Essential Insights On Treating Psoriatic Lesions In The Lower Extremity

Patients with psoriasis can present with multiple levels of involvement and with different types of the chronic condition. Accordingly, this author discusses the presentation of the condition, offers keys to diagnosis and reviews a variety of treatment options, including topical agents and combination therapy.

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Current Concepts With DVT Prophylaxis

When and how should you administer prophylaxis to patients to prevent the potential complication of deep vein thrombosis (DVT) following lower extremity surgery? These authors discuss the risk factors for DVT and examine the research on whether one should provide prophylaxis.

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Current Insights On Imaging Techniques For Diagnosing Infection

Timely diagnosis of lower extremity infections is essential to providing effective treatment and preventing complications. Accordingly, these authors discuss the roles of various imaging modalities ranging from plain radiographs and nuclear imaging to computed tomography, magnetic resonance imaging and positron emission tomography.

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Scope Of Practice Update: Where Things Stand

Even as the APMA continues its efforts to establish a uniform scope of practice for podiatrists, battles continue over how much of the lower extremity podiatrists are allowed to treat. This author speaks to various podiatrists about scope of practice developments in Texas, South Carolina, New York and across the country.

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What You Should Know About Skin Changes In Obese Patients

A recent article in the British Journal of Dermatology outlined many of the skin conditions that occur in obese patients. As podiatric physicians, we are well aware of the effects of obesity on the lower extremity in relation to biomechanics but allow me to focus on some of the skin conditions in these patients.

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Have DPMs Abandoned Taping In Their Practice?

It is disappointing to hear DPMs say they do not use taping in practice, especially when their reasoning is that they only do surgery. If someone does not use taping, I believe he or she is turning away from podiatric roots, which are based strongly in lower extremity biomechanics. The study of biomechanics and its relationship to pathologies and treatment make podiatric medicine unique.

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Can 3D Templating And Simulation Enhance Surgical Planning?

We at the Southern Arizona Limb Salvage Alliance (SALSA) have long embraced the benefits of interconnectivity and open source solutions. Surgical planning and collaboration are no exception. The concept of 3D surgical “printing” (templating and simulation) in lower extremity reconstruction is not entirely commonplace. This is likely for a number of reasons. With the continual maturation of free and open source software applications as well as the ever increasing capabilities of “RepRap” technology (see http://reprap.org/wiki/Main_Page ), we can overcome these limitations.

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Pertinent Insights On Biologic Matrices For Soft Tissue Repair

Given the emergence of biologic matrices, these authors examine the biologic and biomechanical potential of these modalities in the lower extremity. They also offer a review of the current research on these therapies and provide a pertinent case study.

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Understanding The Osseous Contribution To Chronic Wounds

Structural deformities often contribute to the development of chronic wounds in the lower extremity but post-op offloading protocols with traditional surgical techniques can be difficult in high-risk populations. Accordingly, this author offers a closer look at soft tissue and osseous techniques that can address global forefoot deformities associated with chronic wounds, and allow early, guarded weightbearing.

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Rethinking Warm-Up Exercises For The Lower Extremity For Patients With Active Lifestyles

Recently, I attended a seminar called “Feet: Our Dynamic Base” given by Eric Franklin, a dancer and movement educator. He elegantly described the biomechanics of the foot and ankle to an audience mostly consisting of Pilates instructors, dancers and laypeople.

Those who know me well are familiar with my background as a trained dancer who ultimately became a Latin ballroom dancer, which greatly fueled my interest in podiatric medicine. It was logical to me as a dancer to pursue a field of medicine that I could truly relate to.

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Should Cigarettes Include A Graphic Warning Label Highlighting Smoking-Related Foot Amputations?

This week the Food and Drug Administration released nine graphic warning labels to appear on cigarette packs.1 This is a strong message to deter people from smoking by illustrating a variety of related health hazards. The nine warnings did not include any imagery indicating that smoking can lead to foot and lower limb amputations.

Podiatrists, vascular surgeons and orthopedists know that smoking can lead to several serious problems in the lower extremity. Some of these problems include wound healing difficulties, gangrene, non-unions and amputations.

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How To Prevent Plastic Surgery Failures In Lower Extremity Reconstruction

Whether it is diabetes, biofilms, biomechanical abnormalities or inadequate wound debridement, there are a number of factors that can lead to plastic surgery complications in lower extremity reconstruction. Accordingly, these authors emphasize a proactive
approach to managing patient comorbidities, reducing technical errors in surgery and
facilitating solid post-op protocols.

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Key Insights On Platelet-Rich Plasma For Soft Tissue Repair

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.

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