Clinics in podiatric medicine and surgery
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Tears of the peroneus brevis tendon are more frequent than reported in the literature. Because of the vague pain associated with structures of the lateral ankle, peroneal tears are frequently misdiagnosed. Physical signs such as swelling along the course of the peroneal tendon sheath, pain with eversion, and subluxing tendons are diagnostic of peroneal pathologic conditions. ⋯ Débridement and tubularization are recommended for less extensive tears. In more severe cases, resection of the damaged tendon and tenodesis of the proximal and distal segments to the peroneus longus are necessary. Return to maximum activity is prolonged, but with proper patient selection, evaluation, and treatment, good to excellent results can be expected.
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The intent of this article is to present the current understanding of fracture repair and offer investigative evidence to the use of exogenous growth factors enhancing fracture healing. The authors believe that exogenous growth factors have tremendous clinical applications and will continue to influence bone healing in the future. With the expanding knowledge of the intricate molecular and cellular biology of fracture repair being realized, surgeons will be able to enhance and ensure healing of surgical osteotomies, fractured bone ends, or delayed unions. This field of medicine is continuously growing and the possibilities seem endless.
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Unfortunately, many physicians and patients only seek pharmacologic treatments to aid in pain relief; however, many nonpharmacologic interventions exist with excellent potential for pain treatment. This article reviews several of these strategies with an emphasis on clinical indications and expected outcomes. The topics of chronic pain psychology and prescription writing also are reviewed. As a medical provider, it is important to remain open minded to alternative approaches to pain control.
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Clin Podiatr Med Surg · Aug 2011
ReviewAdvanced foot and ankle fixation techniques in patients with diabetes.
This article presents advanced techniques and current fixation constructs that are advantageous for the management of diabetic foot and ankle trauma and Charcot neuroarthropathy. Both these pathologies are often intimately related, and the fixation constructs that are required often require sound biomechanical concepts coupled with innovative approaches to achieve bone healing and limb salvage.
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Clin Podiatr Med Surg · Jul 2008
ReviewPost-operative pain management using patient-controlled analgesia.
Patient-controlled analgesia is an effective form of postoperative pain management for select lower extremity orthopedic procedures in the in-patient setting. The goal of this article is to present an introduction to the prescription and management of patient-controlled analgesia in the acute, postoperative setting. The surgeon should have a thorough understanding of this intervention as it relates to pain control and overall patient care.