The Voice of Podiatrists

Serving Over 10,700 Podiatrists Daily

February 02, 2008 #3,157 Editor-Barry Block, DPM, JD

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Diabetica Solutions Donates Infrared Temperature Measurement Devices to NYCPM

Diabetica Solutions, formerly known as Xilas Medical, based in San Antonio, TX has donated ten TempTouch® infrared temperature measurement devices for use by the students at the New York College of Podiatric Medicine(NYCPM), in conjunction with the purchase of a VPT Meter (biothesiometer) for the College by the NYCPM Alumni Association. According to Ruben G. Zamorano, President of Diabetica Solutions, the company gave the Alumni Association a generous discount on its purchase of the VPT Meter.

Terry L. Spilken, DPM (gray suit), President of the NYCPM Alumni Association, presents a check for the purchase of a VPT Meter (biothesiometer) for the College to Ruben G. Zamorano, President of Diabetica Solutions, Inc., as NYCPM Alumni representatives and students look on.

The VPT Meter is a clinical assessment instrument designed to help healthcare professionals evaluate peripheral sensory neuropathy of the lower extremities. Through use of the VPT Meter, the amount of loss of sensation can be quantified. The TempTouch® infrared temperature device provides patients with an "early warning" of inflammation and potential ulceration. The product is designed as a non-invasive, predictive, self-management tool to be used at home by the patient on a daily basis.

WA Podiatrist Arrested For Bike Thefts - Attempted Suicide

Seattle police say a Longview, WA podiatrist is responsible for an unusual crime spree stretching across three Western states. Following his arrest, the suspect tried unsuccessfully to kill himself. Seattle police arrested Dr. Jacob Bos on January 18, accusing him of stealing expensive bicycles in Oregon, Washington and Utah.

Dr. Jacob Bos

Police say Bos would go to a bike shop, ask to test ride an expensive model, and then never return. Investigators say they think Bos stole about $55,000 total worth of bikes, many of which were high-end models costing thousands of dollars each. When he was arrested in Longview, police say they found a stolen bike at his office. Five more stolen bikes were reportedly found at his home, along with other stolen items.

Bos was booked into the King County Jail for investigation of theft and trafficking in stolen property. He was released on bail Saturday morning. Police say on Sunday, Bos tried to kill himself by taking lidocaine, slitting his forearm and then tried to drive his car into the Kalama River. Bos survived the suicide attempts.

Source: KOMO Seattle, WA [1/31/08]

Query: Re-approximation of Extensor Tendons on an 11y/o boy.

An 11 y/o male presented 6 months S/P re-approximation of lacerated extensor tendons and TA on his right foot, sustained at the level of the ankle. The patient's EDL, EHL, and TA were accurately re-approximated with suture material. He now presents with re-ruptures of the TA and EHL at the talar body level, in addition to a partial tear in the EDL at the tibiotalar joint level, confirmed on MRI.

We were planning on using Wright Medical's GraftJacket, along with a cadaveric tendon specimen, most likely from Arthrex, Inc. Does anyone have any experience with a scenario such as this and if so, any advice would be greatly appreciated.

Zacharia Facaros, DPM, Fountain Valley, CA

Query: Hiring a Foreign Podiatrist as a Medical Assistant

I have been asked to sponsor an Austrian podiatrist wishing to live in the USA. This physician is requesting to work as a medical assistant in my practice. To make this occur, I would need to complete a H-1B work permit visa. If anyone has experience, and could comment, it would be appreciated.

Bret Ribotsky, DPM, Boca Raton, FL

RE: Pediatric Nail Infection (Syed Ahmed, DPM)
From: Multiple Respondents

The presence of nail pitting w/ persistent erythema of the proximal nail fold suggests a non-infectious cause, such as psoriasis or lichen planus, though lingering cellulitis remains in the differential diagnosis. It would have been helpful if the prior drainage had been cultured by the PCP to determine if an infectious agent was originally involved. Check the patient's white count and SED rate. I think it's also wise to review the patient's medical history again and revisit the upper and lower extremity physical exam too i.e., scalp, elbows, knees etc. for other corroborating signs. A current lack of significant nail incurvation with nail fold compromise and persistent inflammatory signs further supports the claim of a non-infectious cause. If any skin lesions are present, they can be biopsied and appropriate systemic therapy instituted.

Barry Mullen, DPM, Hackettstown, NJ, YAZY630@aol.com

It is time to think of an inflammatory etiology for this child's nail problem rather than an infectious one. Check the eyelids, history of allergies in child or family, check the skin of the entire body. Try a topical steroid. Consult with a pediatric dermatologist.

Bryan C. Markinson, DPM, New York, NY, bryan.markinson@mountsinai.org

I would avulse the nail (don't use any chemical or do a matrixectomy) and flush it out really well. Then I would use a curette to open the proximal nail fold. Have the patient do b.i.d. Epsom salt foot soaks and have the parents use a Q-tip to help keep the nail fold open about half way through a fifteen minute soak. This will help it to drain. Dress it with Bactroban cream and a bandage. See him in about a week. I consider oral antibiotics an adjunct treatment to these kinds of nail infections.

Jennifer B. Ryder, DPM, Rapid City, SD, jenbenryder@yahoo.com

RE: Safety of Silicon Injections Debated
From: Barry Mullen, DPM

Editor’s Note: This extended-length note can be read at: http://www.podiatrym.com/letters2.cfm?id=17749&start=1

RE: Medial Deviation of 2nd Digit (Wayne C. Gould, DPM)
From: Neal Frankel, DPM, Tip Sullivan, DPM

I have treated numerous patients with this problem and have several solutions. It appears as if the 2nd metatarsal is much longer than a normal parabola and this patient may have torn their plantar plate or capsule or both. A simple capsulotomy will probably not work since the elongated metatarsal ill just displace the toe again. My solution would be an angulated osteotomy to shorten and the metatarsal to remove the retrograde force as well as shifting the articular cartilage laterally. Also repairing the plantar plate should be performed either sewing it to the base of the proximal phalanx with non absorbable sutures through drill holes on each side of the phalanx or repair through the plantar. I do not like the idea of an incision on the top and bottom of the foot over the same metatarsal, so I would probably approach it from the dorsal through the joint.

Neal Frankel, DPM, Chicago, IL, .drnrf@aol.com

If you are sure that this is not a red herring—i.e.-tumor, systemic etiology, etc—I would say that this looks like a relatively simple plantar plate tear looking at this AP view only. Any history of chronic inflammation? Any history of steroid injections. I usually do a simple lateral soft tissue repair and fixate with a k-wire for 3-4 weeks. I also intra-operatively evaluate the medial structures and if the toe deviates any on plantar pressure to the met head I will lengthen the medial structures as well.

Tip Sullivan, DPM, Jackson, MS, tsdefeet@msfootcenter.net

ASSOCIATE POSITION – VIRGINIA

Must have Virginia license. Requires 24 to 36 month Residency. Permanent position with potential buy in. Includes all phases of Practice excluding nursing homes. Competitive Salary and Benefit package. Please send Resume including salary requirements and availability date to needpodjob@yahoo.com

ASSOCIATE POSITION - NORTHWEST PENNSYLVANIA

Multi-specialty group is looking to add another Podiatric Surgeon or General Podiatrist to our well-established group. Office locations in northwestern Pennsylvania. Unlimited opportunities exist for the right Associate, wound care experience is a plus. Please forward your CV to adminsec@ips-mso.com

EQUIPMENT FOR SALE – PODIATRY CHAIRS, ETC.

SELLING quality clean, sturdy well padded exam chairs priced at $500 each, waiting room chairs $100 each, and large desks with rolling chairs at $200 each pair. Email: dr.wright@bigfoot.com or call 609 267 7707

ASSOCIATE POSITION – NAPLES, FLORIDA

Great opportunity for PSR- 24/36 BE/BC podiatrist with strong surgical skills to join multi-office practice. Hospital privileges available at 648 bed hospital system, 200 bed hospital system and multiple surgical centers. Candidate should have the skills and desire to perform rearfoot surgery including Charcot reconstruction and ankle surgery. Florida has a great scope of practice law and we rotate for ER call at all 4 hospitals. Candidate needs to be ethical and motivated. Established practitioner or new practitioner OK. Base salary, percentage, benefits including 401K. Fax CV to (239)566-8778 or Email CV to Drgordon@gulfcoastfootcare.com

ASSOCIATE POSITION - CENTRAL VIRGINIA

Immediate opening. Two office practice, EMR, digital x-rays, sonography. Full scope of foot and ankle care. Candidate needs to be mature, hardworking, and personable. ABPS certified/eligible. Base salary, percentage, and benefits. Submit letter of introduction, CV, and photo to practice administrator at mtrevor41@yahoo.com

SEEKING ASSOCIATE WITH POTENTIAL TO FULL PARTNER

Busy multi-physician podiatric group with 2 locations seeking BQ/BC surgically trained doctor. Applicant should be well-trained in all aspects of surgical and conservative care. Seeking ethical, hard working and outgoing physician to join our 4-physician group. Excellent quality of life in suburban Houston, near NASA and the Gulf of Mexico. Email CV and cover letter to Dr. M. Rockett at Mrockettman@comcast.net

ASSOCIATE POSITION - VIRGINIA (SOUTHERN)

Immediate full-time and part-time associate position available.
Unlimited income potential. Busy, diverse, 40+yr Hampton Roads practice. Must be compassionate; energetic; and motivated; PSR24/36. Looking for long-term arrangement. Please send letter and CV to dcarrone@cox.net

Busy multi-dimensional practice; 70 miles north of New York City . Currently five (5)-doctor practice. looking to expand – all phases of podiatric medicine. contact: (845) 454-8308 EXT: 106

ASSOCIATE POSITION- CONNECTICUT

Established Practice looking for PSR 24/36 trained surgeon. Must have experience and be responsible for all surgical cases for the practice. EMR and digital x-ray in new 6-treatment room office. Hospital privileges available. Connecticut has a new ankle law for the Properly-trained DPM. Competitive salary, benefits, and bonus. Great area to raise a family. Fax resume to 860 243-5790.

PODIATRISTS NEEDED - CHICAGO --NORTHWEST INDIANA

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