Incisional Surgery for Morton’s Neuroma
There are four principle approaches to gain access to plantar digital neuroma (PDN) and have been described by those who first wrote up the technique. Hoadley (1893) entered the intermetatarsal space from the sole, while McElvenny (1943) split the webspace. Nissen (1948) used a transverse cut on the sole instead of the longitudinal access of Hoadley, and McKeever (1952) accessed the space from the dorsum.
Thermal choices for Morton’s Neuroma?
Thermal choices are now available albeit in some short supply of long term evidence. So we must ask ourselves. Is surgery successful and should I know more about what to expect? In addition which surgery is best – if there is such a thing? And, is there an alternative to surgery? It is in this area we need to explore the other possibilities.
Recruiting the young to podiatry
Recruiting the young to podiatry is important as they are the future work force to develop this exciting profession beyond even todays imagination. It was a pleasure therefore to interview podiatrist Hannah Roberts, private practitioner, and Phil Hendy, lecturer at Plymouth University.
Management pathways for Morton’s Neuroma
Today reports covering alcohol, neurolysis, and sclerosis with phenol, hyaluronic acid (HLA), botox and capsaicin gaining popularity for neuroma treatment and deserve a fresh review. Thermal methods attributed to laser, radiotherapy and cryosurgery have also gained recognition in place of surgery. Whether thermal processes form a second stage treatment remains uncontested at present, although because these have invasive qualities and require image guidance, they form an adjunctive stage and will be included with surgery in an additional paper in this series.
Stretching the boundaries of podiatric practice
A new course – we might just call skin surgery, and now was now well underway.
I was invited to attend the practical day of the weekend Part C section of the skin surgery course. Enabled to observe, comment, and interview the delegates / candidates for this first exposure to skin surgery was exciting as my interest – well, I have been wanting to see a change to current practices that podiatrists would allow simple skin procedures to be undertaken since my time as past Dean of Faculty of Surgery (2012-14).
Mind the Gap
Has the College done a deal to change the membership, or is it a fact that there is little choice because of external factors? The next year will be a testing time for the Council working with the Royal College of Podiatry. Is there a right or wrong decision, and can we learn from history? There again, by forgetting history, we make the same mistakes. Winter 2021 will be marked by the culmination of a change for the Royal College, and doubtless, elements of discussion will rumble on about how the membership is constituted. There are two groups separated by a divide – that gap! Separated by distrust, anger, betrayal and fear of one group while the other has diversified and no longer delivers what once was chiropody. What had caused such disparate behaviour?
The discredited management of Morton’s Neuroma
This is the third article in my new series covering plantar digital neuroma (PDN) for professionals and those interested in approaching this problem seen as the sixth commonest foot condition seen in foot surgery (PASCOM 2021 data).
Digital Neuroma Old Problem New Analysis
Digital neuroma is an old problem and yet new analysis is warranted. This article teases out some of the theories that contribute to the common form of foot metatarsalgia. Many papers overlap with both subjects. The source of papers appear to come from an orthopaedic, radiology, neurology and podiatry source. Overall there are some 1200 papers available written in English but how many in other languages is an unknown.
Does the ‘SAKS Report’ finally reveal the truth?
I decided to look at the new SAKS report published during November, having started life a year ago. There is no intention to replicate the report but to concentrate on the critical concern as to why podiatry is failing to make an impact given so much positive development. Members can access the full account, which echoes five features that focus on the needs of the profession of podiatry – its purpose, its people, its place, its potential and its performance. This article focuses on the disparity of a profession and why it could be better at ground level.
The Changing Face of Consent
As podiatrists undertake more complex procedures the principles behind consent remain the same as surgery. As the profession of podiatry expands at all levels it is worth exploring the concept of consent in more detail. With the ruling of Montgomery applied to a recent podiatric high court case, the reality of isolated consent focusing on a judicial decision is no longer a fairy tale. This article sets out to reflect different views from within and outside the UK covering consent. Patients are encouraged to share decision-making with those who treat them and the manner in which consent is obtained continues to evolve.