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Considering An Autoimmune Etiology In The Differential Diagnosis Of Heel Pain

Mon, 02/05/2018 - 14:40
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Pauravi (Po) Raval, DPM, MS

This author provides pearls on diagnosing a tricky case of heel pain in a 55-year-old woman that turned out to be CREST variant scleroderma.

Section: Online Exclusive

A Closer Look At The Benefits Of Minimally Invasive Achilles Tendon Rupture Repair

Thu, 02/01/2018 - 14:31
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Jonathan L. Hook, DPM, MPH, and T. Craig Wirt, DPM, PhD

Challenging the traditional open approach to Achilles tendon ruptures, these authors note that minimally invasive repair of the Achilles facilitates less incidence of re-rupture, fewer wound complications and an earlier return to activity. 

The optimal modality for treating acute Achilles tendon ruptures continues to be a subject of debate in the current foot and ankle literature. Opposing arguments center around conservative versus surgical management as well as the best surgical methods.

Section: Online Exclusive

What I Think About Running

Fri, 01/26/2018 - 14:04
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): George Wallace, DPM

My running avocation began over 30 years ago. On average, I have been hitting the pavement three times per week, maybe for three miles per session. As age creeps in, the desire is still there, but the performance is, especially the older I get, more labored. Let’s face it. I’m getting slower.

Below are some thoughts about this avocation.

• How many times when beginning the run does my body wonder what the hell I’m doing this for?

Section: Forum

Diagnosing And Treating Calcaneal Tuberosity Fractures

Fri, 01/26/2018 - 13:51
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Saleena Niehaus, DPM, and Les Niehaus, DPM, FACFAS

Calcaneal fractures and their complications can lead to long-term problems for athletes, which can make it difficult to resume play. Tuberosity avulsion fractures of the calcaneus are rare, accounting for 1.3 to 2.7 percent of all calcaneal fractures.1 These fractures involve the posterosuperior aspect of the calcaneus and are not within the subtalar joint.2

Section: Sports Medicine

Pertinent Principles In Treating Juvenile Hallux Valgus

Fri, 01/26/2018 - 12:26
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Patrick DeHeer, DPM, FACFAS, FASPS

Given the relative paucity of literature and lack of consensus on the management of juvenile hallux abducto valgus, this author reviews the existing studies on bunions in children and provides evidence-based treatment recommendations.

Section: Feature

A Guide To Orthotic Prescription Writing With The Tissue Stress Theory Approach

Fri, 01/26/2018 - 10:56
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Eric Fuller, DPM

Can the tissue stress theory approach to biomechanics help podiatrists make more specific orthotic modifications to reduce pathological forces on the foot? With this question in mind, this author offers helpful diagnostic pearls and a closer look at key variables that can influence orthotic treatment decisions.

Section: Feature

Point-Counterpoint: Should We Recommend Motion Control Running Shoes?

Fri, 01/26/2018 - 09:45
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Douglas Richie, DPM, FACFAS, and Nicholas A. Campitelli, DPM, FACFASYes.

Citing recent research, this author notes motion control shoes can offer various benefits to runners in terms of preventing overuse injuries.  

By Douglas Richie, DPM, FACFAS

Section: Feature

Emerging Concepts With Tendon Transfers

Thu, 01/25/2018 - 15:55
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Lawrence A. DiDomenico, DPM, FACFAS, Sharif R. AbdelFattah, DPM and Mohammed K. Hassan, DPM

Transferring the peroneus longus tendon to the peroneus brevis tendon can be a valuable correction for peroneus longus overdrive due to a sub-first metatarsal diabetic foot ulcer as the procedure helps balance the foot and prevents recurrence of deformity. These authors detail the diagnosis of peroneus longus overdrive and offer a comprehensive guide to performing the procedure.

Section: Feature

Diagnosing A Patient With Painful Cracks On Both Soles

Thu, 01/25/2018 - 12:15
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Myron Bodman, DPM

A 12-year-old boy presented with painful cracks on both soles. You are the third doctor he and his parents have seen. The patient’s mother is upset that the rash keeps returning and the father is skeptical about healthcare providers who haven’t cured the problem. The patient is anxious and afraid of what you will do to treat him. He has tried numerous creams and sprays, but nothing works for long. The family has changed laundry soap, softeners and shoes, but the cracks come back.

Section: Dermatology Diagnosis

Secrets To Making Effective Orthotic Modifications

Thu, 01/25/2018 - 12:10
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Guest Clinical Editor: Kevin A. Kirby, DPM

These expert panelists explore making modifications to prevent medial arch irritation, limit over-supination and increase orthosis durability in athletes playing side-to-side sports.


What is the most common cause of medial arch irritation and what are your solutions for preventing and eliminating medial arch irritation in custom foot orthoses?

Section: Orthotics Q&A

Study Compares Proximal Chevron And Double Metatarsal Osteotomies For Hallux Valgus

Thu, 01/25/2018 - 11:54
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Brian McCurdy, Managing Editor

Section: News and Trends

Emphasizing Patient Awareness Of The Serious Complications Of Diabetes

Thu, 01/25/2018 - 10:54
Issue Number: Volume 31 - Issue 2 - February 2018Author(s): Matthew Regulski, DPM

Diabetes is an insidious and devastating disease. It affects every system in the body and the prevalence of this disease is on the rise throughout the world in epidemic proportions.

Section: Diabetes Watch

How Residency Has Changed Career Perceptions And Influenced Career Plans

Fri, 12/29/2017 - 10:23
Issue Number: Volume 31 - Issue 1 - January 2018Author(s): Clinical Editor: David Bernstein, DPM, FACFAS; Panelists: Jamie L. Dermatis, DPM, Alexandra Scrimalli, DPM, Brandon Tucker, DPM, and Thomas Wright, DPM

Third-year residents discuss how their residency program experiences altered their journeys, changed their career perceptions and prepared them to make career choices.


Please explain how your thoughts and perceptions about your podiatry career have changed throughout your time in your residency program.

Section: Residency Corner

Why You Should Consider Cheilectomy As A First-Line Treatment For All Stages Of Hallux Rigidus

Fri, 12/29/2017 - 09:37
Issue Number: Volume 31 - Issue 1 - January 2018Author(s): Jonathan L. Hook, DPM, MHA, and Joseph G. Wilson, DPM

Emphasizing the joint-sparing nature of the procedure and infrequent complications, these authors discuss the benefits of cheilectomy for hallux rigidus.

Section: Online Exclusive

Deep Into Your Podiatry Career, Are You Still Retaining Your Skills?

Wed, 12/20/2017 - 14:36
Issue Number: Volume 31 - Issue 1 - January 2018Author(s): George Wallace, DPM

My brother turned 60 a few months ago and he had a big celebration. His sister-in-law, a recently retired school teacher at the age of 64, comparable to my own age, asked when it would be my turn to retire. I murmured some vague answer.

Section: Forum

Expert Insights On Treatment Options For Cystic Lesions Of The Talus

Wed, 12/20/2017 - 14:35
Issue Number: Volume 31 - Issue 1 - January 2018Author(s): Ryan Carter, DPM, AACFAS, and Bob Baravarian, DPM, FACFAS

An osteochondral lesion is an injury or fracture to the chondral surface or underlying subchondral bone.

Section: Treatment Dilemmas

Current Concepts With The Female Triad And Sports Injuries

Wed, 12/20/2017 - 14:33
Issue Number: Volume 31 - Issue 1 - January 2018Author(s): Jeffrey A. Ross, DPM, MD, FACFAS

Women with the female athlete triad can experience lower extremity injuries as a result of low energy that may be associated with interrelated conditions such as eating disorders, menstrual dysfunction and low bone mineral density. Accordingly, this author shares pertinent insights in diagnosing and managing these issues to facilitate a return to athletic activity.

Section: Feature

Point-Counterpoint: Has The Medial Double Arthrodesis Supplanted The Triple Arthrodesis?

Wed, 12/20/2017 - 14:31
Issue Number: Volume 31 - Issue 1 - January 2018Author(s): By Jeffrey E. McAlister, DPM, FACFAS, and Chad Seidenstricker, DPM, AACFAS; and Mark Hofbauer, DPM, FACFAS Yes.

Offering insights from the literature and their experience, these authors cite several advantages of the medial double arthrodesis, including better visualization leading to easier reduction of the deformity and reduced complication risk.   

By Jeffrey E. McAlister, DPM, FACFAS, and Chad Seidenstricker, DPM, AACFAS

Section: Feature

A Guide To Dorsal Bridge Plating For Lisfranc Fractures

Wed, 12/20/2017 - 14:30
Issue Number: Volume 31 - Issue 1 - January 2018Author(s): Mark Magnus, DPM, Kelli Iceman, DPM, and Thomas Roukis, DPM, PhD, FACFAS

Facilitating direct visualization and offering rigid stabilization, dorsal bridge plating may be more effective for Lisfranc injuries than transarticular screw fixation. Accordingly, these authors provide keys to the surgical technique and offer a closer look at the emerging literature on bridge plating in the tarsometatarsal joint.

Section: Feature

A Closer Look At The Gastroc Recession For Recalcitrant Plantar Fasciitis

Wed, 12/20/2017 - 14:27
Issue Number: Volume 31 - Issue 1 - January 2018Author(s): Patrick DeHeer, DPM, FACFAS, FASPS

Exhorting his surgical colleagues to stop cutting the plantar fascia due to complications of plantar fasciotomy, this author says the gastrocnemius recession can improve function and lead to good results for patients with chronic heel pain.

Section: Feature