Podiatry Today Current Issue

News and Trends

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

Are Orthoses Effective Against Plantar Fasciitis In The Long Run?

Orthoses are an integral part of the podiatric armamentarium to treat plantar fasciitis. However, a recent study calls into question the long-term efficacy of using orthoses to treat the condition.

The study, which was published in a recent issue of the Archives of Internal Medicine, looked at 135 patients with plantar fasciitis, who were randomized to wear either a prefabricated orthosis made of firm foam, a customized orthosis made of semirigid plastic or a sham orth

Current Concepts In Treating Acute Charcot's Arthropathy

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

Charcot’s arthropathy is a devastating complication of diabetes mellitus that frequently leads to permanent disability, ulceration and amputation. It is a rapidly progressive and severe form of arthritis. Researchers have equated the acute Charcot foot to a medical emergency since therapies are available that may alter its natural history.¹ Unfortunately, the pathophysiology and development are poorly understood. This is frequently complicated by a delay in diagnosis until bony destruction is visible on plain radiographs. This delay often leads to worse outcome

Exploring The Potential Of Bioengineered Alternative Tissues

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

Bioengineered alternative tissues, or skin substitutes, can lead to success in patients with wounds that have not responded well to other modalities. Accordingly, our expert panelists offer a closer look at where these products fit into the wound healing armamentarium and share pertinent pearls from their clinical experience with these products. Q: What skin substitutes do you utilize in treating lower extremity wounds? A: Paul Kim, DPM, has had success using Apligraf^® (Organogenesis) for more superficial chronic wounds. He cautions practitioners that it may take multipl

Emphasizing The Minimally Invasive Benefits Of The KobyGard System

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

Foot and ankle surgeons have no shortage of choices when it comes to selecting instruments for surgical procedures. Our surgical team has found success in using the Koby line of instruments (OsteoMed) for the treatment of various conditions.

For the last four years, surgeons have found success using Koby instruments for three procedures commonly performed in the foot and ankle. Koby instruments are designed to perform the partial plantar fasciotomy for heel spur syndrome, intermetatarsal ligament decompression of neuroma and release of the gastrocnemius

Bioabsorbable Implants For Flatfoot: Can They Work?

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

The balance between technology and clinical practice is difficult to obtain. In the past, technology lagged far behind. Innovative thought and technique was stymied by the inability to develop practical instrumentation and implants. In recent years, however, the opposite effect has occurred. New materials and devices have inundated the marketplace. While these devices have been demonstrated to be safe, they are not necessarily any more efficacious and are certainly more costly than existing products.

Indeed, practitioners must be vigilant in evaluating t

Current Concepts In Managing The Wound Microenvironment

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

Wound healing is a process that involves the stages of coagulation, inflammation, cell proliferation and repair of the matrix, epithelialization and remodeling of the scar tissue. These stages overlap and the entire process can last for months.¹

During the post-injury coagulation phase, platelets initiate the wound healing process by releasing a number of soluble mediators including platelet-derived growth factor (PDGF), insulin-like growth factor-1 (IGF-1), epidermal growth factor (EGF), fibroblast growth factor (FGF), and transforming growt

A Pertinent Primer On Current Orthobiologics

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

Surgeons have traditionally relied upon autografts, replacement bone from sources within the patient’s own body, as the gold standard for graft remodeling in bone fracture and primary osseous repair. While autograft bone is superior in its ability to provide osteogenic mesenchymal stem cells (MSCs), it has the inherent problem of limited supply and morbidity associated with harvesting from donor sites. Given these limitations, there has been a need for orthobiologic bone substitutes and these products continue to emerge and evolve as viable graft alternatives.

&nbs

A Guide To Detecting Nail Pathology

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

As all those who specialize in the treatment of lower extremity ailments will acknowledge, there is nothing uncommon about nail unit pathology. Though pristine appearing nail units are commonplace in children, advancing age may bring a combination of acute and chronic trauma, neoplastic processes, non-infectious dermatological diseases, and bona-fide mycotic and non-mycotic infections that take their toll. These stressors manifest as alterations in nail color, shape and/or texture.

Too often in mainstream medicine, there is a tendency to attribute such c

How To Obtain Premium Value For Your Practice

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

Many podiatric physicians are suddenly realizing the importance of their practice as a retirement asset. The sale of a practice, its value and the associated terms of the sale can either substantially supplement a retirement nest egg or be the source of retirement delaying frustration. Understanding the process of a practice transaction or sale, and having a deliberate and proactive strategy to enhance the value of the practice are likely to reduce the stress and frustration in addition to providing some supplementary retirement funds.

There are a my

Persistent Pain After Ankle Sprain: Is A Peroneal Tendon Injury The Cause?

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

In a follow-up to the last column (see “A Guide To Treating Ankle Sprains From Start To Finish, pg. 92, June issue), I would like to discuss common secondary injuries that often occur in relation to ankle injuries, especially sprains. One of the most common and often misdiagnosed secondary complications of ankle sprains is a tear or injury to the peroneal tendon(s).

Since the tendons are in such close proximity to the lateral ankle and the lateral ankle is most often injured during a sprain, there is a tendency to perceive the two painful regions as on