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Podiatry Lecture for the Primary Care Symposium

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.

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Podiatry Lecture for the Primary Care Symposium

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

  2. 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.

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

  4. Plantar Fasciitis/Pes PlanusWould 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

  5. Plantar fasciitis/Pes PlanusWhat 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

  6. NeuromasWhat can you do… • NSAIDS • OTC INSOLES (SUPERFEET, ROAD RUNNER INSERTS, SOF SOLE, POWERSTEPS) • WIDE SHOES • RICE

  7. NeuromasWhat can I do… • ORTHOTICS WITH MET PADS • INJECTIONS WITH CORTISONE AND B-12 • SURGICAL EXCISION OF THE NEUROMA

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

  9. Bunions (Hallux Abducto Valgus)What can Ido… • Orthotics to help limit poor mechanics • Surgery • Tough love

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

  11. Toenails: Fungus and IngrownsWhat can Ido… • Lamisil tabs • For both: permanent removal, either chemical or surgical matrixectomy

  12. 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

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

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