The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

July 05, 2008 #3,290 Editor-Barry Block, DPM, JD

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ATTENTION MIDWEST FLOOD VICTIMS

A generous podiatrist (who wishes to remain anonymous) has offered to donate 3 podiatry chairs, 2 X-ray machines, a CO2 laser, and podiatry cabinets to any podiatrist adversely affected by the recent floods. Please contact bblock@podiatrym.com for details.

There’s No Scientific Basis for Detox Foot Pads: NY Podiatrist

After a night of debauchery, it might be impossible to restore your memory and cleanse your conscience, but what if while you were sleeping you could rid your liver and body of the evening’s damage? That’s what reflexology-based BodyRelief detox pads promise to do by sucking toxins and surplus fluids out through your soles.

Dr. Tzvi Bar-David

According to Columbia University Medical Center/New York–Presbyterian Hospital podiatrist Tzvi Bar-David, there’s no scientific basis to the miracle-inducing product. Since most folks’ feet don’t sweat much during the night (surprise!), the doc posits that an oxygenation reaction or a gel that becomes liquid when exposed to the air might cause the goo to appear. “It could just be—for lack of a better term—witch oil,” he says. “It seems to be a benign product, but if there was some real evidence that it works, I’d know about it,” he adds.

Source: Helen Yun, Time Out New York

OCPM Holds Footprints & Shoe Prints Forensics Seminar

On Saturday, June 28, The Ohio College of Podiatric Medicine (OCPM) welcomed over 50 podiatrists and law enforcement officers to the Footprints & Shoe Prints Forensics Seminar, in which participants learned more about the value of footwear and footprints in forensic science.

Michael S. Nirenberg, DPM, Michael W. Forman, DPM, Sergeant Robert B. Kennedy, Michael A. Wasowicz and Professor Wesley Vernon

The seminar included topics and lectures such as preservation of a crime scene, and what a podiatrist can learn from a shoe print at a crime scene. The seminar was very interesting and provided an inside look at the role podiatrists often play in solving crimes. The seminar included lectures by Michael S. Nirenberg, DPM, Michael W. Forman, DPM, Sergeant Robert B. Kennedy, Michael A. Wasowicz and Professor Wesley Vernon.

Use Walkie-Talkies for Improved Staff Communication

At an AAPPM meeting, Dr. Hal Ornstein recommended two-way radios in the office. I have found this method of communication to be a very valuable asset to my practice and must conservatively estimate that this has increased my staff efficiency by 50%. I find that my staff is within the reach of the small button attached to my tie and have trained them to respond to a few beeps. I relay commands over the air many times during my average work day and have found that this has increased the quality of care which I render to my patients.

Source: Frank DiPalma, DPM

Query: EHB as a Spacer for Keller Procedure

I have a frail, 67 y/o woman who wants/needs a Keller. Although her pulses are good, her skin is thin & atrophic. I'm concerned about the quality of her capsule. I would also like to minimize the dissection.

Hallux valgus in 67 y/o woman

Has anyone ever used a free graft of the EHB tendon as a spacer? I assume I would need to fan out the tendon and secure it to the adjacent capsule. I know that hand surgeons do something similar when treating CMC arthritis.

Greg Caringi, DPM, Lansdale, PA

Query: Diabetic Socks

We've been purchasing diabetic socks from the Sock Outlet in Huntingdon Valley, PA. Unfortunately, they are closing the factory. Their socks (style 200) are 90% Dura Spun Acrylic and 10% Nylon. They offered sizes 9-11, 10-13, 13-15, and 15-17. The sole was cushioned and they had a special non-irritating seam in addition to being wide without falling down. The cost was $3/pr plus S&H. Does anyone dispense a similar sock in their practice, and if so, where do I find them?

John Hickey, DPM, Levittown, NY

Query: Repair of STJ Cyst and Os Trigonum

My patient has a subtalar joint (STJ) cyst located on the posterior facet. In addition she has os trigonum syndrome due to a severe ankle injury. What codes would I use for repair of the STJ cyst, and removal of the os trigonum?

Scott Morris, DPM, Oklahoma City, OK

Response: I would recommend the following:

CPT 28100 - excision or curettage bone cyst, or benign tumor, talus or calcaneus

CPT 28120 - partial excision bone, talus or calcaneus

Howard Zlotoff DPM, Camp Hill, PA

Codingline subscription information can be found here

RE: Paronychia in a 6 Week Old Infant (Stuart W. Honick, DPM)
From: Multiple Respondents

First and foremost, you must remove the granulation tissue. The child will scream and mom will cringe (after you have warned her). No anesthesia and with tissue nippers remove the granulation tissue and if you need to use a currette, make sure the distal nail edge is free and does not remain embedded into the skin. Thereafter, show the mother how to pull the distal tuft of skin plantarly away from the distal nail plate. See the child every 2 weeks and slowly this should resolve the problem. Remind the parents that patience is the key. This has always worked for me.

Gregory T. Amarantos, DPM, Lake Forest, IL, amogreg@aol.com

I have seen this several times in newborns which apparently began by in-utero position and have had success by gently trimming back the distal aspect of the nail with a #61 blade & (if necessary) applying silver nitrate to shrink/cauterize the granulation (Advise the mother it will darken/ oxidize the skin & wears off in about 28 days). I then advise/illustrate to the mother how to "train" the nail by gingerly lifting/freeing the distal edge of the nail on a daily basis to allow the nail to grow over the distal soft tissue, by using an orange stick soaked/sterilized in isopropyl alcohol or Betadine, followed by application of Neosporin, Bactroban or 3AO. I check it on a weekly basis to assure compliance & resolution. If infection does occur (rarely) , I coordinate antibiosis with pediatrician. Surgical avulsion should always/only be a last resort.

Robert K Hall, DPM, Ft Lauderdale, FL, robertkhalldpm@bellsouth.net

You might have success with weekly or bi-weekly applications of 75% silver nitrate to shrink the granulation tissue. Don’t forget to warn Mom about the color change.

Evan F. Meltzer, DPM, Jackson, MS, Evan.Meltzer@va.gov

RE: AED’s in the Office (Bob Levoy)
From: Brian Kiel, DPM

We have AED's in each of our offices. Everyone (front and back staff) has been trained to use them. Fortunately, we have never needed to use one.

Brian Kiel, DPM, Memphis, TN, Footdok4@gmail.com

ASSOCIATE POSITION - CALIFORNIA

Central Valley/Southern CA. Salary excellent with all paid benefits/incentives including malpractice/401k and profit sharing. Surgery Center and hospital based with no HMOs/no rest homes. Bilingual in English and Spanish. Offering a permanent position/partnership in a multi-million dollar hi-tech practice. E-mail CV to: Tonya@wetreatyourfeet.com

ASSOCIATE POSITION – CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for full-time podiatrist in a multi practice location
in the Chicago land and Northwest Indiana area. Must have two years of surgical residency. Please e-mail resume to d-kitchens@footexperts.com

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com

IMMEDIATE OPENING - MINNEAPOLIS, MN

Associate leading to partner in well-established practice. Seeking personable, skillful, and attentive podiatrist. No nursing homes, evenings or weekends. Competitive compensation package including health insurance, malpractice, short term disability, 401(k), generous vacation, paid holidays, and excellent salary plus bonus! E-mail cover letter and CV to jbremer@associatedpodiatrists.com or fax to (612) 866-5875 attn: Jennifer Bremer

ASSOCIATE POSITION - BOSTON, MA

Associate wanted, Full-time or part-time, for busy long time, well established, and well rounded practice. Good mix of general podiatry and surgery. Office will generate approximately 100+ surgical cases per year. Must have surgical background for this practice, ABPS Qualified minimum needed to obtain hospital privileges. Associate position is open for partnership or purchase. Contact robert.nunberg@comcast.net

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists. We are located in Chicago and Northwest Indiana. Full and part time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

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