Podiatry Today Current Issue

Point-Counterpoint: Is Arthrodiastasis A Viable Option For Ankle Arthrosis

admin — Tue, 30 Sep 2008 10:30:47 -0400

Yes. By George Vito, DPM FACFAS. With appropriate experience, surgeons can help relieve symptoms of severe osteoarthritis of the ankle with this procedure and delay the need for a joint destructive procedure.

There are basically two major forms of osteoarthritis, both of which can be severely disabling. In primary osteoarthritis, the cause is generally unknown. In secondary osteoarthritis, the cause is generally traumatic in origin. Both forms present with similar clinical symptoms, which include pain, decreased range of motion and swelling.

Radiologically, there is a decrease in

Current Concepts In Orthotic Therapy For Pes Cavus

admin — Tue, 30 Sep 2008 10:51:30 -0400

Despite the prevalence of pes cavus, questions abound about etiology, classifications and appropriate treatment. Accordingly, these authors sort through the various classification systems, offer insights on the pathomechanics and share their thoughts on the role of orthoses for managing symptoms of pes cavus.

Pes cavus occurs in about 8 to 15 percent of the population but it does not get nearly as much attention in the medical literature as its counterpart pes planus.¹ Sixty percent of the population with cavus feet develop foot pain.²

Why does this chronical

Key Insights For Treating Navicular Stress Fractures

admin — Tue, 30 Sep 2008 11:04:04 -0400

Stress fractures of the tarsal navicular are an uncommon injury in the general population. However, people who engage in ballistic sporting events or recreational activities are at an increased risk of such an injury. The recognition of this injury seemed to parallel an increased fitness craze in the population over the last 30 years. Since Towne, et al., originally described tarsal navicular stress fractures in 1970, they have increased in prevalence secondary to our increased awareness of the injury and the emergence of faster and more powerful athletes.¹
The formation of a st

How To Address Spastic Gait In Children

admin — Tue, 30 Sep 2008 11:24:37 -0400

Cerebral palsy (CP) is a non-progressive brain disorder characterized by insufficient development of postural reflexes (i.e. head control), prolonged retention of primitive patterns of activity, abnormal coordination and muscle patterning.
As a result, those with cerebral palsy have delayed motor development and impaired patterns of movement.”^1,2 It is a chronic disabling condition of childhood. It is occurs in 1.5/1,000 to 3/1,000 live births with spasticity as a prevalent disabling clinical symptom.³

When evaluating infants, physicians should be aware there are t

CE: A Guide to NSAIDs For Pain Management In the Lower Extremity

admin — Tue, 30 Sep 2008 11:41:10 -0400

Please click here for the full Continuing Medical Education article:

http://www.naccme.com/program/2008-pd-10/

Given the prevalent use of nonsteroidal anti-inflammatory drugs (NSAIDs) for OA, RA, soft tissue injuries and perioperative pain management, these authors review the literature on the use of NSAIDs and offer a primer on the potential side effects.

Is There A DPM Shortage On The Horizon?

admin — Tue, 30 Sep 2008 11:57:27 -0400

A decline in the number of graduating podiatric medical students combined with increasing demand for podiatric services could result in a shortage of DPMs, according to a recent study in the Journal of the American Podiatric Medical Association (JAPMA).

Study authors note that since the late 1990s, podiatric medical schools have experienced a decline in the number of applications, resulting in a decreased number of DPMs per capita in the United States. The study notes that the number of DPM graduates must increase “dramatically” or the supply of podiatrists will not keep up with the de

Can The Fibula-Pro-Tibia Technique Have An Impact For Diabetic Ankle Fractures?

admin — Tue, 30 Sep 2008 12:41:08 -0400

Ankle fractures in patients with diabetes present a great challenge for the foot and ankle surgeon. Indeed, there is an abundance of literature documenting the difficulty of managing diabetic ankle fractures. Surgical treatment can be fraught with complications such as delayed bone and wound healing, and the development of Charcot neuroarthropathy.

When it comes to treating diabetic ankle fractures, complication rates are high, especially in patients with neuropathy. One reason for this is the altered osteogenesis in patients with diabetes in comparison to that of people without diabetes.

Key Insights On Modifying Orthoses For Specific Conditions

admin — Tue, 30 Sep 2008 15:45:57 -0400

Given the variety of conditions one sees in practice and the challenge of ensuring optimal results with orthoses, expert panelists offer their take on utilizing orthotic modifications for different case presentations.

Q: What modifications would you make for a patient who has flexible forefoot valgus, excessive midstance and propulsive phase pronation?

A: As Richard Blake, DPM, notes, a flexible forefoot valgus pronates late in the gait cycle because it initially supinates in contact phase. He emphasizes that control of this foot primarily depends on four factors. The first factor is

When A Patient Has Increased Thickening Of The Skin And Increased Discoloration

admin — Tue, 30 Sep 2008 15:59:09 -0400

Key Questions To Consider

1. What essential question does one still need to ask to help make the diagnosis?
2. What is the tentative diagnosis?
3. Can you list at least three differential diagnoses?
4. What features in this condition differentiate it from other conditions?
5. What is the suitable treatment of this condition?

A 26-year-old African-American female presents with thickening of the skin on the soles and sides of her feet as well as discoloration on two of her toes. She says the discoloration and thickening started eight years ago and has slowly become worse over time.

New Products

admin — Tue, 30 Sep 2008 16:04:54 -0400

New Options For Healing Damaged Skin

Podiatrists may have two new options in their dermatology armamentarium.

Kerol Emulsion and Kerol ZX can help promote healing of hyperkeratotic conditions such as psoriasis, xerosis and eczema, according to the manufacturer PharmaDerm.

The company notes that physicians can also use the Kerol products to treat dry skin and damaged nails.

PharmaDerm says the Kerol products contain zinc undecylate and lactic acid, which gently dissolve the intercellular matrix and