symptoms include numbness or tingling in the soles of the feet and toes or a burning pain in the ankles.
22,169 reads | 0 comments | 01/03/2008
Nonunion is a well-documented potential complication of the Lapidus arthrodesis. It reportedly occurs anywhere from 3.3 percent to 12 percent of the time, and is a very challenging problem to fix.1-7 Granted, a strict definition of nonunion and timeline for classifying a nonunion varies from one surgeon to another. However, for the purpose of this discussion, nonunion has both clinical and radiographic definitions. Nonunions involve the failure of bone healing at the fusion site after six months, broken hardware or both. A clinical nonunio| Continue reading
24,694 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
19,864 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
41,880 reads | 0 comments | 07/03/2007
6,901 reads | 0 comments | 05/03/2007
9,363 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
18,793 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
14,251 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