The PODdoctors with Dr. Dauphinee and Dr. Hussain

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.

QUOTES: 

“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.

 QUOTES:

“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.

 QUOTES:

“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.

QUOTES:

“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.

QUOTES:

"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.

 QUOTES:

“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

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 hammer toes. They discuss what causes this cosmetic and physical problem, the three main reasons for hammer toe contractures and other associated problems. They also describe the most common treatment options from conservative to surgical treatments.

 QUOTES:

“There’s not a lot you can do conservatively to fix the hammer toe. You’re pretty much cushioning the problem.” - Dr. Raafae Hussain [19:10]

“They’re not just a cosmetic problem. They are a mechanical issue. There’s a hereditary component obviously with a lot of folks. But we’re able to address both the cosmetic aspect of it and the mechanical aspect of it, which is a nice win-win for the patient.” - Dr. Damien Dauphinee [38:31]

Top Takeaways:

• What is a hammer toe?
• Why are hammer toes a problem?
• What do the Pod Doctors look for in clinical exams?
• What causes a hammer toe?
• Three main reasons for hammer toe contractures
• Associated problems with hammer toes
• Treatment options

What You Will Learn:

• [00:40] Intro
• [02:07] What is a hammer toe
• [03:19] Why are hammer toes a problem
• [09:12] What do the Pod Doctors look for in clinical exams
• [09:48] What causes a hammer toe
• [13:08] Associated problems
• [13:53] Most common treatment options
• [24:28] Surgical options
• [31:26] Additional procedures
• [35:34] Recovery for hammer toe 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 Charcot foot, a typical problem seen in neuropathic patients. They discuss the two theories behind this condition: neuro-traumatic theory and neurovascular theory. They share examples of what they see at the clinic and how they treat it through internal and/or external fixations.

QUOTES: 

“The real issue is these feet become severely deformed. And when you have neurotrophy and you can’t feel it, the deformations then lead to ulcers which get infected and then can cause amputations.” - Dr. Damien Dauphinee [03:38]

“You can chase the bump all you want, but then that bump is just going to keep on collapsing more and more and more.” - Dr. Raafae Hussain [20:10]

Top Takeaways:

• What is Charcot foot? Plus, two theories about it
• What are the surgical goals when trying to fix these?
• Why they over-engineer during treatment
• When it’s appropriate to use internal or external fixation
• The social problems associated with this condition

What You Will Learn:

• [00:40] Intro
• [01:39] What is Charcot foot
• [02:33] Two theories about it
• [03:52] Why they have to over engineer during treatment
• [10:41] The surgical goals to fix these
• [19:08] An example of not addressing the original issue
• [22:37] When it’s appropriate to do internal or external fixation
• [30:04] Dr. Damien Dauphinee’s theory on Charcot ankle
• [31:21] How someone broke their ankle brushing his teeth
• [35:02] A sad, difficult outcome
• [41:27] Social problems that associated with this condition 

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 hallux rigidus, a common problem and specific arthritic joint pain in the big toe. They share what they typically see with the disorder clinically and why x-rays are important to diagnose the problem. They also discuss the various treatment options for hallux rigidus.

QUOTES:

“A lot of people will come in with those memory foam, the gel inserts. And it’s like look, these are great and comfortable for the first day or two you wore them, but the problem isn’t that you’re walking on stones. The problem is that your foot is not functionally to its peak biomechanical ability.” - Dr. Raafae Hussain [12:37]

“The goal of the surgery is pain relief.” - Dr. Damien Dauphinee [21:07]

Top Takeaways:

• What is hallux rigidus?
• How does it differ from gout?
• What happens to your foot with hallux rigidus?
• Treatments options for hallux rigidus

What You Will Learn:

• [00:39] Intro
• [03:06] What is hallux rigidus?
• [03:59] What the Pod Doctors see clinically
• [06:58] What happens when you lose the joint movement compl?etely?
• [07:58] What happens to your foot with hallux rigidus
• [12:16] Why over-the-counter arch supports are not helpful for hallux rigidus
• [13:01] How x-rays determine how bad the joint is
• [13:49] Some conservative options to take care of the pain
• [16:04] Available procedures based on the damage

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 achilles injuries. They discuss what causes the chronic and acute injuries and how they treat them. Listen to why it’s important to treat an achilles injury as quickly as possible.

 QUOTES:

“A lot of women are in high heel shoes and they come back down. They’re like ‘Oh, my heel hurts, but I’m so comfortable in these shoes. It’s the only shoes I’m comfortable in....’ That’s that problem. When you’re in that short achilles state, when that heel is elevated, right? That tendon… so it’s new normal is nice and short. If you spend seven, eight hours a day in those types of shoes, it’s going to add up.” - Dr. Raafae Hussain [18:39]

“The goal is try to catch these as early as possible because the neglected ones are much harder to fix.” - Dr. Damien Dauphinee [27:25]

Top Takeaways:

• The basic anatomy for the achilles tendon
• The different types of achilles injuries
• Treatment and recovery for acute and chronic injuries

What You Will Learn:

• [00:40] Intro
• [02:44] The basic anatomy of the achilles tendon
• [04:11] Types of minor achilles injuries and most common causes
• [10:18] Treatment options for acute injuries
• [17:07] Chronic injuries - causes and how it differs from acute injuries
• [20:50] Treatment options for chronic injuries
• [24:46] Recovery for these injuries

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