Podiatry Today Current Issue

Study Examines Combination Of Procedures For Hallux Rigidus

admin — Wed, 03 Sep 2008 17:01:41 -0400

Can a combination of two procedures yield positive results for patients with hallux rigidus? A recent study, presented as an abstract at the annual meeting of the American College of Foot and Ankle Surgeons (ACFAS), notes increased function and decreased pain in patients who underwent a combination of a hemi-implant arthroplasty with a decompressional osteotomy. As part of the study, 11 patients with hallux rigidus underwent the combination of surgical procedures. Patients had either grade III or IV hallux rigidus, less than 20 degrees of first metatarsophalangeal joint (MPJ) dorsiflexion, an

A Guide To Understanding The Various Wound Classification Systems

admin — Wed, 03 Sep 2008 17:01:41 -0400

There are as many classification systems for wounds as there are clinicians who believe they have developed the proverbial “better mousetrap.” The various wound classification systems include the Wagner classification, the University of Texas scheme, the S(AD) SAD classification, the Red Yellow Black breakdown, which is prominent in the nursing literature, the PEDIS classification and the DEPA Score.
Several questions invariably come up in a discussion of these classification systems

Essential Secrets To Marketing Your Practice Successfully

admin — Wed, 03 Sep 2008 17:01:41 -0400

When I was in podiatry school 20-something years ago, there was a podiatrist on the faculty who was very impressive to me. He wore stylish clothes, drove a Mercedes convertible and took vacations to Australia. One day, I asked him: “What does it take to have a successful career as a podiatrist?” The doctor looked me square in the eye and said “Son, it only takes two things to be a successful podiatrist. One, you have to have a touch of gray hair so that you look experienced. Two, you need to have a couple of hemorrhoids so you look … concerned.” I did not want to wait for the gray

Exploring Orthotic Indications For Various Conditions

admin — Wed, 03 Sep 2008 17:01:41 -0400

In this edition of “Orthotics Q&A,” the panelists discuss various issues ranging from indications for the Richie Brace, Arizona AFO and prefabricated orthoses to whether orthotic casting should reduce supinatus. Without further delay, here is what the panelists had to say. Q: What are the indications for using a Richie brace versus using an Arizona brace? A: For Doug Richie Jr., DPM, each custom ankle foot orthotic (AFO) has a different clinical indication and choosing one to treat a pathology is the same as choosing a surgical procedure. He notes the rigid Arizona AFO has a mol

A Guide To Orthobiologics In Podiatric Surgery

admin — Wed, 03 Sep 2008 17:01:41 -0400

In our ongoing quest to find viable graft alternatives in bone fracture and primary osseous repair, the technology of orthobiologic bone substitutes continues to evolve. Traditionally, we have looked for replacement bone from sources within the patient’s own body. Indeed, autograft is widely considered the gold standard for grafting. While autograft bone is superior in its ability to provide osteogenic mesenchymal stem cells, it does have a couple of inherent problems, namely, a limited supply and morbidity associated with harvesting from donor sites. Accordingly, we have brought together a

How To Address Pronation-Related Pathology

admin — Wed, 03 Sep 2008 17:01:41 -0400

Everyone pronates and everyone supinates. It is a matter of how much and when each occurs that determines whether lower extremity problems will occur. Shoe companies have marketed their products based on the words “pronation” and “supination.” They have done such a good job at this that people come into our offices thinking they are either pronators or supinators. As we know, high arched feet can pronate too much just as low arched feet may not pronate enough. Now more than ever before, there is more awareness of orthotic devices as a result of foot-related products becoming availabl

Point-Counterpoint: Is Plantar Plate Repair More Effective Than Flexor Tendon Transfer?

admin — Wed, 03 Sep 2008 17:01:41 -0400

Yes. After discussing the importance of the plantar plate in facilitating MTPJ stability, this author points out key shortcomings of the flexor tendon transfer and emphasizes the more direct focus of plantar plate repair. By Leon Reber, DPM When it comes to pain below the metatarsal head, clinicians have described this with various names such as predislocation syndrome, monoarticular nontraumatic synovitis, capsulitis or simply metatarsalgia. Although the terminology varies, the one thing they have in common is pressure. Excessive pressure below the metatarsal head is the reason

Essential Insights For Managing Nonunions

admin — Wed, 03 Sep 2008 17:01:41 -0400

Nonunions can be a troubling condition for both the patient and the podiatric physician. Failed unions can result from a host of factors arising from the patient, surgeon or both. In many surgical cases, one primary cause is difficult to identify and the end result may actually result from a combination of various etiologies. As with any surgical complication, it is important to emphasize preventive efforts. However, even with diligent efforts, a nonunion may still occur. In my opinion, there are three different perspectives that dictate how one should treat. There is the academic perspecti

Seven Secrets To Successful Hiring

admin — Wed, 03 Sep 2008 17:01:41 -0400

What is more nerve wracking than hiring people to staff your practice? Tightrope walking might qualify but more often than not, there is a net below to catch you if you take a wrong step. Jumping out of an airplane also comes to mind but you would usually have a parachute that should keep you from really hurting yourself. Indeed, hiring can be more intimidating or worrisome than either of those things partly because there are no safety measures that keep you from danger after you have brought a person on board. A new employee is live, in person, on your phones, in front of your patients,

How To Diagnose And Treat Insect Bites And Stings

admin — Wed, 03 Sep 2008 17:01:41 -0400

There are abundant crawling and flying insects that infest, bite and sting humans, particularly on the foot and ankle regions. At this time of the year, people may be particularly susceptible to bites from ants, fleas, ticks and spiders. Other possible problems may include infestations with scabies and stinging insects. There are various types of ants that can inflict different levels of bites and stings. The three main stinging and biting ants are fire, harvester and pharaoh ants. The fire ant is common in the southeastern United States and Caribbean islands. Its sting causes immediat