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Updated: 2 hours 55 min ago

Current Insights On Primary Tarsometatarsal Fusion For Lisfranc Injuries

Fri, 03/31/2017 - 12:15
Issue Number: Volume 30 - Issue 4 - April 2017Author(s): Nicholas J. Bevilacqua, DPM, FACFAS

While surgeons commonly employ open reduction and internal fixation for injuries to the tarsometatarsal joint complex, this author suggests that primary fusion offers a single-stage alternative with more stable, predictable outcomes over time.

Section: Online Exclusive

Key Pearls On Diagnosing And Addressing Leiomyoma Of The Foot

Fri, 03/31/2017 - 12:03
Issue Number: Volume 30 - Issue 4 - April 2017Author(s): Rhonda Cornell, DPM

Emphasizing the importance of early diagnosis, this author presents a guide to the treatment of the rare leiomyoma tumor in two patients.

Section: Online Exclusive

Why The Term ‘First Ray Hypermobility’ Should Be Extinct

Tue, 03/21/2017 - 15:11
Issue Number: Volume 30 - Issue 4 - April 2017Author(s): Kevin A. Kirby, DPM

Over 80 years ago, Dudley J. Morton, MD, first coined the term “hypermobility of the first metatarsal segment” in his classic book on functional disorders of the human foot.1 In his book, Morton described that “if the plantar ligaments of any segment are slack when the head of its metatarsal bone lies on the same plane as the others whose ligaments are taut, that segment will fail to share in the carriage of body weight” and will become “ineffective as a weightbearing structure” with “an unusual amount of motion” occurring “between the medial and middle cuneiform bones.”

Section: Forum

How To Conquer Talar Neck Fracture Malunions

Tue, 03/21/2017 - 15:06
Issue Number: Volume 30 - Issue 4 - April 2017Author(s): H. John Visser, DPM, FACFAS, Jesse Wolfe, DPM, Melanie Gonzalez, DPM, Neil Ermitano, DPM, and Kristina Berns-Thompson, DPM

Given their high post-traumatic malunion rate, talar neck fractures present considerable challenges for foot and ankle surgeons. These authors present effective techniques for performing an opening wedge osteotomy to resolve talar neck malunions, offering a closer look at the literature and an illustrative case study.

Section: Feature

Can Carbon Dioxide Angiography Have An Impact For Patients With PAD And Renal Insufficiency?

Tue, 03/21/2017 - 14:53
Issue Number: Volume 30 - Issue 4 - April 2017Author(s): Amanda Crowell, DPM, and Andrew J. Meyr, DPM, FACFAS

Angiography with carbon dioxide can be a valuable tool to diagnose and treat patients with peripheral arterial disease and renal insufficiency. These authors take a closer look at the research and practical considerations with CO2 angiography.

Section: Feature

Addressing Osteochondral Lesions Of The Talus

Tue, 03/21/2017 - 14:39
Issue Number: Volume 30 - Issue 4 - April 2017Author(s): John Grady, DPM, FASPS, and Patrick Sanchez, DPM

Treating osteochondral lesions of the talus can pose challenges and delayed diagnosis due to late presentation after an ankle sprain. These authors evaluate the effectiveness of procedures such as microfracture and arthroscopy, and recent innovations such as juvenile particulate chondrocyte allografts.

Section: Feature

Point-Counterpoint: Is Frontal Plane Correction Essential For Addressing Bunion Deformities?

Tue, 03/21/2017 - 14:14
Issue Number: Volume 30 - Issue 4 - April 2017Author(s): Lawrence DiDomenico, DPM, FACFAS, and Zachary Flynn, DPM, AACFAS; and Doug Richie, Jr., DPM, FACFASYes.

These authors note that recent literature and surgeon experience have shown that frontal plane deformity has been grossly underestimated and inadequately addressed in the surgical correction of hallux valgus.

By Lawrence DiDomenico, DPM, FACFAS, and Zachary Flynn, DPM, AACFAS

Section: Feature

Understanding The Biomechanics Of Plantar Plate Injuries

Tue, 03/21/2017 - 13:57
Issue Number: Volume 30 - Issue 4 - April 2017Author(s): Kevin A. Kirby, DPM

Given the common incidence of plantar plate injuries and the complications that can arise from more severe tears, this author offers a comprehensive guide to the biomechanics inherent to the plantar plate as a foundation for effective treatment of related injuries. 

Section: Feature

Prescribing Effective Orthotics For Pediatric Patients

Tue, 03/21/2017 - 13:31
Issue Number: Volume 30 - Issue 4 - April 2017Author(s): Guest Clinical Editor: Robert Eckles, DPM

These expert panelists discuss orthotic considerations for pediatric flatfoot, when prefab devices can be helpful and other factors in the treatment of pediatric patients.

Q:

While pain is always the dominant factor in making decisions around pediatric flatfoot, what objective clinical criteria exist that, even in the absence of severe symptoms, validate the prescription of a custom foot orthosis?

Section: Orthotics Q&A

Diagnosing Dry, Peeling Skin And Redness In Between The Toes

Tue, 03/21/2017 - 12:08
Issue Number: Volume 30 - Issue 4 - April 2017Author(s): Mark Couture, DPM

A 64-year-old male presents to the clinic complaining of dry, flaky skin between his toes with noticeable redness. This has been present for at least a week. He denies pruritus and has not scratched in between his toes. There is no history of trauma. He wears socks with his shoes but has not been wearing his compression stockings for the past several weeks. His self treatment includes using lotion in and around his toes without any relief.

Section: Dermatology Diagnosis

Pertinent Insights On Preventing Injuries On Tennis Court Surfaces

Fri, 03/03/2017 - 13:31
Issue Number: Volume 30 - Issue 3 - March 2017Author(s): Zach Thomas, DPM, AACFAS

This author provides a guide to preventing unnecessary tennis injuries caused by inappropriate shoe selection on the sport’s three most common surfaces.

Section: Online Exclusive

Emerging Concepts With Dynamic Compression Staples In Foot Surgery

Thu, 03/02/2017 - 09:41
Issue Number: Volume 30 - Issue 3 - March 2017Author(s): Troy A. Harris, DPM, Lt., MSC, USN (US)

Nitinol dynamic compression staples may provide unique benefits in a wide variety of foot surgeries. Accordingly, this author shares his experience with staple fixation in recent cases involving an active duty military population. 

Section: Online Exclusive

Leadership For The Multidisciplinary Team, Your Staff And Your Patients

Fri, 02/24/2017 - 11:53
Issue Number: Volume 30 - Issue 3 - March 2017Author(s): Camille Ryans, DPM

With patient care, there is always a team involved in obtaining a certain outcome. When it comes to the care of high-risk patients, podiatric physicians are leaders of these fragile patient care teams and the consequences from an error in healthcare may be irreversible, costing a patient life or limb. Accordingly, podiatrists must exhibit insightful leadership in regard to facilitating optimal outcomes for their patients.

Section: Forum

Emerging Implant May Be An Effective Option For First MPJ Arthroplasty

Fri, 02/24/2017 - 11:50
Issue Number: Volume 30 - Issue 3 - March 2017Author(s): Robi Garthwait, Contributing Editor

An innovative product offers surgeons a user-friendly option for restoring motion and reducing pain in individuals suffering from first metatarsophalangeal joint (MPJ) pathologies.

Section: Technology In Practice

New Products March 2017

Fri, 02/24/2017 - 11:46
Issue Number: Volume 30 - Issue 3 - March 2017Author(s): 

Unique Plating Options For Foot And Ankle Surgery

An emerging plating system offers multiple options for a range of foot and ankle surgeries.

Section: New Products

Keys To Diagnosing And Treating Peroneal Tendon Dysfunction

Fri, 02/24/2017 - 11:42
Issue Number: Volume 30 - Issue 3 - March 2017Author(s): Laura Bohman, DPM, and Bob Baravarian, DPM

Peroneal tendon pathology occurs due to a wide range of etiologies including, most commonly, overuse and ankle sprains.

Section: Treatment Dilemmas

Reexamining The Gold Standard For Offloading Of DFUs

Fri, 02/24/2017 - 11:32
Issue Number: Volume 30 - Issue 3 - March 2017Author(s): James McGuire, DPM, PT, LPed, FAPWHc, and Joshua A. Sebag, BA

Although the total contact cast can be effective for offloading diabetic foot ulcers, it is not in wide usage. These authors assert the gold standard for offloading lies in the non-removability of the device and offer a closer look at the merits of transitional offloading. 

Section: Feature

Emerging Concepts In Beaming For Charcot

Thu, 02/23/2017 - 16:43
Issue Number: Volume 30 - Issue 3 - March 2017Author(s): Lisa M. Grant-McDonald, DPM, William P. Grant, DPM, FACFAS, and Jeffery Yates, BS

Midfoot beaming for patients with Charcot can be a valuable tool for deformity correction and may help obviate complications that can hamper healing. These authors detail their experience with the use of beaming, focusing on effective correction techniques and innovative concepts such as titanium trusses.

Section: Feature

A Guide To Cutaneous Manifestations Of Diabetes In The Lower Extremity

Thu, 02/23/2017 - 15:23
Issue Number: Volume 30 - Issue 3 - March 2017Author(s): Joseph Vella, DPM, AACFAS

Patients with diabetes may be especially susceptible to cutaneous complications including acquired perforating dermatosis, bullous diabeticorum, yellow nails and calciphylaxis. This author provides a guide to diagnosis and treatment of common cutaneous manifestations.

Section: Feature

Current And Emerging Modalities For MRSA

Thu, 02/23/2017 - 14:28
Issue Number: Volume 30 - Issue 3 - March 2017Author(s): Konstantinos Markakis, MD, PhD, Barzo Faris, MD, Sheikh T. Rashid MD, PhD, David G. Armstrong, DPM, MD, PhD, Andrew J.M. Boulton, MD, DSc, and Frank L. Bowling, DPM, PhD

Given the increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and that improperly managed diabetic foot infections can lead to tissue loss, amputation or even death, it is crucial to have a grasp of effective treatment options.

Section: Feature

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