The Clinical Visit
Comprising three distinctive parts, the clinician uses the five senses to guide the process–one might take the humourous view of Sherlock Holmes or Poirot in determining evidence from visual observation and verbal questioning. I hope these small introductory articles provide some interest. The first in the series covers observation as in the Physician’s Eye.
Why Can’t You Make Ganglions Disappear?
Hitting any tissue is not recommended, and indeed, one should avoid using computer tablets and iPads in place of the Bible – that is, unless you are searching for information such as this site, then hit the keyboard instead.
When did podiatrists first use local anaesthetic?
The story of when podiatrists first use local anaesthetic was published here at ConsultingFootPain in August 2018. I have updated this slightly because a recent article in the January 2021 edition of The Podiatrist- ‘rising from the ranks’, has provided a little more information which is worth highlighting (Potter, M). Additionally I go behind the scenes in my latest book, Podiatrist on a Mission.
How Long Does Bunion Surgery Last?
Fusion is a safer bet than most alternatives and offers better longevity. Third surgeries seldom come without loss of function. More surgery involves deeper tissue scarring, and even then, a joint-sparing operation could lead to limited joint movement. Minimal incisional surgery (MIS) appeals to many for obvious reasons, but the follow-up is not as well presented as other surgeries and is limited to specific criteria. MIS is available and has advantages. New screw systems allow surgical placement through keyholes under X-ray-guided control.
An Introduction to Biopsy for Podiatrists
This article will describe the main types of sampling skin and include:
Shave
Punch
Excisional
Please note that some of the hyperlinked videos shown are graphic and do not show the foot as specific examples.
New Bunion Guide for Patients
This new edition is without doubt an extensive tour de force of all thing’s bunion.
David Tollafield wisely teamed up with Dr Tim Kilmartin bringing together two experts with 60 years’ experience of caring for patients and fixing bunions. It’s fair to say few, if any, will have contributed more to the development of podiatric surgery and bunion correction in the UK. And what a result, this book leaves no stone unturned in helping patients understand what a bunion is, how to manage the condition themselves before delving into the surgical options, surgical risks and complications.
Writing From The Past
“At the time [1978] research in chiropody was rather sparse, poorly owing to the lack of a foundation degree. In one paper from a US doctor [DPM], there was extensive material covering bacteria recovered from surgical infections. This left me in awe of their academic standards and only heightened my ambition to become a podiatrist.
Back at Weston Favell clinic, I bumped into April Reilly, the sister who ran the GP’s clinic. ‘I see you’ve got your own autoclave now. You won’t be needing mine anymore is that right? She said in jest.
I just smiled and said, ‘Anyway, not sure if you’ve heard, but Luuk has just promoted me after a year. Not bad eh’ I exuded happiness in sharing my the news.”
Osteomyelitis
Defining a role and executing a treatment plan does not just include performing a physical service. All podiatrists are trained in medical sciences. The principle of what one does is predicated on knowledge, training and exposure. The qualification, without doubt, aids action, but what if you do not have a fellowship? Those podiatrists who deal with lepromatous ulcers and, in particular, neuropathy should and can remove bone if this is observable because they understand tissue compliance.
Books and all that written stuff
Taking a look at the range of books by author and podiatrist David Tollafield
Midfoot Pain Mysteries
Alternatives to steroids include sodium hyaluronate as Ostenil, which has some promise in some patients. Sodium hyaluronate is found in normal synovial fluid, which bathes joint surfaces and provides some nutrient service.