Journal of the American Podiatric Medical Association

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Open AccessArticle

How Health Policy and Practice Affects Your Practice

by Lloyd S. Smith

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 218-219; https://doi.org/10.7547/0950218 - 1 Mar 2005

Viewed by 40

APMA’s Department of Health Policy and Practice handles a wide range of activities that directly affect you as a practicing podiatric physician. Think in terms of Medicare, Medicaid, TRICARE, CMS, OIG, HIPAA, DME, CoPs, BMAD data, CAC and PIAC, private insurance, managed care, [...] Read more.

APMA’s Department of Health Policy and Practice handles a wide range of activities that directly affect you as a practicing podiatric physician. Think in terms of Medicare, Medicaid, TRICARE, CMS, OIG, HIPAA, DME, CoPs, BMAD data, CAC and PIAC, private insurance, managed care, hospital privileging, state scope of practice, JCAHO, CPT and coding, and RUC and reimbursement, and this department has the bases covered [...] Full article

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Open AccessLetter

Brucella Osteomyelitis of the Calcaneus

by Lutfu Baktiroglu, Fadile Zeyrek, Adil Ozturk, Pelin Yazgan, Ocal Sirmatel and Erdem Isikan

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 216-217; https://doi.org/10.7547/0950216 - 1 Mar 2005

Cited by 3 | Viewed by 47

Abstract

To the Editor: Brucellosis was first described by Hippocrates in 450 BC, and it has been known by many terms, including Malta fever, Mediterranean fever, Gibraltar fever, Cyprus fever, and undulant fever [...] Full article

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Open AccessArticle

Internet Resources for Podiatric Medical Students

by Charles R. Fikar

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 211-215; https://doi.org/10.7547/0950211 - 1 Mar 2005

Cited by 2 | Viewed by 53

Abstract

This article presents a selection of Internet resources covering most of the subject areas found in standard medical education curricula. Basic-sciences sites are emphasized, but clinical resources are also included. Sites were evaluated on the basis of their potential to enhance the learning [...] Read more.

This article presents a selection of Internet resources covering most of the subject areas found in standard medical education curricula. Basic-sciences sites are emphasized, but clinical resources are also included. Sites were evaluated on the basis of their potential to enhance the learning process, provide practice questions or study guides for examinations, or aid in the preparation of papers. Podiatric medical students, residents, and practitioners who require a quick reference guide to sources covering the basic-science foundations of podiatric medicine or the clinical side of general medicine may find this article useful. Full article

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Open AccessArticle

Capsular Interposition for the Keller Bunionectomy with the Use of Soft-Tissue Anchors

by Keith D. Cook

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 180-182; https://doi.org/10.7547/0950180 - 1 Mar 2005

Cited by 5 | Viewed by 57

Abstract

The Keller procedure has been used during the past century for the treatment of first metatarsophalangeal joint pathology. Many modifications to the procedure have been made, including interposition of the joint capsule into the first metatarsophalangeal joint space. Capsular interposition is often the [...] Read more.

The Keller procedure has been used during the past century for the treatment of first metatarsophalangeal joint pathology. Many modifications to the procedure have been made, including interposition of the joint capsule into the first metatarsophalangeal joint space. Capsular interposition is often the most difficult step in performing the Keller bunionectomy. This article describes a new, simplified technique for capsular interposition with the use of a dorsal capsular flap and soft-tissue anchors. Full article

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Open AccessArticle

Onychoplasty with Carbon Dioxide Laser Matrixectomy for Treatment of Ingrown Toenails

by Tara Farley-Sakevich, John F. Grady, Emil Zager and Timothy M. Axe

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 175-179; https://doi.org/10.7547/0950175 - 1 Mar 2005

Cited by 11 | Viewed by 81

Abstract

Ingrown toenails are one of the most common pathologic conditions encountered in podiatric medical practice. Many methods of treatment for ingrown toenails have been used and studied, including chemical matrixectomies, surgical approaches, and CO₂ laser ablation. This study is a retrospective review [...] Read more.

Ingrown toenails are one of the most common pathologic conditions encountered in podiatric medical practice. Many methods of treatment for ingrown toenails have been used and studied, including chemical matrixectomies, surgical approaches, and CO₂ laser ablation. This study is a retrospective review of a new technique that consists of resection of the involved nail matrix using a No. 15 blade and controlled cauterization using a CO₂ laser. The technique was performed on 381 painful ingrown toenails, and all of the patients were followed up postoperatively for an average of 34 months. The results showed minimal pain, a low recurrence rate, rapid return to activity, and good cosmesis. Full article

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Open AccessArticle

Ulceration of Pyoderma Gangrenosum Treated with Negative Pressure Wound Therapy

by Stephen M. Geller and James A. Longton

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 171-174; https://doi.org/10.7547/0950171 - 1 Mar 2005

Cited by 14 | Viewed by 64

Abstract

Pyoderma gangrenosum is a skin disease characterized by wounds with blue-to-purple undermined borders surrounding purulent necrotic bases. This article reports on a patient with a circumferential, full-thickness, and partially necrotic lower-extremity ulceration of unknown etiology. Results of laboratory tests and arterial and venous [...] Read more.

Pyoderma gangrenosum is a skin disease characterized by wounds with blue-to-purple undermined borders surrounding purulent necrotic bases. This article reports on a patient with a circumferential, full-thickness, and partially necrotic lower-extremity ulceration of unknown etiology. Results of laboratory tests and arterial and venous imaging studies were found to be within normal limits. The diagnosis of pyoderma gangrenosum was made on the basis of the histologic appearance of the wound tissue after biopsy as a diagnosis of exclusion. Negative pressure wound therapy was undertaken, which saved the patient’s leg from amputation. Although negative pressure wound therapy has demonstrated efficacy in the treatment of chronic wounds in a variety of circumstances, this is the first documented use of this technique to treat an ulceration secondary to pyoderma gangrenosum. Full article

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Open AccessArticle

Melorheostosis in a Pediatric Patient

by Michael A. Schreck

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 167-170; https://doi.org/10.7547/0950167 - 1 Mar 2005

Cited by 5 | Viewed by 48

Abstract

Melorheostosis is a nonhereditary and uncommon condition that can affect both adults and children. It can appear on radiographs as increased sclerosis on bones of the upper and lower extremities and may mimic other bony conditions such as osteopoikilosis, osteopetrosis, arthrogryposis multiplex congenita, [...] Read more.

Melorheostosis is a nonhereditary and uncommon condition that can affect both adults and children. It can appear on radiographs as increased sclerosis on bones of the upper and lower extremities and may mimic other bony conditions such as osteopoikilosis, osteopetrosis, arthrogryposis multiplex congenita, and osteopathia striata. The sclerotic appearance can differ greatly between adults and children. The skin and subcutaneous tissues may be affected by fibrosis, resulting in contractures of joints and limbs that lead to deformities and limb-length discrepancies. This article reviews the literature on melorheostosis and describes a case in a 10-year-old boy. Full article

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Open AccessArticle

Diffuse Pigmented Villonodular Synovitis

by Hai-En Peng, Christopher P. Segler, James W. Stavosky, Bruce M. Dobbs and Hai-En Peng,

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 161-166; https://doi.org/10.7547/0950161 - 1 Mar 2005

Cited by 2 | Viewed by 51

Abstract

Pigmented villonodular synovitis is nonmalignant and nonmetastasizing, but it is locally destructive and can result in considerable disability through infiltration and involvement of surrounding soft tissues and bone. This article briefly describes the clinical picture of the diffuse form of pigmented villonodular synovitis [...] Read more.

Pigmented villonodular synovitis is nonmalignant and nonmetastasizing, but it is locally destructive and can result in considerable disability through infiltration and involvement of surrounding soft tissues and bone. This article briefly describes the clinical picture of the diffuse form of pigmented villonodular synovitis and reports on two cases involving juxta-articular erosions of the calcaneocuboid joint. Treatment involved substantial curettage of bone and resection of infiltrated intrinsic musculature. Full article

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Open AccessArticle

Unusually Large Cellular Schwannoma of the Foot

by Warren A. Pasternack and Deborah J. Winter-Reiken

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 157-160; https://doi.org/10.7547/0950157 - 1 Mar 2005

Cited by 13 | Viewed by 51

Abstract

This article presents a case of an unusually large cellular schwannoma of the foot. This uncommon lesion of the lower extremity is described with regard to clinical appearance, radiologic evaluation (including magnetic resonance imaging), histologic characteristics, and intraoperative findings. Full article

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Open AccessArticle

A Simple Technique for Correcting Footdrop. Suspension Tenodesis of the Tibialis Anterior Tendon to the Distal Tibia

by Thomas S. Roukis, Adam S. Landsman, Khushroo E. Patel, Marc Sloan and Dina Petricca

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 154-156; https://doi.org/10.7547/0950154 - 1 Mar 2005

Cited by 7 | Viewed by 55

Abstract

Surgical correction of the footdrop deformity caused by various neuromuscular diseases is a time-honored technique, with most surgical procedures intended to correct the absence of active dorsiflexion and a concomitant cavovarus foot deformity. We describe suspension tenodesis of the tibialis anterior tendon to [...] Read more.

Surgical correction of the footdrop deformity caused by various neuromuscular diseases is a time-honored technique, with most surgical procedures intended to correct the absence of active dorsiflexion and a concomitant cavovarus foot deformity. We describe suspension tenodesis of the tibialis anterior tendon to the distal tibia to correct the footdrop deformity. This technique is simpler to perform and more secure than transferring the distal attachment of a tendon to a new location in the foot itself or using tendon weaving techniques. In addition, compared with an ankle fusion, our technique allows for a certain amount of shock absorption during gait and is much less invasive, and a future ankle fusion could be performed if needed for full stability and definitive correction of the symptomatic footdrop. Finally, the technique we describe is easily reproducible and seems to remain stable over time. (J Am Podiatr Med Assoc 95(2): 154–156, 2005) Full article

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Open AccessArticle

A Critical Discussion of the Use of Antiseptics in Acute Traumatic Wounds

by Robert G. Smith

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 148-153; https://doi.org/10.7547/0950148 - 1 Mar 2005

Cited by 21 | Viewed by 62

Abstract

Approximately 10 million patients with traumatic wounds are treated in US emergency departments annually. The practice of wound cleansing or antiseptic management has a dichotomous history anchored in tradition and science. The merits of antiseptic fluid irrigation of traumatic wounds have received little [...] Read more.

Approximately 10 million patients with traumatic wounds are treated in US emergency departments annually. The practice of wound cleansing or antiseptic management has a dichotomous history anchored in tradition and science. The merits of antiseptic fluid irrigation of traumatic wounds have received little scientific study. The purpose of this article is to critically evaluate the potential harm to patient outcome by the use of antiseptics on acute wounds. First, animal and cell culture data that describe the effects of topical antiseptics on wound healing are offered. Second, human case studies are presented to illustrate the potential harm of the indiscriminate use of antiseptics. Finally, data from previously published reviews are presented and evaluated for clinically based evidence to justify the current practice of antiseptic use in acute traumatic wounds. (J Am Podiatr Med Assoc 95(2): 148–153, 2005) Full article

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Open AccessArticle

Improved Sensitivity in Patients with Peripheral Neuropathy. Effects of Monochromatic Infrared Photo Energy

by Salvatore L. DeLellis, Dale H. Carnegie and Thomas J. Burke

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 143-147; https://doi.org/10.7547/0950143 - 1 Mar 2005

Cited by 33 | Viewed by 55

Abstract

The medical records of 1,047 patients (mean age, 73 years) with established peripheral neuropathy were examined to determine whether treatment with monochromatic infrared photo energy was associated with increased foot sensitivity to the 5.07 Semmes-Weinstein monofilament. The peripheral neuropathy in 790 of these [...] Read more.

The medical records of 1,047 patients (mean age, 73 years) with established peripheral neuropathy were examined to determine whether treatment with monochromatic infrared photo energy was associated with increased foot sensitivity to the 5.07 Semmes-Weinstein monofilament. The peripheral neuropathy in 790 of these patients (75%) was due to diabetes mellitus. Before treatment with monochromatic infrared photo energy, of the ten tested sites (five on each foot), a mean ± SD of 7.9 ± 2.4 sites were insensitive to the 5.07 Semmes-Weinstein monofilament, and 1,033 patients exhibited loss of protective sensation. After treatment, the mean ± SD number of insensate sites on both feet was 2.3 ± 2.4, an improvement of 71%. Only 453 of 1,033 patients (43.9%) continued to have loss of protective sensation after treatment. Therefore, monochromatic infrared photo energy treatment seems to be associated with significant clinical improvement in foot sensation in patients, primarily Medicare aged, with peripheral neuropathy. Because insensitivity to the 5.07 Semmes-Weinstein monofilament has been reported to be a major risk factor for diabetic foot wounds, the use of monochromatic infrared photo energy may be associated with a reduced incidence of diabetic foot wounds and amputations. (J Am Podiatr Med Assoc 95(2): 143–147, 2005) Full article

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Open AccessArticle

Future of Gait Analysis. A Podiatric Medical Perspective

by Sarah A. Curran and Howard J. Dananberg

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 130-142; https://doi.org/10.7547/0950130 - 1 Mar 2005

Cited by 14 | Viewed by 55

Abstract

Despite the plethora of information on human gait analysis, its continued use as a clinical tool remains uncertain. Analysis of gait dysfunction has become integral to podiatric medical practice, and, like many specialized fields, it is rapidly changing to meet the needs of [...] Read more.

Despite the plethora of information on human gait analysis, its continued use as a clinical tool remains uncertain. Analysis of gait dysfunction has become integral to podiatric medical practice, and, like many specialized fields, it is rapidly changing to meet the needs of the future. Practice in the 21st century is predicated on the concept of multidisciplinary working approaches and a growing trend toward evidence-based practice, in which gait analysis could play a prominent role. This article provides a historical synopsis of instrumented gait analysis and its associated subcomponents and discusses the salient issues concerning its future role in podiatric medicine. (J Am Podiatr Med Assoc 95(2): 130–142, 2005) Full article

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Open AccessArticle

Management of Hallux Limitus with Distraction of the First Metatarsophalangeal Joint

by Leonard M. Talarico, George R. Vito, Larry Goldstein and Adam D. Perler

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 121-129; https://doi.org/10.7547/0950121 - 1 Mar 2005

Cited by 22 | Viewed by 50

Abstract

This article describes a joint-preserving and joint-restoring procedure for the management of hallux limitus and hallux rigidus. The procedure uses a minirail external fixator to obtain distraction with or without arthrotomy of the first metatarsophalangeal joint. This procedure aims to restore joint function [...] Read more.

This article describes a joint-preserving and joint-restoring procedure for the management of hallux limitus and hallux rigidus. The procedure uses a minirail external fixator to obtain distraction with or without arthrotomy of the first metatarsophalangeal joint. This procedure aims to restore joint function through elimination of the pathologic forces involved in hallux limitus and hallux rigidus. Both intrinsic and extrinsic muscular imbalances are reduced. Follow-up of 133 patients treated in this manner since 1997 demonstrates excellent long-term results. (J Am Podiatr Med Assoc 95(2): 121–129, 2005) Full article

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Open AccessArticle

Use of the Longitudinal Arch Angle to Predict Dynamic Foot Posture in Walking

by Thomas G. McPoil and Mark W. Cornwall

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 114-120; https://doi.org/10.7547/0950114 - 1 Mar 2005

Cited by 52 | Viewed by 46

Abstract

To determine whether differences exist in the longitudinal arch angle based on sex or extremity, the longitudinal arch angle was assessed in 21 men and 21 women using a digital image of the medial aspect of each subject’s feet. The image was obtained [...] Read more.

To determine whether differences exist in the longitudinal arch angle based on sex or extremity, the longitudinal arch angle was assessed in 21 men and 21 women using a digital image of the medial aspect of each subject’s feet. The image was obtained with the subject in relaxed standing posture and in maximum internal rotation of the lower leg. To determine whether the longitudinal arch angle could be used to predict dynamic foot posture during walking, 50 different subjects were asked to walk across a 6-m walkway while the medial aspect of each foot was videotaped. The longitudinal arch angle was digitized from digital images obtained at midstance for three walking trials. No differences in the longitudinal arch angle were found based on sex or extremity. The longitudinal arch angles obtained in the static positions of relaxed standing posture and maximum internal rotation were highly predictive of dynamic foot posture at midstance during walking. Relaxed standing posture and maximum internal rotation significantly contributed to explaining more than 90% of the variance associated with the longitudinal arch angle position at midstance during walking. These results validate use of the longitudinal arch angle as part of the foot and ankle physical examination. (J Am Podiatr Med Assoc 95(2): 114–120, 2005) Full article

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Open AccessArticle

Sinus Tarsi Denervation. Clinical Results

by A. Lee Dellon and Stephen L. Barrett

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 108-113; https://doi.org/10.7547/0950108 - 1 Mar 2005

Cited by 32 | Viewed by 82

Abstract

Traumatic neuroma of the branches of the deep peroneal nerve that innervate the sinus tarsi can be the source of recalcitrant lateral ankle pain. That these nerves can be the source of the pain can be demonstrated by nerve blocks, and this pain [...] Read more.

Traumatic neuroma of the branches of the deep peroneal nerve that innervate the sinus tarsi can be the source of recalcitrant lateral ankle pain. That these nerves can be the source of the pain can be demonstrated by nerve blocks, and this pain can be surgically treated by resection of the appropriate branch of the deep peroneal nerve. This article documents the clinical results of this approach in 13 patients with sinus tarsi syndrome. At a minimum of 6 months postoperatively, 10 patients (77%) were completely pain-free, wore normal shoes, and had returned to work. Two patients (15%) had a small degree of residual pain but resumed usual activities and wore normal footwear. One patient had some pain relief but could not resume usual activities. We conclude that denervation of the sinus tarsi can relieve recalcitrant pain emanating from the sinus tarsi. This approach may reduce the need for subtalar fusion or evacuation procedures, including arthroereisis, thus avoiding their potential complications. Moreover, sinus tarsi denervation may allow the continued use of an arthroereisis implant in the presence of satisfactory objective findings, despite the subjective presence of postoperative pain. (J Am Podiatr Med Assoc 95(2): 108–113, 2005) Full article

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Open AccessArticle

Cooling the Foot to Prevent Diabetic Foot Wounds. A Proof-of-Concept Trial

by David G. Armstrong, Melinda B. Sangalang, David Jolley, Frank Maben, Heather R. Kimbriel, Brent P. Nixon and I. Kelman Cohen

J. Am. Podiatr. Med. Assoc. 2005, 95(2), 103-107; https://doi.org/10.7547/0950103 - 1 Mar 2005

Cited by 23 | Viewed by 49

Abstract

The etiology of neuropathic diabetic foot wounds can be summarized by the following formula: pressure × cycles of repetitive stress = ulceration. The final pathway to ulceration consists of an inflammatory response, leading to tissue breakdown. Mitigation of this response might reduce the [...] Read more.

The etiology of neuropathic diabetic foot wounds can be summarized by the following formula: pressure × cycles of repetitive stress = ulceration. The final pathway to ulceration consists of an inflammatory response, leading to tissue breakdown. Mitigation of this response might reduce the risk of ulceration. This proof-of-concept trial evaluates whether simple cooling of the foot can safely reduce the time to thermal equilibrium after activity. After a 15-min brisk walk, the six nondiabetic volunteers enrolled were randomly assigned to receive either air cooling or a 10-min 55°F cool water bath followed by air cooling. The process was then repeated with the intervention reversed, allowing subjects to serve as their own controls. There was a rise in mean ± SD skin temperature after 15 min of activity versus preactivity levels (87.8° ± 3.9° versus 79° ± 2.2° F; P = .0001). Water cooling immediately brought the foot to a point cooler than preactivity levels for all subjects, whereas air cooling required an average of nearly 17 min to do so. Ten minutes of cooling required a mean ± SD of 26.2 ± 5.9 min to warm to preactivity levels. No adverse effects resulted from the intervention. We conclude that cooling the foot may be a safe and effective method of reducing inflammation and may serve as a prophylactic or interventional tool to reduce skin breakdown risk. (J Am Podiatr Med Assoc 95(2): 103–107, 2005) Full article

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J. Am. Podiatr. Med. Assoc., Volume 95, Issue 2 (03 2005) – 17 articles , Pages 103-219

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