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 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 Olarian 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. Dr. “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

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 all things total ankle replacement. They break down when it's time to get ankle surgery, the types of replacements, and the recovery process for a total ankle replacement.“Generally speaking, ankle replacements are super new as far as joint replacements go.” - Dr. Raafae Hussain [08:13]“The 3D printed options for these templates has really made a huge difference in that those templates literally fit the anatomy based on that three-dimensional CT.” - Dr. Damien Dauphinee [15:59]“The technology has finally caught up with the need and the need is only getting greater with the folks that have had ankle fracture repairs… the car accident victims, people who have slip and fall injuries… even if it was fixed correctly 15-20 years ago.” - Dr. Damien Dauphinee [20:01]Top Takeaways:When is ankle surgery necessary?Types of ankle replacements: old vs. newRecent innovations that make total ankle replacements more effectiveWhat the recovery process is like for a total ankle replacement?What You Will Learn:[00:39] Intro[02:16] Overview of the ankle[03:30] Examining an arthritic ankle & Pain management options for acute injuries[06:11] Ankle surgery options[07:59] Ankle replacement types & cases[17:42] Recovering from a total ankle replacementResources: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 common chronic wounds or ulcers they see every day, particularly diabetic foot ulcers, and how to treat them.“Probably the most common that we'll see is your neuropathic, aka your diabetic, foot ulcer. This is when you have uncontrolled diabetes, you have that neuropathy, you have that poor healing potential, and they end up walking until they get a sore, typically on the bottom of their foot, on a high-pressure spot. These are things we're able to take care of if we stay ahead of it.” - Dr. Raafae Hussain [04:51]“It's probably more important to get rid of the dead tissue, the broken-down collagen in the wound bed, than it is to use a silver dressing to prevent infection.” - Dr. Damien Dauphinee [18:23]“Every day a wound is open, especially in diabetic patients, is another chance for that to get infected. So, we really need to use whatever advanced therapy that we can get ahold of to get that wound closed rapidly because the expenses in these wounds are not in the stuff we're using to treat them. The expensive stuff is the amputation, the six weeks of antibiotics, the 3-4 trips to the hospital.” - Dr. Damien Dauphinee [22:40]Top Takeaways:4 major types of chronic wounds Methods of treating and dressing diabetic foot ulcersSantyl vs. Silver dressings: Which is better?How to offload diabetic foot ulcers to facilitate healingCan you reverse neuropathy in diabetic patients?Treating vascular and venous issues in patients with foot ulcersKey methods and biologics used in treating chronic woundsWhat You Will Learn:[00:39] Intro[02:07] Common wounds we see on a daily basis & Their causes[07:56] Diagnosing and treating ulcers on the feet[15:19] Dressing foot ulcers after the first treatment[23:33] Offloading diabetic foot ulcers[26:47] Important data & statistics on diabetic foot ulcers[28:46] Why podiatrists work with vascular specialists[36:04] Using hyperbaric oxygen therapy and NPWT to heal wounds[46:33] Biologics used for treating wounds[52:19] Important takeaways on chronic wounds in diabetic patients[57:23] Breaking down a few of Dr. Dauphinee's past chronic wound casesResources:Visit our website: https://thepoddoctors.comBook Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien DauphineeLearn more about the Wise Healing Center in Argyle, TX: https://www.wisehealthsystem.com/location/wise-healing-center-argyle

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 everything you need to know about diagnosing, treating, and healing plantar warts, aka warts on the feet.“The way that salicylic acid works is it's an anti-karatolytic agent, fancy words for saying that the cells, the way that they adhere to one another like bricks and mortar, it goes in and breaks up that mortar around the bricks and lets that skin just kind of shed off, which works great for corns, calluses, warts, [and] diffuse, dry, cracky skin. That's why we use it for warts.” - Dr. Raafae Hussain [09:22]“Recovery for any of these… you just got to keep it covered, keep the pressure off of it as much as you can… and let that wart resolve.” - Dr. Raafae Hussain [21:34]“If you decide to use oregano oil on your foot, I will find you.” - Dr. Raafae Hussain [23:17]Top Takeaways:What are plantar warts? Are warts worrisome?How to know you have a plantar wartThe two types of wartsHow to treat warts & Do home remedies actually work?Best wart treatments for childrenWhen is surgery needed to remove a wart?At-home wart recovery protocolWhat You Will Learn:[00:39] Intro[02:13] Diagnosing a plantar wart[06:42] Treatments for warts at home and in the office[18:37] When do warts need to be surgically removed?[21:34] Wart recovery at homeResources: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, speak with Dr. Ramnik Singh, a podiatrist from the UK. Dr. Singh shares what it's like being a podiatrist from education to scope of work. He also talks about why the biggest need for podiatrist is diabetic wound care.   “Even here in the U.S., diabetic foot care, ulcers, wounds, very common. We just started with a wound care clinic of our own just because it's become so prevalent in the practice.” -Dr. Raafae Hussain [09:22]   “Mind you, it's not the amount of hours that you do, it's the work you do.” -Dr. Ramnik Singh [29:58]   “I think the team approach is so vital in what we do for a living, for sure.” -Dr. Damien Dauphinee [33:32]   Top Takeaways: The medical training program in the UK The scope of practice as a podiatrist in the UK The use of information technology The lifestyle of a UK podiatrist: private practice or hospital-based?   What You Will Learn: [00:39] Intro [02:32] Medical training in the UK [07:53] The scope of practice in the UK [18:39] Research is a big part of training [22:56] The lifestyle of a UK podiatrist [33:37] Continuing medical education classes [34:37] Treating lymphedema   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

In this episode of The PODdoctors podcast, Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, speaks with Dr. Jordan Meyers, a podiatrist at Raleigh Foot and Ankle. They talk about the TayCo brace that is used for ankle problems. They discuss the features of the TayCo brace and the benefits of using it.   “It pretty much works like a canned boot or a fracture boot in the sense that it locks up the ankle, except it has some nice little differences that make it that much more better.” -Dr. Raafae Hussain [04:52]   “The big thing is the continuum of care that you can get with a brace like this.” -Dr. Jordan Meyers [12:29]   Top Takeaways: What is TayCo brace and how it helps with ankle problems The benefits of the TayCo brace Common uses for the brace The future of total ankle replacements with the TayCo brace   What You Will Learn: [00:50] Intro [02:02] Jordan's background [04:44] What is TayCo brace [09:57] The benefits [16:02] Personal experiences [24:17] Common uses [28:54] The future of total ankle replacements [33:05] Where to learn more about the TayCo brace   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

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 rheumatoid foot, an autoimmune disease that affects the joints. They talk about the development of DMARD medications and how they help control deformities in patients.   “If I was looking at just one joint I would think this is probably osteomyelitis or some type of septic arthritis. But if we are seeing it (no cartilage) uniform across all their joints we know this is most likely rheumatoid arthritis.” -Dr. Raafae Hussain [07:17]   “If your patient is on DMARDs, they are relatively well controlled and they're not dealing with polyarthritis all the time, I would treat them like any other hallux rigidus patient. Give them the option of fusing it or doing an implant. Because this is a progressive problem, you want joint fusion over an implant” -Dr. Damien Dauphinee [22:45]   Top Takeaways: What is rheumatoid foot? Treatment options for rheumatoid arthritis Post-surgery recovery    What You Will Learn: [00:50] Intro [02:00] What is rheumatoid foot  [10:14] Offloading weight from bone sites  [15:17] Treatment options [20:05] DMARDs [23:25] Implants [26:00] Recovery   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

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 Tailor's bunions. They talk about treatment options and what you can do with your Tailor's bunion.   “A Tailor's bunion, people assume it's a bump, it's a growth, it's a tumor. Can you knock it down? But then I talk to them, Look, it's an ​​angulation or a deviation of that fifth metatarsal. It's literally just slightly rotating out.” -Dr. Raafae Hussain [06:11]   “These are common problems. They have reasonable success with conservative, non-surgical options, but you have to be willing to adjust your shoes.” -Dr. Damien Dauphinee [20:08]   Top Takeaways: What is Tailor's bunion How the PODdoctors treat a Tailor's bunion The recovery process   What You Will Learn: [00:50] Intro [02:22] What is Tailor's bunion [07:18] Two measurements they look at [08:56] Treatment options [19:01] Recovery   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

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 ankle arthroscopy, also known as ankle scope. They discuss how this underutilized technique can help with interior ankle pain, such as synovitis. They walk through the process, including portal placement, the most important part of arthroscopy.   “We see ankle problems. We see synovitis. We see these aches and pain. And I feel like we're doing conservative therapy, steroid shots and all that, and we're worried about the next step, big surgery, but that medial ground, that middle ground, that ankle scope, super underutilized.” -Dr. Raafae Hussain [02:01]   “It's a great underutilized technique for lingering ankle pain.” -Dr. Damien Dauphinee [19:09]   Top Takeaways: What is ankle arthroscopy and why it's underutilized Examples of interior ankle pain such as synovitis Portal placement - the most important part of arthroscopy Recovery   What You Will Learn: [00:50] Intro [01:43] What is ankle arthroscopy [03:00] Interior ankle pain [06:54] The portal placement process [12:28] A walkthrough of a recent case [18:34] Recovery [20:23] Outro   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

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 neuroma pain and Morton's Endoscopic Nerve Decompression (MEND) surgery.    “The downside and the risk are extremely low and the upside when it works makes this an incredibly effective procedure.” -Dr. Damien Dauphinee [11:45]   “If you have nerve pain in your foot, talk to your doctor about releasing that nerve rather than cutting that nerve out.” -Dr. Raafae Hussain [13:49]   Top Takeaways: What is neuroma pain and typical symptoms A walkthrough of MEND surgery   What You Will Learn: [00:50] Intro [02:23] Typical symptoms for neuroma pain [04:14] Traditional treatments [05:34] What is MEND surgery [10:09] Recovery [14:42] Outro   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

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, walk through a recent tendon laceration surgery. They discuss the surgical procedure to repair this common injury.   “You want a locking type suture that will help hold the tendon.” -Dr. Raafae Hussain [03:37]   “If you lose a centimeter with that tendon, it's not that big a deal. They can gain that back with physical therapy.” -Dr. Damien Dauphinee [07:42]   Top Takeaways: A walk through of the surgical procedure  The type of suture the PODdoctors use to repair the tendon Why it's important to avoid adhesions The recovery period   What You Will Learn: [00:50] Intro [02:28] The exams to determine the injury [03:26] How the PODdoctors repair the tendon [07:51] Repairing the synovial lining [11:07] How they do the hand ties [16:06] Recovery [16:48] Outro   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

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, provides a general overview of “The Great Imposter”: gout. A crystalline disorder, Gout is caused by uric acid crystals forming inside the joint and affects 4-6% of the U.S population. The PODdoctors discuss the multifaceted problems attached to this arthritis, the stages of pain and inflammation, and the treatment options currently available.    “Seven in ten people don't know that gout is a type of arthritis. People think it is a come and go deformity. ” -Dr. Raafae Hussain [14:35]   “They call gout “The Great Imposter” because it could be a number of different things. The workup requires us to usually get blood work and x-rays to see what is going on.” -Dr. Damien Dauphinee [03:02]   Top Takeaways: What is gout? Gout: an indicator of other serious problems Uric acid crystallization Gout flares and the impacts of climate PODdoctor's surgery experiences Treatment options   What You Will Learn: [01:39] Intro [02:20] Common indicators of gout [06:45] Things that add to your risk of gout [10:08] The two types of gout [13:43] Treatment options [18:18] What gout is signaling in the body [22:50] Krystexxa treatment [24:21] Caring for the joint   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

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, provide a general overview of common ankle pain and ankle problems. They discuss traction neuritis, posterior tibial tendon dysfunction, Os trigonum syndrome and other types of pain people will feel inside the ankle.   “Sprain ankle is the number one injury in sports injuries.” -Dr. Raafae Hussain [02:18]   “We never want to forget about the nerves. ‘Cause these will come back to bite you if you ignore them.” -Dr. Damien Dauphinee [09:40]   Top Takeaways: What causes ankle pain and common ankle injuries What is traction neuritis Most common anterior ankle pathologies What is posterior tibial tendon dysfunction (PTTD) Other pain people will feel inside the ankle What is Os trigonum syndrome Treatment options   What You Will Learn: [00:49] Intro [02:34] Common ankle injuries [04:28] How they determine ankle sprain from strain [07:16] Treatment options [09:34] What is traction neuritis [12:20] Conservative management [15:18] Common anterior ankle pathologies [22:45] What is PTTD and treatment options [26:12] Other pain inside the ankle [28:30] What is Os trigonum Syndrome [33:14] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, walk through a recent hallux rigidus surgery. They also discuss when they decide to do surgery to address the arthritic joint pain and what type of surgery to pursue.   “If you've got a joint issue, and you're asking a lot of that joint because of the flexibility of the shoe, you're going to make it worse and it's gonna really hurt.” -Dr. Damien Dauphinee [02:53]   “When we decide to do surgery and what type of surgery we decide to do is based on the patient's activity level and based on how much damage is done to the joint.” -Dr. Raafae Hussain [03:37]   Top Takeaways: What is hallux rigidus When the Pod Doctors decide to do surgery and what type of surgery A walk through of a recent hallux rigidus surgery   What You Will Learn: [00:50] Intro [02:07] What is hallux rigidus [03:37] When to do surgery and what type [05:02] A walk through a recent case [18:18] Recovery protocol [20:41] Outro   Resources: Previous episode on hallux rigidus: https://poddoctors.podbean.com/e/the-poddoctors-hallux-rigidus/ Visit our website: https://thepoddoctors.com/ Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, walk through peripheral nerve injury and provide a general overview of some of the different classifications of nerve injury. They discuss some of the tests they conduct for nerve injuries and treatment options.   “If you've got a motor injury, you've got up to a year to do something, but realistically, you have nine to ten months.” -Dr. Damien Dauphinee [12:44]   “So our different treatment options for all of these, they're all different. That's the downside of this, because every injury needs a specific type of repair.” -Dr. Raafae Hussain [24:52]   Top Takeaways: The two major parts of the nervous system and where they meet The different classification of nerve injury An overview of Wallerian degeneration Common types of reflect tests they conduct in office Treatment options   What You Will Learn: [00:40] Intro [02:21] Two major parts of the nervous system [05:59] What a nerve looks like in cross section [07:44] Different classification of nerve injury [12:01] An overview of Wallerian degeneration [13:08] Some of the tests they do in office [24:52] Treatment options [30:35] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, dive into one of their cases and walk through Haglund's surgery that removes the dreaded “pump bump.”   “The paratenon has been argued should you dissect it free or should you not dissect it free. I've gone both ways and I feel in my mind that the less trauma you cause to it, the better you end up doing, so I don't like to dissect mine free too much.” -Dr. Raafae Hussain [04:40]   “The dissection around those spurs is time consuming, and if you do it right and if you save as much tendon as possible, your repair is going to be much more vigorous and robust.” -Dr. Damien Dauphinee [07:01]   Top Takeaways: A quick recap on how the “pump bump” appears A walk-through of the surgery to handle this deformity Recovery from surgery   What You Will Learn: [00:40] Intro [02:06] A quick recap on “pump bump” [04:09] How they approach the incision [06:24] The surgical procedure [12:31] Inserting suture anchors [19:08] Repairing superficial achilles tendon [21:06] Mobilizing the patient and recovery [22:49] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about Haglund's deformity and the associated achilles tendonitis. They discuss the conservative and surgical treatment options.   “As far as surgery's concern, there's no conservative treatment to get rid of the bone. So when you have a golf ball in the back of your heel... so when you have that mass, that golf ball, that's going to continue to be a source of irritation and the only way to fix that is surgery.” -Dr. Damien Dauphinee [11:14]   “I had plantar fasciitis. It's cumbersome and weird. But if you put (a night splint) on and you're watching TV, you're computering, you're Facebooking, YouTubing, whatever you're doing, you watch an episode of Tiger King, bam, that's an hour of stretch right there. Super easy.” -Dr. Raafae Hussain [08:43]   Top Takeaways: What is Haglund's deformity and what do the Pod Doctors seen in the X-rays What is Equinus Conservative and surgical treatments   What You Will Learn: [00:40] Intro [01:58] What they see in the deformity [03:17] What they see in the X-rays [05:57] What is Equinus [07:06] Conservative treatment [11:04] Surgical treatment [20:45] Recovery [22:15] Outro   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 Revisit our episode on Jones fracture: https://poddoctors.podbean.com/e/the-poddoctors-jones-fractures/

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, highlight a surgical technique that they use to fixate Jone fractures.   “I tell them if it's good apposition and you can stay off of it, we can definitely try conservative, but more often than not, these fractures are gapped just on the mechanism of how they're pulled. Their tendon's pulling one way. Their foot's pulling the opposite way. There's typically a gap there and we typically end up fixing these surgically.” - Dr. Raafae Hussain [03:51]   “Not only is the tendon attachment working against you, but it's just hard to keep people to stay off their foot.” - Dr. Damien Dauphinee [04:15]   Top Takeaways: What qualifies as a Jones fracture How the Pod Doctors treat Jones fracture   What You Will Learn: [00:40] Intro [02:08] A recap of what Jones fracture [05:26] How Dr. Hussain treats a patient's Jones fracture [16:52] Recovery [17:37] Bad outcomes do happen [20:03] Outro   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 Revisit our episode on Jones fracture: https://poddoctors.podbean.com/e/the-poddoctors-jones-fractures/

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about bunion surgery. They walk through the surgical procedure and share their thought process along the way.   “You can see the curvature of that proximal phalanx or if they just got a lot of soft tissue pulling on that toe, you're just going to get a better correction, you're going to have a happier patient, if you just take that wedge out.” - Dr. Damien Dauphinee [16:36]   “Quick and easy. You know, your classic bunions. We're not doing anything fancy. We're literally going in, fixing the problem.” - Dr. Raafae Hussain [24:23]   Top Takeaways: What they see clinically with bunions The step-by-step process of bunion surgery, including incision placement, lateral release and the osteotomy procedure The Pod Doctors' thought process during the procedure The recovery options   What You Will Learn: [00:40] Intro [02:27] What they see with bunions [03:04] Incision placement and lateral release [07:57] The osteotomy procedure [15:18] The Akin osteotomy [21:14] Closure technique [24:47] Recovery [25:24] A listener question [27:16] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about recurrent neuroma, a post-op complication from nerve entrapment removal, and the various treatment options.   “The issue, we believe and have believed for decades now, is that the ligament is the problem.” - Dr. Damien Dauphinee [03:11]   “Here's what a classic stump neuroma looks like. You have the nerve spindles coming through and the end is blocked off, injured, whatever, so instead of growing out to where it's supposed to provide either sensation or muscle intervention, it's a little bundle ball of angryness.” - Dr. Raafae Hussain [08:41]   Top Takeaways: What is a recurrent neuroma and the issue they are treating The go-to treatment for stump neuroma and other treatment options What is endoscopic nerve decompression What a classic stump neuroma looks like   What You Will Learn: [00:40] Intro [01:42] What is Recurrent Neuroma [03:34] The go-to treatment for stump neuroma [05:57] What is endoscopic nerve decompression [08:40] What a classic stump neuroma looks like [10:05] Other treatment options [19:26] Recovery [20:51] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, address a question from a subscriber on bunion treatments. They talk about basic bunion procedures as well as different incision placements and the suture button technique.   “If you don't fix the boney aspect well the first time, all the soft tissue correction in the world is probably not going to make up for that.” - Dr. Damien Dauphinee [05:24]   “One of the big things that we've noticed over time is that different specialities that do foot and ankle surgery do different incision placements.” - Dr. Raafae Hussain [05:37]   Top Takeaways: Basic bunion procedures Why they do different incision placements More common incisions Lateral release, suture button and lengthening techniques   What You Will Learn: [00:40] Intro [02:19] A brief recap on bunions [03:34] Basic bunion procedures [05:44] Different incision placements [10:45] The lateral release [16:21] Suture button technique [21:43] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about plantar plate repair, also known as crossover toe. They discuss what happens with crossover toes and how the conservative therapy and surgery options to repair it.   “It's a complex balancing act between the ligaments and the plantar plate holding that second toe where it's supposed to be.” - Dr. Damien Dauphinee [04:36]   “It's so, so hard. You have to understand. If this was your finger, we can strap that down. You're not walking on your hand. You're walking on these and that's the hard part.” - Dr. Raafae Hussain [12:20]   Top Takeaways: What happens with crossover toes What is the plantar plate How they look at the condition of the deformity Conservative therapy and surgery options   What You Will Learn: [00:40] Intro [02:40] What is crossover toe and plantar plate [06:55] How they look at the deformity [11:55] Conservative therapy options [14:58] Surgery options [23:10] Recovery [25:07] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about the very common fungal infection: tinea pedis, also known as athlete's foot. They discuss the different types of infections and home remedies and topical solutions to treat them.   “A lot of this has to do with whether your immune system can fight it off. And some people don't have that capability so they get this over, over and over.” - Dr. Damien Dauphinee [05:23]   “It's a very straightforward problem and we offer very straightforward solutions.” - Dr. Raafae Hussain [17:16]   Top Takeaways: What is athlete's foot The different types of infections Home remedies and topical treatments   What You Will Learn: [00:40] Intro [01:49] What is athlete's foot [04:02] Three types of athlete's foot [08:46] What happens with tinea pedis [09:17] Home remedies and topical treatments [17:33] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about Ganglion cysts, a fairly common musculoskeletal problem. They describe what they see in the clinic, how they determine if a lesion is a Ganglion cyst and how they use aspiration surgery to treat it.   “One does not simply pop a Ganglion cyst.” - Dr. Damien Dauphinee [06:08]   “The surgery part works really well. Like you said, maybe 10-20 percent it'll come back, but yeah, very low chance of it coming back.” - Dr. Raafae Hussain [15:59]   Top Takeaways: What is Ganglion cysts What the Pod Doctors see common see with Ganglion cysts in the clinic How they determine it's a Ganglion cyst How they treat a Ganglion cyst with aspiration surgery The recovery period   What You Will Learn: [00:39] Intro [01:42] Why you should get the COVID-19 vaccine [05:59] What is Ganglion cysts [06:28] What the Pod Doctors see clinically [08:18] How they determine it's a Ganglion cyst [11:33] Treating with aspiration surgery [16:41] Recovery [17:43] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about the different types of bunion procedures and how they decide which procedure to do.   “Bunion is not a bony growth.” - Dr. Raafae Hussain [03:27]   “When patients are saying, ‘Well Doc, when do I need to get this fixed?' I usually say, ‘Look, once you start having internal joint pain in the great toe joint or if you start to see it deform your other toes, it's time to get it fixed.'” - Dr. Damien Dauphinee [12:03]   Top Takeaways: How bunions present themselves How the Pod Doctors categorize the severity of the bunion What they look for in imaging Conservative therapy and types of ​​bunionectomy   What You Will Learn: [00:39] Intro [01:58] The different ways to fix a bunion [03:12] How bunions present themselves [04:58] How to categorize the severity [06:39] What they're looking at in imaging [08:08] Conservative therapy [13:03] Various types of bunionectomy [27:22] Fixation methods and minimally invasive surgery [38:09] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about pediatric flat foot, one of the more common foot problems they see among kids. They discuss what they typically see with this condition in the clinic and how they can treat it with conservative measures and surgery.   “So general rule of thumb, all you young docs out there, soft tissue procedures and flat foot deformities, you're fighting an uphill battle. You got whatever hundred pounds of weight in a young child, 80 pounds of weight in a young child, whatever it might be, coming down on a specific tendon. You can't expect that tendon, especially a tendon like that, to hold that arch up. There's too much fighting against it. You gotta do your additional procedures behind it.” - Dr. Raafae Hussain [21:33]   “It's important to note that not everybody grows out of this. That it is ok to watch it until they're preteen age wise. You can prevent really a world of hurt as an adult if you address it early.” - Dr. Damien Dauphinee [25:46]   Top Takeaways: The two common foot problems with kids What the Pod Docs see with pediatric flat foot clinically How they treat pediatric flat foot Three common ways to lengthen the Achilles tendon Conservative treatment and surgery   What You Will Learn: [00:39] Intro [01:44] How pediatric flat foot is a common problem [03:16] What the Pod Docs see clinically [06:11] How they use imaging to check the condition [12:51] Conservative measures and treatment [15:22] How they treat this problem with surgery [25:07] Recovery [26:59] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, give an in depth look of charcot reconstruction. They first provide a recap of what charcot is and why it's such an issue for diabetic patients. As they walk through the surgery procedure, they share the thinking process with each step.   “So just getting the heel into position is a huge part of this. So we're really kind of yanking on that thing trying to pull it down back into at least a neutral position, if not, back to an anatomic position.” - Dr. Damien Dauphinee [06:38]   “It'll be one giant platform that he's standing on. The motion of mobility, he's lost that. The motion of mobility has kind of led to the problem that he has, and we want to lock that up to make sure everything stays stable.” - Dr. Raafae Hussain [20:54]   Top Takeaways: A recap of what is Charcot foot An indepth look of charcot reconstruction Why it's such an issue for diabetic patients Thinking process as they go through the surgery step by step   What You Will Learn: [00:39] Intro [02:18] What is Charcot foot [04:29] Dissecting the ankle joint [09:10] Why Dr. Dauphinee prefers the frame [10:05] Dissecting the subtalar joint [15:04] Working on the midfoot [20:14] The working conditions [22:08] Creating the frame and the stability block [28:20] The before and after [30:16] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, discuss one of their most interesting cases in the last few weeks: lateral ankle ligament with peroneal tendon repair and groove deepening surgery. They break down this common surgery with patients who have chronic lateral ankle pain.   “The lack of range of emotion certainly puts people at greater risk for lateral ankle sprains.” - Dr. Damien Dauphinee [03:06]   “This is my all-time favorite surgery, especially because at the end of this, this tendon, it looks so beautiful.” - Dr. Raafae Hussain [09:35]   Top Takeaways: A brief overview of the anatomy How they perform surgery to repair the lateral ankle ligament,  How they repair the Peroneal Tendon with groove deepening The recovery process   What You Will Learn: [00:39] Intro [02:18] A brief overview of the anatomy [03:13] The surgical procedure [11:05] Tendon repair with groove deepening [14:03] The ligament disrepair [18:18] Recovery [20:18] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about Heloma Molle, a soft but painful skin lesion. They discuss where they typically find this callus on the foot and why it's important to address the underlying bone issue. They also talk about the conservative and surgical options to treat the problem.   “The worst part about them is it's so small, but it's so painful.” - Dr. Raafae Hussain [01:56]   “I think addressing this on both sides of the problem is far more effective long term. You're hedging your bets.” - Dr. Damien Dauphinee [09:36]   Top Takeaways: Which toes they commonly see the Heloma Molle Why you must address the underlying bone issue to care for Heloma Molle How they treat Heloma Molle through conservative and surgical options What to expect with recovery What is heterotopic bone   What You Will Learn: [00:39] Intro [02:21] Typical corns and calluses on the foot [03:34] Conservative and surgical options [10:00] Recovery [12:50] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about Freiberg's Disease, also known as Freiberg infraction, a fairly common source of forefoot pain. They discuss what causes this pain and what they see clinically. They also talk about the conservative and surgical treatments.   “Once this joint goes, they're painful until you do something about it.” - Dr. Damien Dauphinee [06:23]   “There's a big push on flexible shoe gear right now, where these slip on type shoes, and they show in the commercials where you can bend and fold them and stuff them into your pocket. Horrible for your feet.” - Dr. Raafae Hussain [08:49]   Top Takeaways: What is Freiberg's Disease and what do the Pod Docs see clinically? The Smillie classification for Freiberg disease What causes this problem? Conservative therapy and surgical treatment options What is recovery like after treatment?   What You Will Learn:   [00:40] Intro [02:00] What is Freiberg's Disease [02:35] What they see clinically [05:13] Smillie classification for Freiberg's disease [07:03] What causes this problem [08:00] Conservative therapy [10:26] Surgical treatment [22:31] Recovery after treatment [23:24] Outro   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about surgical treatments for heel pain, specifically for plantar fasciitis. They explain what plantar fasciitis is and why it's the most common foot problem. They discuss some surgical options including endoscopic and gastroc recession techniques.   “This is definitely a problem that we like to say, ‘You got to attack it with everything but the kitchen sink.'” - Dr. Damien Dauphinee [03:03]   “Give it some time. It's something that you're walking on. You have to go through all the steps: stretching, good shoes, good insoles.” - Dr. Raafae Hussain [28:09]   Top Takeaways: Why plantar fasciitis is the most common foot problem How they use the endoscopic and gastroc recession techniques Pros and cons of performing a gastroc recession Recovery for plantar fasciitis   What You Will Learn:   [00:40] Intro [02:01] The most common foot problem: plantar fasciitis [03:35] How they use the endoscopic technique [08:59] What is gastroc recession [14:23] One thing Dr. Raafae Hussain adds with plantar fascia surgeries [15:56] Recovery for plantar fasciitis   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about posterior tibial tendonitis (PTT) that cause flat foot deformities. The Pod Doctors discuss the symptoms of PTT, what they see in the clinic and how they determine treatment options based on the flat foot stage.   “I say get it fixed while you're younger.” - Dr. Raafae Hussain [06:26]   “So getting in early. Getting it checked out. Getting some x-rays. Determining what your options are is important. Burying your head in the sand and waiting for your joints to break down to the point where they're broken down into oblivion is probably not in your best interest.” - Dr. Damien Dauphinee [47:21]   Top Takeaways: How posterior tibial tendonitis (PTT) presents What the Pod Doctors see in the clinic The different stages of flat foot What is the heel rise test Conservative treatment and surgery options for PTT   What You Will Learn:   [00:39] Intro [02:07] How PTT presents and what they see in the clinic [07:27] Flat foot staging and the heel rise test [10:59] How they use imaging to see the structure of the foot [16:34] Conservative treatments [20:44] Surgery options [43:05] Recovery   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about peroneal tendon repair surgery, by walking through the process from a recent case.   “You see how he's cutting out that damaged tendon, because we want to get it back to where it's a solid core. Sometimes if they're salvageable, we'll tuberlize them, but in this case, you can tell. That tendon has gone. It's like string cheese. Like I said this last time, you squish that string cheese and that's what that tendon looks like. You're taking all those fibers and you're smooshing them and laying them out. Very unhealthy to say the least.” - Dr. Raafae Hussain [06:22]   “That's the other advantage of I think of the Artelon. I can get them into early physical therapy, which I think is important for all of these issues.” - Dr. Damien Dauphinee [28:05]   Top Takeaways: A recent case where they conducted peroneal tendon repair surgery A walk through of the procedure The type of incisions and sutures they use in this type of surgery What is  Broström procedure What is Artelon material   What You Will Learn: [00:40] Intro [01:35] An interesting case [03:20] A walk through of the procedure [13:02] Part 2 of the surgery [21:27] Critical part of the procedure [21:47] A quick recap [25:06] The delivery system [29:30] Coming up in future episodes   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

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, start season two of The Pod Doctors podcast talking about diabetic neuropathy and what role nerve decompression plays into it. They discuss what they typically see with patients who have diabetic neuropathy and the various ways to treat it from conservative therapy to surgery.   “I think that's the restriction nowadays. People are like it's diabetic neuropathy. There's no treatment aside from treating the diabeties which is not true.” - Dr. Raafae Hussain [05:33]   “That study is going to be remarkable. It's going to be groundbreaking, and it already is. And I think the repercussions of it are hopefully that people will take another look at the option of surgical decompression in diabetic neuropathy as something for pain relief, but also sensory restoration and to prevent wounds. I think it can do all of those things.” - Dr. Damien Dauphinee [54:44]   Top Takeaways: What is neuropathy What role does nerve decompression play into neuropathy Typical symptoms for patients with diabetic neuropathy What is the double crush theory What are some conservative therapy before surgery The different levels of release through surgery and treatment plans Why it's important to take prescribed supplements What is a sham surgery How can a sham surgery be used for the painful diabetic neuropathy patient   What You Will Learn:   [00:39] Intro [02:29] What is neuropathy [07:51] What they see in patients with diabetic neuropathy [10:32] What is double crush theory [17:23] Conservative therapy options [28:04] Different levels of surgery [39:14] What is restless leg syndrome [40:32] Why it's important to take the prescribed supplements [44:44] Slight symptoms vs sever symptoms [49:25] What is a sham surgery   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

In this episode of The Pod Doctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about Jones fractures, a common foot fracture that can be quite complicated. They discuss the mechanics of the injury and treatment options. Listen as they talk about what makes these fractures so complicated.   “This one can have some healing complications and oftentimes require surgery.” - Dr. Damien Dauphinee [02:06]   “Jones fractures are known to be at-risk for what is called a nonunion. A nonunion happens when the blood supply or the area that needs to heal isn't healing as well, and your bone is trying to push to heal. It's not healing, and it just becomes a chronic fracture. Painful, tender and obviously unstable.” - Dr. Raafae Hussain [06:54]   Top Takeaways: What is a Jones fracture The mechanics of the injury Why are Jones fractures complicated Treatment options   What You Will Learn: [00:39] Intro [02:13] What is a Jones fracture [04:39] What the Pod Doctors look for [06:48] Why are Jones fractures complicated [09:12] The mechanics of the injury [12:14] Why this fracture is so important [14:27] Treatment options [20:56] Recovery   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