Podiatry Lecture for the Primary Care Symposium

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Presentation transcript:

Podiatry Lecture for the Primary Care Symposium CDR Anthony Rabaiotti, MSC, USN

What is a Podiatrist? Is a four year trained physician specializing in foot and ankle medicine and surgery. The first two years are similar to a DO/MD program. Podiatrists then do a three year surgical residency. Some may also do a one year fellowship to specialize in foot and ankle reconstruction, sports medicine or diabetic wound care.

Common conditions Plantar fasciitis/Pes Planus Neuromas Bunions Fungal/Ingrown toenails Corns/Calluses/Warts

Plantar Fasciitis/Pes Planus Would you can do….. NSAIDS OTC INSOLES (SUPERFEET, ROAD RUNNER INSERTS, SOF SOLE, POWERSTEPS) STRETCHING ICE LLD REST WB X-RAYS PT REFERRAL LOSE WEIGHT, LIMIT WEARING FLIP-FLOPS

Plantar fasciitis/Pes Planus What can I do… CORTISONE INJECTIONS SHOE RECOMMENDATIONS PREFAB INSERTS OR CUSTOM INSERTS NIGHT SPLINT AMIONIOFIX INJECTIONS TOPAZ RADIOFREQUENCY COBLATION OPEN RELEASE W/WO SPUR EXCISION

Neuromas What can you do… NSAIDS OTC INSOLES (SUPERFEET, ROAD RUNNER INSERTS, SOF SOLE, POWERSTEPS) WIDE SHOES RICE

Neuromas What can I do… ORTHOTICS WITH MET PADS INJECTIONS WITH CORTISONE AND B-12 SURGICAL EXCISION OF THE NEUROMA

Bunions (Hallux Abducto Valgus) What can you do… RECOMMEND WIDER SHOES, BOOTS NSAIDS RICE

Bunions (Hallux Abducto Valgus) What can I do… Orthotics to help limit poor mechanics Surgery Tough love

Toenails: Fungus and Ingrowns What can you do… Discuss hygiene OTC topicals Lamisil rx: Remember to order LFTs Antibiotics Temporary removal Do not use Silver Nitrate

Toenails: Fungus and Ingrowns What can I do… Lamisil tabs For both: permanent removal, either chemical or surgical matrixectomy

Corn or Callus or Wart or ?? What can you do… Corn: recommend toe padding, Urea Cream, pumice stone Callus: recommend otc/insoles padding, Urea Cream, pumice stone Wart/Porokeratoma: Sal acid, OTC pads ??: biopsy, referral

Corn or Callus or Wart or ?? What can I do… Corn: debridement, excision/arthroplasty Callus: debridement, orthotics to off load area, surgical osteotomy Wart/Porokeratoma: debridement, cantharone, laser removal ??: biopsy, excision, referral, MRI