How Effective Is The PTB Test In Diagnosing Osteomyelitis?

     There has been some recent debate within the profession about the effectiveness of the probe-to-bone (PTB) test in diagnosing osteomyelitis. A new study in Diabetes Care has found that the PTB test has a relatively low positive predictive value when it is utilized for diabetic patients with foot wounds.

     The two-year study tracked 1,666 patients with diabetes who underwent regular foot exams and were instructed to come to the clinic if they developed signs of lower-extremity

      Although the patient with diabetes and renal failure presents serious challenges to the limb salvage team, there is evidence and argument to support aggressive treatment and attempted limb salvage in a multidisciplinary clinical environment. An abundance of medical literature discusses the separate wound care challenges posed by diabetes and renal failure.

      Less work has been done, however, to identify proper treatment and salvage techniques for patients who suffer from both maladies. While many do opt for primary amputation in the patient with diab

      Practitioners have described various osteotomies for the proximal hallux. However, the Akin closing wedge osteotomy is currently the most common procedure. Podiatric surgeons commonly employ the transverse plane closing wedge osteotomy for the correction of hallux abductus interphalangous deformity. One may also use this as an additional procedure for the correction of hallux abductovalgus deformity.

      Akin noted that one should perform the closing base wedge osteotomy at the proximal one-third of the proximal hallux and orient it in the transverse p

      Yes. By Guy R. Pupp, DPM, FACFAS, and Mark A. Kachan, DPM. Given the increasing incidence of methicillin-resistant Staphylococcus aureus, one should consider empiric coverage against MRSA in high-risk patients with infected ulcerations in the lower extremity.

      The most common pathogens in nosocomial skin and skin structure infections in the United States and Canada in 2000 were Staph aureus. Researchers have stated that approximately 30 to 60 percent of all Staph aureus isolates are methicillin-resistant Staph aureus (MR

     Honey is an ancient wound remedy that is reappearing in clinical practice in developed countries. The availability of licensed wound care products in Europe, New Zealand and Australia is prompting healthcare practitioners in conventional medicine to consider the use of honey within their treatment armamentarium. Ulcer remedies such as honey are necessary as the prevalence of diabetes rises.

     The American Diabetes Association has estimated that about 7 percent of the population had diabetes.¹ It is an increasing problem that has serious impl