Conservative treatment of peripheral neuropathy and neuropathic pain.

There are many types of peripheral nerve disorders that lead to peripheral neuropathy. Symptoms associated with peripheral neuropathy lack consistent, easy to treat qualities, and provide a constant challenge for physicians who encounter the sequelae of neuropathy. This review discusses medications, nutritional supplements, and topical and physical modalities that are effective in treating neuropathy associated with diabetes.

Psychosocial management of the foot and ankle surgery patient.

Currently, many patients undergo surgery when they and their families are not prepared or resilient enough to recover fully, predisposing them to poor outcomes. These poor outcomes lead to missed work, patient depression, chronic pain, litigation, and surgeon frustration. Sometimes these individuals require the surgeon's oversight and are more likely to improve with rapid vocational therapy, physical therapy, and aggressive, continuous chronic-pain management. The foot and ankle surgeon who takes a biopsychosocial multidisciplinary perspective will prescreen his or her patients for positive risk factors and expand his or her intervention long before and after surgery. This strategy of triaging medical cases to differential treatment is not a new concept in medicine. What is novel is the necessity of triaging and prioritizing patients on the basis of the most significant factors that determine successful surgical outcome: psychologic, social, environmental, and historical medical factors . Robert Sternberg of Yale University suggested that three psychologic problem-solving strategies are available: (1) I can try to change myself, (2) I can try to change others, or (3) I can try to change the situation. Naturally, the authors of this article encourage applying all three: (1) the caring surgeon is attentive to these issues; (2) the medical community prepares the patient, themselves, and the patient's family; and (3) the environment into which the patient is released is altered to support their rehabilitation. The ABLE Presurgical Assessment Tool and related treatment strategies provide foot and ankle surgeons with an easy-to-use, research-based application to better screen and manage their surgical patients. The goal of this review and assessment tool is not to determine a quantitative level of risk. Instead, the authors hope to facilitate a surgeon's awareness of critical preoperative risk factors and provide a tool to efficiently identify these factors and arrange appropriate treatment as needed.

Deep venous thrombosis risk assessment, incidence, and prophylaxis in foot and ankle surgery.

As discussed in this review, DVT and PE are dangerous clinical diagnoses that can occur following foot and ankle surgery. The authors have provided a clinical protocol, a risk assessment tool, and treatment guidelines for this condition that can be applied to the everyday practice of foot and ankle surgeons. Unlike recommendations in previous studies, the authors believe that podiatric and orthopedic surgeons operating on the foot and ankle should evaluate each patient carefully and consider pharmacologic prophylaxis against DVT formation when significant risk factors are present.

Perioperative management of foot and ankle trauma.

This review covers the perioperative management of trauma to the foot and ankle. The goal when treating these injuries is to return the patient to a sensate, plantigrade, painless, and functioning foot and ankle. Depending on the nature of the trauma, realistic outcomes should be established for the patient, family, and surgeon. The importance of early recognition and treatment of foot and ankle injuries has been established and is paramount for the overall recovery of traumatized patient.

Progressive post-traumatic ankle arthrosis treated with total ankle joint replacement: a case review.

This article discusses the joint degeneration progression associated with post-traumatic arthrosis of the ankle. A representative case study of this debilitating condition was outlined, and treatment with total ankle joint replacement was presented. Although ankle arthrodesis continues to be a standard option following the progression of severe post-traumatic osteoarthritis, total ankle replacement is maturing as a viable option for this condition.

X-ray evaluation using the X-PODite digital radiograph analyzer. A preliminary study.

The traditional methods of manual radiograph measurement lack standardization and are often inaccurate and time consuming. By addressing the documented variables that create these inaccuracies, the X-PODite Digital Radiograph Analyzer appears to maximize the accuracy, reproducibility, and usefulness of radiographic measurements. Additionally, the time required for an evaluation, ease of use, and database capabilities of the X-PODite system facilitate thorough clinical evaluations and important outcomes research. Although the authors plan to evaluate this new system further, opportunities exist for applications and studies using X-PODite's HAV, biomechanical, tailor's bunion, and calcaneal trauma evaluation options.