Chapter 116 - Podiatric care

Question 1

William Scholl

Answer 1

MD 1904 with advocate in podiatry grandfather was shoemaker in Germany

Question 2

First state to licence podiatrist

Answer 2

new york 1895

Question 3

Podiatric training

Answer 3

1) 9 colleges in USA 2) Doctor of Podiatric Medicine 3) 4 year program after undergrad 4) 3 year residency

Question 4

% of diabetics that have foot ulcer in their life

Answer 4

25% 50% become infected 20% amputated

Question 5

How many amputated limbs have foot ulcer on them

Answer 5

84%

Question 6

Two categories of foot abnormalities

Answer 6

1) visible 2) mechanical

Question 7

normal gait pressure transition

Answer 7

heel –> lateral –> metatarsal head –> medial –> hallux pushoff

Question 8

Equinus definition

Answer 8

failure of the ankle to doriflex > 10 degrees

Question 9

most common location of DFU

Answer 9

under hallux

Question 10

Hallux limitus

Answer 10

limited dorsiflexion at first metatarsophalangeal joint

Question 11

normal angle limit dorsiflexion of hallux

Answer 11

> 45 degrees

Question 12

Podiatrist in preventing foot ulcer and cellulitis and charcot foot

Answer 12

31% less likely ulcer 77% less likely cellulitis/charcot

Question 13

Three progressive categories of amputation prevention pathway

Answer 13

TABLE 116.4

Question 14

Foot temperature monitoring

Answer 14

Can predict ulcers 1 month in advance

Question 15

WBC elevation in diabetic foot infection

Answer 15

46% only

Question 16

Classification of diabetic foot infections

Answer 16

TABLE 116.1

Question 17

5 methods of wound debridement

Answer 17

1) mechanical: rip off dressing 2) autolytic: allow body to do it 3) enzymatic: collagenase 4) surgical 5) biosurgical

Question 18

Surgical debridement new tools

Answer 18

1) Versajet (Smith & Nephew) hydroscalpel 2) SonicOne (Misonix) ultrasound with irrigation

Question 19

Dressing type from dry wound to heavily draining wounds

Answer 19

Hydrogen collagens Hydrocolloids Gauze Alginates Foams

Question 20

CelluTome

Answer 20

Acelity/KCI –> suction blister epidermal grafts in clinic without anesthesia

Question 21

Benefit of amniotic membrane-based tissue

Answer 21

Epifix Grafix provide abundant growth factors to wound to speed granulation non-immunogenic

Question 22

Treatment of pressure off load in a equinus and varus foot with lateral 5th metatarsal ulcer

Answer 22

Tibialis anterior tendon transfer from medial cuneiform and transposed laterally to cuboid or lateral cuneiform

Question 23

Armstrong-Frykberg classification of diabetic foot surgery

Answer 23

CLASS I: elective, sansate CLASS II: prophylactic, insensate with deformity CLASS III: curative, wounds CLASS IV: emergency, acute infection higher class = higher risk of amputation