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

Can External Fixation Have An Impact For Pediatric Patients?

Ron Raducanu DPM FACFAS's picture
Blog By: Ron Raducanu DPM FACFAS

In the last several years, there has been a large push toward the use of external fixation for complex surgeries such as Charcot reconstruction and foot and ankle trauma. A little known application for external fixation is podopediatric surgery.

Podopediatric surgery can be stressful in general. This is not because of a lack confidence in one’s skills nor is it a lack of successful outcomes. It is the nature of performing surgery in this patient population.


Experts At DFCon 2010 To Combat ‘Amputation Tsunami’

David G. Armstrong DPM PhD's picture
Blog By: David G. Armstrong DPM PhD

With an amputation performed every 30 seconds due to diabetes-related complications we are dealing with a worldwide amputation tsunami. The Diabetic Foot Global Conference (DFCon 2010) serves as something of an early warning system for doctors worldwide.


Fixation Of The Medial Malleolus Fracture: What You Should Know

Neal Blitz DPM FACFAS's picture
Blog By: Neal Blitz DPM FACFAS

Figure 1. The five patterns of fracture are the avulsion “fleck” fracture, transverse fracture, oblique fracture, long oblique/vertical fracture, and comminuted fracture. Some fracture patterns are more amenable to certain types of fixation.Figure 2. Medial ankle ligamentous avulsions may be suspicious for lateral ankle and/or syndesmotic injury, which one should evaluate thoroughly and treat appropriately.Figure 3. The tension band technique is ideal for transverse fractures of the medial malleolus.Figure 4. Ideally one should use two screws to prevent rotation. However, small fracture fragments may only accommodate one screw with the medial malleolus.Figure 5. In an oblique fracture of the medial malleolus, one should place screws so they are divergent in one plane.Figure 6. In a vertical fracture, malleolar screws that penetrate the distal lateral cortex of the tibia provide additional stability.Figure 7. In a vertical fracture, a medial buttress may prevent upwards fracture displacement.Figure 8. The tension band technique is particularly useful for comminuted medial malleolus fractures.
Figure 1. The five patterns of fracture are the avulsion “fleck” fracture, transverse fracture, oblique fracture, long oblique/vertical fracture, and comminuted fracture. Some fracture patterns are more amenable to certain types of fixation.
Figure 2. Medial ankle ligamentous avulsions may be suspicious for lateral ankle and/or syndesmotic injury, which one should evaluate thoroughly and treat appropriately.
Figure 3. The tension band technique is ideal for transverse fractures of the medial malleolus.
Figure 4. Ideally one should use two screws to prevent rotation. However, small fracture fragments may only accommodate one screw with the medial malleolus.
Figure 5. In an oblique fracture of the medial malleolus, one should place screws so they are divergent in one plane.
Figure 6. In a vertical fracture, malleolar screws that penetrate the distal lateral cortex of the tibia provide additional stability.
Figure 7. In a vertical fracture, a medial buttress may prevent upwards fracture displacement.
Figure 8. The tension band technique is particularly useful for comminuted medial malleolus fractures.

Those with experience in the surgical treatment of ankle fractures often consider the medial malleolus fracture a relatively straightforward fracture to repair. Most commonly, surgeons use two screws to fixate the fracture and it is a short procedure in terms of operative time.

The surgery is often so predictable that the surgeon may go into “auto pilot” mode (more appropriately termed “auto surgeon” mode). However, there is some fracture variability that occurs and it is important for the surgeon to slow down and choose the best fixation for the fracture pattern.


Striving To Stay At The Top Of Your Surgical Game

William Fishco DPM FACFAS's picture
Blog By: William Fishco DPM FACFAS

I have been practicing for 12 years now and some things have not changed. I still worry about my patients. I often wake up in the middle of the night feeling flushed when the stress of a recent surgery or an upcoming surgery is on my mind.

You run the surgery over and over in your head questioning whether the fixation is strong enough. Will the patient be adherent? Did I get enough correction? Will the correction hold over time? Did I do the best procedure for that given circumstance?


Why Did DPMs Miss The Boat On Therapeutic Diabetic Hosiery?

Doug Richie Jr. DPM FACFAS's picture
Blog By: Doug Richie Jr. DPM FACFAS

While the incidence of diabetes and foot-related complications continues to spiral out of control in this country, medical professionals need to step back and evaluate their role in preventive medicine.

Most of my podiatric colleagues are unaware of the significant role that the Internet and direct-to-consumer businesses have in the care of the patient with diabetes. Today, millions of patients with diabetes turn to the Internet and commercial companies to provide information and products to prevent the complications of diabetes.


Why Shoe Fit Matters Even For Non-Deformed Feet

Jenny L Sanders DPM's picture
Blog By: Jenny L Sanders DPM

Every podiatrist understands the relationship between poorly fitting shoes and foot deformity. Many of us routinely order diabetic shoes, extra-depth shoes and sometimes even casts for custom molded shoes for the deformed foot. For the non-deformed foot, we simply rely on an “approved shoe list” or a “specialty running shoe store” to which we send our patients.


Will CPME 320 Changes Jeopardize Dr. Jolly’s ‘Foot Function’ Goals For Surgical Outcomes?

Kathleen Satterfield DPM FACFAOM's picture
Blog By: Kathleen Satterfield DPM FACFAOM

If you have been involved in a really good grand rounds, you know what it means to prepare well for a surgery, a care plan or a discharge.

As a first-year resident in Connecticut a long time ago, I remember facing Gary Jolly, DPM, and proposing a surgical procedure for one of his patients. I gave him a typical “NLDOCAT” breakdown of the patient’s problem. After describing the nature, location, duration, onset, course, aggravation and treatment for the patient, I was proud of my presentation to this brilliant surgeon.


Can Metformin Use Increase The Risk Of Diabetic Neuropathy?

Allen Jacobs DPM FACFAS's picture
Blog By: Allen Jacobs DPM FACFAS

Metformin (Glucophage, Bristol-Myers Squibb) is a commonly utilized biguanide agent for the treatment of diabetes. Increasingly, it appears that metformin may paradoxically increase the risk of neuropathy in the patient with diabetes. Therefore, when you see a patient with diabetes who is taking metformin, greater surveillance may be necessary for the presence of sensory, autonomic and motor neuropathy.


Recognizing The Potential Impact Of Stress With Skin Conditions

Tracey Vlahovic DPM's picture
Blog By: Tracey Vlahovic DPM

How many times has a new or established patient presented to you with a new onset skin rash that was acute and angry in nature? As you are digging deeper with your patient interview, you find that a large stress (or stressors) has occurred in that person’s life. Sources of stress may include unemployment, divorce, a new baby, etc.


Is The Closing Base Wedge Osteotomy Extinct?

Patrick DeHeer DPM FACFAS's picture
Blog By: Patrick DeHeer DPM FACFAS

The closing base wedge osteotomy (CBWO) has long been a favorite for the severe bunion deformity in podiatric surgical history, especially throughout the 1970s and 1980s. Has the once sacred procedure become extinct? Is this procedure still a viable option for the severe bunion deformity? Do the potential complications move this procedure to the back of the bus when it comes to treating the severe bunion deformity?

In my opinion, the answer to all of these questions is yes.


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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/





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