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10/24/2014
RESPONSES/COMMENTS (PODIATRY MANAGEMENT)
RE: Management of the Flexible Adult Acquired Flatfoot Deformity
From: Kevin A. Kirby, DPM
I just got done reading an article in the October 2014 issue of Podiatry Management titled "Management of the Flexible Adult Acquired Flatfoot Deformity." Even though I thought the authors did a nice job of outlining the surgical treatment of this condition, there was not a single sentence in this eight-page article describing how adult acquired flatfoot deformity may also be quite effectively treated by non-surgical means. There was no mention of custom foot orthoses, Richie Braces, Arizona braces, physical therapy and/or immobilization braces as valuable therapies that can be used to treat this condition, without surgery.
In fact, the headline under the title of the article read "Aggressive surgical management of stage II AAFF is important in preventing progression of the deformity." Really, is that so? I have been preventing the progression of these deformities without any surgery quite nicely with custom foot orthoses, high top shoes, ankle-foot orthoses, physical therapy, and immobilization therapy now for the past quarter century.
I hope this was simply an oversight of the authors in their article and that their patients are given the option of non-surgical treatment when presenting with AAFF. I have many very happy patients who have been treated conservatively with the above mentioned treatments without the risks, complications, and disability of foot surgery. Let's hope podiatry isn't becoming a one-trick-pony show of surgery-only treatments being offered to their patients.
Other messages in this thread:
10/27/2014
RESPONSES/COMMENTS (PODIATRY MANAGEMENT)
From: Connie Lee Bills, DPM, Dennis Shavelson, DPM
I echo Dr. Kirby’s remarks wholeheartedly.
Kevin and I have consensus when he states: “Let's hope podiatry isn't becoming a one-trick-pony show of surgery-only treatments being offered to their patients.” Biomechanics remains a viable Plan B “cut and paste” when and if patients are contraindicated or not ready for a procedure. DPMs who are passionate and dedicated to foot surgery should, in those cases, ally themselves with colleagues who are passionate and dedicated more on external biomedical engineering and consider a cross-consulting relationship.
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