FOOT & ANKLE
Achilles Tendon Repair
An Achilles tendon rupture is a common injury that involves a tearing of the thick band of tissue that connects the calf muscle to the heel and helps with nearly any kind of foot movement. The Achilles tendon can be partially or completely torn and most commonly occurs as a result of repeated stress on the tendon.
Most Achilles tendon injuries require surgery to reattach the tendon and allow the patient to resume normal foot function. Nonsurgical treatment is only reserved for the mildest of cases or for patients who lead a sedentary life . Until surgery is performed, patients will likely suffer from recurring (chronic) tears.
During the Achilles tendon repair procedure, an incision is made along the back of the ankle to access the tendon. The torn ends are then reattached using strong sutures that are placed on both ends. The sutures are tied together and the incision is then closed.
After surgery, patients will need to undergo six to eight weeks of physical therapy while the foot heals in a walking boot or cast. The foot may be positioned differently within the cast as healing progresses to maximize movement.
Ankle arthritis is not as common as other forms of arthritis; however, it is still a painful condition for those affected. Arthritis is classified as an inflammation of a joint and can develop as a result of several factors, but most commonly occurs as a result of aging. The bone ends of a joint are covered by a material called cartilage which helps cushion the bone and allow for a smooth movement of the bones within the joint. As we age, this cartilage gradually wears away and leaves the bone ends rough and uncovered, causing symptoms to develop.
Patients with ankle arthritis may not experience any symptoms as the cartilage holding the joint together becomes damaged. As the condition progresses, symptoms usually worsen and may include pain, stiffness, swelling, instability, bone spurs, joint deformity and difficulty walking. If the nerves surrounding the joint become irritated as well, patients may experience numbness and tingling as well.
Treatment for ankle arthritis varies depending on its severity. Mild cases of ankle arthritis can often be remedied with cushioned shoe inserts, limiting impact activities, wearing a brace, cortisone injections, and anti-inflammatory medications. Surgery may be necessary for cases of ankle arthritis that do not respond to conservative treatment methods. Your doctor will determine which treatment option is most appropriate for your individual condition.
Talk to your doctor to assess your risk of developing ankle arthritis and to learn more about how you can prevent this condition.
Athlete’s foot is a kind of fungal infection that causes cracked red patches to form on the feet, usually between the toes. The affected areas may itch, burn, flake or ooze. Athlete’s foot and other fungal infections may spread to the toenails (onychomycosis), causing them to change color, thicken, or crumble. Fungi grow fastest in warm, moist conditions; accordingly, risk factors for contracting fungal infections include keeping the feet wet for long periods of time, walking barefoot in wet public places such as pools or showers, wearing closed shoes that do not allow the feet to “breathe,” and having sweaty feet.
Fungal infections may be mild or severe, last a short or a long time, clear on their own or require professional treatment. They may recur over time. They may also develop into more significant problems such as bacterial infection, especially if a person scratches at the infected areas. People with diabetes should be especially attentive.
A bunion is a common condition that involves an abnormal, bony bump at the base of the big toe, causing the joint to swell outward and become painful. The big toe may also turn inward toward the second toe as a result of the enlarged joint, which can then lead to difficulty walking, ingrown toenails and corns and calluses.
Bunions can form when there is an improper balance of forces exerted on the joints of the foot, causing instability in the joint of the big toe. This often occurs as a result of shoes that do not fit properly, abnormal walking habits or an inherited foot type. Bunions can also be caused by injury, birth defects, arthritis or certain neuromuscular disorders.
Bunion treatment depends on the severity of the condition, although early treatment is considered most effective. Mild bunions may be relieved of pain simply by changing shoes, applying ice or taping your foot into a normal position. Medication, orthotics and physical therapy may also be recommended by your doctor. Surgical treatment, usually reserved for more severe cases, can improve pain, inflammation, deformities and stiffness.
Although bunions are not usually a serious condition, they can be painful and embarrassing. If left untreated, they will usually grow larger and more painful over time. It is important to seek medical attention and discuss treatment options with your doctor.
One in four adults in the U.S. has flat feet or fallen arches. Some people are born with flat feet, while others acquire it as they get older. The foot may be flat all the time or it may lose its arch when the person stands (“flexible flatfoot”). Many people with flat feet don’t experience any symptoms. Others, however, suffer from heel or ankle pain, tired feet, bunions, arthritis in the foot or ankle, foot or ankle deformity, knee or back pain, or other problems that need professional treatment.
Adult Acquired Flat Foot begins during or after childhood and worsens over time. Causes include a tight Achilles tendon, obesity, “wear and tear” as a person ages, abnormalities higher up the leg, and rupture of a tendon or ligament in the foot. The most common and serious cause of flat foot is Posterior Tibial Tendon Dysfunction, where the main tendon that supports the arch gradually weakens.
Foot & Ankle 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 of place or break the skin. Fractures in the bones of the foot and ankle cause a variety of symptoms and require different treatments depending on the location and severity of the break as well as the patient’s overall health.
- Digits (toes/phalanges) and metatarsals (long bones of the forefoot) – There are many different kinds of fractures that can happen to the bones of the forefoot and toes. They are painful but often heal without the need for surgery. The metatarsals are prone to stress fractures, or cracks in the bone. These are usually related to a recent increase or change in activity. The fifth metatarsal below the small toe may fracture if it is landed on badly or if the ligament of a twisted ankle pulls off a piece of the bone. Symptoms of a toe or metatarsal fracture include pain that gets worse when walking; swelling; and sometimes bruising.
- Lisfranc joint (midfoot) – Often caused by dropping something heavy on the top of the foot or by falling after catching the foot in a hole. Symptoms are similar to a sprain and include swelling and pain at the top of the foot; bruising; possible inability to bear weight; and pain when moving the foot while the ankle is held steady. If you think you have a sprain and it does not improve with rest and ice after one to two days, you may have a Lisfranc joint fracture and should see a doctor to prevent further injury.
- Calcaneus (heel) – Usually the result of an automobile accident or fall from a great height. Symptoms include pain on the outside of the ankle or under the heel; inability to bear weight; swelling and stiffness. May be accompanied by back or knee injury due to the amount of force required to break the heel bone.
- Ankle – Like severely sprained ankles, broken ankles are often caused by a fall, injury or car accident. Symptoms that one or more of the three bones that make up the ankle may be fractured are: severe pain in the ankle; swelling; bruising; tenderness; inability to bear weight; and deformity of the joint. May be accompanied by dislocation or ligament damage (sprain).