The Voice of Podiatrists

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February 12, 2007 #2,808 Editor-Barry Block, DPM, JD

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NC Podiatrist Publishes Percutaneous TAL Paper

Dr. Anthony Haro has published an article in the January 2007 edition of Journal of Foot and Ankle Surgery. The article is entitled "Frontal Plane-Guided Pecutaneous Tendo Achilles' Lengthening." The article details a surgical procedure to change the structure and function of the Achilles tendon.

Dr. Anthony Haro

"The paper was written to encourage other foot and ankle surgeons to consider the position of the heel as related to the leg when performing a lengthening procedure of the Achilles tendon," Haro said. "It will serve as a guide for current and future surgeons operating on the Achilles tendon."

This is the seventh article he has published. He has 14 additional works in progress that are slated for future publication.

Source: The Pinehurst Pilot [2/8/07]

NYCPM Third-Year Student Helps Provide Medical Care to Haitians

This past December, NYCPM third-year student Job Timeny, along with a local doctor and several other medical students, spent a week in his native Haiti helping to provide medical care to people with ailments of the lower extremities. Since most Haitians cannot afford the cost of a medical visit, and seeing a doctor is almost a privilege.

NYCPM Student Job Timeny examines Haitian patient

Timeny, summed up his experience as follows: “During the time I spent as a volunteer in Haiti, I learned that in some places, a doctor’s visit is a luxury. People rushed to us for their pain, but from their faces one could tell that their visit was mostly motivated by their inability to pay for a doctor’s visit and medication. I knew it was impossible to respond to everybody’s need, but saving someone’s life means everything. The project helped me grow and reminded me why I am training to be a podiatrist. Medicine is not just for making a living, but also a response to the imperative to help others in need. I hope to go back as soon as possible.”

New Mexico Annual Meeting is an Enchanted Success

This year’s Annual Seminar of the New Mexico Podiatric Medical Association (NMPMA) was one of the biggest and best ever. Mild weather and the Southwest ambience of the newly-built Sandia Hotel and Casino was appreciated by attendees, some of which came from nearby states. Kudos to Scientific Chair Roya Mirmiran, DPM, Janet Simon, DPM, and the NMPMA Board for presenting a first-class educational experience.

L-R Vice President Nathan Ivey ; Member-at-large Philip Bartel; Treasurer Tommy Roe; Member-at-large Steve Wrege

Elected to office at the business meeting were:

Vice-President – Nate Ivey, DPM
Treasurer – Tommy Roe, DPM
Board Members at Large – Philip Bartel, DPM & Steve Wrege, DPM

Query: Retrocalcaneal Pain and ESWT

My patient is a 37 y.o. male who underwent a retrocalcaneal exostectomy utilizing a Mitek anchor. He got great relief for about 7 months but now has recurrence of pain in the same area. I know ESWT has been used for insertional Achilles pain (even though it is an off-label use) with good results. Would a retained bone anchor be a contraindication to doing this procedure?

Keith D. Pfeifer, DPM, Fort Gordon, GA

RE: Revision First MTP Joint Arthrodesis (David Arkin, DPM)
From: Godfrey Viegas, DPM, Francisco Jose Oliva, DPM

Although there are reports in our literature about the success of latent implant arthroplasty to salvage a 1st MTPJ fusion and/or non-union, my opinion would be to revise the fusion to a position where the hallux in transverse plane alignment with the second toe. Several plate constructs are available. My favorites are "locking plates" where screws lock into the plate. A reasonable choice is the EBI Optilock (5 hole) distal radius plate, which I have been using for at least two years. Acumed and Nexa Orthopedics also make a "locking" 1st MTP fusion plate that also may be of interest. Removal of a plantarly-based wedge of bone at the arthrodesis site would appear necessary to re-position the great toe parallel with the second toe. Dr. Arkin’s choice of 2nd ray procedures would be exactly what I would do.

Godfrey Viegas, DPM, Crystal Lake, IL, gviegas1234@sbcglobal.net

One of the pearls I have learned is to be overly cautious with your informed consent. I have seen some of these cases need revisions in the future, whether to replace or change the type of implant, to lesser MTPJ symptoms which can develop later on after your revision. My goal in accepting these patients is to help them wear closed toe shoes with less pain but any symptoms that develop after your intervention should be expressed to the patient so as to fully understand that there are risks you will be assuming that were initially caused with the original surgery. I have found that total silastic implants have worked best for these patients.

Francisco Jose Oliva, DPM, Coral Gables, FL, Fyoliva@cs.com

RE: Exertional Compartment Syndrome (Cory Pilling, DPM)
From: John Sullivan, LMT

The patient might want to seek out a massage therapist who is trained in neuromuscular therapy. I have seen great results with this method.

John Sullivan, LMT, NY, NY, rss@eneslow.com

RE: Radiographs for Nail Pathology (Barry Mullen, DPM)
From: Multiple Respondents

Editor’s note: This discussion concludes at: http://www.podiatrym.com/letters2.cfm?id=12705&start=1

ASSOCIATE WANTED - NORTH CAROLINA , CHARLOTTE AREA

Incredible opportunity to join a busy, well-established group practice. Looking for a self-motivated, hard-working individual seeking to become a partner. Hospital and surgery center privileges. Salary plus percentage, 401k and real estate opportunities. Send CV to universityoffice@ bellsouth.net

ASSOCIATE POSITION -MINNESOTA – PRIME MINNEAPOLIS SUBURB

Busy, well-established, full-scope podiatry practice, seeking highly motivated podiatrist for a full-time position with potential partnership opportunity. Looking for PSR 24+ individual. Excellent opportunity for long-term growth with unlimited income potential. E-mail CV to employment@associatedpodiatrists.com or fax to (612) 866-5875 Attn. Jennifer.

ASSOCIATE POSITION- KANSAS CITY, MO

Excellent opportunity for a hard working, ethical podiatrist to join a vibrant, successful and growing podiatric medical and surgical practice. Dedicated, supportive staff with strong marketing and medical knowledge. Must be board eligible/certified. PSR/24. Partnership opportunity. Competitive salary, bonus structure, benefits. Wonderful place to raise a family. Fax CV to 816-455-8901

ASSOCIATE POSITION – MISSISSIPPI

Well established, busy, 3-doctor practice seeks PSR 12 or 24 trained podiatrist for associate position to fill vacancy of retiring member. East central location is a great area to raise a family and is a prime location for accessibility to several major cities. Competitive salary, benefits, and incentives. Partnership possible in 2 years to right individual. June - July start date. Applicant must be ethical, personable, and motivated. Please E-mail CV and letter of intent to shanegan@bellsouth.net

ASSOCIATE POSITION – NEW YORK & CONNECTICUT

Opportunity to be a part of a prestigious and well-established large Orthopaedic and Rehabilitation practice, with locations in Stamford, CT and West Harrison, NY. Looking for a podiatrist to join an already busy practice with opportunity to build. We have state-of-the-art offices with MRI, digital x-ray, paperless charts, physical and occupational therapy. Applicants should be Board Certified or Board Eligible. Competitive salary and benefits. For further information on the practice, log onto WWW.NYCONNORTHO.COM Interested candidates should forward their C.V. to: Cliff Katz, Executive Director ckatz@nyconnortho.com

ASSOCIATE POSITION- WEST CENTRAL FLORIDA

Position available for PSR 24/36 trained DPM to join the Podiatry Service of the largest multi-specialty Rural Health Group Practice in Florida. Good salary/incentive compensation and excellent fringe benefits plan, which includes paid vacation days, CME dollars and much more. EOE/DFWP Send CV and letter of interest to: MCRHS, P.O. Box 499, Parrish, FL 34219 or fax to (941) 776-4013.

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