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July 2008
 How To Address Puncture Wounds
Barry Rosenblum, DPM, Drew Taft, DPM, and Kevin Riemer, DPM
Regardless of your type of practice or institution, it is inevitable that you will come across puncture wounds. In fact, puncture wounds are probably more common than we think as many people delay or never seek medical attention.
Most puncture wounds will heal uneventfully but approximately 10 percent of those people who delay medical evaluation will develop a complication. Problems do not always arise from the initial insult but often from inadequate history, under-treatment and inadequate follow-up. When it comes to puncture wounds, there can be considerable sequelae of complications including cellulitis, osteomyelitis, foreign body granulomas and septic joints.
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June 2008
 A Guide to Topical Steroid use for Dermatological Conditions
By M. Joel Morse, DPM
Topical corticosteroids have been in extensive use for over 50 years and physicians commonly prescribe these agents for dermatological problems. There are four separate groups of steroids: mineralocorticoids (aldosterone), glucocorticoids (cortisol), androgens (testosterone) and estrogens (estrogen and progesterone). They are grouped by the receptors to which they bind. Synthetic steroids interact with the steroid receptors because of a similarity of shape and exert the desired effect. Glucocorticoids have been synthetically manufactured for use on the skin.
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May 2008
 Tarsal Coalition And Pes Planus: What Is The Best Treatment Option?
Jesse B. Burks, DPM, FACFAS
Given the challenges inherent in diagnosing and treating tarsal coalitions, this author reviews key clinical findings, offers keys to diagnostic imaging, explores the merits of conservative therapy and discusses indications for resection and arthrodesis.
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April 2008
 Wound Debridement: Are Adjunct Therapies Cost Effective?
Leon R. Brill, DPM, FACFAS, CWS
There is a variety of debridement options ranging from sharp debridement and mechanical debridement to enzymatic debridement. In recent years, physicians have also seen the emergence of ultrasound debridement and the use of a hydro scalpel. Accordingly, this author evaluates the various debridement methods and assesses their cost effectiveness.
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March 2008
 Pertinent Pearls On Grading Diabetic Foot Ulcers
Ronald A. Sage, DPM
Given that ulcers are a common complication for patients with diabetes, it is important to understand the various ulcer grading systems and how they can aid in treatment. This author reviews common classification systems and how to apply them in a clinical setting.
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January 2008
 Keys To Facilitating Optimal Orthotic Success
By David Levine, DPM, CPed
In order to enhance one’s ability to prescribe custom orthoses, this author emphasizes a thorough exam, a focused evaluation of the patient’s footwear, accurate impressions and fabrication, and key nuances to maximizing the effectiveness of modifications.
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December 2007
 How To Address Lower Extremity Tendon Injuries
By William Fishco, DPM
Given that many patients will present with tendon-related pain, this author offers key diagnostic tips, insights on conservative treatment and pearls on appropriate surgical options.
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November 2007
 A Guide To The Differential Diagnosis Of Plantar Fasciitis
By Charles F. Peebles, DPM
There may be a tendency to leap to a plantar fasciitis diagnosis when patients present with heel pain. However, this author emphasizes the importance of a thorough differential diagnosis. Accordingly, he offers diagnostic insights on a variety of potential causes ranging from calcaneal spur fractures and neurogenic heel pain to systemic etiologies.
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October 2007
 A Guide To Current Concepts In Skin Grafting
By Tod Storm, DPM
Podiatric surgeons commonly use skin grafting for the closure of cutaneous wounds secondary to trauma, post-amputation wounds and chronic ulcerations. Accordingly, this author details the pros and cons of various types of skin grafts, including full-thickness and split-thickness skin grafts, and offers step-by-step insights on graft application.
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September 2007
 How To Address Puncture Wounds
By Michael Keller, DPM, and Jacob D. Fassman, DPM
Given the relatively common nature of these wounds in the lower extremity, these authors discuss keys to the clinical exam, diagnostic imaging and how to prevent and address potential complications.
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August 2007
 How To Address Failed Peroneal Tendon Surgery
By Neal M. Blitz, DPM, FACFAS
The long-term effects of a failed peroneal tendon surgery may lead to structural foot deformity. Accordingly, this author reviews pre-op considerations and discusses key nuances of peroneal tendon repair options to help facilitate improved outcomes.
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July 2007
 Understanding The Impact Of MRSA On Limb Preservation
By Loan Lam, DPM, Peter Blume, DPM, FACFAS, and Michael Palladino, DPM, FACFAS
Given the increasing prevalence of methicillin resistant Staphylococcus aureus (MRSA), these authors discuss the differences between HA-MRSA and CA-MRSA, what the literature reveals about antibiotic therapy and keys to the diagnostic workup of these patients.
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June 2007
 A Guide To Conservative Care For Adult-Acquired Flatfoot
By Paul R. Scherer, DPM
Given the challenges of treating the common condition of adult-acquired flatfoot, this author reviews the literature and shares insights from his clinical experience. He discusses the proper staging of this condition and offers pertinent pearls on the use of conservative therapy.
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May 2007
 How To Perform A Thorough Vascular Exam
By Daniel T. Halloran, DPM, Peter A. Blume, DPM, Michael G. Palladino, DPM, and Bauer E. Sumpio, MD, PhD
Given the relatively common prevalence of peripheral vascular disease and its potential complications in the lower extremity, these authors offer key diagnostic insights with a particular emphasis on non-invasive screening tools.
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April 2007
 Pertinent Pointers On DVT Prophylaxis
By Mario Ponticello, DPM, and John Steinberg, DPM
While there is sparse information in the podiatric literature on deep vein thrombosis (DVT), these authors offer a thorough review of the orthopedic studies. They discuss potential causes of DVT, the use and timing of prophylaxis medications, and other key points in regard to preventing this serious complication among patients undergoing podiatric surgery.
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March 2007
 Assessing Debridement Options For Diabetic Wounds
By Eric H. Espensen, DPM
Although debridement can help facilitate healing in lower extremity diabetic wounds, there are key considerations to keep in mind when selecting an appropriate method of debridement. With this in mind, this author discusses the pros and cons of sharp, enzymatic, mechanical and other forms of debridement.
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January 2007
 How To Address Pediatric Intoeing
By Edwin Harris, DPM
Given the frequent presentation of pediatric intoeing, this author reviews the possible etiologies, offers keys to diagnosis and notes pertinent pointers for proper treatment.
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December 2006
 Exploring Current Approaches To Plantar Warts
By Harvey Lemont, DPM
Given the difficulties of treating plantar warts and the potential for recurrence, this author emphasizes the importance of patient education on expectations, and discusses a variety of treatment modalities ranging from monochloroacetic acid to intralesional immunotherapy.
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November 2006
 How To Address Mechanically-Induced Subcalcaneal Pain
By Paul R. Scherer, DPM, and Lori L. Waters, BSc, BEd
Emphasizing the need for specific nomenclature and clearly defined etiologies with various forms of heel pain, these authors offer key insights on mechanically-induced subcalcaneal pain and whether orthotic therapy can have a treatment impact.
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October 2006
 A Guide To Foot Surgery For The Geriatric Patient
By William D. Fishco, DPM, FACFAS
Given that people are living longer lives and may have active lifestyles into their 70s, this author reviews key parameters for evaluating possible surgical treatment options for these patients. Drawing from his clinical experience, he also discusses bunion procedures, hammertoe repair and how to resolve failed first MPJ implants in this patient population.
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September 2006
 A Guide To Detecting Nail Pathology
By Bradley W. Bakotic, DPM, DO
An insufficient understanding of nail pathology can lead to inappropriate management. Accordingly, this author discusses a variety of possible contributing factors and presents a classification of different types of nail unit dystrophy.
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August 2006
 A Closer Look At Redefining Charcot
By Molly Judge, DPM
In order to treat Charcot neuroarthropathy effectively, one must have a strong understanding of the etiology and potential contributing factors to the disease process. Accordingly, this author offers a thorough review of the literature in an attempt to find answers and a more defined standard of care.
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July 2006
 A Guide To Transmetatarsal Amputations In Patients With Diabetes
By Christine Salonga, DPM, and Peter Blume, DPM
Given the incidence of complications among patients with diabetes, transmetatarsal amputation can be a viable technique for long-term limb salvage. Accordingly, these authors discuss preoperative considerations, pointers on the amputation procedure and how to manage patients postoperatively.
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June 2006
 How To Diagnose And Treat Insect Bites And Stings
By Gary Dockery, DPM, and Stephen Schroeder, DPM
As spring moves into the summer season, people are enjoying a variety of outdoor activities. Unfortunately, they may be more prone to ant bites, bee stings or ticks affecting the lower extremity. With this in mind, these authors discuss the initial presentation, clinical ramifications and treatment recommendations for various insect bites and stings.
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May 2006
Soft Tissue Masses: When To Treat, When To Refer
 By Bradley W. Bakotic, DPM, DO
Delayed treatment of malignant soft tissue tumors can have serious ramifications for patients. Accordingly, this author discusses key diagnostic considerations, biopsy techniques and when one should ensure an appropriate referral.
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April 2006
 Essential Insights On Treating Fifth Metatarsal Fractures
By Nicholas Romansky, DPM, and Todd Becker, DPM
Given the potential complicated nature of a fifth metatarsal fracture, these authors offer a thorough review of diagnostic considerations, classification systems and key treatment pearls.
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March 2006
Treating Difficult Nails In Diabetic Patients
 By Peter Blume, DPM, Jared T. Wilkinson, DPM, and Jonathan J. Key, DPM
Given the increased risk of nail abnormalities among people with diabetes, these authors offer essential diagnostic insights and a thorough review of treatment options ranging from topical and oral medications to surgical intervention.
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