Journal of the American Podiatric Medical Association

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APMA Online: A Major Resource for Members and the Public

by Richard B. Viehe

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 424; https://doi.org/10.7547/87507315-92-7-424 - 1 Jul 2002

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American Podiatric Medical Association. 82nd Regular Sessions, House of Delegates. March 24, 25, and 26, 2002, Washington, DC

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J. Am. Podiatr. Med. Assoc. 2002, 92(7), 412-423; https://doi.org/10.7547/87507315-92-7-412 - 1 Jul 2002

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Technique for Fabrication of an “Instant Total-Contact Cast” for Treatment of Neuropathic Diabetic Foot Ulcers

by David G. Armstrong, Brian Short, Eric H. Espensen, Patricia L. Abu-Rumman, Brent P. Nixon and Andrew J. M. Boulton

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 405-408; https://doi.org/10.7547/87507315-92-7-405 - 1 Jul 2002

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Abstract

Addressing pressure reduction in the treatment of diabetic foot wounds is a critical component of therapy. The total-contact cast has proven to be the gold standard of treatment because of its ability to reduce pressure and facilitate patient adherence to the off-loading regimen. [...] Read more.

Addressing pressure reduction in the treatment of diabetic foot wounds is a critical component of therapy. The total-contact cast has proven to be the gold standard of treatment because of its ability to reduce pressure and facilitate patient adherence to the off-loading regimen. Removable cast walkers have proven to be as effective as total-contact casts in pressure reduction, but this has not translated into equivalent time to healing. A simple technique to convert the removable cast walker into a device that is not as easily detached from the lower extremity, thereby encouraging the use of this device over a 24-hour period, is presented in this article. The procedure involves wrapping the cast walker with cohesive bandage or plaster of Paris. In the authors’ opinion, this technique addresses many of the disadvantages of the total-contact cast, resulting in an adequate compromise in this aspect of care. (J Am Podiatr Med Assoc 92(7): 405-408, 2002) Full article

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How and Why to Surgically Debride Neuropathic Diabetic Foot Wounds

by David G. Armstrong, Lawrence A. Lavery, Jeffrey R. Vazquez, Brent P. Nixon and Andrew J. M. Boulton

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 402-404; https://doi.org/10.7547/87507315-92-7-402 - 1 Jul 2002

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Wound debridement, when systematically performed, may be as important as off-loading in reducing the prevalence of chronic inflammatory by-products in a wound and thus in converting a chronic wound into an acute one. Although it has been suggested that aggressive surgical debridement of [...] Read more.

Wound debridement, when systematically performed, may be as important as off-loading in reducing the prevalence of chronic inflammatory by-products in a wound and thus in converting a chronic wound into an acute one. Although it has been suggested that aggressive surgical debridement of wounds may be beneficial, there have been few, if any, technical descriptions of this aspect of therapy. It is therefore the purpose of this article to describe the general principles, process, and technique of outpatient surgical debridement of noninfected, nonischemic neuropathic diabetic foot wounds performed at the authors’ institutions. The authors hope to foster further discussion leading to improvement in the process and the prevalence of such debridement. (J Am Podiatr Med Assoc 92(7): 402-404, 2002) Full article

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Maggot Debridement Therapy. A Primer

by David G. Armstrong, Jeff Mossel, Brian Short, Brent P. Nixon, E. Ann Knowles and Andrew J. M. Boulton

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 398-401; https://doi.org/10.7547/87507315-92-7-398 - 1 Jul 2002

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Treatment of chronic wounds of the lower extremity requires a systematic, multidisciplinary approach as well as flexibility in order to achieve acceptable, consistent short-term and long-term results. Maggots, once considered an obsolete therapeutic modality, can be a useful addition to the armamentarium of [...] Read more.

Treatment of chronic wounds of the lower extremity requires a systematic, multidisciplinary approach as well as flexibility in order to achieve acceptable, consistent short-term and long-term results. Maggots, once considered an obsolete therapeutic modality, can be a useful addition to the armamentarium of the foot and ankle specialist. This article describes the use of maggot debridement therapy for intractable wounds of the lower extremity. (J Am Podiatr Med Assoc 92(7): 398-401, 2002) Full article

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Use of Subatmospheric (VAC) Therapy to Improve Bioengineered Tissue Grafting in Diabetic Foot Wounds

by Eric H. Espensen, Brent P. Nixon, Lawrence A. Lavery and David G. Armstrong

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 395-397; https://doi.org/10.7547/87507315-92-7-395 - 1 Jul 2002

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The use of bioengineered tissue and topical subatmospheric pressure therapy have both been widely accepted as adjunctive therapies for the treatment of noninfected, nonischemic diabetic foot wounds. This article describes a temporally overlapping method of care that includes a period of simultaneous application [...] Read more.

The use of bioengineered tissue and topical subatmospheric pressure therapy have both been widely accepted as adjunctive therapies for the treatment of noninfected, nonischemic diabetic foot wounds. This article describes a temporally overlapping method of care that includes a period of simultaneous application of bioengineered tissue (Apligraf, Novartis Pharmaceuticals Corp, East Hanover, New Jersey) and subatmospheric pressure therapy delivered through the VAC (Vacuum Assisted Closure) system (KCI, Inc, San Antonio, Texas). Future descriptive and analytic works may test the hypothesis that combined therapies used at different and often overlapping periods during the wound-healing cycle may be more effective than a single modality. (J Am Podiatr Med Assoc 92(7): 395-397, 2002) Full article

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Charcot’s Arthropathy of the Foot

by David G. Armstrong and Edgar J. G. Peters

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 390-394; https://doi.org/10.7547/87507315-92-7-390 - 1 Jul 2002

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Neuropathic osteoarthropathy, also known as Charcot’s arthropathy, is a common complication in patients with diabetes mellitus and severe neuropathy [...] Full article

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From Acute to Chronic. Monitoring the Progress of Charcot’s Arthropathy

by Vanessa L. Nubé, Margaret McGill, Lynda Molyneaux and Dennis K. Yue

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 384-389; https://doi.org/10.7547/87507315-92-7-384 - 1 Jul 2002

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The monitoring of Charcot’s arthropathy in patients with diabetes mellitus is twofold: 1) assessment of disease activity as the condition progresses from the acute to the chronic phase, and 2) identification of structural abnormalities and complications that may arise as a result of [...] Read more.

The monitoring of Charcot’s arthropathy in patients with diabetes mellitus is twofold: 1) assessment of disease activity as the condition progresses from the acute to the chronic phase, and 2) identification of structural abnormalities and complications that may arise as a result of the disease. The former guides the clinician as to the duration of primary treatment, and the latter provides important information regarding the long-term prognosis and facilitates clinical decision making regarding other treatments including surgery, footwear, and orthoses. The mainstay of assessing disease activity remains thorough and regular assessment of swelling, temperature differences, and bony abnormalities. Radiographic assessment performed at baseline and periodically throughout the course of the disease will show stages of early fracture and fragmentation followed by eventual trabecular bridging, ankylosis of the affected joints, and sclerosis, heralding the chronic phase of the disease. Radiographic assessment also provides visualization of bony deformities and prominences. In addition to these assessments, changes may be further quantified by the use of infrared dermal thermography and quantitative bone scanning techniques. Careful clinical monitoring of patients is essential to optimize treatment for acute Charcot’s arthropathy and improve the long-term outcome for patients presenting with this condition. (J Am Podiatr Med Assoc 92(7): 384-389, 2002) Full article

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Medical Treatment of Charcot’s Arthropathy

by Edward B. Jude and Andrew J. M. Boulton

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 381-383; https://doi.org/10.7547/87507315-92-7-381 - 1 Jul 2002

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Charcot’s arthropathy is a devastating condition affecting diabetic patients with peripheral neuropathy, resulting in a foot at risk for ulceration and amputation. Early diagnosis is important for the institution of appropriate treatment, which may help prevent disease progression and foot deformity. This article [...] Read more.

Charcot’s arthropathy is a devastating condition affecting diabetic patients with peripheral neuropathy, resulting in a foot at risk for ulceration and amputation. Early diagnosis is important for the institution of appropriate treatment, which may help prevent disease progression and foot deformity. This article discusses the pathogenesis and treatment options available for the disorder. (J Am Podiatr Med Assoc 92(7): 381-383, 2002) Full article

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Jean-Martin Charcot (1825–1893). The Man Behind the Joint Disease

by Lee J. Sanders

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 375-380; https://doi.org/10.7547/87507315-92-7-375 - 1 Jul 2002

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Jean-Martin Charcot was one of the most celebrated French physicians of the 19th century. A masterful teacher and a captivating lecturer, Charcot created the foundations of neurology as an independent discipline, and transformed the Salpêtrière hospital, in Paris, into one of the world’s [...] Read more.

Jean-Martin Charcot was one of the most celebrated French physicians of the 19th century. A masterful teacher and a captivating lecturer, Charcot created the foundations of neurology as an independent discipline, and transformed the Salpêtrière hospital, in Paris, into one of the world’s greatest teaching centers for clinical neurologic research. His name is attached to the distinct pathologic entity, Charcot’s joint disease, that he so meticulously described. This article reviews the highlights of Charcot’s career and his clinicoanatomic studies of patients with tabetic arthropathies. (J Am Podiatr Med Assoc 92(7): 375-380, 2002) Full article

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Introduction

by Robert Frykberg

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 374; https://doi.org/10.7547/87507315-92-7-374 - 1 Jul 2002

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The diabetic Charcot foot continues to be an enigma nearly one and a half centuries after the condition was thoroughly described in 1868 by Professor Jean- Martin Charcot of Paris [...] Full article

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Foreword

by David G. Armstrong

J. Am. Podiatr. Med. Assoc. 2002, 92(7), 373; https://doi.org/10.7547/87507315-92-7-373 - 1 Jul 2002

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We are approaching one and a half centuries since neuropathic arthropathy was formally [...] Full article

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J. Am. Podiatr. Med. Assoc., Volume 92, Issue 7 (07 2002) – 12 articles , Pages 373-424

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