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A newsletter from Ankle & Foot Care Centers.

July 2012 Edition:

Drs. DiDomenico and Groner Contribute to International Textbook

The next generation of orthopedic and podiatric surgeons around the world may be studying from a textbook written, in part, by a pair of Ankle & Foot Care Centers podiatric physicians.

Dr. Lawrence A. DiDomenico, DPM, managing partner, authored three chapters in the recently published "International Advances in Foot and Ankle Surgery" textbook being used in medical and podiatry schools globally. Colleague Dr. Thomas Groner, DPM, co-authored two of the three chapters.

Authors from United States, Austria, England, Germany, Ireland, Italy and the Netherlands contributed to the book, published by Springer. The publisher describes it as "A comprehensive textbook of some of the most common and difficult to deal with pathologies. The first truly international, multidisciplinary manual of foot and ankle surgery by the specialty"s leaders and most experienced surgeons."

"Being included in a project like this is an honor in that it means influential people respect the work you"re doing and consider it state-of-the-art," Dr. DiDomenico said. "The authors of this textbook represent a prestigious group of world-renowned foot and ankle surgeons.

"Researching and writing for a textbook makes me better at what I do. You never get to stop learning, and this kind of project gives you a chance to step back and research subject matter from a new perspective."

Dr. DiDomenico collaborated with Dr. Groner on chapters on endoscopic gastrocnemius recession and intermedullary nail fixation for tibiotalocalcancal arthrodesis, and he worked with a traumatologist in Atlanta and a North Carolina podiatric surgeon on a chapter about the use of external fixation in the lower extremity.

"I enjoy the writing and research aspects of the profession, and to work with Dr. DiDomenico and be published in a textbook of this magnitude is quite an honor," Dr. Groner said.

Dr. DiDomenico, who has authored portions of textbooks numerous times in his career, is also completing three chapters for another textbook to be published this fall. He practices out of the Boardman, Northside (Youngstown) and East Liverpool offices. Dr. Groner sees patients in the Alliance and Niles offices.

Copyright © July 2012 Ankle & Foot Care Centers

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Dr. DiDomenico Co-Chairs Ohio Podiatric Medicine Seminar

Dr. Lawrence DiDomenico, DPM, managing partner of Ankle and Foot Care Centers, recently served as panelist for six seminars at the Ohio Podiatric Medical Association Regional CME (Continuing Medical Education) Seminar in Columbus. Dr. DiDomenico, who was scientific co-chair for the three-day event in July, also moderated several of the panels.

Dr. DiDomenico, an adjunct professor at the Ohio College of Podiatric Medicine, provided his expertise on revision surgery, video surgical techniques, keeping up with technology and management of difficult cases.

The panelists examined such important concerns as ensuring that all procedures have been completed correctly, developing of protocols to handle traumatic conditions in the office or emergency room, increasing the use of video as part of the surgeon"s decision-making process, and developing a systematic approach to managing the more difficult cases podiatrists may expect to face in the operation of their practice.

In the CME category that Dr. DiDomenico served as scientific co-chair, Ohio law requires podiatric doctors to attend a minimum of 40 hours and a maximum of 100 hours of seminars. The educational program is certified by the OPMA and approved by the State Medical Board of Ohio.

Copyright © July 2012 Ankle & Foot Care Centers

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A&F Doctors Initiate "Save A Leg Save A Life" Chapter

Drs. Gregory Blasko, DPM, and Lawrence DiDomenico, DPM, are coordinating the creation of a tri-county chapter of the "Save A Leg, Save A Life"™ Foundation (SALSAL).

A membership drive among healthcare professionals and allied staff is being conducted in Columbiana, Mahoning and Trumbull Counties to form the group that will carry on the organization's mission to raise awareness of amputation prevention, limb salvage, wound care treatments and peripheral arterial disease through education and community based outreach.

SALSAL was founded in Jacksonville, Fla., in 2005 and has grown to approximately 40 chapters in the United States, Latin America and overseas. The group's immediate goal is to reduce lower extremity amputations in chapter communities by 25 percent.

More information can be found at

Copyright © July 2012 Ankle & Foot Care Centers

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Chronic Back Pain Works Way into Patient's Foot

Ralph Saylor has not had much success treating a chronic back problem, but he did experience some much-needed pain relief in his foot and ankle when nerve damage from his back found its way to his lower extremities.

Ralph, 60, of Greenville, Pa., has had two back surgeries and is no longer able to work. He's also no longer able to live the active lifestyle he'd grown accustomed to, which included working multiple jobs, riding a motorcycle, hiking, bicycling, swimming and walking.

"When your back goes you lose everything," he said.

After his back pain started working its way down his left leg, his back doctor referred him to Dr. M. Craig Beaudis, DPM, of Ankle & Foot Care Center in Greenville. The first symptom he experienced was heel pain, and then it evolved into numbness in his foot from a neurological complication.

Dr. Beaudis prescribed an ankle foot orthosis (AFO), a commonly used orthotic device that can help support limbs, control the position of the foot and ankle, and compensate for weakness. In Ralph's case it was to treat a peripheral neuropathy.

"The brace worked great for strengthening and stabilizing my foot and ankle," Ralph said. "My ankle was swollen twice its size, and since I started wearing the AFO the swelling and pain went away. It moves with the ankle but it doesn't allow me to go side to side. I wear it about 90 percent of the day and I'll probably wear it forever."

With his left leg feeling better Ralph and his wife of 40 years have gotten out to do a little camping.

"I feel bad because she's got to carry everything," he said. "I do what I can do, but I just have to stop a lot because of my back."

It's a small victory, but a victory nonetheless; one that Ralph attributes in large part to Dr. Beaudis restoring the nerve feeling in his lower left leg.

Copyright © July 2012 Ankle & Foot Care Centers

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Dr. Groner Sports an Active Schedule In and Out of the Office

Growing up in Youngstown surrounded by sports not only helped lead Dr. Thomas Groner into a career as a podiatric physician, but it provided a foundation for being an active parent to his own children through coaching youth sports.

A parent with his wife Leanne to four boys ages 2, 4, 6 and 8, Dr. Groner can often be found on area baseball fields and basketball courts teaching young children how to field grounders and box out for rebounds. That is, when he's not maintaining a full clinical schedule.

"Playing sports growing up gave me an appreciation for the sports medicine aspect of the profession, which is what ultimately drew me to podiatry," the Boardman resident, Dr. Groner said.

In addition to practicing general podiatry, Dr. Groner has developed a subspecialty in wound care, and spends a great deal of time at the practice's wound center in Alliance. He also works as the assistant director of the residency program at Alliance Hospital. Further, he holds the officer position of secretary for the Eastern Academy of the Ohio Podiatric Medical Association.

Dr. Groner is a graduate of Youngstown State University and the Ohio College of Podiatric Medicine in Cleveland. He joined Ankle & Foot Care Centers in 2004.

"Ankle & Foot Care Centers continues to grow and is among the most well-known, cutting-edge facilities for podiatric medicine in our area," he said of his employer.

Among the reasons the practice is so highly acclaimed is the volume and sophistication of the research and published works it produces, Dr. Groner included. He recently co-authored with colleague Dr. Lawrence DiDomenico two chapters of a medical school textbook used internationally on foot and ankle surgery topics. As a resident under Dr. DiDomenico earlier in his career, Dr. Groner also co-authored articles published in podiatric medical journals.

Copyright © July 2012 Ankle & Foot Care Centers

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Tina Adkins: A Job Fit for a Mom (and Grandma)

There are a lot of reasons Tina Adkins credits for Ankle & Foot Care Centers providing such a rewarding workplace and career experience for her.

Throughout her combined 21 years as a medical technician for Dr. DiDomenico and now the 19-office Ankle & Foot Care Centers practice, perhaps the most notable reason, she says, is that it's been a great "mom job."

"I've got three boys (ages 14, 21 and 25) who are very active in school events and sports, and I've never missed anything while they were growing up," she said. "I'm very fortunate with the flexibility I have here."

As of earlier this month, the Columbiana County resident can even say it's been a great "grandma job," as her oldest son and his wife welcomed their first child, a boy named Carter, into the world.

Tina Adkins recently became a proud grandmother with the addition of grandson, Carter.

For the past nine years Tina has worked at Ankle & Foot Care Centers' Boardman Testing Center. There, she administers non-invasive pressure-specified sensory device (PSSD) tests and designs orthotics.

The PSSD procedure uses hyper-sensitive prongs to test the sensitivity of small nerve fibers. It's often performed for pre-operative patients and individuals with diabetic neuropathy, entrapped nerves and carpal tunnel, among other diagnoses.

Designing custom-made orthotics involves having a patient walk on a specially designed mat connected to software that measures pressure points and gait to produce a most-effective orthotic device for use in almost any kind of shoe. Tina says she sees a range of patients ordering orthotics, including many high school and college athletes.

When she started, this process involved casting a patient's foot in foam, but now through the use of the computer software it serves the patients so much better, she said.

Copyright © July 2012 Ankle & Foot Care Centers

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The "Ouch" Factor: What to Do about Splinters

The warm, sunny weather of summer is an invitation for us to shed our shoes and socks and run barefoot. However, running or walking (both inside and outside) barefoot places us a risk of splinters.

When you have a splinter in your foot, you will feel pain or discomfort and the sensation that something is embedded in the skin. Although wood splinters are most common, tiny bits of plastic, shards of metal or even broken glass can penetrate an unprotected foot.

While small splinters can be removed at home, any large or deep splinters in the foot should be removed by a podiatric physician. Anyone with diabetes should be especially vigilant, because a small splinter can grow quickly into a serious infection.

There are numerous home remedies that can help make removing splinters simple and fairly painless. Here are steps you can follow to safely remove a splinter from the foot:

  1. Start by soaking the foot in warm water to soften the skin.
  2. Wash your hands and gently clean the area of your foot in which the splinter is lodged.
  3. Once the skin is soft, try to squeeze out the splinter by putting your fingers on either side of the splinter and pinching gently.
  4. If the splinter won't come out by squeezing, disinfect a pair of tweezers and a needle with rubbing alcohol, iodine, or boiling water and let them dry. If the splinter is still sticking out of the skin, use the tweezers to grasp the end and pull gently but firmly.
  5. You want to avoid breaking the splinter, which would leave the tail end in the skin. To remove the entire splinter, pull it out at the same angle that it entered the body. Most splinters will come out easily.
  6. If you can't grasp the splinter with the tweezers, use the very tip of a sterile needle to slightly open the skin where the splinter is lodged. Grasp the end of the splinter with the tweezers and pull firmly. DO NOT dig for the splinter. Disclaimer: Use of a needle can assist with the removal of a splinter. However, use with caution to prevent further injury.
  7. Remember to gently wash your foot once you're done.

Contact a podiatric physician if you're having trouble reaching the splinter, if you are making the wound worse, or if the area becomes red, swollen, or hot to the touch, either after you remove the splinter or you cannot see any foreign body under the skin. Whatever is embedded in your foot will determine how the podiatric physician will treat you. Deeply embedded foreign bodies may require a surgical procedure. Sometimes a local anesthetic is needed to completely remove a foreign body.

One good way to avoid splinters is to wear shoes both in the house and outside. There are many great options for summer besides bare feet, so keep feet healthy and happy by making good choices and avoiding splinters.

Copyright © July 2012 Ankle & Foot Care Centers

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From The Kitchen: Diabetic-Friendly American Macaroni Salad

Yield: 6 servings

2 cups dry elbow macaroni, cooked, rinsed and drained
1/3 cup diced celery
1/4 cup minced red onion, soaked in cold water for 5 minutes, drained
1 tablespoon minced flat-leaf parsley
1/2 cup diced vine-ripened tomato (optional)
1/2 cup prepared mayonnaise
3/4 teaspoon dry mustard
1 1/2 teaspoons sugar
1 1/2 tablespoons cider vinegar
3 tablespoons sour cream
1/2 teaspoon kosher salt, plus more to taste
Freshly ground black pepper

Preparation time: 30 minutes (prep: 20 minutes, cook: 10 minutes)

In a large bowl combine the macaroni, celery, onion, parsley and tomato, if using. In a small bowl, whisk together the mayonnaise, mustard, sugar, vinegar, sour cream and salt. Pour the dressing over the salad and stir to combine. Season with salt and pepper to taste. Serve. Store covered in the refrigerator for up to 3 days.

Per serving: Calories: 286; Total Fat: 16.5 grams; Saturated Fat: 3 grams; Protein: 5 grams; Total carbohydrates: 28 grams; Sugar: 3 grams; Fiber: 1 grams; Cholesterol: 10 milligrams; Sodium: 292 milligrams.

Copyright © July 2012 Ankle & Foot Care Centers

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