ABSTRACT
Hyperbaric oxygen therapy (HBOT) is a useful tool for many conditions within the scope of practice of a Doctor of Podiatric Medicine (DPM). More wound-care clinics are adding HBOT as a service line. The increasing prevalence of DPMs operating inside of these wound-care clinics has raised questions about the licensure and privileging of DPMs to supervise HBOT. This document reviews the safety of outpatient HBOT and provides guidelines for hospitals to credential DPMs to supervise treatments.
Subject(s)
Credentialing/standards , Hyperbaric Oxygenation/standards , Podiatry/organization & administration , Practice Guidelines as Topic/standards , Wounds and Injuries/therapy , Humans , United StatesABSTRACT
Charcot's arthropathy is a destructive arthritis that can occur in patients with peripheral neuropathies of various etiologies. This report describes a rare case of Charcot's arthropathy attributable to the distal sensory polyneuropathy associated with HIV infection. As treatments for HIV/AIDS advance and life expectancy increases, cases of end-organ sequelae, such as Charcot foot, may become more common.
Subject(s)
Arthropathy, Neurogenic/virology , HIV Infections/complications , Polyneuropathies/complications , Arthropathy, Neurogenic/diagnosis , Arthropathy, Neurogenic/therapy , Humans , Male , Middle AgedABSTRACT
Central ray resections often result in a biomechanically unsound forefoot often accompanied by a cleft wound that is difficult to heal. Narrowing the forefoot enables the surgeon to close the plantar defect primarily, foregoing prolonged wound care and lowering the risk for postoperative complications. The authors present a technique of narrowing the forefoot using a small light-weight external fixation device that allows for immediate wound closure without adjacent metatarsal osteotomies. Four patients were treated with this technique, and all four healed in a timely fashion and resumed their previous lifestyle without skin breakdown. The forefoot narrowing technique results in a stable plantigrade forefoot in individuals at high risk for diabetes-related lower extremity reulceration and amputation.
Subject(s)
Amputation, Surgical , Forefoot, Human/surgery , Wound Healing , External Fixators , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
Trauma to the foot is commonly seen in the emergency setting. An accurate diagnosis and step-wise management is appropriate. Although most injuries respond to aggressive non-surgical treatment, surgical intervention may be required for an unstable or a displaced fracture, particularly of the first metatarsophalangeal joint.
