Ian Reilly

Second day teaching on the bounce. Verrucae and local anaesthesia today #teaching #podiatry #verrucae #podsfixfeet #anaesthesia #edinburgh @ Edinburgh, United Kingdom

Case of the week #38.
One of my fave patients of the year so far - and my least fave verrucae!
A bilobed flap for skin closure (and a tricky local anaesthesia - in her previous needling we had struggled to get her numb. A bit of real life surgery thus presented and I leave that part in on purpose).
... Extra narration from my SpR colleague as I was away from the mike...
These are tricky procedures. I learnt this (and other techniques) on post grad courses run by the ACFAS in the US. There are various principles on flap design, movement and protection to help ensure a good outcome - don't try this at home!
https://www.youtube.com/watch?v=jSlaR2k0Z n0
See More

Still YouTubeing when I can ... new vid up on Sunday on bilobed flap. #youtube #podsfixfeet #podsurgeon

Warm intro from my buddy Matt at the NEC today. Good crowd. Good conference for pods. TY to all those that waited till 4.25. #collegepodiatry #podsfixfeet #mortonsneuroma #pronationexists @ NECBirmingham

Case of the week #37.
Back in the day we were taught 'don't cut the plantar surface of the foot'. Well, I do my neuromas through a plantar approach and they work out better for me that way.
Slideshow below and a link to a paper we did on the subject.
... http://faoj.org/…/longitudinal-plantar- approach-for-excisi…/
See More

Nice bilateral spikes on this IGTN. The hypergran was impressive. Sorry no photo! #igtn #cryptosis #nailsurgery

Case of the week #35.
6 months ago I did a bilateral PNA on a young guy who would not let me take his hypergranulation tissue off (picture 1).
Sadly he was lost to follow up as I wanted to see how he progressed. He has just returned: one side settled but the other did not and he returned for the soft tissue to be removed.
... Hopefully this time that will sort it…
See More

Case of the week #34.
This lady had her hallux IPJ fused some 8 years ago (R/A foot) but the screw cheesewired though the bone and exited out of the bottom of the toe, causing an ulcer and infection.
I took the screw out, irrigated the incection out and filled the void with teicoplanin-impregnated Stimulan to treat the infection at source. This was injected deep into the cavity.
... https://www.biocomposites.com/our-product s/stimulan/
As always - see my disclaimer video. This is for education only. https://www.youtube.com/watch?v=iZytE...< br> See More

Case of the week #33.
This lady had a painful soft tissue mass excised from her right heel. It was painful due to the location, ie being walked on. She had noticed it for the last year or so though in truth it had likely been there for some time before.
My approach for such masses is as follows: ... 1. Begin with a thorough history and physical examination 2. Order diagnostic imaging as guided by the clinical impression 3. Consider biopsy to confirm the diagnosis if there is a suspicion of something invasive, if it is greater than 5cm or if it is rapidly growing 4. Confirm the diagnosis post-surgery by biopsy
The scan suggested it was benign therefore excision was planned.
See the END of the video for the diagnosis.
https://www.youtube.com/watch?v=Fm3aRA1B_ 3o&t=19s
As always - see my disclaimer video. This is for education only. https://www.youtube.com/watch?v=iZytE...< br> See More

Case of the week #32.
This lady had a 2nd MTP joint surgery late 2016 for pretty bad OA of the joint (with a 2nd interspace neurectomy). The clinical photo shows an early post op picture... there was some AB-duction of the toe so we did a small capsulotomy as an in-office procedure.
https://www.youtube.com/watch?v=ZQRr6ZOk8 Fw
... (yes - it says LEFT foot in the title slide - oooops).
2 years later there is some return of pain in the joint. Some CSi is injected to the joint to help with pain and fibrosis. I expect to keep her comfortable for 5 years or so like this and consider joint replacement surgery at a later date.
As always - see my disclaimer video. This is for education only. https://www.youtube.com/watch?v=iZytE...< br> See More

Great course with a receptive crowd in Glasgeeee. Love that accent. #teaching #verrucae #la #podsfixfeet @ Holiday Inn Express Glasgow Airport

Case of the week #31.
This patient young lady stepped on a piece of glass. It was located on X-ray but two failed attempts (in A&E and St Elsewhere) only gave her a heloma vasculare type scar – pinpoint bleeding on callus debridement.
Plan: punch biopsy to create a nice, new scar. The shard of glass was found in the 4mm skin punch - look closely at the section on the scalpel handle.
... Outcome: happy patient.
See More

Case of the week #30.
This patient is a sixty-two-year-old diabetic female patient from Jamaica, who presents with a painful, involuted nail on the right hallux, complicated by hypergranulation tissue. She controls her diabetes with medication (2 x OAD's: metformin and gliclazide) and had a total knee replacement four years ago. The knee replacement was uneventful, but her diabetic control has deteriorated since then (last HbA1c was 60mmol/mol).
WHAT WOULD YOU DO?

There are always three speeches for every one you actually gave. The one you practiced, the one you gave, and the one you wish you gave. Dale Carnegie.
Version 2 was given - at the Faculty of Podiatric Surgery annual conference last week. Some of the slides from the 8 hours I spent on this...

Case of the week #30.
A new patient who presented with pain between her 1st and 2nd toes:
She had been told she might be suffering from that rareest of all foot neuromas – the 1st interspace Houser’s neuroma. In fact, on taking an X-ray, it seems the explanation was a sewing needle. She had no idea how it got there!
... This will be listed for excision (under live X-ray guidance)
See More

Lecturing on the Weil osteotomy today at the Directorate of Podiatric Surgery annual conference #podiatricsurgery #collegepodiatry #surgery #weil @ Mercure Daventry Court Hotel

Case of the week #29.
This is my 2010 injection video for a policeman's heel injection (with some additional explanation). In practice it is difficult to distinguish between a plantar calcaneal bursitis and a more proximal presentation of plantar fasciitis. Hopefully this makes sense... :-)
https://www.youtube.com/watch?v=r0oftKF8o JQ&feature=youtu.be
... I’ve also updated my intro vid: https://www.youtube.com/watch?v=iZytEnK-E 4Y
See More

Case of the week #28.
Here I injection a cheeky hammer toe that is painful at the MTP (knuckle) joint but also in the interspace where a Morton's neuroma is present. https://www.youtube.com/watch?v=5IoMMFDgk gM&t=15s
... I’ve also updated my intro vid: https://www.youtube.com/watch?v=iZytEnK-E 4Y
See More