When do you make the transition to advanced modalities for diabetic foot ulcers? With this question in mind, these authors discuss key diagnostic pointers and offer salient insights from the literature on when physicians should consider advanced modalities to facilitate improved healing and outcomes.
Reviewing the evolution of the Evans calcaneal osteotomy, this author discusses the impact on biomechanics, shares insights from the literature on osteotomy placement and bone graft size, and offers pearls on minimizing the risk of common complications.
Given the decreased bone mineral density and poorer bone healing potential in people with osteoporosis, achieving adequate fixation can be challenging for osteotomies or arthrodesis procedures in this patient population. Accordingly, these authors review the literature and assess a range of fixation options including traditional plate fixation, cannulated screws and locking compression plates.
Given the relatively common incidence of venous insufficiency and the high likelihood of recurrence with venous leg ulcers, these authors offer a thorough review of the literature and share their insights on compression modalities ranging from inelastic (short stretch) bandages to intermittent pneumatic compression therapy.
When getting athletes back on their feet following a stress fracture, one must balance the need to return to sport with the need for safe healing. Combining a thorough review of the literature with practical pearls from his clinical experience, this author offers salient diagnostic insights and perspectives on non-weightbearing, bone stimulation and other treatment measures.
In recent years, radiofrequency nerve ablation has emerged as a potential modality for plantar fasciitis. Accordingly, this author details his experience in using radiofrequency nerve ablation, provides a closer look at the literature and compares the modality to other treatments for heel pain.
Given the common presentation of neglected Achilles tendon ruptures, these authors discuss signs and symptoms, and keys to diagnosis. They also survey the literature and offer their perspectives on excision with direct repair and performing a flexor hallucis longus transfer.
As orthobiologic technology continues to advance, these authors discuss the theory behind platelet-rich plasma (PRP), offer a thorough review of the literature on PRP for Achilles tendon injuries and provide insights from their clinical experience on the role of this emerging modality.
As I mentioned in a previous post, there are a number of journals I follow to stay abreast of developments in the infectious disease, microbiology and antibiotic world (see http://bit.ly/iLJb6k ). For updates on the latest in antibiotic development from pre-clinical through clinical testing, no journal beats the American Society of Microbiology’s Antimicrobial Agents and Chemotherapy (http://aac.asm.org/ ).
Offering insights from the literature as well as clinical experience, this author discusses conservative modalities, reviews important considerations for choosing an optimal surgical procedure and shares pearls on resection and arthrodesis options.
Can the total ankle replacement (TAR) provide a viable alternative to ankle arthrodesis? In addition to reviewing the FDA approved TARs in the United States, advances in device design and the current literature, these authors emphasize proper patient selection, sound pre-op planning and other insights from their experience in performing total ankle arthroplasty procedures.
The more I read the infectious disease literature, the more limited my diet becomes. It seems that new reports of contaminated food are published regularly. It gets to a point where you do not know what you should and should not eat.
I have always been wary of raw foods and rarely eat sushi. This was especially the case after an article was published in Clinical Infectious Diseases a number of years ago complete with pictures of the worm coughed up by a patient who ate salmon sushi.1 (I apologize to those of you who love to eat sushi. It’s just not for me.)
Yes. Doug Richie Jr., DPM, FACFAS says evidence-based medicine is overwhelmingly in favor of preventive bracing and notes that the literature discounts perceived negative
effects on athletic performance.
No. Lisa M. Schoene, DPM, ATC, FACFAS argues that clinicians should consider other modalities and be wary of a hasty return to play with bracing as a lack of follow-through with appropriate rehabilitation may lead to compromised tissue repair and recurrent sprains.
Proper preparation of the wound bed is essential to priming the wound for effective healing. Accordingly, this author discusses key principles from the literature and shares insights from his clinical experience in employing debridement and adjunctive modalities to help facilitate better wound healing and eventual wound closure.
“Equinus deformity is the most profound causal agent in foot pathomechanics and is frequently linked to common foot pathology,” is a quote from an article by Johnson and Christensen.1 This statement about equinus is something that is vastly underappreciated. It is profound but in my opinion, we as practitioners are not paying enough attention to it. I believe that is because there is no absolute definition of equinus.
While platelet-rich plasma (PRP) has emerged as a potential adjunctive modality for some lower extremity injuries, there is a lack of conclusive evidence in this regard. Accordingly, this author reviews the available literature and offers insights from his experience in using PRP for Achilles tendinosis and chronic plantar fascial pain.