The PODdoctors with Dr. Dauphinee and Dr. Hussain

In this episode, Dr. Damien Dauphinee, a board-certified Foot and Ankle Surgeon, and Dr. Raafae Hussain, a fellowship trained Foot and Ankle Surgeon, discuss plantar fasciitis as the most common reason for heel pain. They talk about how pain originates in the heel area, the variety of treatments that exist to treat plantar fasciitis, and methods of prevention.

QUOTES:

“It's not like a cold, it isn't gonna go away completely and you'll never have to deal with it again because it's a biomechanical problem, it's a structural support problem” - Dr. Damien Dauphinee [45:19]

Top Takeaways:

• Learn about heel pain and what causes it
• Learn about plantar fasciitis as one of the most common causes of heel pain
• Learn about how plantar fasciitis occurs and the options available to treat it.

What You Will Learn:

• [00:39] Intro
• [02:30] How common is plantar fasciitis?
• [03:43] Other causes of heel pain
• [04:43] How does plantar fasciitis occur and why do people get it?
• [08:49] The mechanics of stretching
• [10:16] Recommended treatment protocol
• [16:17] Orthotics: what are they? And how are they a long term solution for heel pain?
• [20:29] Night splint for plantar fasciitis
• [22:06] Heel pain injection treatment
• [24:14] Physical therapy treatment
• [26:07] The effectiveness of extracorporeal shockwave therapy
• [28:18] Surgical options for treating plantar fasciitis
• [32:19] Topaz Microdebridement treatment for plantar fasciitis
• [33:15] What is the Tenex procedure?
• [38:40] The MLS laser options for treating musculoskeletal pain
• [41:25] What is “stem cell therapy” for plantar fasciitis?
• [44:57] Prevention practices to fight 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

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 Dauphinee

Top 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 patients

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 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 Hussain

Top 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 foam
• Post-op shoe preference
• Risks: injury to lateral dors-cutaneous nerve branch, stunt neuromas

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, 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.

QUOTES:

“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 wart
• The two types of warts
• How to treat warts & Do home remedies actually work?
• Best wart treatments for children
• When is surgery needed to remove a wart?
• At-home wart recovery protocol

What 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 home

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, 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 Dauphinee

Top 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/