BLOGS

By Doug Richie, DPM A recent study published in the Journal of Biomechanics underpins previous concerns about the increased risk of falls when non-neurologic impaired individuals are prescribed solid, non-articulated AFO braces.(1).  Nevisipour and Honeycutt studied 10 young healthy subjects who had no neurologic deficits to learn the effects of a semi-rigid plastic AFO (See Figure 1) on the compensatory stepping response after perturbation while standing on a treadmill.   Kinematic and kinetic data were collected during perturbations simulating forward trips and included: trunk angle and angular velocity, step length, Center Of Mass-Boundary Of Stability, [...]

By Doug Richie, DPM Several foot and ankle surgical companies such as  Arthrex, Crossroads, Paragon 28, and Treace Medical are marketing direct to the consumer on the internet to promote their technologies while also featuring  “Find a Doctor” tools . Of concern, two surgical companies are marketing directly to consumers (patients) on the internet and touting questionable advantages of “3-D and 4-D” correction of bunions utilizing a modified Lapidus procedure.   Practitioners are now reporting frustration with having to defend their recommendation of traditional surgical procedures for hallux valgus deformity (HAV) when patients confront them with [...]

By Doug Richie, DPM Considerable Decrease in Podiatric Medical School Enrollment With the beginning of the 2022-2023 academic year, a significant number of available first-year positions at the colleges of podiatric medicine are not filled due to a drastic reduction of qualified applicants.(1)  Conversely,  applications to allopathic medical schools substantially increased by 18% compared to last year. (2) I wrote Part 1 of this blog 8 years ago in 2014. (3) At that time, I was alarmed by the relatively small number of people applying for admission to the nine colleges of podiatric medicine in [...]

By Doug Richie, DPM A new study underscores the importance of training and competency in conservative care of foot and ankle disorders.1 Kadakia and coworkers reviewed the Westlaw legal database for medical malpractice lawsuits pertaining to foot and ankle surgery for the years 2008 thru 2018. The reasons for litigation, among the forty-nine cases reviewed included: o   Negligent operative treatment (33 percent) o   Negligent nonoperative treatment (27 percent) o   Unnecessary operation (8 percent) o   Delayed diagnosis (4 percent) o   Lack of informed consent (2 percent) Kadakia, et al found that most of the malpractice claims in [...]

By Doug Richie, DPM A recent published study from the Netherlands conducted by Rasenberg and coworkers concluded that referral of patients with plantar heel pain by general practitioners (GPs) to podiatrists for custom orthotic insoles provided no benefit after 12 weeks of follow-up.1 In fact, the study showed that patients given the “usual care” provided by GPs resulted in less pain during activity compared to the group referred to a podiatrist for custom insoles. However, the difference was only one point on an 11-point numerical rating scale and did not meet the standard of minimal clinical [...]

By Doug Richie, DPM How do you teach a parent the necessary steps to verify that their child’s shoes fit properly? Is a “thumb’s width” all that is necessary? Does this space requirement change as the child’s foot grows longer? The answers to these questions may surprise you, as recent studies provide interesting insight into the challenges of fitting shoes properly for a growing child. Allowing adequate volume inside shoes worn by children is critical to reduce the risk of acquired deformity which can carry forward into adult life.1-4 In last month’s blog in Podiatry Today, I presented [...]