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Updated: 2 hours 17 min ago

Pertinent Pearls On Using A Hexapod Frame For Charcot Fixation

Fri, 04/28/2017 - 12:17
Issue Number: Volume 30 - Issue 5 - May 2017Author(s): Noman Siddiqui, DPM, AACFAS, and Jessica Wilczek, DPM

Section: Online Exclusive

Covering Plantar Wounds With An Abductor Digiti Minimi Muscle Flap

Fri, 04/28/2017 - 10:57
Issue Number: Volume 30 - Issue 5 - May 2017Author(s): Jayson N. Atves, DPM, CO, Tammer Elmarsafi, DPM, MBBCh, Christopher E. Attinger, MD, and John S. Steinberg, DPM, FACFAS

These authors discuss using the abductor digiti minimi muscle flap to help facilitate limb salvage in a 63-year-old patient with Charcot neuroarthopathy and a diabetic plantar ulcer.

Section: Online Exclusive

Forging An Identity Beyond Medicine As Retirement Looms

Mon, 04/24/2017 - 16:23
Issue Number: Volume 30 - Issue 5 - May 2017Author(s): George Wallace, DPM

At a very recent birthday, my mom offered this fact: “You have more years behind you than in front of you.” Thanks for stating the obvious.

Her perception was for my life but I can also apply it to my career. Right now, the latter spans 33 years post-residency. With the former, let’s just say I can collect some Social Security. However, I’m not ready to do so just yet.

Section: Forum

Topical Agent Combines Antifungal, Cosmetic And Nail Renewal Treatment

Mon, 04/24/2017 - 16:20
Issue Number: Volume 30 - Issue 5 - May 2017Author(s): Robi Garthwait, Contributing Editor

Podiatric physicians now have at their disposal a single product to fight nail fungus while simultaneously rejuvenating the appearance of nails.

New Products May 2017

Mon, 04/24/2017 - 16:15
Issue Number: Volume 30 - Issue 5 - May 2017

Preserving Hammertoe Correction

Surgeons seeking allograft solutions for hammertoe can now take advantage of a line of four implants.

Section: New Products

Emerging Insights On Shoe Recommendations For Patients

Mon, 04/24/2017 - 16:12
Issue Number: Volume 30 - Issue 5 - May 2017Author(s): Bob Baravarian, DPM, FACFAS, and Laura Bohman, DPM

Section: Treatment Dilemmas

Emerging Insights On Interdigital Neuromas And Metabolic Syndrome

Mon, 04/24/2017 - 15:54
Issue Number: Volume 30 - Issue 5 - May 2017Author(s): Richard Jacoby, DPM, and Chad Thomas, DPM

The prevalence of metabolic syndrome and diabetes is increasing at a startling rate, and there is a high occurrence of neuroma pain with patients who exhibit symptoms of metabolic syndrome. Taking a closer look at the research and offering insights from their own experience, these authors suggest that clinicians should consider any patient with “neuroma pain” as being at risk for pre-diabetes.

Section: Feature

Current Perspectives On Nutrition And Wound Healing

Mon, 04/24/2017 - 15:38
Issue Number: Volume 30 - Issue 5 - May 2017Author(s): Kazu Suzuki, DPM, CWS, and Zoe Birnbaum, BS

Given that malnutrition and a loss of lean body mass can have an adverse effect on wound healing, clinicians should have a strong understanding of the impact of adequate protein intake and the pros and cons of different vitamin supplements. Accordingly, these authors offer a salient review of current guidelines and recommendations for facilitating optimal nutrition in patients with lower extremity wounds.

Section: Feature

Point-Counterpoint: Locking Plates Or Staples: What Is The Best Fixation For First MPJ Arthrodesis?

Mon, 04/24/2017 - 13:02
Issue Number: Volume 30 - Issue 5 - May 2017Author(s): Patrick A. DeHeer, DPM, FACFAS, and William Fishco, DPM, FACFASLocking plates.

Acknowledging that researchers have yet to come to a consensus on the most effective fixation on first MPJ arthrodesis, this author touts the benefits of locking plates.  

By Patrick A. DeHeer, DPM, FACFAS

Section: Feature

Addressing Deltoid Ligament Insufficiency In Stage III/IV Adult-Acquired Flatfoot

Mon, 04/24/2017 - 12:10
Issue Number: Volume 30 - Issue 5 - May 2017Author(s): Joshua Wilder, DPM, and Alan Catanzariti, DPM, FACFAS

Given the importance of the deltoid ligament for patients with stages III and IV adult-acquired flatfoot, numerous authors have proposed surgical solutions. Accordingly, these authors offer a thorough review of the literature and share surgical pearls from their experience.

Section: Feature

Exploring Treatment Options For Osteochondral Lesions

Thu, 04/06/2017 - 12:20
Issue Number: Volume 30 - Issue 5 - May 2017Author(s): Brian McCurdy, Managing Editor

In a discussion of osteochondral lesions of the talus at the ACFAS Annual Scientific Conference, several panelists delved into treatments including microfracture, osteochondral autograft transplantation and mesenchymal stem cells.

Section: Online Exclusive

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.


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