Volume 18 - Issue 1 - January 2005
Fridays are the usual days for eruptions in my podiatry clinic. Friday afternoons are the most typical times when Murphy’s Law rules. An eruption is a diabetic patient with a severe infection or an osteotomy that falls apart or a pin tract infection. If patients hate a new pair of orthotics, they usually show up Friday afternoon to give me an earful.
Last Friday was no exception to the eruption rule but the fun started early. Fridays are always busy in our clinic. My schedule was booked solid with mostly straightforward podiatric cases. Then the emerge
Diabetes Watch »
Management of the diabetic foot is a tremendous challenge. It has been estimated that the annual healthcare costs of caring for the diabetic foot range in the billions.1 Approximately 15 percent of diabetic patients will develop a foot or leg ulceration at some point during the course of their disease and 50 percent of those patients suffer reulceration within 18 months.2 Researchers have observed that the prevalence of neuropathy in the diabetic population is 33.5 percent, the prevalence of vascular disease is 12.7 percent and the prevalence of foot ulc
Diagnostic Dilemmas »
In 1876, Morton described a peculiar and painful affliction of the foot in the area of the fourth and fifth metatarsals as the metatarsals compress the plantar interdigital nerve. Describing this as a neuroma is bit of a misnomer as the condition is more likely an entrapment rather than a true neuroma. The effects of compression on nerve fibers are extensive. Nerve compression can be from external edema surrounding the nerve, edema within the nerve or external compression from other anatomical structures in the area.
It may be more appropriate to refer t
News and Trends »
In the past, the majority of comparative studies of antibiotics for diabetic foot infections have been relegated to smaller, unblinded trials. However, a new randomized, multicenter study of over 500 patients found that the simpler dosing regimen of ertapenem (Invanz, Merck) had comparable results to piperacillin/tazobactam in treating these infections.
In what study co-author David G. Armstrong, DPM, MSc, PhD, calls “easily the largest ever randomized controlled trial of diabetic foot infections,” the double-blinded SIDESTEP Study of Diabetic Foot I
Wound Care Q&A »
Do growth factors improve the rate of wound healing? When is it appropriate to use them on chronic wounds? Is the cost of growth factor modalities worth the results? Our expert panelists answer these key questions, share their experiences and ponder the future of these modalities with their discussion about the efficacy of growth factors in chronic wound care. Without further delay, here is what they had to say …
Q: When, why and how do you utilize growth factors in the treatment of foot and ankle wounds?
A: Wound bed prepar
There are many instances when it is appropriate for the foot and ankle surgeon to use bone grafts in order to enhance a patient’s clinical outcome. When it comes to reconstructive osteotomies for angular realignment, arthrodeses and the repair of nonunions and cystic bone lesions, these are often best performed with procedures that take advantage of the many desirable features of bone grafts and, more recently, bone graft substitutes.
Before discussing the details of bone graft substitutes, it is helpful to review the bone graft options that are availa
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