08:00:05	 From  Christina Billings : Welcome to the final day of FASST: Diabetic Surgery Symposium! As they become available, speaker handouts and session recordings can be found online at: https://cme.dmu.edu/FASST-Feb-2021-materials

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08:02:43	 From  Christina Billings  to  All panelists : Still waiting on Dr. Early. Will get him over as soon as he logs in.
08:03:04	 From  Narmo Ortiz  to  All panelists : Open posterior heel ulcer
08:03:23	 From  Narmo Ortiz  to  All panelists : Patient is being hospitalized tomorrow for management
08:03:34	 From  Narmo Ortiz  to  All panelists : He has Charcot on the contralateral foot
08:04:08	 From  Narmo Ortiz  to  All panelists : yes he is
08:04:11	 From  Narmo Ortiz  to  All panelists : he was offered a BKA
08:04:21	 From  Narmo Ortiz  to  All panelists : but pleased to have his leg saved if possible
08:04:33	 From  Narmo Ortiz  to  All panelists : pleaded*
08:05:43	 From  Narmo Ortiz  to  All panelists : Yes. it is a Wright Medical nail and will have the equipment at hand
08:07:06	 From  Narmo Ortiz  to  All panelists : I agree on proximal reaming
08:07:50	 From  Narmo Ortiz  to  All panelists : Agree on MRI
08:08:02	 From  Narmo Ortiz  to  All panelists : yes
08:08:57	 From  Narmo Ortiz  to  All panelists : yes, chest tube is what I'm using
08:09:18	 From  Narmo Ortiz  to  All panelists : Could I leave the PMMA rod permanently?
08:11:57	 From  John Early  to  All panelists : on line but having trouble getting mike and video on. One point to make is when removing  nail do not take all of the locking screws out until you have a good control of the nail. Nothing worse than trying to chase a loose nail
08:13:06	 From  Narmo Ortiz  to  All panelists : Excellent
08:14:35	 From  Narmo Ortiz  to  All panelists : Absolutely/ I think his Charcot arthropathy contributed to migration and possible early WB
08:15:13	 From  Narmo Ortiz  to  All panelists : Thank you gentlemen!
08:15:29	 From  Narmo Ortiz  to  All panelists : Will do.
08:15:35	 From  Narmo Ortiz  to  All panelists : I will email you follow up pics
08:16:08	 From  Ashley Mychak  to  All panelists : yep
08:22:19	 From  Ashley Mychak  to  All panelists : he had a tal
08:25:34	 From  Ashley Mychak  to  All panelists : he refused an AFO with a filler because of sweating.
08:26:11	 From  Ashley Mychak  to  All panelists : he did make socks with my face on it for christmas, so there's that.
08:26:39	 From  Ashley Mychak  to  All panelists : thanks for all the input! will set him up for pt release!
08:26:56	 From  Ashley Mychak  to  All panelists : skin te, awesome and easy
08:35:46	 From  Damien Richardson  to  All panelists : What are your options for placing screws around the nail besides posterior to anterior and how do you place them.
08:36:26	 From  Damien Richardson  to  All panelists : With regards for securing midfoot to hindfoot. Anyone use beams?
08:36:40	 From  Narmo Ortiz  to  All panelists : Sometimes the midfoot and dislocated talus are "marblelized" and present as rock solid bone even though they look osteopenic.
08:37:31	 From  Narmo Ortiz  to  All panelists : Lateral and anterior medial incisions can be made for complete dissection and reconstruction while preserving NVS packages.
08:39:23	 From  Damien Richardson  to  All panelists : Is strict non-weightbearing a requirement for surgery with nails or frame? If patient cannot be non-weightbearing is that a contra-indication and would you still offer surgery?
08:39:29	 From  Narmo Ortiz  to  All panelists : BMAc needed here with PRP as well.
08:49:45	 From  Narmo Ortiz  to  All panelists : PT tenotomy and flexor retinaculum should be released.
08:54:58	 From  Damien Richardson  to  All panelists : Arizona Brace
08:55:41	 From  Damien Richardson  to  All panelists : Pain at lateral column
08:55:52	 From  Damien Richardson  to  All panelists : Anterolateral ankle joint pain
08:56:16	 From  Damien Richardson  to  All panelists : HbA1c less than 7 on 3 separate occassions
08:58:27	 From  Narmo Ortiz  to  All panelists : If I may contribute, if there are no open wounds, I would maintain in a CROW walker and refer for Bariatric surgery. Most, if not all internal fixation will eventually fail. My humble opinion.
09:18:42	 From  Narmo Ortiz  to  All panelists : FHL tenotomy with MIS exostectomy of the spurring at the IPJ area of involvement.
09:21:24	 From  Narmo Ortiz  to  All panelists : Notice the plantar medial IPJ accessory bone.
09:28:12	 From  Narmo Ortiz  to  All panelists : Ex fix distraction and inject BMAc into the defect intraop, then inject PRP on a weekly basis.
09:33:04	 From  Narmo Ortiz  to  All panelists : awesome job on the tibia
09:35:48	 From  Narmo Ortiz  to  All panelists : Fantastic symposium! Thank you all!