The Foot Doc Blog – Leading Blog on foot and ankle pain
If you ever had an ingrown toenail that never responded to your “bathroom” surgery then you may want to read this to see why.
Typically when the nail plate irritates the surrounding nail fold, it breaks the king and gets covered by the inflamed nail fold. When one tries to “cut the corner” out, they typically miss the entire side and cut a portion of the nail and apply pressure to pull it out. A spike of nail is left behind and continues to grow and eventually is stuck into the nail fold which complicates the situation even further. Now bacteria is enabled to enter the skin and an infection occurs. When this occurs, the only way to remove the nail is through surgical excision and excising the entire side of the nail.
Plantars warts are caused by a virus that invades the skin on the bottom of the foot and creates thick callus like lesions that can be very painful. They are more common in children and adolescents, but can occur in adults. You can differentiate them from calluses by the interruption of skin tension lines and occasional appearance of tiny black dots which are small ruptured vessels as they are very vascular.
It is very common to be born with or acquire a contracted or curled toe. I see these routinely in the office and they’re really easy to fix as long as they’re still “flexible” in nature. In other words, don’t wait until the deformity is so far advanced that the toes are “rigid” and no longer able to bend or straighten.
Fracture blisters occur when a bone is fracture which leads to swelling that has no where to go and eventually ends up accumulating in the skin forming a blister. Sometimes when these blisters are seen after trauma, it is very likely to find a fracture on X-ray.
Here’s an example of a woman who had dropped a picture frame on her toe and ended up with a severely swollen toe and blister that formed 3 days later. The toe was found to be fractured after X-rays were taken.
If you’ve ever heard of carpal tunnel syndrome, there is a very similar condition that exists in the foot and leg. The condition is commonly referred to as tarsal tunnel syndrome. Symptoms vary but typical are burning and numbness in the foot, heel, and toes. Tingling and shooting sensations can also radiate up the leg to the knee.
It’s never too late to fix your bunion. Too often patients will present with a severe bunion deformity asking for possible options to reduce the pain so they can be more functional and do the activities they would like to do, but will not consider surgery. Sometimes they think they are simply “just too old“. This is not true.
If the patient a is healthy enough to undergo anesthesia and has no serious medical conditions that would put them at risk, then even patients who are in their 80s can have corrective surgery to fix their bunion.
Here are two examples of patients who were in their 80’s and had undergone what is known as a Keller procedure to fix their deformity.
The surgery is out-patient and takes roughly 45 in a hospital or surgery center and the patient can bear weight in the foot in a walking boot the same day. The foot is kept in bandages which are changed weekly for 3 weeks. During this period the patient will keep a surgical shoe or walking boot on. By 4-6 weeks an athletic or casual shoe Can be worn.
So how do you know if you need to fix your bunion? If it’s preventing you from doing the things in life you want to do and enjoy doing, then it’s certainly an option.
If you’ve ever known someone to have a leg ulcer that took months to heal, then you’ll appreciate how long and complex leg and foot wounds can be. There are many health variables which play a role in why some of these wounds take longer to heal which is specialized wound centers exist to care for these wounds. Our practice works at two wound centers in Ohio where we see unimaginable wounds of all complexities and we have an large array of resources to treat these wounds. Hyberic oxygen chambers exist to improve oxygenation of blood in patients who have bone infection or poor blood supply. Sometimes we implant skin grafts or new bioengineered tissue substitutes to close a wound quicker than it would take to heal naturally.
Hallux limitus is the medical word for arthritis of the great toe which is the most common area to encounter arthritis in the foot. Symptoms typically consist of lack of motion and pain to the joint with associated bony formation present to the top of the joint. When you compare your great toe joints you may see the painful one not bending as far upward as the uninvolved joint. There may also be grinding associated with this.
Treatment consists of flatter shoes to decrease the amount of motion to the joint, NSAIDS such as ibuprofen, cortisone injections, and surgical correction. Surgical correction may consist of cleaning out the fragments and arthritis from the joint, inserting an implant, or fusing the joint. Most of the times if this is caught early enough, cleaning out the joint or performing a cheilectomy will resolve the problem.
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