The PODdoctors with Dr. Dauphinee and Dr. Hussain

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss plantar fibromas, benign tumors that form in the plantar fascia of the foot. The doctors discuss the characteristics, causes, and treatment options for these growths, emphasizing that while they can cause discomfort, they are typically not a cause for alarm. The conversation covers various diagnostic methods, including ultrasound and MRI, and explores conservative and surgical treatment approaches. Listeners will gain insights into the importance of addressing these fibromas before they lead to more serious complications, as well as the nuances of surgical intervention when necessary. Top Takeaways:The evolution of advanced therapies for diabetic limb preservation showcased a significant increase in treatment options over the last two decades.Plantar fibromas, while often benign, can cause significant discomfort and should be evaluated through careful examination and imaging techniques like ultrasound.Treatment for plantar fibromas often begins conservatively with physical therapy and may escalate to injections or surgical options if necessary.Understanding the potential for benign versus malignant processes is crucial in managing plantar fibromas effectively and safely.The importance of proper post-operative care and rehabilitation after surgical removal of plantar fibromas cannot be overstated for optimal recovery.Resources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss the surgical correction of big toe hammertoe, a condition that, while seemingly benign, can pose significant risks for individuals with neuropathy, particularly those with diabetes. The Doctors discuss the complexities of treating this condition and share insights from a specific case involving a high-risk diabetic patient, highlighting the delicate balance between managing diabetes and ensuring proper foot health. The episode covers surgical techniques, including the use of screws for fixation, and the recovery process, which allows for quick weight-bearing activities post-surgery.Top Takeaways:The podcast episode discusses the significant advancements in diabetic limb preservation over the last 20 years, highlighting new technologies and treatment options.Doctor Damian Dauphine emphasizes the importance of understanding complex cases in diabetic patients to prevent amputations.The surgical correction of big toe hammertoe, particularly its complications in patients with neuropathy.The risks associated with untreated hammertoe deformities can lead to dangerous ulcers, especially in diabetic patients.The anatomy of the big toe and the surgical procedures involved in correcting contractures.The importance of post-operative care and recovery strategies for patients undergoing foot surgery.Resources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss the prevalent issue of athlete's foot, its symptoms, and the best treatment options. They provide a detailed analysis of three primary treatment methods for athlete's foot: topical antifungals, moisture control, and oral antifungals. Highlighting the importance of treating even minor symptoms, particularly in diabetic patients, they share professional recommendations to prevent severe complications. Quotes"It’s been estimated that one in four people have some level of fungal pathology going on at some time or another. So super common athletes foot, it's a fungal infection typically of the interspaces between your toes because it stays moist, and it typically presents with burning, itching, and scaling of the skin.” -Dr. Raafae Hussain"People will have athlete’s foot for years and not realize that they have it because they don't feel the itching. We have to cure them of that thought process and say, no, that's athlete's foot until proven otherwise.” -Dr. Damien DauphineeTop Takeaways:Topical Antifungals: Start treatment using topical antifungals like fungifoam that pull moisture off the foot while killing the fungus.Moisture Control: Employ methods for controlling foot moisture including moisture-absorbing shoe liners and antiperspirant products like Drysol.Oral Antifungals: For severe, recalcitrant cases, consider oral antifungals but be mindful of their potential side effects on the liver.Importance for Diabetics: Diabetic patients must pay attention to athlete's foot due to their higher risk of complications like foot ulcers and infections.Treating Shoes and Feet: Clean shoes thoroughly using products like Lysol and ensure they are dry before use to prevent re-infection.Resources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss one of the most common foot ailments: plantar fasciitis. This episode's comprehensive guide covers everything from the basics of plantar fasciitis to the most effective treatments currently available. The doctors discuss the anatomy and mechanics of plantar fasciitis, emphasizing the importance of distinguishing between heel spurs and plantar fasciitis pain. They also highlight the significance of stretching, the use of proper orthotics and footwear, and the benefits of steroid injections.Quotes"Orthotics are about architectural support, not just cushioning. Stiffer devices are more effective than gel insoles for plantar fasciitis.” -Dr. Raafae Hussain"Standing calf stretches are technique dependent, and that's where the ProStretch shines by leveraging gravity for optimal stretch.” -Dr. Damien DauphineeTop Takeaways:Steroid Injections: Steroid injections can help in reducing inflammation and pain, making it easier to follow through with other treatments like stretching and wearing orthotics.Advanced Treatment Options: For chronic cases not responsive to conventional therapies, treatments like Topaz and amnio injections offer promising results.Diagnostic Imaging: Utilizing tools like ultrasound to measure plantar fascia thickness can aid in determining the severity of the condition and tailoring the treatment plan accordingly.What You Will Learn:Effective stretching exercises, such as standing calf stretches, towel stretches, and using tools like the ProStretch, play a crucial role in managing plantar fasciitis.Choosing well-made, supportive shoes and custom orthotics can significantly alleviate plantar fasciitis symptoms. Resources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, evaluate the complexities of an Achilles tendon repair using a Flexor Hallucis Longus (FHL) tendon transfer. This particular case involved a patient with a history of clubfoot, multiple surgeries, and a significant Achilles tendon rupture. The doctors explain their surgical approach to repairing the damaged Achilles tendon by harvesting the FHL tendon. They emphasize the importance of this technique in providing the necessary strength and functionality for the patient to regain a normal gait. Quotes"We did what's called an interference screw or anchor. We drill a pocket hole for that tendon to go through, and then we'll put an anchor in right next to it that will hold that tendon up against that bone without any type of limitations.” -Dr. Raafae Hussain“The non-absorbable suture will tear your gloves and tear your finger before it'll break. You can really crank on this stuff, which is perfect for stout, tender repairs where you're going to be putting a tremendous amount of force through this tendon.” -Dr. Damien DauphineeTop Takeaways:Achilles Tendon Repair with FHL Transfer: The utilization of the FHL tendon to enhance the strength and functionality of a damaged Achilles tendon.Surgical Case Details: Insight into a complex foot surgery involving a patient with previous clubfoot reconstructions.Advanced Surgical Techniques: The use of advanced techniques, such as the whip stitch and interference screw, to ensure successful tendon transfer.What You Will Learn:The importance of post-surgery protocols, including non-weight bearing periods and early active range of motion exercises.Surgical procedure steps and the reasoning behind specific surgical choices.Resources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss a case involving a severe Achilles tendon injury in a young athlete. They highlight the importance of having backups for backups when relying on imaging, as MRIs can sometimes be misleading. Dr. Dauphinee and Dr. Hussain explain the surgical procedure they performed, including the use of a cadaveric calcaneal Achilles graft. They also discuss the post-operative care and rehabilitation process. Quotes"When tamping the bone you can use screws, wires, staples, plates, but I think the most common is a single screw.” -Dr. Raafae Hussain“The moral of the story from a surgeon's standpoint is, MRIs can lie to you Have a backup for your backup.” -Dr. Damien DauphineeTop Takeaways:Cadaveric Achilles grafts can be a viable option to bridge extensive gaps.Encouraging interdisciplinary learning through real-life cases is vital for medical professionals' growth and preparedness for complex surgeries.What You Will Learn:Postoperative care involves lengthier immobilization and physical therapy when using cadaveric grafts, highlighting the need for tailored recovery protocols.MRIs can sometimes provide misleading information; it's important to be prepared with multiple treatment plans.Proper fixation using screws and consideration for nerve location, such as sural nerves, is crucial during Achilles tendon surgery.Resources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, cover the intricacies and surgical treatment of fibular nerve release, a crucial procedure for patients experiencing various complications often associated with nerve entrapments in the lower limbs. They discuss the nitty-gritty of podiatric surgery, specifically the peroneal, or technically the fibular nerve, and its susceptibility to injury or entrapment. Doctors Dauphine and Hussein then discuss the surgical nuances of nerve release, providing critical insights into how such procedures substantially improve patient outcomes.Quotes"Nerve flossing is a really great technique. We'll get folks into the physical therapists and have them start nerve-flossing as quickly as we can. Usually, right after we get the stitches out at two weeks.” -Dr. Raafae Hussain“You've got to always keep in mind that when patients are complaining of burning, stabbing, shooting pain, tightness at nighttime, that is nerve-related pain for sure.” -Dr. Damien DauphineeTop Takeaways:Fibular nerve release is improving patient outcomes, with modern technology playing a pivotal role.Detailed nerve anatomy understanding and careful surgical techniques are essential for the successful treatment of the fibular nerve and its branches.The surgical approach to decompressing the fibular nerve involves meticulous dissection Diagnostic blocks are a helpful tool in identifying specific nerve entrapments that could contribute to conditions like restless leg syndrome (RLS).Nerve flossing is crucial to prevent adhesions and maintain nerve health.What You Will Learn:Surgical procedures to address nerve entrapmentUsing diagnostic blocks as a toolHow the application of protective materials like umbilical cord tissue prevent scarring and promote healingPostoperative care that encourages movementResources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss bunion surgery and its various outcomes, especially focusing on revision bunionectomy. They explore the numerous techniques to correct bunions, emphasizing the importance of matching the surgical approach to the patient's specific condition. The doctors also suggest that one solution does not fit all, and the choice of procedure can greatly impact long-term satisfaction and functionality. They also suggest personalized surgical plans, which are crucial for achieving the best outcomes in foot and ankle health.Quotes"The difference between doing an open versus MIS is minimally incisional surgery. The benefit is that you don't have a long incision.” -Dr. Raafae Hussain“Most bunion surgeries that fail, are a failure of the choice of the bunionectomy.” -Dr. Damien DauphineeTop Takeaways:The success of bunion surgeries largely depends on selecting the proper procedure that aligns with the patient's degree of deformity and clinical presentation.The Lapidus Bunionectomy: among other techniques, is becoming increasingly popular for treating severe and hypermobile bunionsMinimally invasive surgeries (MIS) for bunions require careful patient selection, with ideal candidates being young, healthy, and free of complicating factors like smoking or diabetes.Revision bunion surgeries are sometimes the consequence of an initial procedure that did not sufficiently address all aspects of the deformityFusion of the big toe joint can be a highly effective solution for long-term relief in patients with recurring bunions or persistent joint breakdown.What You Will Learn:Different options for revision bunion surgeryCommon complications and concernsPatient Selection Criteria for MIS Bone HealingHow to Choose the Right Bunion Surgery and SurgeonResources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, dive deep into a lesser-known yet intriguing condition called chilblains. Characterized by itchy, red, and tender skin lesions, chilblains is often exacerbated by cold, damp conditions, without necessitating freezing temperatures. Leveraging their practical experience, Dr. Dauphinee and Dr. Hussain delineate the distinction between chilblains and related conditions like Raynaud's phenomenon and frostbite. The doctors also provide tips for prevention and treatment, including wearing thick socks, using topical medications, and avoiding hot foot baths.Quotes"When chilblains occurs, you can put your feet in lukewarm water for a certain period of time. Not blazing hot, not boiling. You just want them to be lukewarm. If this is a more chronic problem, it flares up every couple months, or during the cold weather, your doctor might prescribe something topical.” -Dr. Raafae Hussain“Between chilblains and frostbite, the difference is temperature. So it doesn't require a frigid 20, you know, in the teens Fahrenheit to cause chilblains. It could, like we talked about, be in the forties outside.” -Dr. Damien DauphineeTop Takeaways:Chilblains: a condition characterized by itchy, red, and tender skin lesions, often exacerbated by cold, damp conditions, without necessitating freezing temperatures.Individuals with a history of Raynaud's or who are smokers may be more susceptible to developing chilblains.While self-limiting, recommendations include lukewarm foot baths, topical steroids, or vasodilators like topical Nitroglycerin for acute cases. Systemic medications are considered for more chronic issues.Appropriate insulative clothing and thick socks are key preventive measures during cold weather, especially for slender individuals who may be more prone to the condition.Patients with sensory loss due to neuropathy should take extra caution when using heat-related treatments to prevent accidental burns.What You Will Learn:What is chilblains?The difference between chilblains and frostbiteTreatment options and prevention tipsNeuropathy ConsiderationResources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss the proper technique for applying wound dressings and the different types of wounds commonly seen in podiatric medicine. They emphasize the importance of maintaining a balanced, moist wound environment and provide tips for choosing the appropriate dressing based on the level of moisture or drainage. The doctors demonstrate a simple dressing change using Hydrofera Blue and Coban wrap, highlighting the importance of sterile technique and proper dressing application. They also debunk the myth that wounds need to be aired out and explain the benefits of modern wound dressings.Quotes" There's a lot of different types of wounds out there, but the dressings themselves are fairly similar. So there's primary intention healing wounds or secondary intention healing wounds, and there's tertiary intention healing wounds. Primary are your surgical incisions. The dressings on those are very simple. Secondary intention healings are like your sores and ulcers or big gouges. And tertiary intentions are more of like a delayed primary healing type of surgical incisions.” -Dr. Raafae Hussain“It still seems to be deeply embedded in the brainstem of human beings that you need to let wounds air out. They don't need to be aired out. The dressing needs to be applied. And you need to change that dressing in a reasonable schedule to prevent maceration, which is the white stuff, and to prevent things from drying out. So if there's got to be a happy medium there somewhere where you're changing the dressing frequently enough that you're avoiding some of those complications we got way better wound dressings and capabilities in 2023.” -Dr. Damien DauphineeTop Takeaways:Proper wound dressing technique involves moistening dry wounds and drying excessively moist or draining wounds.Hydrofera blue is a versatile dressing that absorbs drainage, provides antimicrobial properties and helps maintain a balanced wound environment.Coban wrap is an elastic dressing that can be easily molded and provides secure coverage for the wound.It is important to maintain sterile technique during dressing changes and to avoid using household scissors or unclean instruments.Modern wound dressings have advanced significantly, and the belief that wounds need to be aired out is outdated.What You Will Learn:How to do a wound dressing change Explanation of different types of wounds and dressings Debunking the myth of letting wounds air out Qualifications for being considered homebound for Medicare patientsResources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss a case of complex regional pain syndrome (CRPS) type two. They explain the difference between CRPS type one and type two, and how a discrete nerve injury can be misdiagnosed as CRPS. They share the story of a patient who developed debilitating nerve pain after bunion surgery and was suffering for six and a half years before being properly diagnosed. The doctors perform a diagnostic block and identify a specific nerve injury. They then perform a surgical procedure to cap the damaged nerve and bury it in muscle to prevent the development of a stump neuroma. The patient experiences significant pain relief and is on the path to recovery.QUOTES:"As long as that end nerve is no longer connected to the brain, that's going to wither and shrivel up and go through Wallerian degeneration and go away." -Dr. Damien Dauphinee“Complex regional pain syndrome. There are two versions. There's a type one, which is nondescript, there's no specific nerve pathway, and there's a type two, which it's more associated with a specific nerve pathway, usually associated with an injury.” -Dr. Raafae HussainTop Takeaways:Complex regional pain syndrome (CRPS) can be misdiagnosed if a discrete nerve injury is not identified.Discrete nerve injuries can cause chronic pain and other symptoms similar to CRPS.Surgical intervention, such as capping the damaged nerve and burying it in muscle, can provide significant pain relief for patients with a discrete nerve injury.What You Will Learn:Differentiating between general CRPS and discrete nerve injuryOptions for nerve reconstruction or cappingPreventing stump neuromaImportance of identifying discrete nerve injuries in CRPS patients The need for psychiatric care in some cases The importance of multimodal pain management CRPS Warriors support group for patientsResources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss the excision of a lipoma, a benign fatty nodule that can cause pain in the foot and ankle. They explain that lipomas are commonly found in the subcutaneous layer of the foot and ankle, and while they are usually benign, they can become painful. The doctors emphasize the importance of clinical diagnosis, as an MRI may not show whether the lipoma is causing pain. They also mention that lipomas are often misdiagnosed as underlying ankle sprains. The surgical procedure involves making an oblique incision along the relaxed skin tension lines, carefully dissecting the lipoma, and removing it as a solid piece. The doctors highlight the need to identify and protect the lateral branch of the superficial peroneal nerve during the procedure.QUOTES:"You can get something called lipidema, and that's a different animal where a known normal fatty deposit can become painful. A lipedema can be a real problem in different parts of the body, and that's a normal place for adipose tissue. But if it becomes painful, sometimes we have to consider removing it. I've not appreciated that as much over the years as I do now. I think I'm seeing that that can become a source of pain all by itself in some patients. And I think it's probably a poorly understood problem." -Dr. Damien Dauphinee“So we get the closure on this and you'll see we'll do deep to superficial. The reason we do that is so the knot stays buried. It's not close to the skin. So when she ends up tying this, you'll see that the knot will stay nice and low and hopefully the patient won't ever feel it. And then as time goes on, the weeks go on, the stitches will dissolve away, and hopefully no more score. There no more palpable nodule there using.” -Dr. Raafae HussainTop Takeaways:Lipomas are benign fatty nodules that can cause pain in the foot and ankle.Lipomas are commonly found in the subcutaneous layer and can be misdiagnosed as ankle sprains.Clinical diagnosis is crucial, as an MRI may not show whether the lipoma is causing pain.Surgical excision involves making an oblique incision along the relaxed skin tension lines and carefully dissecting the lipoma.What You Will Learn:Surgical procedure for lipoma excision Importance of dissecting carefully to avoid nerve damage Closure technique: two layers, running subcuticular, deep vertical mattress Superficial dressing choice: zebra foamPost-op shoe preferenceRisks: injury to lateral dors-cutaneous nerve branch, stunt neuromasResources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss a surgical case of a gangrenous toe amputation in a patient with severe peripheral arterial disease and diabetes. The patient had dry gangrene and underwent vascular treatment to open up two vessels, but the tibialis anterior vessel remained blocked, leading to tissue death in the big toe. The doctors talk about the potential use of bone marrow aspirate concentrate injections to stimulate collateralization and neovascularization in patients with severe vascular disease.QUOTES:"The tibialis anterior vessel was the one that they were not able to open up. And that was his downfall because the tibialis anterior is the one that comes and perfuses the top half of your big toe. Kind of important when you have blood flow problems, you don't have blood flow coming in, you're losing that toe or whatever part of the body." -Dr. Damien Dauphinee“Anytime we can get collateralization or new tributaries to grow into an area that is not getting enough blood flow, we can improve pain.” -Dr. Raafae HussainTop Takeaways:Considerations for patients with severe vascular diseaseImportance of incision placement and goal of restoring healthy blood flowWhat You Will Learn:Gangrenous toe amputation caseBone marrow aspirate concentrate injectionsPotential use of BMAC for staving off major amputationsResources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, discuss wet gangrene vs. dry gangrene and the advanced treatments available to prevent amputations in diabetic patients. They highlight the modern use of wound care technology such as antibiotic beads for wound healing and water jet wound cleaning. Dr. Dauphinee and Dr. Hussain also share their expertise in treating peripheral nerve problems and talk about the benefits of hyperbaric therapy for wounds.  QUOTES:"Ischemic pain is deep. It's not responsive to narcotics. The only thing that's gonna fix it is, unfortunately, amputation or fix the blood flow problem." -Dr. Damien Dauphinee“One of the things to keep in mind about ABIs ankle-brachial index is it can be falsely elevated in diabetic patients.”  -Dr. Raafae HussainTop Takeaways:External Fixation and Limb SalvageAdvanced Treatments for Diabetic Limb PreservationWhat You Will Learn:Diabetic limb preservationThe types of gangrene and treatment optionsWound care and recoveryResources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, explore the potential of using Chat GPT in healthcare for diagnosing common foot and ankle problems. While the technology has limitations, it could prove helpful in narrowing down differential diagnoses for obscure disease states. The POD Docs also discuss how AI can assist in distinguishing between different skin lesions and conditions, and help in the management of underlying conditions.QUOTES:"I really do think that for certain disease states that we don't run into routinely, possibly some of the more obscure skin lesions that we might see, it would be nice to be able to plug those signs and symptoms into Chat GPT and see what it comes up with.” -Dr. Damien Dauphinee“We can do tendon work, but obviously if you're only addressing the tendon, the foot structure is always gonna be the origin of the problem. The tendonitis is just the secondary effect of it."  -Dr. Raafae HussainTop Takeaways:Chat GPT could potentially change the way we do medical research The use of AI in medicine requires control and restrictions to avoid potential dangersAI can help in the management of underlying conditionsWhat You Will Learn:The Potential of Chat GPT in HealthcarePodiatrists do more foot and ankle surgery than any other specialtyResources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, are joined by Michael Schurr and Elliot Phillips from Embed to discuss Microlyte Matrix. They talk about the advancements in wound care technology for diabetic patients that have taken place in the past twenty years and how this has helped to save limbs and save lives. They also discuss a fully synthetic wound dressing and revolutionary bioresorbable wound healing technology that was developed over the course of 8 years with 8 Million dollars of the National Institute of Health funding. QUOTES:“We felt that it was very important for it to be antimicrobial to kill bacteria. And we all know as providers that bacteria in the wound impairs wound healing. That was an essential part of the technology. The second thing that we wanted to do, we wanted to make this bioresorbable so you could put it in a wound and not have to take it out. That also gives you some flexibility to take an antimicrobial matrix and maybe prevent a wound complication.” -Dr. Michael Shurr“It is amazing what the body can do when it's also not trying to fight microbes and fight bacteria and fight other things. And so you're providing really just the optimal healing environment and allowing the body to do what it does."  -Elliot Phillips Top Takeaways:The Benefits of Synthetic Wound DressingsAntimicrobial Product for Department of Defense UseWhat You Will Learn:05:48 Bioresorbable Antimicrobial Matrix for Wound Healing11:17 Microlyte: A Disruptive Antimicrobial Product for Wound Care20:50 Case Study: Successful Treatment of Radiation Wound 27:28 Silver-Polymer Wound Healing and Antimicrobial ProductResources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, take a deep dive into a specific technique used for treating difficult cases of plantar fasciitis, also known as plantar fasciosis. They discuss the differences between these two conditions and how only about 2% of patients need surgery for this issue. They explore various conservative treatments, including stretching, good shoes with insoles, steroid shots, custom orthotics, physical therapy, laser therapy, and stem cell injections. They also discuss the growing use of biologics in medical procedures and the importance of using them judiciously due to associated costs.QUOTES:“I think biologics are becoming a bigger part of a lot of the procedures that we do, and we're trying to use them…And if it makes that procedure that much more effective than it's completely worth it." - Dr. Damien Dauphinee “Most of the time, conservatively, we're able to take care of plantar fasciitis."  -Dr. Raafae Hussain Top Takeaways:Treating Planar Fasciosis With Surgical ProceduresUtilizing Biologics for Chronic Planar FasciitisWhat You Will Learn:02:48 - The Impact of Overused Planar Fascia 09:40 - The Benefits of Umbilical Cord Grafting 11:54 - The Spur and Pain Management Resources:Visit our website: https://thepoddoctors.com/

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon talk about the common symptoms of restless leg syndrome and how they overlap with the symptoms of fibular nerve entrapment. They discuss how restless leg syndrome can cause insomnia, irritability, discomfort, and sensitivity in the lower extremities. Dr. Dauphinee and Dr. Hussain also discuss the use of drugs such as Gabapentin and Lyrica to manage chronic pain conditions, such as entrapment syndrome, and explain how these drugs can help to stabilize the nerve.QUOTES:“Quite often with restless leg syndrome, the patient will also have sleep disorders. They'll have insomnia, irritability, discomfort, and sensitivity, all from their lower extremities.” - Dr. Damien Dauphinee [03:04]“Spinal cord stimulators are expensive and it's an invasive procedure. I think for the patients who failed everything else, that may be an option. But if nobody's looked at whether or not there is the potential for nerve entrapment, the neurolysis procedure or the nerve decompression procedure there are far fewer potential complications from that than having wires inserted into your spinal column.” -Dr. Raafae Hussain [13:12]Top Takeaways:Common symptoms of restless leg syndromeFibular nerve entrapment treatment optionsManaging chronic pain with Gabapentin and LyricaWhat You Will Learn:2:32 Common Symptoms of Fibular Nerve Entrapment 4:28 Treatment of Restless Leg Syndrome8:16 Gabapentin and Lyrica for Pain Management16:52 Anatomy, EMG Testing, and Surgical Procedures with Jim Anderson22:09 Benefits of Using Thickened Nerve Conduction Gel for Peroneal Muscle StimulationResources:Visit our website: https://thepoddoctors.com/Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about the intersection of plantar fasciitis and nerve pain in heel pain sufferers. They also discuss the differences between fasciitis, an acute inflammation, and fasciosis, a degenerative problem with scar tissue and fibrous tissue build up. Dr. Hussain and Dr. Dauphinee recommend steroid shots for space-occupying lesions like cysts and lesions, and orthotics to address foot structure problems.Quotes:“One of the reasons why we wanted to do this particular show was to highlight the potential for patients to have both plantar fascial pain and peripheral nerve pain at the same time. This is a subset that is more common than not. It's incumbent on us to be able to tease that out from the patient and that there is a potential surgical option for these folks if they fail the conservative stuff where we can address both at the same time.” - Dr. Damien Dauphinee [20:52]“With tarsal tunnel syndrome, you'll have those symptoms with the tingling, burning, most commonly we associate with nerves. But you can also have that sharp pain usually in that arch or in that forefoot. But that first branch that comes off that nerve also goes to the heel, that medial calcaneal heel nerve that comes down right here and innervates that plantar fascia area.” -Dr. Raafae Hussain [05:05]Top Takeaways:Treating heel pain caused by plantar fasciitis and tarsal tunnel tyndromeThe differences between fasciitis and fasciosisPeripheral nerve pain treatmentWhat You Will Learn:[00:39] Intro[02:50] Plantar fasciitis and tarsal tunnel syndrome[07:11] Treatment options for tarsal tunnel syndrome and plantar fasciitis[15:18] Releasing fascia tissue to heal nerve compression [21:18] Treatment of chronic plantar fasciitis and nerve compressionResources:Visit our website: https://thepoddoctors.com/Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

In this episode of The PODdoctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, a fellowship-trained foot and ankle surgeon, analyze the x-ray of a patient experiencing a bunion and hallux valgus deformity, a lateral deviation of the big toe on the first metatarsal, and discuss treatment options. “Depending on who you read they estimate the first MPJ should take about forty to sixty percent of the forefoot pressure and the lesser metatarsal should take about ten percent across the board. When you have a bunion you have a toe that has deviated out and it is hyper-mobile which is why we correct it sometimes.” -Dr. Raafae Hussain [02:38]“Equinus is the root of all evil. It destroys the biomechanics of the foot like nothing else and if you have neuropathy that is gonna drive Charcot. But in patients that have normal sensation they get the forefoot capsulitis if it is one particular joint capsule, so lengthening that joint tissue can be a tremendous benefit to those patients.” -Dr. Damien Dauphinee [04:12]Top Takeaways:Hallux valgus deformity and the effects of stretchingRecommended procedures for the deformity and presence of a bunionEquinus and the Achilles lengthening What You Will Learn:[00:39] Intro[02:14] X-ray analysis: bunion and hallux valgus deformity [07:29] Treatment suggestions and surgery [19:01] Screw placement[26:50] Lazy S incision [30:13] Lengthening the Achilles[34:04] Protecting the tendon from becoming adhered Resources:Visit our website: https://thepoddoctors.com/Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee