Foot Fractures Treatment | Bunion Treatment | Hammertoes Treatment | Tucson

Foot Fractures Treatment | Bunion Treatment | Hammertoes Treatment | Tucson

Foot Conditions
Onaverage, Foot and Ankle conditions combined constitute over 20percent of allvisits to an Orthopaedic Surgery practice. Ourphysicians have specialized training in treatment of all foot andankleconditions including:
FracturesBunionsHammertoesRheumatoid and inflammatoryarthropathies and changesDiabetic foot deformitiesTorn tendons and ligamentsGait and pressureabnormalitiesNeuromasArthritisCongenital deformities
Foot Fractures
A fracture is a break in a bone. It may be a crack in the bone(a stress fracture) or a complete break; the bones may shift out ofplace orbreak the skin. Fractures in the bones of the foot and anklecause a variety ofsymptoms and require different treatments dependingon the location and severityof the break as well as the patient'soverall health.
Digits(toes/phalanges) and metatarsals (long bones of theforefoot) - There are manydifferent kinds of fractures that can happento the bones of the forefoot andtoes. They are painful but often healwithout the need for surgery. Themetatarsals are prone to stressfractures, or cracks in the bone. These areusually related to a recentincrease or change in activity. The fifthmetatarsal below the smalltoe may fracture if it is landed on badly or if theligament of atwisted ankle pulls off a piece of the bone. Symptoms of a toe ormetatarsal fracture include pain that gets worse when walking; swelling;andsometimes bruising.Lisfranc joint(midfoot) - Often caused by dropping somethingheavy on the top of the foot orby falling after catching the foot in ahole. Symptoms are similar to a sprainand include swelling and painat the top of the foot; bruising; possibleinability to bear weight;and pain when moving the foot while the ankle is heldsteady. If youthink you have a sprain and it does not improve with rest andice afterone to two days, you may have a Lisfranc joint fracture and shouldseea doctor to prevent further injury.Calcaneus(heel) - Usually the result of an automobileaccident or fall from a greatheight. Symptoms include pain on theoutside of the ankle or under the heel;inability to bear weight;swelling and stiffness. May be accompanied by back orknee injury dueto the amount of force required to break the heel bone.
Bunion Treatment
A bunion is a common condition that involves an abnormal, bonybump at the base of the big toe, causing the joint to swell outward andbecomepainful. The big toe may also turn inward toward the second toeas a result ofthe enlarged joint, which can then lead to difficultywalking, ingrown toenailsand corns and calluses.

Bunions can form when there is an improper balance of forcesexerted on the joints of the foot, causing instability in the joint ofthe bigtoe. This often occurs as a result of shoes that do not fitproperly, abnormalwalking habits or an inherited foot type. Bunionscan also be caused by injury,birth defects, arthritis or certainneuromuscular disorders.

Although bunions are not usually a serious condition, they canbe painful and embarrassing. If left untreated, they will usually growlargerand more painful over time. It is important to seek medicalattention anddiscuss treatment options with your doctor.

Bunion treatment depends on the severity of the condition,although early treatment is considered most effective. Mild bunions mayberelieved of pain simply by changing shoes, applying ice or tapingyour footinto a normal position. Medication, orthotics and physicaltherapy may also berecommended by your doctor. Surgical treatment,usually reserved for moresevere cases, can improve pain, inflammation,deformities and stiffness.

Medications
While Tylenol can be taken to control pain, anti-inflammatorydrugs (NSAIDs) may be more effective in both relieving pain and reducinginflammation. Cortisone injections may also be used.

Orthotics
Padded shoe inserts help restore the foot to a normal positionand restrict any abnormal movement. While over-the-counter inserts mayhelp,custom-made orthotics are usually much more beneficial.

PhysicalTherapy
The pain and inflammation of bunions can often be reducedthrough therapeutic techniques such as ultrasound therapy or whirlpoolbaths.

Surgery
Surgery to treat bunions is often used for more severe cases, orafter conservative treatment methods have failed. There are severaldifferentsurgical options available, depending on the cause andsymptoms of the bunion.
The most common surgical procedure for bunions is abunionectomy, which includes:
Removing theswollen tissue from the big toe jointRemoving partof the bone to straighten the big toePermanentlyjoining the bones of the big toe joint
A bunionectomy may be performed alone or in conjunction withother procedures that may:
Shave off theswollen bumpRepair thetissue in the jointFracture andrealign the bones of the toeRemove part ofthe bone to decrease the angle of the toeRemove thebump on the toe joint
Some of these procedures will require the use of metal screws,wires or plates to hold the joint structures together, especially afterpieceshave been removed. Your doctor will help you decide whichprocedure will bemost effective for your individual condition afterevaluating your medicalhistory and X-ray images.

Most bunion procedures are performed on an outpatient basisunder local anesthesia. General anesthesia may be used in certainsituationsdepending on the complexity of the procedure and thepreference of the patient.Complications from these procedures are rarebut may include infection,recurring bunion or nerve damage.

Recovery from bunion surgery depends on the complexity of theprocedure. Some people will be able to walk on their foot immediatelyaftersurgery, while others may need to use crutches or a cane and maynot be able towalk for a few weeks or longer. It is important to keepyour dressing clean anddry to ensure proper healing. Most patientsrequire the use of orthotics aftersurgery in order to maintain stableand correctly-positioned feet.

While these procedures can be beneficial, they are usually onlyrecommended for patients with bunions that cause severe pain. There isalso achance that a bunion may form again after surgery. Patients withrealisticexpectations are usually satisfied with the results of theirsurgery. Call ustoday to speak to a doctor about how buniontreatments can help you.

Rheumatoidand inflammatory arthritis and deformities
Patients with rheumatoid arthritis in the feet are at anincreased risk of developing certain physical deformities such asbunions,metatarsalgia and hammertoes, which are extremely painful anddisablingconditions. These conditions develop as a result of jointinflammation,loosening of the ligaments and capsule lining and adegeneration of cartilagein the joint. Patients with these conditionsoften have difficulty walking andwearing shoes as the foot becomesmore and more inflamed.

Treatment of forefoot deformities may vary depending on the typeand severity of the condition, but aims to relieve pain and restore thenormalappearance and alignment of the foot. Conservative treatmentsmay includemodifying your shoes or wearing orthotics, while mostpatients will need toundergo surgery for this condition. Surgery forrheumatoid forefoot deformitiesmay involve the Hoffman procedure,joint fusion or osteotomy of the metatarsalsin severe cases.

After surgery, most patients are able to walk and wear shoeswithout pain. Deformities rarely recur and patients are able to enjoytheseresults for many years.

DiabetesMellitus
People with diabetes are at high risk for developing problemswith their feet. More than half of diabetics lose sensation in theirfeet dueto nerve or blood vessel damage, and can hurt themselveswithout knowing it. Tomake things worse, diabetes slows healing andweakens the immune system, sowhat may seem like an inconsequentialinjury can quickly become a major problem. Even the smallest of foot andankle injuries such as a blister oringrown toenail can lead toinfection and tissue death. One of the most seriouscomplications ofthe diabetic foot is Charcot foot, a deformity that developswhenpeople fracture bones in their feet without realizing it and thencontinueto walk on the injury because they don't feel any pain.

If you or a loved one has diabetes, be sure to inspect your feetevery day and visit your doctor regularly to ensure that you and yourfeetremain healthy.

DiabeticReconstructive Surgery
Diabetic patients with foot problems often experience pain,difficulty walking and other symptoms that may affect their overallquality oflife. Surgery is often needed to correct these conditionsand to keep the footas healthy as possible and prevent more seriousproblems that can requireamputation of the foot.

The type of surgery performed depends on the type and severity ofthecondition, but aims to restore function and stability to the foot,as well asrelieving pain and restoring a proper appearance. Surgerymay involve any partof the foot, including the tendons, bones, joints,tissue or skin. Metalscrews, pins, wires and plates may be used tohelp the foot heal and ensure afull recovery. Most reconstructiveprocedures can be performed on an outpatient basis using minimallyinvasive techniques.

It is important to exercise extreme care when undergoing surgery, aspatients with diabetes are at a higher risk for infection and othercomplications. Choosing an experienced doctor to perform your procedurecan help reduce the associated risks.

Neuromas
A neuroma is a painful swelling of a nerve, usually in the ballorheel of the foot. Symptoms include sporadic pain; burning, tingling ornumbness of one or more toes; and a popping sensation when walking. Painisoften soothed by taking weight off the foot or by massaging thearea.

In the foot, there are the long bones (metatarsals) and thinnervesrunning between them. The nerves split in a Y-shape when they reach thetoes. If the metatarsals move abnormally, they can pinch the nervebetweenthem, causing inflammation and, eventually, permanent nervedamage. Morton'sNeuroma is the most common of this type and affectsthe nerve between the thirdand fourth toes. Neuromas may also occurafter a nerve has been injured, eitherfrom a traumatic wound or fromdamage suffered during surgery.

A physical examination and one or more imaging tests willdeterminewhether the pain is caused by a neuroma or by a condition withsimilarsymptoms such as arthritis, stress fractures, tendon inflammation,tarsal tunnel syndrome and nerve compressions in the ankle or leg.Treatmentbegins with a combination of cortisone injections to reduceswelling andorthotic inserts to correct problematic metatarsalmovement. If the nerve ispermanently damaged, the patient may decideto undergo chemical destruction ofthe nerve, have the nerve surgicallyremoved, or endure the pain.

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