Today I have an interview with Ron McCulloch. See below for the interview and details. I actually got in touch with Ron because his centre treats Ledderhose but it also uses Cryotherapy. He has not yet used cryo to treat plantar fibroma's but has not ruled out used it for this purpose in the future.
Bio:
Ron
McCulloch is the principal Podiatric Surgeon and Director of the London
Podiatry Centre. During his many years as a specialist Podiatric
Surgeon, he has performed thousands of successful foot operations.
Ron
McCulloch is Consultant Podiatric Surgeon at London's Homerton
University Hospital.He lectures extensively both on the national and
international circuit and helped to develop podiatry in the Middle East.
Ron
McCulloch built a state of the art gait laboratory at The London
Podiatry Centre. This is one of the most advanced dedicated podiatric
gait facilities in the world. He is a published author on surgical
techniques and is one of only two practitioners in Great Britain to
offer invasive cryosurgery of the foot.
This information was taken, with Permission from http://www. londonpodiatry.com/podiatry/ staff/
1) How long having you been treating Dupuytren's and
Ledderhose disease?
About 20 years
2) Roughly how many Dupuytren's patients have you
treated and how many Ledderhose patients have you treated?
Plantar fibroma formation varies from discreet
nodules to multiple lesions. (Of course you know this). I have probably
treated several hundred of these over my career. They are not uncommon. I
cannot recall exactly how many I have operated on probably around 20 or 30
3) What treatments have you used for these conditions?
Would you recommend the treatment and roughly how successful is the treatment
for each condition?
Conservative
care/redistributive orthoses. Injection therapy, mainly steroid. Surgery to
excise the lesions. As you know I'm now looking at providing cryosurgery
as cases now come along.
4) What would your recommendations be to Dupuytren's
and Ledderhose patients and do you have any advice you would like to give?
Always start with conservative
care. If this fails injection therapy which involves breaking the fibroma down
with a needle and then infiltrating the steroid. After this I would be inclined
to try cryosurgery and full wide excision if this fails.
5) What do you think of other treatments such as
steroid injections, Xiapex, Radiotherapy and cryosurgery (which I see you do
for other conditions)?
I only have experience
with injections and excision. The key thing with excision is to do a
large marginal one to minimise the chance of recurrence.
6) What success have you had with cryosurgery for
other conditions?
I have done almost 100
operations with cryosurgery but these have mainly been for the management of
neuroma formation. As of now I have not had to treat fibroma using
cryosurgery as this is a fairly new treatment in our facility. However when the
right case comes along I'm sure we will be using this as part of our armoury to
treat plantar fibroma formation.
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