Pes Cavus Deformity: Anatomic, Functional Considerations, and Surgical Implications.

Pes cavus is a complicated, multiplanar deformity that requires a thorough understanding in order to provide the appropriate level of care. The foot and ankle surgeon should perform a comprehensive examination, including a neurologic evaluation, in the workup of this patient population. Understanding the cause of the patient's deformity is a critical step in predicting the disease course as well as the most acceptable form of treatment.

Use of an aseptically processed, dehydrated human amnion and chorion membrane improves likelihood and rate of healing in chronic diabetic foot ulcers: A prospective, randomised, multi-centre clinical trial in 80 patients.

Amnion and chorion allografts have shown great promise in healing diabetic foot ulcers (DFUs). Results from an interim analysis of 40 patients have demonstrated the accelerated healing ability of a novel aseptically processed, dehydrated human amnion and chorion allograft (dHACA). The goal of this study was to report on the full trial results of 80 patients where dHACA was compared with standard of care (SOC) in achieving wound closure in non-healing DFUs.

Management of diabetic small-fiber neuropathy with combination L-methylfolate, methylcobalamin, and pyridoxal 5'-phosphate.

Agents used to treat symptoms of diabetic peripheral neuropathy (DPN) are only palliative, not disease modifying. Although studies of monotherapy with L-methylfolate, methylcobalamin, or pyridoxal 5'-phosphate suggest that each of these bioavailable B vitamins may reverse the pathophysiology and symptoms of DPN, data on the efficacy of this combination therapy are limited. Therefore, we assessed the efficacy of an oral combination of L-methylfolate, methylcobalamin, and pyridoxal 5'-phosphate for improving epidermal nerve fiber density (ENFD) in the lower extremity of patients with DPN.

Perioperative management of the patient with rheumatoid arthritis.

Familiarity with the systemic manifestations of rheumatoid arthritis as well as familiarity with drug therapy used for the management of rheumatoid arthritis may be helpful in the avoidance of some postoperative complications. Drug effects on soft tissues and bone may complicate reduction, stabilization, and fixation of deformities. Evaluation of the patient with rheumatoid arthritis for extraarticular disease may also explain symptomatology, and reduce the incidence of complications by unrecognized contributions of soft tissue pathology of osseous and articular disorders.

Evaluation of Bensal HP for the treatment of diabetic foot ulcers.

Background: The extract of oak bark (QRB7) has been used for years as a topical medication with success. QRB7 is the proprietary oak bark extract in Bensal HP. It is indicated as an external treatment for the inflammation and irritation associated with many common forms of dermatitis, including certain eczematoid conditions.

Soft tissue procedures for the stabilization of medial arch pathology in the management of flexible flatfoot deformity.

Soft tissue procedures for the stabilization of symptomatic, advanced hyperpronation deformity are performed most frequently in conjunction with osteotomy, arthrodesis, or arthroereisis of the subtalar joint. A variety of such procedures are available for the selective reinforcement or repair of the posterior tibial tendon, spring ligament, deltoid ligament, or medial intertarsal joint capsules. Recently, the focus has been on the direct repair or reinforcement of the posterior tibial tendon using the long flexor tendons.

Bisphosphonates for the treatment of Charcot neuroarthropathy.

Excess osteoclastic activity is believed to be responsible for the destruction in Charcot neuropathic joint disease. By intervening early in the destructive process, it may be possible to halt the progression toward the devastating bone and joint deformity responsible for morbidity in Charcot feet. This retrospective study evaluated the effects of the bisphosphonate pamidronate on associated signs of Charcot.