Hosey Foot & Ankle Centers

Pediatric Flatfoot

noreply@blogger.com (Anonymous) — Tue, 29 Jan 2013 22:19:00 +0000

Pediatric Flatfoot

What Is Pediatric Flatfoot?

Flatfoot is common in both children and adults. When this deformity occurs in children, it is referred to as “pediatric flatfoot.” Although there are various forms of flatfoot, they all share one characteristic – partial or total collapse of the arch.

Pediatric flatfoot can be classified as symptomatic or asymptomatic. Symptomatic flatfeet exhibit symptoms such as pain and limitation of activity, while asymptomatic flatfeet show no symptoms. These classifications can assist your foot and ankle surgeon in determining an appropriate treatment plan.

Symptoms
Flatfoot can be apparent at birth or it may not show up until years later. Most children with flatfoot have no symptoms, but some have one or more of the following symptoms:

Pain, tenderness, or cramping in the foot, leg, and knee
Outward tilting of the heel
Awkwardness or changes in walking
Difficulty with shoes
Reduced energy when participating in physical activities
Voluntary withdrawal from physical activities

Diagnosis
In diagnosing flatfoot, a Doctor from Hosey Foot and Ankle Centers will examine the foot and observes how it looks when the child stands and sits. One of our doctors at Hosey Foot and Ankle Centers also observes how the child walks and evaluates the range of motion of the foot. Because flatfoot is sometimes related to problems in the leg, the surgeon may also examine the knee and hip.

X-rays are often taken to determine the severity of the deformity. Sometimes additional imaging and other tests are ordered.

Non-surgical Treatment
If a child has no symptoms, treatment is often not required. Instead, the condition will be observed and re-evaluated periodically by the foot and ankle surgeon.

Custom orthotic devices may be considered for some cases of asymptomatic flatfoot.

When the child has symptoms, treatment is required. The foot and ankle surgeon may select one or more of the following non-surgical approaches:

Activity modifications. The child needs to temporarily decrease activities that bring pain as well as avoid prolonged walking or standing.
Orthotic devices. Hosey Foot and Ankle Centers can provide custom molded orthotics that fit inside the shoe to support the structure of the foot and improve function.
Physical therapy. Stretching exercises, supervised by the foot and ankle surgeon or a physical therapist, provide relief in some cases of flatfoot.
Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to help reduce pain and inflammation.
Shoe modifications. The foot and ankle surgeon will advise you on footwear characteristics that are important for the child with flatfoot.

When Is Surgery Needed?
In some cases, surgery is necessary to relieve the symptoms and improve foot function. The surgical procedure or combination of procedures selected for your child will depend on his or her type of flatfoot and degree of deformity.

Raynaud’s Phenomenon

noreply@blogger.com (Anonymous) — Mon, 21 Jan 2013 21:38:00 +0000

Raynaud’s Phenomenon

Raynaud’s phenomenon is a condition which results in a bluish-white discoloration of fingers and toes, often as a result of exposure to cold. Stress, smoking, and certain medications may trigger or worsen symptoms. The color change, which occurs from spasms in small blood vessels, becomes red and then returns to normal when blood flow resumes.

The condition most often affects women, with symptoms varying depending on the severity of the condition. Because there are no specific blood tests to diagnose this condition, the diagnosis is based on symptoms.

However, a Doctor from Hosey Foot and Ankle Centers may order blood tests to determine whether the Raynaud’s phenomenon is associated with certain autoimmune diseases or other medical conditions.

Treatment for Raynaud’s phenomenon is aimed at prevention and protection of the digits.

Contact Dermatitis

noreply@blogger.com (Anonymous) — Tue, 15 Jan 2013 17:26:00 +0000

Contact Dermatitis

Contact dermatitis of the foot is an inflammation of the skin in response to an irritant. This irritant is something with which the foot has come into contact, such as materials and chemicals with which shoes are made, poison ivy or harsh chemicals.

When the skin of the foot comes into contact with the substance, an allergic response is initiated. Symptoms, including:

redness
itchiness
small blisters

usually occur within 24 hours of exposure to the irritant. The symptoms should be evaluated by one of our Doctors at Hosey Foot and Ankle Centers for proper diagnosis and treatment.

Visit our website, http://www.hoseypodiatry.com for more information and to contact our offices.

Talar Dome Lesion

noreply@blogger.com (Anonymous) — Tue, 08 Jan 2013 15:02:00 +0000

Talar Dome Lesion

What is a Talar Dome Lesion?

The ankle joint is composed of the bottom of the tibia (shin) bone and the top of the talus (ankle) bone. The top of the talus is dome-shaped and is completely covered with cartilage—a tough, rubbery tissue that enables the ankle to move smoothly. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage.

Talar dome lesions are usually caused by an injury, such as an ankle sprain. If the cartilage doesn’t heal properly following the injury, it softens and begins to break off. Sometimes a broken piece of the damaged cartilage and bone will “float” in the ankle.

Signs and Symptoms

Unless the injury is extensive, it may take months, a year, or even longer for symptoms to develop. The signs and symptoms of a talar dome lesion may include:

Chronic pain deep in the ankle—typically worse when bearing weight on the foot (especially during sports) and less when resting

An occasional “clicking” or “catching” feeling in the ankle when walking

A sensation of the ankle “locking” or “giving out”

Episodes of swelling of the ankle—occurring when bearing weight and subsiding when at rest

Diagnosis

A talar dome lesion can be difficult to diagnose, because the precise site of the pain can be hard to pinpoint. To diagnose this injury, one of our Doctors at Hosey Foot and Ankle Centers will question the patient about recent or previous injury and will examine the foot and ankle, moving the ankle joint to help determine if there is pain, clicking, or limitation of motion within that joint.

Sometimes the surgeon will inject the joint with an anesthetic (pain-relieving medication) to see if the pain goes away for a while, indicating that the pain is coming from inside the joint.
X-rays are taken, and often an MRI or other advanced imaging tests are ordered to further evaluate the lesion and extent of the injury.

Treatment: Non-Surgical Approaches

Treatment depends on the severity of the talar dome lesion. If the lesion is stable (without loose pieces of cartilage or bone), one or more of the following non-surgical treatment options may be considered:

Immobilization. Depending on the type of injury, the leg may be placed in a cast or cast boot to protect the talus. During this period of immobilization, non-weightbearing range-of-motion exercises may be recommended.

Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.

Physical therapy. Range-of-motion and strengthening exercises are beneficial once the lesion is adequately healed. Physical therapy may also include techniques to reduce pain and swelling.

Ankle brace. Wearing an ankle brace may help protect the patient from re-injury if the ankle is unstable.

When is Surgery Needed?

If non-surgical treatment fails to relieve the symptoms of talar dome lesions, surgery may be necessary. Surgery may involve removal of the loose bone and cartilage fragments within the joint and establishing an environment for healing. A variety of surgical techniques is available to accomplish this. One of our Doctors at Hosey Foot and Ankle Centers will select the best procedure based on the specific case.

Complications of Talar Dome Lesions

Depending on the amount of damage to the cartilage in the ankle joint, arthritis may develop in the joint, resulting in chronic pain, swelling and limited joint motion. Treatment for these complications is best directed by a foot and ankle surgeon, and may include one or more of the following

Non-steroidal or steroidal anti-inflammatory medications

Physical therapy

Bracing

Surgical intervention

Puncture Wounds

noreply@blogger.com (Anonymous) — Wed, 02 Jan 2013 20:13:00 +0000

Puncture Wounds

What Is a Puncture Wound?

Puncture wounds are not the same as cuts. A puncture wound has a small entry hole caused by a pointed object, such as a nail that you’ve stepped on. In contrast, a cut is an open wound that produces a long tear in the skin. Puncture wounds require different treatment from cuts because these small holes in the skin can disguise serious injury.

Puncture wounds are common in the foot, especially in warm weather when people go barefoot. But even though they occur frequently, puncture wounds of the foot are often inadequately treated. If not properly treated, infection or other complications can develop.

Proper treatment within the first 24 hours is especially important with puncture wounds because they carry the danger of embedding the piercing object (foreign body) under the skin. Research shows that complications can be prevented if the patient seeks professional treatment right away.

Foreign Bodies in Puncture Wounds

A variety of foreign bodies can become embedded in a puncture wound. Nails, glass, toothpicks, sewing needles, insulin needles, and seashells are some common ones. In addition, pieces of your own skin, sock, and shoe can be forced into the wound during a puncture, along with dirt and debris from the object. All puncture wounds are dirty wounds because they involve penetration of an object that isn’t sterile. Anything that remains in the wound increases your chance of developing other problems, either in the near future or later.

Severity of Wounds

There are different ways of determining the severity of a puncture wound. Depth of the wound is one way to evaluate it. The deeper the puncture, the more likely it is that complications such as infection will develop. Many patients cannot judge how far their puncture extends into the foot. Therefore, if you’ve stepped on something and the skin was penetrated, seek treatment as soon as possible.

The type and the “cleanliness” of the penetrating object also determine the severity of the wound. Larger or longer objects can penetrate deeper into the tissues, possibly causing more damage. The dirtier an object, such as a rusty nail, the more dirt and debris are dragged into the wound, increasing the chance of infection.

Another thing that can determine wound severity is if you were wearing socks and shoes, particles of which can get trapped in the wound.

Treatment

A puncture wound must be cleaned properly and monitored throughout the healing process to avoid complications.

Even if you have gone to an emergency room for immediate treatment of your puncture wound, see a foot and ankle surgeon for a thorough cleaning and careful follow-up. The sooner you do this, the better: within 24 hours after injury, if possible.

The surgeon will make sure the wound is properly cleaned and no foreign body remains. He or she may numb the area, thoroughly clean inside and outside the wound, and monitor your progress. In some cases, x-rays may be ordered to determine whether something remains in the wound or if bone damage has occurred. Antibiotics may be prescribed if necessary.

Avoiding Complications

Follow the Doctors instructions from Hosey Foot and Ankle Centers for care of the wound to prevent complications (see “Puncture Wounds: What You Should Do”).

Infection is a common complication of puncture wounds that can lead to serious consequences. Sometimes a minor skin infection evolves into a bone or joint infection, so you should be aware of signs to look for. A minor skin infection may develop in two to five days after injury. The signs of a minor infection that show up around the wound include soreness, redness, and possibly drainage, swelling, and warmth. You may also develop a fever. If these signs have not improved, or if they reappear in 10 to 14 days, a serious infection in the joint or bone may have developed.

Other complications that may arise from inadequate treatment of puncture wounds include painful scarring in the area of the wound or a hard cyst where the foreign body has remained in the wound.

Although the complications of puncture wounds can be quite serious, early and proper treatment can play a crucial role in preventing them.

Puncture Wounds: What You Should Do

Seek treatment right away.
Get a tetanus shot if needed (usually every ten years).
See one of our doctors at Hosey Foot and Ankle Centers within 24 hours.
Follow your doctor’s instructions:
Keep your dressing dry.
Keep weight off of the injured foot.
Finish all your antibiotics (if prescribed).
Take your temperature regularly.
Watch for signs of infection (pain, redness, swelling, fever). Call your doctor if these signs appear.

Bone Tumors in the Foot

noreply@blogger.com (Anonymous) — Wed, 26 Dec 2012 20:29:00 +0000

Bone Tumors in the Foot

Bone tumors are caused by an abnormal growth of cells. They may be benign (noncancerous) or malignant (cancerous). Although rare, bone tumors can occur in the foot and ankle. They can be primary (originating in the bone), or secondary (originating in another part of the body).

Symptoms of a bone tumor may include:

•Fracture from slight injury,
•Bone pain, often at night,
•Occasionally a mass or swelling in the area.

A bone tumor is first diagnosed with x-rays. Advanced imaging modalities may be used to further evaluate the tumor. One of our Doctors at Hosey Foot and Ankle Centers may require surgical removal for a definitive diagnosis.

Drop Foot

noreply@blogger.com (Anonymous) — Mon, 17 Dec 2012 21:35:00 +0000

Drop Foot

“Drop foot” refers to the inability to lift the front part of one’s foot off the ground when walking, resulting in a scuffing or dragging of the foot or lifting the thigh (known as “steppage” gait). It is most often caused by nerve or muscle disorders or damage, or by a central nervous system disorder.

Drop foot is usually diagnosed by physical examination through a Doctor at Hosey Foot and Ankle Centers, although additional testing may be recommended in some cases. Treatment may include use of braces, physical therapy, and electrical nerve stimulation. In some cases surgery may be required.

Eczema of the Foot

noreply@blogger.com (Anonymous) — Wed, 12 Dec 2012 22:16:00 +0000

Eczema of the Foot

Eczema is a general term that includes many conditions that cause inflammation of the skin. The symptoms of eczema vary, but generally appear as dry, red, extremely itchy patches of skin. Small blisters may sometimes form.

Eczema can occur on any part of the body including the foot. It occurs in both children and adults and is not contagious. There is no known cause for eczema, but it often affects people with a family history of allergies.

Although there is no cure for this disease, treatments make it very manageable. The most helpful treatment is to prevent scratching. Cold compresses can be applied to help reduce itching. Lotions and creams are often used to help keep the skin as moist as possible. Corticosteroid creams can also be used to help reduce inflammation. The first step in effective treatment of eczema is a correct diagnosis. After examination and diagnosis, one of our Doctors at Hosey Foot and Ankle Centers can recommend the best treatment for you or your child.

What is a Podiatrist?

noreply@blogger.com (Anonymous) — Tue, 04 Dec 2012 16:22:00 +0000

What is a Podiatrist?

A podiatrist is responsible for the medical and surgical treatment of the foot. They treat all foot problems including corns, bunions, hammertoes, problems with tendons and ligaments, bone disorders and complications from diabetes. If you suffer from any foot problems, you should immediately see a podiatrist.

They may be symptoms of a disease that if not treated quickly may develop into serious health problems. The podiatrist must complete a minimum of four years of medical school and three years of residency before receiving the degree of doctor of podiatric medicine. Many podiatrists obtain advanced training during a residency at a hospital.

For more information, please visit http://hoseypodiatry.com/

Hallux Rigidus

noreply@blogger.com (Anonymous) — Mon, 26 Nov 2012 18:10:00 +0000

Hallux Rigidus

What Is Hallux Rigidus?

Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the joint, and with time it gets increasingly harder to bend the toe. ‘Hallux” refers to the big toe, while “rigidus” indicates that the toe is rigid and cannot move. Hallux rigidus is actually a form of degenerative arthritis.

This disorder can be very troubling and even disabling, since we use the big toe whenever we walk, stoop down, climb up, or even stand. Many patients confuse hallux rigidus with a bunion, which affects the same joint, but they are very different conditions requiring different treatment.

Because hallux rigidus is a progressive condition, the toe’s motion decreases as time goes on. In its earlier stage, when motion of the big toe is only somewhat limited, the condition is called “hallux limitus.” But as the problem advances, the toe’s range of motion gradually decreases until it potentially reaches the end stage of “rigidus,” in which the big toe becomes stiff, or what is sometimes called a “frozen joint.”

Causes

Common causes of hallux rigidus are faulty function (biomechanics) and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. This type of arthritis – the kind that results from “wear and tear” – often develops in people who have defects that change the way their foot and big toe functions. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus.

In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse – especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often have to stoop or squat. Hallux rigidus can also result from an injury, such as stubbing your toe. Or it may be caused by inflammatory diseases such as rheumatoid arthritis or gout. A Doctor from Hosey Foot and Ankle Centers can determine the cause of your hallux rigidus and recommend the best treatment.

Symptoms

Early signs and symptoms include:

· Pain and stiffness in the big toe during use (walking, standing, bending, etc.)

· Pain and stiffness aggravated by cold, damp weather

· Difficulty with certain activities (running, squatting)

· Swelling and inflammation around the joint

As the disorder gets more serious, additional symptoms may develop, including:

· Pain, even during rest

· Difficulty wearing shoes because bone spurs (overgrowths) develop

· Dull pain in the hip, knee, or lower back due to changes in the way you walk

· Limping (in severe cases)

Diagnosis

The sooner this condition is diagnosed, the easier it is to treat. Therefore, the best time to see a Doctor from Hosey Foot and Ankle Centers is when you first notice symptoms. If you wait until bone spurs develop, your condition is likely to be more difficult to manage.

In diagnosing hallux rigidus, the surgeon will examine your feet and move the toe to determine its range of motion. X-rays help determine how much arthritis is present as well as to evaluate any bone spurs or other abnormalities that may have formed.

Non-Surgical Treatment

In many cases, early treatment may prevent or postpone the need for surgery in the future. Treatment for mild or moderate cases of hallux rigidus may include:

· Shoe modifications. Shoes with a large toe box put less pressure on your toe. Stiff or rocker-bottom soles may also be recommended.

· Orthotic devices. Custom orthotic devices may improve foot function.

· Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be recommended to reduce pain and inflammation.

· Injection therapy. Injections of corticosteroids may reduce inflammation and pain.

· Physical therapy. Ultrasound therapy or other physical therapy modalities may be undertaken to provide temporary relief.

When Is Surgery Needed?

In some cases, surgery is the only way to eliminate or reduce pain. There are several types of surgery for treatment of hallux rigidus. In selecting the procedure or combination of procedures for your particular case, one of the Doctors from Hosey Foot and Ankle Centers will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

Varicose Veins

noreply@blogger.com (Anonymous) — Mon, 19 Nov 2012 15:55:00 +0000

Varicose Veins

Varicose veins are usually due to improperly functioning valves within the veins. The veins typically appear prominent or look "raised." The condition can cause swelling of the legs, ankles, and feet. The skin may become discolored due to leakage of blood into the surrounding tissues, and ulcers may form on the skin. One of the Doctors from Hosey Foot and Ankle Centers may advise use of compression stockings or other treatments

Yellow Toenails

noreply@blogger.com (Anonymous) — Mon, 12 Nov 2012 21:56:00 +0000

Yellow Toenails

The most common cause of yellow discoloration in the toenails is a fungal infection. The fungus often develops underneath the nail, resulting in it becoming thick, raised, and yellow in color.

Other potential causes for yellow discoloration of the nail include diabetes mellitus and lymphedema (chronic leg swelling). Yellow staining of the nails can also occur in individuals who use nail polish. A stained nail may take several months to grow out.

Fractures of the Calcaneus

noreply@blogger.com (Anonymous) — Mon, 05 Nov 2012 21:57:00 +0000

Fractures of the Calcaneus (Heel Bone Fractures)

What is the Calcaneus?
The calcaneus, also called the heel bone, is a large bone that forms the foundation of the rear part of the foot. The calcaneus connects with the talus and cuboid bones. The connection between the talus and calcaneus forms the subtalar joint. This joint is important for normal foot function.

The calcaneus is often compared to a hard boiled egg, because it has a thin, hard shell on the outside and softer, spongy bone on the inside. When the outer shell is broken, the bone tends to collapse and become fragmented. For this reason, calcaneal fractures are severe injuries. Furthermore, if the fracture involves the joints, there is the potential for long-term consequences such as arthritis and chronic pain.

How do Calcaneal Fractures Occur?
Most calcaneal fractures are the result of a traumatic event—most commonly, falling from a height, such as a ladder, or being in an automobile accident where the heel is crushed against the floorboard. Calcaneal fractures can also occur with other types of injuries, such as an ankle sprain. A smaller number of calcaneal fractures are stress fractures, caused by overuse or repetitive stress on the heel bone.

Types of Calcaneal Fractures
Fractures of the calcaneus may or may not involve the subtalar and surrounding joints. Fractures involving the joints (intra-articular fractures) are the most severe calcaneal fractures, and include damage to the cartilage (the connective tissue between two bones). The outlook for recovery depends on how severely the calcaneus was crushed at the time of injury.

Fractures that don’t involve the joint (extra-articular fractures) include:

· Those caused by trauma, such as avulsion fractures (in which a piece of bone is pulled off of the calcaneus by the Achilles tendon or a ligament) or crush injuries resulting in multiple fracture fragments

· Stress fractures, caused by overuse or mild injury.

The severity and treatment of extra-articular fractures depend on their location and size.

Signs and Symptoms
Calcaneal fractures produce different signs and symptoms, depending on whether they are traumatic or stress fractures.

The signs and symptoms of traumatic fractures may include:

· Sudden pain in the heel and inability to bear weight on that foot

· Swelling in the heel area

· Bruising of the heel and ankle

The signs and symptoms of stress fractures may include:

· Generalized pain in the heel area that usually develops slowly (over several days to weeks)

· Swelling in the heel area

Diagnosis
To diagnose and evaluate a calcaneal fracture, one of the Doctors at Hosey Foot and Ankle Centers will ask questions about how the injury occurred, examine the affected foot and ankle, and order x-rays. In addition, advanced imaging tests are commonly required.

Treatment
Treatment of calcaneal fractures is dictated by the type of fracture and extent of the injury. The foot and ankle surgeon will discuss with the patient the best treatment—whether surgical or non-surgical—for the fracture.

For some fractures, non-surgical treatments may be used. These include:

· Rest, ice, compression, and elevation (R.I.C.E.) Rest (staying off the injured foot) is needed to allow the fracture to heal. Ice reduces swelling and pain; apply a bag of ice covered with a thin towel to the affected area. Compression (wrapping the foot in an elastic bandage or wearing a compression stocking) and elevation (keeping the foot even with or slightly above the heart level) also reduce the swelling.

· Immobilization. Sometimes the foot is placed in a cast or cast boot to keep the fractured bone from moving. Crutches may be needed to avoid weightbearing.

For traumatic fractures, treatment often involves surgery to reconstruct the joint, or in severe cases, to fuse the joint. The surgeon will choose the best surgical approach for the patient.

Rehabilitation
Whether the treatment for a calcaneal fracture has been surgical or non-surgical, physical therapy often plays a key role in regaining strength and restoring function.

Complications of Calcaneal Fractures
Calcaneal fractures can be serious injuries that may produce lifelong problems. Arthritis, stiffness, and pain in the joint frequently develop. Sometimes the fractured bone fails to heal in the proper position. Other possible long-term consequences ofcalcaneal fractures are decreased ankle motion and walking with alimp due to collapse of the heel bone and loss of length in the leg. Patients often require additional surgery and/or long term or permanent use of a brace or an orthotic device (arch support) to help manage these complications.

Achilles Tendon Rupture

noreply@blogger.com (Anonymous) — Tue, 30 Oct 2012 20:59:00 +0000

Achilles Tendon Rupture

What is the Achilles Tendon?

A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the "heel cord," the Achilles tendon facilitates walking by helping to raise the heel off the ground.

What is an Achilles Tendon Rupture?

An Achilles tendon rupture is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Forceful jumping or pivoting, or sudden accelerations of running, can overstretch the tendon and cause a tear. An injury to the tendon can also result from falling or tripping.

Achilles tendon ruptures are most often seen in "weekend warriors" – typically, middle-aged people participating in sports in their spare time. Less commonly, illness or medications, such as steroids or certain antibiotics, may weaken the tendon and contribute to ruptures.

Signs and Symptoms

A person with a ruptured Achilles tendon may experience one or more of the following:

· Sudden pain (which feels like a kick or a stab) in the back of the ankle or calf – often subsiding into a dull ache

· A popping or snapping sensation

· Swelling on the back of the leg between the heel and the calf

· Difficulty walking (especially upstairs or uphill) and difficulty rising up on the toes

These symptoms require prompt medical attention to prevent further damage. Until the patient is able to see a doctor, the "R.I.C.E." method should be used. This involves:

· Rest. Stay off the injured foot and ankle, since walking can cause pain or further damage.

· Ice. Apply a bag of ice covered with a thin towel to reduce swelling and pain. Do not put ice directly against the skin.

· Compression. Wrap the foot and ankle in an elastic bandage to prevent further swelling.

· Elevation. Keep the leg elevated to reduce the swelling. It should be even with or slightly above heart level.

Diagnosis

In diagnosing an Achilles tendon rupture, the Doctors at Hosey Foot and Ankle Centers will ask questions about how and when the injury occurred and whether the patient has previously injured the tendon or experienced similar symptoms. The surgeon will examine the foot and ankle, feeling for a defect in the tendon that suggests a tear. Range of motion and muscle strength will be evaluated and compared to the uninjured foot and ankle. If the Achilles tendon is ruptured, the patient will have less strength in pushing down (as on a gas pedal) and will have difficulty rising on the toes.

The diagnosis of an Achilles tendon rupture is typically straightforward and can be made through this type of examination. In some cases, however, the surgeon may order an MRI or other advanced imaging tests.

Treatment

Treatment options for an Achilles tendon rupture include surgical and non-surgical approaches. The decision of whether to proceed with surgery or non-surgical treatment is based on the severity of the rupture and the patient’s health status and activity level.

Non-Surgical Treatment
Non-surgical treatment, which is generally associated with a higher rate of re-rupture, is selected for minor ruptures, less active patients, and those with medical conditions that prevent them from undergoing surgery. Non-surgical treatment involves use of a cast, walking boot, or brace to restrict motion and allow the torn tendon to heal.

Surgery
Surgery offers important potential benefits. Besides decreasing the likelihood of re-rupturing the Achilles tendon, surgery often increases the patient’s push-off strength and improves muscle function and movement of the ankle.

Various surgical techniques are available to repair the rupture. A Doctor from Hosey Foot and Ankle Centers will select the procedure best suited to the patient.

Following surgery, the foot and ankle are initially immobilized in a cast or walking boot. The Doctor from Hosey Foot and Ankle Centers will determine when the patient can begin weightbearing.

Complications such as incision-healing difficulties, re-rupture of the tendon, or nerve pain can arise after surgery.

Physical Therapy

Whether an Achilles tendon rupture is treated surgically or non-surgically, physical therapy is an important component of the healing process. Physical therapy involves exercises that strengthen the muscles and improve the range of motion of the foot and ankle.

Nail Fungus

noreply@blogger.com (Anonymous) — Wed, 24 Oct 2012 20:02:00 +0000

Nail Fungus

A fungus is an organism that lives in warm moist areas. Fungus of the toenails is a common problem that can affect people of all ages, although it most commonly affects individuals who are older.

Toenail fungus often begins as an infection in the skin called tinea pedis (also known as athlete’s foot). The fungus often starts under the nail fold at the end of the nail. Over time it grows underneath the nail and causes changes to its appearance, such as a yellow or brownish discoloration. It can also cause thickening and deformity of the toenail.

Many people have difficulty with their toenails and need assistance in caring for them. A Doctor at Hosey Foot and Ankle Centers can diagnose the cause of toenail problems and recommend treatments.

Tingly Feet

noreply@blogger.com (Anonymous) — Mon, 15 Oct 2012 16:50:00 +0000

Tingly Feet

“Tingly feet" can be a sign of nerve loss. The nerves in the feet come from the lower back. Pressure or chemical change in the nerve can cause a tingling sensation in the feet. Any sensation that is out of the ordinary can be an early sign of neurologic or vascular problems. In addition to tingling, feet may feel numb or feel like they are "falling asleep." There may also be a burning sensation in the feet.

Diabetes is one of the most common medical conditions with which "tingly feet" can be associated. A thorough evaluation by one of the Doctors at Hosey Foot and Ankle Centers is advised to determine the cause of "tingly feet."

Foot Lumps

noreply@blogger.com (Anonymous) — Mon, 08 Oct 2012 19:18:00 +0000

Foot Lumps

Foot lumps are soft tissue masses (not bone) that can occur anywhere on the foot. They can be caused by soft tissue swelling, sacs of fluid, fatty tissue, and nerve, vessel or muscle enlargements. Foot lumps may be without pain (asymptomatic) or they can cause pain and affect the function of the foot. Painful foot lumps can be treated by the Doctors of Hosey Foot and Ankle Centers use a variety of conservative treatments. In some cases, surgery may be necessary.

Charcot Foot

noreply@blogger.com (Anonymous) — Tue, 02 Oct 2012 15:23:00 +0000

Charcot Foot

What Is Charcot Foot?
Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.

Charcot foot is a very serious condition that can lead to severe deformity, disability, and even amputation. Because of its seriousness, it is important that patients with diabetes—a disease often associated with neuropathy—take preventive measures and seek immediate care if signs or symptoms appear.

Causes
Charcot foot develops as a result of neuropathy, which decreases sensation and the ability to feel temperature, pain, or trauma. Because of diminished sensation, the patient may continue to walk—making the injury worse.

People with neuropathy (especially those who have had it for a long time) are at risk for developing Charcot foot. In addition, neuropathic patients with a tight Achilles tendon have been shown to have a tendency to develop Charcot foot.

Symptoms
The symptoms of Charcot foot may include:

· Warmth to the touch (the affected foot feels warmer than the other)

· Redness in the foot

· Swelling in the area

· Pain or soreness

Diagnosis
Early diagnosis of Charcot foot is extremely important for successful treatment. To arrive at a diagnosis, the surgeon will examine the foot and ankle and ask about events that may have occurred prior to the symptoms. X-rays and other imaging studies and tests may be ordered.

Once treatment begins, x-rays are taken periodically to aid in evaluating the status of the condition.

Non-Surgical Treatment
It is extremely important to follow the surgeon’s treatment plan for Charcot foot. Failure to do so can lead to the loss of a toe, foot, leg, or life.

Non-surgical treatment for Charcot foot consists of:

· Immobilization. Because the foot and ankle are so fragile during the early stage of Charcot, they must be protected so the weakened bones can repair themselves. Complete non-weightbearing is necessary to keep the foot from further collapsing. The patient will not be able to walk on the affected foot until the surgeon determines it is safe to do so. During this period, the patient may be fitted with a cast, removable boot, or brace, and may be required to use crutches or a wheelchair. It may take the bones several months to heal, although it can take considerably longer in some patients.

· Custom shoes and bracing. Shoes with special inserts may be needed after the bones have healed to enable the patient to return to daily activities—as well as help prevent recurrence of Charcot foot, development of ulcers, and possibly amputation. In cases with significant deformity, bracing is also required.

· Activity modification. A modification in activity level may be needed to avoid repetitive trauma to both feet. A patient with Charcot in one foot is more likely to develop it in the other foot, so measures must be taken to protect both feet.

When is Surgery Needed?
In some cases, the Charcot deformity may become severe enough that surgery is necessary. The Doctors of Hosey Foot and Ankle Centers will determine the proper timing as well as the appropriate procedure for the individual case.

Preventive Care
The patient can play a vital role in preventing Charcot foot and its complications by following these measures:

· Keeping blood sugar levels under control can help reduce the progression of nerve damage in the feet.

· Get regular check-ups from a foot and ankle surgeon.

· Check both feet every day—and see a surgeon immediately if you notice signs of Charcot foot.

· Be careful to avoid injury, such as bumping the foot or overdoing an exercise program.

· Follow the surgeon’s instructions for long-term treatment to prevent recurrences, ulcers, and amputation.

Foot Odor

noreply@blogger.com (Anonymous) — Mon, 24 Sep 2012 15:34:00 +0000

Foot Odor

Foot odor is a common condition in children and adults who wear shoes on a daily basis. People with smelly feet may also suffer from sweaty feet. Most people with this condition will have sweaty and smelly feet year round, not just in the hot summer months.

The odor is produced by bacteria and/or fungus that grows in the shoes and attaches to the skin. Some bacteria actually eat away the top layer of the skin, producing a foul odor. Hygiene is very important to help prevent smelly feet. Feet should be washed daily with soap and water and clean dry socks worn.

Some synthetic materials used in shoes, when mixed with sweat and bacteria, can produce smelly feet. The Doctors of Hosey Foot and Ankle Centers will recommend one of a variety of treatments for this condition.

Who is Dr. Hosey?

noreply@blogger.com (Anonymous) — Mon, 17 Sep 2012 15:17:00 +0000

Dr. Thomas C. Hosey graduated from Michigan State University, East Lansing, Michigan in 1977 and from the Ohio College of Podiatric Medicine in 1981. He completed his residency at St. John North Shore Hospital in Harrison Township. Dr. Hosey has written numerous publications for medical journals and has lectured throughout the country on Foot and Ankle Surgery.

He is one of the premier podiatrists in the country who is board certified in foot and ankle reconstruction surgery. In addition, he is a fellow of the American College of Foot and Ankle Surgeons, a member of the Michigan State Podiatry Association and American Podiatric Medical Association. He is on staff at numerous hospitals in both Macomb and Oakland Counties including Troy Beaumont, Henry Ford Health Systems, St. John Hospital, St. Joseph Medical Center and Mount Clemens Regional Medical Center. In addition to his medical practice, he is past president of the Mount Clemens Rotary Club and past president of the Selfridge Air National Guard Base Community Council. He is active in numerous charitable organizations throughout the county and one of his favorites is Angel Flight where he flies medical patients throughout the United States when needed.

Check out Hosey Foot & Ankle's website at: www.HoseyPodiatry.com

Diabetic Complications and Amputation Prevention

noreply@blogger.com (Anonymous) — Tue, 11 Sep 2012 15:27:00 +0000

Diabetic Complications and Amputation Prevention

People with diabetes are prone to having foot problems, often because of two complications of diabetes: nerve damage (neuropathy) and poor circulation. Neuropathy causes loss of feeling in your feet, taking away your ability to feel pain and discomfort, so you may not detect an injury or irritation. Poor circulation in your feet reduces your ability to heal, making it hard for even a tiny cut to resist infection.

Having diabetes increases the risk of developing a wide range of foot problems. Furthermore, with diabetes, small foot problems can turn into serious complications.

Diabetes-related Foot and Leg Problems

· Infections and ulcers (sores) that don’t heal. An ulcer is a sore in the skin that may go all the way to the bone. Because of poor circulation and neuropathy in the feet, cuts or blisters can easily turn into ulcers that become infected and won’t heal. This is a common – and serious – complication of diabetes and can lead to a loss of your foot, your leg, or your life.

· Corns and calluses. When neuropathy is present, you can’t tell if your shoes are causing pressure and producing corns or calluses. Corns and calluses must be properly treated or they can develop into ulcers.

· Dry, cracked skin. Poor circulation and neuropathy can make your skin dry. This may seem harmless, but dry skin can result in cracks that may become sores and can lead to infection.

· Nail disorders. Ingrown toenails (which curve into the skin on the sides of the nail) and fungal infections can go unnoticed because of loss of feeling. If they are not properly treated, they can lead to infection.

· Hammertoes and bunions. Nerve damage affecting muscles can cause muscle weakness and loss of tone in the feet, resulting in hammertoes and bunions. If left untreated, these deformities can cause ulcers.

· Charcot foot. This is a complex foot deformity. It develops as a result of loss of sensation and an undetected broken bone that leads to destruction of the soft tissue of the foot. Because of neuropathy, the pain of the fracture goes unnoticed and the patient continues to walk on the broken bone, making it worse. This disabling complication is so severe that surgery, and occasionally amputation, may become necessary.

· Poor blood flow. In diabetes, the blood vessels below the knee often become narrow and restrict blood flow. This prevents wounds from healing and may cause tissue death.

What Hosey Foot and Ankles Centers Can Do

Your foot and ankle surgeon can help wounds heal, preventing amputation. There are many new surgical techniques available to save feet and legs, including joint reconstruction and wound healing technologies. Getting regular foot checkups and seeking immediate help when you notice something can keep small problems from worsening. Your foot and ankle surgeon works together with other health care providers to prevent and treat complications from diabetes.

Your Proactive Measures
You play a vital role in reducing complications. Follow these guidelines and contact Hosey Foot and Ankle Centers if you notice any problems:

· Inspect your feet daily. If your eyesight is poor, have someone else do it for you. Inspect for:

· Skin or nail problems: Look for cuts, scrapes, redness, drainage, swelling, bad odor, rash, discoloration, loss of hair on toes, injuries, or nail changes (deformed, striped, yellowed or discolored, thickened, or not growing).

· Signs of fracture: If your foot is swollen, red, hot, or has changed in size, shape, or direction, see your foot and ankle surgeon immediately.

· Don’t ignore leg pain. Pain in the leg that occurs at night or with a little activity could mean you have a blocked artery. Seek care immediately.

· Nail cutting. If you have any nail problems, hard nails, or reduced feeling in your feet, your toenails should be properly trimmed.

· No “bathroom surgery.” Never trim calluses or corns yourself, and don’t use over-the-counter medicated pads.

· Keep floors free of sharp objects. Make sure there are no needles, insulin syringes, or other sharp objects on the floor.

· Don’t go barefoot. Wear shoes, indoors and outdoors.

· Check shoes and socks. Shake out your shoes before putting them on. Make sure your socks aren’t bunched up.

· Have your circulation and sense of feeling tested. We will perform tests to see if you’ve lost any feeling or circulation.

When Is Amputation Necessary?
Even with preventative care and prompt treatment of infection and complications, there are instances when amputation is necessary to remove infected tissue, save a limb, or even save a life.

Peripheral Arterial Disease (P.A.D.)

noreply@blogger.com (Anonymous) — Tue, 04 Sep 2012 16:53:00 +0000

Peripheral Arterial Disease (P.A.D.)

What is Peripheral Arterial Disease?

Commonly referred to as “poor circulation,” Peripheral Arterial Disease (P.A.D.) is the restriction of blood flow in the arteries of the leg. When arteries become narrowed by plaque (the accumulation of cholesterol and other materials on the walls of the arteries), the oxygen-rich blood flowing through the arteries cannot reach the legs and feet.

The presence of P.A.D. may be an indication of more widespread arterial disease in the body that can affect the brain, causing stroke, or the heart, causing a heart attack.

Signs and Symptoms

Most people have no symptoms during the early stages of P.A.D. Often, by the time symptoms are noticed, the arteries are already significantly blocked.

Common symptoms of P.A.D. include:

· Leg pain (cramping) that occurs while walking (intermittent claudication)

· Leg pain (cramping) that occurs while lying down (rest pain)

· Leg numbness or weakness

· Cold legs or feet

· Sores that won’t heal on toes, feet, or legs

· A change in leg color

· Loss of hair on the feet and legs

· Changes in toenails—color and thickness

If any of these symptoms are present, it is important to discuss them with a foot and ankle surgeon. Left untreated, P.A.D. can lead to debilitating and limb-threatening consequences.

Risk Factors of P.A.D.

Because only half of those with P.A.D. actually experience symptoms, it is important that people with known risk factors be screened or tested for P.A.D.

The risk factors include:

· Being over age 50

· Smoking (currently or previously)

· Diabetes

· High blood pressure

· High cholesterol

· Personal or family history of P.A.D., heart disease, heart attack, or stroke

· Sedentary lifestyle (infrequent or no exercise)

Diagnosis of P.A.D.

To diagnose P.A.D., the Doctors at Hosey Foot and Ankle Centers obtain a comprehensive medical history of the patient. The surgeon performs a lower extremity physical examination that includes evaluation of pulses, skin condition, and foot deformities to determine the patient’s risk for P.A.D. If risk factors are present, our Doctors may order further tests.

Several non-invasive tests are available to assess P.A.D. The ankle-brachial index (ABI) is a simple test in which blood pressure is measured and compared at the arm and ankle levels. An abnormal ABI is a reliable indicator of underlying P.A.D. and may prompt the our Doctors to refer the patient to a vascular specialist for additional testing and treatment as necessary.

Lisfranc Injuries

noreply@blogger.com (Anonymous) — Mon, 27 Aug 2012 17:45:00 +0000

Lisfranc Injuries

The Lisfranc Joint
The Lisfranc joint is the point at which the metatarsal bones (long bones that lead up to the toes) and the tarsal bones (bones in the arch) connect. The Lisfranc ligament is a tough band of tissue that joins two of these bones. This is important for maintaining proper alignment and strength of the joint.

How Do Lisfranc Injuries Occur?
Injuries to the Lisfranc joint most commonly occur in automobile accident victims, military personnel, runners, horseback riders, football players and participants of other contact sports, or something as simple as missing a step on a staircase.

Lisfranc injuries occur as a result of direct or indirect forces to the foot. A direct force often involves something heavy falling on the foot. Indirect force commonly involves twisting the foot.

Types of Lisfranc Injuries
There are three types of Lisfranc injuries, which sometimes occur together:

· Sprains. The Lisfranc ligament and other ligaments on the bottom of the midfoot are stronger than those on the top of the midfoot. Therefore, when they are weakened through a sprain (a stretching of the ligament), patients experience instability of the joint in the middle of the foot.

· Fractures. A break in a bone in the Lisfranc joint can be either an avulsion fracture (a small piece of bone is pulled off) or a break through the bone or bones of the midfoot.

· Dislocations. The bones of the Lisfranc joint may be forced from their normal positions.

Symptoms
The symptoms of a Lisfranc injury may include:

· Swelling of the foot

· Pain throughout the midfoot when standing or when pressure is applied

· Inability to bear weight (in severe injuries)

· Bruising or blistering on the arch are important signs of a Lisfranc injury. Bruising may also occur on the top of the foot.

· Abnormal widening of the foot.

Diagnosis
Lisfranc injuries are sometimes mistaken for ankle sprains, making the diagnostic process very important. To arrive at a diagnosis, the Doctors at Hosey Foot and Ankle Center will ask questions about how the injury occurred and will examine the foot to determine the severity of the injury.

X-rays and other imaging studies may be necessary to fully evaluate the extent of the injury. The surgeon may also perform an additional examination while the patient is under anesthesia to further evaluate a fracture or weakening of the joint and surrounding bones.

Non-surgical Treatment
Anyone who has symptoms of a Lisfranc injury should see a foot and ankle surgeon right away. If unable to do so immediately, it is important to stay off the injured foot, keep it elevated (at or slightly above hip level), and apply a bag of ice wrapped in a thin towel to the area every 20 minutes of each waking hour. These steps will help keep the swelling and pain under control. Treatment by the Doctors at Hosey Foot and Ankle Center may include one or more of the following, depending on the type and severity of the Lisfranc injury:

· Immobilization. Sometimes the foot is placed in a cast to keep it immobile, and crutches are used to avoid putting weight on the injured foot.

· Oral medications. Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.

· Ice and elevation. Swelling is reduced by icing the affected area and keeping the foot elevated, as described above.

· Physical therapy. After the swelling and pain have subsided, physical therapy may be prescribed.

When is Surgery Needed?
Certain types of Lisfranc injuries require surgery. Our Doctors will determine the type of procedure that is best suited to the individual patient. Some injuries of this type may require emergency surgery.

Black Toenails

noreply@blogger.com (Anonymous) — Tue, 21 Aug 2012 14:12:00 +0000

Black Toenails

A black, purple, or brownish discoloration under or involving a toenail is frequently due to trauma to the toe nail, such as when something is dropped on the toe. The color results from a blood clot or bleeding under the nail, and may involve the entire nail or just a small portion of it. This can be very painful when the entire nail is involved, and may need medical attention to relieve the pressure caused by bleeding under the toenail.

Although it is very rare, a more serious cause of black toenails is malignant melanoma. Since early diagnosis and treatment of melanoma improves the chances for a good outcome, it is important that all black toenails be evaluated by our doctors to rule out this cause.

Other rare causes of black toenails include fungal infections, chronic ingrown nails, or health problems affecting the rest of the body.

Nail Fungus

noreply@blogger.com (Anonymous) — Mon, 13 Aug 2012 20:20:00 +0000

Nail Fungus

A fungus is an organism that lives in warm moist areas. Fungus of the toenails is a common problem that can affect people of all ages, although it most commonly affects individuals who are older.

Many people have difficulty with their toenails and need assistance in caring for them. Hosey Foot and Ankle Centers can diagnose the cause of toenail problems and recommend treatments.