Podiatry Today Current Issue

Steroid Injections: Are They Overutilized In Athletes?

admin — Wed, 03 Sep 2008 17:01:39 -0400

When treating athletes, podiatrists may use corticosteroid injections to treat various conditions. However, are such injections overutilized in athletes? Here is what our expert panelists have to say about what factors to consider in using injectable steroids, differences in treating athletes and non-athletes, and the type of steroids to use.

Q: When treating an athlete, which condition are you most likely to treat with corticosteroid injection?
A: Mike Lowe, DPM, and Amol Saxena, DPM, both use corticosteroid injections for neuromas. As Dr. Lowe notes,

How To Address Sesamoids in Hallux Valgus Surgery

admin — Wed, 03 Sep 2008 17:01:39 -0400

The surgical correction of hallux valgus (aka bunion) is one of the most common operations a foot and ankle surgeon will face. With over 130 procedures described to date, no one procedure has proven to be the definitive solution for every bunion situation. However, the common denominators for success remain osseous realignment and soft tissue balancing. The location of the sesamoid complex in relationship to the first metatarsal plays an integral part in determining whether one has achieved this realignment and balancing act.

The exact etiology of hallux valgus still remains rather controve

A Guide To Detecting And Treating Limb Length Discrepancy

admin — Wed, 03 Sep 2008 17:01:39 -0400

Limb length discrepancy (LLD) can cause a variety of symptoms. There are a variety of common clinical techniques clinicians can use to help detect LLD. Radiographic imaging provides the best method for measuring LLD. Treatments vary but can lead to significant improvement of symptoms. Indeed, the detection and treatment of LLD can be a very satisfying aspect of a clinical biomechanics practice.

In cases of LLD, gait evaluation normally shows the dominance of one side or leg. As the patient walks down the hall, there is a tendency to lean to one side. One can see this on every step o

A Closer Look At Neoteric Biomechanics

admin — Wed, 03 Sep 2008 17:01:39 -0400

For years, it seems like the $5,000 bunion and pressures from HMOs diverted DPMs’ attention from biomechanics. The emphasis of our education and practices strayed from Root toward Ilizarov and coding. “Gold standard” orthotics cast from foam or “posted to cast” do not generate the pride and acceptance that a Root device once did for podiatry and our orthotic fees are less justified when compared to high-tech, over-the-counter footbeds and custom devices casted by other providers or over the Internet.

The solution is neoteric biomechanics, a school of func

How To Develop A Thriving Sports Medicine Practice

admin — Wed, 03 Sep 2008 17:01:39 -0400

When it comes to being recognized as a true sports medicine physician, Lisa Schoene, DPM, ATC, says in order to “talk the talk, you better walk the walk.” Dr. Schoene says the best sports medicine practitioners are the ones who cover the events and are out there covering races even when it is cold and rainy or starting very early in the morning.

“Hands-on experience is imperative in my mind,” emphasizes Dr. Schoene, who has covered many marathons, triathlons and other races. “I question the physician who says he or she is a ‘sports medicine spe

How To Address Puncture Wounds

admin — Wed, 03 Sep 2008 17:01:39 -0400

Continuing Education Course #156
September 2007

I am pleased to introduce the latest article, “How To Address Puncture Wounds,” in our CE series. This series, brought to you by the North American Center for Continuing Medical Education (NACCME), consists of complimentary CE activities that qualify for one continuing education contact hour (.1 CEU). Readers will not be required to p

Turning Evidence Into Practice: A Guide To Treating Chronic Wounds In The Diabetic Foot

admin — Wed, 03 Sep 2008 17:01:39 -0400

In reading many of the recent articles in podiatry publications, we will need to expand our vocabularies to include various new phrases. These phrases will include pay for performance, evidence-based medicine or evidence based treatment plans, and evidence-based treatment guidelines. Electronic medical records (EMR) and electronic health records (EHR) will be linked to evidence-based guidelines at the point of care. These changes are also reverberating within the primary care settings and in other selected specialties.

What can this mean for any practitioner let alone the solo practitioner w

Can Prophylactic Antibiotics Help Reduce The Risk Of Infection During Surgery?

admin — Wed, 03 Sep 2008 17:01:39 -0400

Podiatric surgery can carry inherent risks including the possibility of perioperative infection. A recent article in the Journal of Bone and Joint Surgery (JBJS) offers several pertinent recommendations that aim to prevent some of the reported 780,000 surgical site infections that occur every year in the United States, according to the study authors.

Although they acknowledge that preoperative antibiotics are associated with lower rates of surgical site infections, the authors of the JBJS article say surgeons should continue antibiotics for no more than 24 hours afte

Key Insights On Using VAC Therapy For Post-Op Wound Management

admin — Wed, 03 Sep 2008 17:01:39 -0400

Vacuum Assisted Closure (VAC) is one of our greatest tools in managing large as well as deep wounds. It crosses multiple surgical disciplines and is applicable to virtually all anatomical sites. This technology has revolutionized limb salvage surgery and has prevented untold numbers of amputations. There is an exciting growth curve with the use of this technology. Surgeons can modify the technology to aid in the closure of a multitude of wound scenarios.

In the course of utilizing VAC therapy (KCI), one must be cognizant of adjacent tissue and protect it from the deleterious effects of negat

Key Insights On Treating Early Adult-Acquired Flatfoot Deformity

admin — Wed, 03 Sep 2008 17:01:39 -0400

When a patient presents to the office complaining of medial ankle pain, one should consider several differential diagnoses. These include an ankle sprain, posterior tibialis or flexor digitorum longus tenosynovitis, a rupture or tarsal tunnel syndrome.

However, if the patient is middle-aged, female, mildly obese and has had medial ankle pain for several months, there should be a high index of suspicion of insufficient posterior tibialis (PT) tendon leading to adult-acquired flatfoot (AAF) syndrome. When the loss of PT tendon function due to partial or complete rupture occurs, the devel