tag:blogger.com,1999:blog-92167409216223444652024-03-24T17:52:24.298-04:00Central Florida Foot and Ankle Center's Guide To RunningWe offer the latest technology in diagnostic studies, our office is the only one in Polk County to offer PSSD testing for peripheral nerve problems.Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.comBlogger44125tag:blogger.com,1999:blog-9216740921622344465.post-74517555224376215052018-08-07T16:01:00.001-04:002018-08-07T16:01:35.997-04:00Tenex Plantar Fascia Release and Amniox Injection with Dr. Wellens<iframe allowfullscreen="" frameborder="0" height="270" src="https://www.youtube.com/embed/EAYFpioXbgM" width="480"></iframe><br />
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Central Florida Foot & Ankle Center, LLC<br />
101 6th Street N.W.<br />
Winter Haven, FL 33881<br />
Phone: 863-299-4551<br />
http://www.FLFootandAnkle.comCentral Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-26670803851526504422017-11-09T15:24:00.001-05:002017-11-09T15:24:38.761-05:00Tarsal Tunnel Surgery Testimony with Dr. Wellens<iframe allowfullscreen="" frameborder="0" height="270" src="https://www.youtube.com/embed/dMZGLnJfj74" width="480"></iframe><br />
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Central Florida Foot & Ankle Center, LLC101 6th Street N.W.Winter Haven, FL 33881Phone: 863-299-4551http://www.FLFootandAnkle.comCentral Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-9323561157872833612016-03-10T17:02:00.001-05:002016-03-10T17:02:47.118-05:00Regenerative Treatment for Chronic Plantar Fasciitis using an Amniotic M...<iframe allowfullscreen="" frameborder="0" height="344" src="https://www.youtube.com/embed/DPHRYig-84c" width="459"></iframe><br />
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Central Florida Foot & Ankle Center, LLC101 6th Street N.W.Winter Haven, FL 33881Phone: 863-299-4551http://www.FLFootandAnkle.comCentral Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-73419276230597481122016-01-07T13:59:00.001-05:002016-01-07T13:59:27.427-05:00Olympic Track Star Marlena Wesh's patient testimony after Achilles Tendo...<span style="background-color: #f6f6f6; color: #333333; font-family: Roboto, arial, sans-serif; font-size: 13px; line-height: 17px;">Listen to Marlena's testimony after Dr. Wellens performs Achilles Tendon surgery on her. Marlena earned All-American designation in March 2012 in a Division I championship at Boise State University in Idaho. In early July 2012, just prior to the London Olympics, Wesh ran her personal best in the 400-meters with a time of 51.23, just 0.03 seconds behind the first place finisher. On Friday, August 3, she achieved her goal of making it to the 400-meter semi-finals in the 2012 London Olympics, having come in third in her heat. On Saturday, August 4, she failed to make it to the finals, placing 8th in her heat and 19th overall, with a time of </span><a href="https://www.youtube.com/watch?v=3yKXXQtFGHk&feature=youtu.be#" style="background: rgb(246, 246, 246); border: 0px; color: #167ac6; cursor: pointer; font-family: Roboto, arial, sans-serif; font-size: 13px; line-height: 17px; margin: 0px; padding: 0px; text-decoration: none;">52:49</a><span style="background-color: #f6f6f6; color: #333333; font-family: Roboto, arial, sans-serif; font-size: 13px; line-height: 17px;">.</span><br /><br />
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<iframe allowfullscreen="" frameborder="0" height="344" src="https://www.youtube.com/embed/3yKXXQtFGHk" width="459"></iframe><br />
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Central Florida Foot & Ankle Center, LLC101 6th Street N.W.Winter Haven, FL 33881Phone: 863-299-4551http://www.FLFootandAnkle.comCentral Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-15241193865001629562015-11-16T10:03:00.001-05:002015-11-16T10:03:28.711-05:002 month Post-Op Patient Testimony after Achilles Tendon Surgery with Dr....<iframe allowfullscreen="" frameborder="0" height="344" src="https://www.youtube.com/embed/w4MDx_b_oOU" width="459"></iframe><br />
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Central Florida Foot & Ankle Center, LLC101 6th Street N.W.Winter Haven, FL 33881Phone: 863-299-4551http://www.FLFootandAnkle.comCentral Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-63291724908070395192015-10-23T10:09:00.001-04:002015-10-23T10:09:37.029-04:00Amniox Regenerative Services for Achilles Tendinitis with Dr. Wellens<iframe allowfullscreen="" frameborder="0" height="344" src="https://www.youtube.com/embed/Dey74086KnM" width="459"></iframe><br />
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Central Florida Foot & Ankle Center, LLC101 6th Street N.W.Winter Haven, FL 33881Phone: 863-299-4551http://www.FLFootandAnkle.comCentral Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-47158346699658435572015-09-03T13:30:00.001-04:002015-09-03T13:30:14.452-04:00Post-Op Patient Testimony after Posterior Tibal Tendon Tear with Dr Wel...<iframe allowfullscreen="" frameborder="0" height="344" src="https://www.youtube.com/embed/h9RhYDJZTK8" width="459"></iframe><br />
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Central Florida Foot and Ankle Center, LLC.101 6TH St. NW. Winter Haven, Fl. 33881 863-299-4551http://www.FLFootandAnkle.comCentral Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-67864440776466979992012-05-17T15:39:00.000-04:002012-05-17T15:39:11.505-04:00Darren McFadden’s Lisfranc Injury<br />
<div class="MsoNormal">
Darren McFadden, running back for the Oakland Raiders, has
reportedly been making great strides in his rehabilitation and training
following a season-ending Lisfranc injury last season. The running back has been reported to have
been making cuts at full speed, an indication that he is feeling much better.</div>
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The Lisfranc joint is comprised of the tarso-metatarsal
joints across the entire midfoot. This
includes the five metatarsals, and their articulations with their respective
tarsal bones. This joint complex is
generally very strong, but can be injured in twisting injuries, with axial
loading mechanisms of injury, crush injuries, or in high velocity injuries such
as falls or motor vehicle accidents. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Injuries to the Lisfranc joint can be devastating,
particularly when they are not addressed properly. Unfortunatley, this can happen often in the
emergency room setting. The reason for this is that many Lisfranc injuries can
show up as subtle changes on x-ray, and those unfamiliar with the injury may
miss it. In fact, it is one of the most
commonly missed diagnoses. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The anatomy of the midfoot and Lisfranc joint contributes to
its stability, and lends to the relative infrequency of Lisfranc injuries. Strong ligaments connect the three cuneiforms
and the cuboid to their respective metatarsals, and the tendons and fascia of
the foot contribute to it’s stability as well.
<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
For McFadden, his injury was considered a sprain, and was
treated non-surgically. He sat out the
remainder of the season after it happened, but it was determined that he would
not need surgery on his foot. For many,
this is not the case.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Surgical correction for Lisfranc injuries is recommended in
many cases. These cases often involve
fractures of the bones of the midfoot, but may be purely ligamentous
injuries. Surgical correction may
involve using screws and/or plates to hold the bones in place while the
ligaments can heal. For fractured bones,
they may be pieced back together, and also held in place with screws and/or
plates while they heal. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Another option for treatment is to fuse the joints
permanently that are affected by the injury.
This is known as arthrodesis.
Arthrodesis for Lisfranc injuries has become a more popular option, as
research has shown that this may lead to a more functional and less painful
foot. Because there is limited motion at
the tarso-metatarsal joints to begin with, eliminating motion at the joints
altogether does not lead to a great difference in function. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Non-surgical treatment for Lisfranc injuries is typically to
keep the patient non-wieghtbearing in a cast or splint. Evaluation by a podiatric surgeon is helpful
to determine the definitive treatment for the injury.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
For McFadden, hopefully he will return to play and will have
a great season. <o:p></o:p></div>
<br />
<br />
<b>Central Florida Foot & Ankle Center, LLC </b><br />
<b>101 6th Street N.W. </b><br />
<b>Winter Haven, FL 33881 </b><br />
<b>Phone: 863-299-4551 </b><br />
<b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-61808686126122576152012-04-16T10:30:00.000-04:002012-04-16T10:30:42.913-04:00Walk This Way – Steven Tyler’s Bum Feet<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgI431GPfui-keU6_Zm6Bxq3pY_YvKkCMmWkuxOeFpEyQGX9z_Fsem6btibrIXdX2SJWFkVTmf3FYy_JPq6lgoPUdXEkougm4eDs8C-aYWsFC6l4CCSf_mr1yE9T3KMD1EM1paan9gyy3M/s1600/st.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="239" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgI431GPfui-keU6_Zm6Bxq3pY_YvKkCMmWkuxOeFpEyQGX9z_Fsem6btibrIXdX2SJWFkVTmf3FYy_JPq6lgoPUdXEkougm4eDs8C-aYWsFC6l4CCSf_mr1yE9T3KMD1EM1paan9gyy3M/s320/st.png" width="320" /></a></div>
<div class="MsoNormal">
Steven Tyler, the Aerosmith frontman turned American Idol
judge, has been in the news recently for his foot pain. The 64-year-old rocker was photographed
recently walking in sandals on the beach, which highlighted to the world why
his feet hurt so much.</div>
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
According to Tyler, he suffers from a Morton’s Neuroma. Morton’s neuroma is a growth of the tissue
that surrounds the nerve, typically between the third and fourth
metatarsals. The nerve sustains damage
from repetitive trauma, and develops a thick, fibrous tissue around
itself. Neuromas can be very painful,
sending electric-like shocks of pain through the toes. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
He also reports that he has had surgery on his feet. While it is unclear what exactly the surgery
was for, it is clear from looking at his feet that he still has some residual deformity. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The right foot, from looking at this photograph, appears to
have rotational deformities of the lesser digits. The second toe coming over the great toe is
known as a crossover digit, and can often be seen with long-standing
bunions. These are caused by muscle
imbalances. As a bunion deformity
develops, and the great toe drifts towards the second digit, the second digit
will often be forced to rest either above or below the plane of the first. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
As for the left foot, it looks as though from this picture
that a bunion deformity, while not as severe as the right, is developing.<o:p></o:p></div>
<div class="MsoNormal">
Steven Tyler even mentioned that part of the reason he took
the job with American Idol was to give his feet a break.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Tyler blames his aching feet on years of dancing in poorly
fitting shoes. While this can certainly
aggravate the problem, it is not necessarily the cause. Most structural deformities such as hallux
valgus and hammer toes are caused by biomechanical forces acting upon the foot,
which are determined by the structure of the foot. Things like bunions and flatfeet tend to run
in families, which leads many to believe that there is a genetic predisposition
for foot problems. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Steven Tyler is not alone, though. Bunions and hammertoes affect millions of
people, and are one of the most common complaints seen in the podiatrist’s
office. Surgical correction for these
painful conditions is performed often, and is generally well-tolerated. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
For the man who told us to “Walk this Way”, it looks like
Steven Tyler might be teaching us how to walk in post-op shoes soon. As for the toenail polish, that’s a whole
different story. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<br />
<br />
<b>Central Florida Foot & Ankle Center, LLC </b><br />
<b>101 6th Street N.W. </b><br />
<b>Winter Haven, FL 33881 </b><br />
<b>Phone: 863-299-4551 </b><br />
<b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-4468686846258285542012-03-05T16:49:00.003-05:002012-03-05T16:49:38.474-05:00Staying Ahead of Athlete’s Foot<div class="separator" style="clear: both; text-align: center;">
</div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_LzBEqicTwWlTncbRKQhGM_RrJpfE4rM_y0toTRPoR_UoRY50U_Wn6mHVZikPmydN3NuT53-UIR8_4uFp6JIlHy762oNqNWr0fhKMGd1qj3duPtVv78o6Ifk19L3TjsOSPtDpjorJG78/s1600/tinea_s19-01.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="135" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_LzBEqicTwWlTncbRKQhGM_RrJpfE4rM_y0toTRPoR_UoRY50U_Wn6mHVZikPmydN3NuT53-UIR8_4uFp6JIlHy762oNqNWr0fhKMGd1qj3duPtVv78o6Ifk19L3TjsOSPtDpjorJG78/s200/tinea_s19-01.jpg" width="200" /></a></div>
<div class="MsoNormal" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em; text-align: left;">
<br />Athlete’s foot, or tinea pedis, is a fungal infection of the
foot that can cause burning and itching, and may lead to cracks in the skin,
scaling of the skin, or blisters. It is
most commonly caused by the fungus trychophyton rubrum, a ubiquitous species
that thrives in warm, moist environments.
This can often include a shoe, pool decks, and locker rooms.</div>
<br />
<br />
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal" style="text-align: left;">
Symptoms of athlete’s foot are a burning sensation and
itching on the bottom of the foot or in-between the toes. The skin may become red and inflamed. Blisters can form on an area that is affected,
and these blisters may ooze a clear liquid. </div>
<div class="MsoNormal" style="text-align: left;">
<o:p></o:p></div>
<div class="MsoNormal" style="text-align: left;">
<br /></div>
<div class="MsoNormal" style="text-align: left;">
Most commonly, tinea pedis is treated with anti-fungal
topical creams that are applied to the feet.
These creams may or may not contain a mild steroid that can help reduce
the inflammation associated with the </div>
<div class="MsoNormal" style="text-align: left;">
fungal infection. However, the steroid may not always be
necessary, as the anti-fungal cream combats the fungus, which in turn will
reduce inflammation. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: left;">
<br /></div>
<div class="MsoNormal" style="text-align: left;">
The greatest form of treatment for athlete’s foot is through
prevention. Since the organism that
causes the infection is so common in moist and wet environments, using proper
socks is key. Socks should be made of
cotton or of a moisture-wicking fabric, and a clean pair should be worn
daily. In fact, changing socks through
the day can help keep feet dry, particularly for people whose feet have a
tendency to sweat a lot.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: left;">
<br /></div>
<div class="MsoNormal" style="text-align: left;">
Feet should be washed daily with soap and water, from the
heel to the toes and in-between the toes as well. Use of a soap that contains tea tree oil, a
natural anti-fungal, can help prevent fungal infection. Be sure to dry the feet thoroughly before
putting socks and shoes back on. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: left;">
<br /></div>
<div class="MsoNormal" style="text-align: left;">
Shoes may be sterilized with a variety of shoe sprays. Many people will simply use Lysol to
accomplish this. Devices that use
ultraviolet light to sterilize the shoes are also on the market, though they
are relatively expensive. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: left;">
<br /></div>
<div class="MsoNormal" style="text-align: left;">
Wearing sandals or shower shoes on pool decks (particularly
indoor pools) and in locker rooms can help prevent transmission of the
fungus. These areas are commonly cited
as the source of fungal infections. <o:p></o:p></div>
<div class="MsoNormal" style="text-align: left;">
<br /></div>
<div class="MsoNormal" style="text-align: left;">
If left untreated, athlete’s foot will continue to be a
chronic problem, and can lead to excessive cracking or flaking of the skin. This may create a portal for bacterial
infection, as the protective skin layers can be partially or completely
lost. The fungal infection may also
enter underneath the nail plate, causing a fungal infection of the
toenail. Toenail infections are notoriously
difficult to cure.<o:p></o:p></div>
<div class="MsoNormal" style="text-align: left;">
<br /></div>
<div class="MsoNormal" style="text-align: left;">
A foot and ankle specialist will be able to go through some
of the treatment options with you if you are experiencing pain in your feet due
to fungal infections, or any other condition of the foot and ankle.<o:p></o:p></div>
<br />
<div style="text-align: left;">
<br /></div>
<div style="text-align: left;">
<b>Central Florida Foot & Ankle Center, LLC </b></div>
<div style="text-align: left;">
<b>101 6th Street N.W. </b></div>
<div style="text-align: left;">
<b>Winter Haven, FL 33881 </b></div>
<div style="text-align: left;">
<b>Phone: 863-299-4551 </b></div>
<div style="text-align: left;">
<b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b></div>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-62777971309830106952012-01-03T12:15:00.000-05:002012-01-03T12:15:49.207-05:00Diagnosis and Treatment of Acute Compartment Syndrome<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="http://2.bp.blogspot.com/-lPv4E3mTRSI/TwM2JhmlmGI/AAAAAAAAA5U/DUy_uPN0lJQ/s1600/New+Picture+%25287%2529.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-lPv4E3mTRSI/TwM2JhmlmGI/AAAAAAAAA5U/DUy_uPN0lJQ/s1600/New+Picture+%25287%2529.jpg" /></a></div>
<div class="MsoNormal">
The onset of acute compartment syndrome is something of
great concern to the emergency room physician, trauma surgeon, and podiatric
foot and ankle surgeon. It is something
that is routinely screened for an any lower extremity trauma.</div>
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The muscles of the foot and leg are divided into
compartments, each of which is separated by a layer of fascia. This dividing fascia is tough and
restricting, and does not allow for much expansion of the tissues within the
compartment. Normally this is a good
thing, as it helps separate and organize the muscle compartments of the foot
and leg. However, when the volume of the
compartment expands following injury, these bands of tissue help to restrict
the fluid, creating an increase in the compartmental pressure. This increase in pressure can cause damage to
the muscles, nerves, and vessels within the compartment, and can lead to tissue
death if not addressed properly. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Signs and symptoms of acute compartment pressure include
intense pain out of proportion for the given injury, numbness or tingling in
the toes, loss of function of the toes or an inability to move them, and
coolness to touch caused by decreased blood flow. Later in the development of compartment
syndrome, pulses may be absent and the toes may turn white in color. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The diagnosis of compartment syndrome is largely based on
the history and physical findings, but a device called a wick catheter may be
used to confirm the diagnosis. This is
an instrument that is mainly composed of a needle attached to a pressure gauge,
which acts to measure the compartmental pressure. The normal pressure reading for a muscular
compartment should be between 0 and 10 mmHg.
Pressures between 10-20mmHg are closely monitored, as they may continue
to increase. Pressures above 30mmHg are
considered diagnostic of compartment syndrome in most cases. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Once the diagnosis of compartment syndrome is made, the
patient must be taken to surgery right away.
A delay in surgical treatment may result in irreversible muscle and
tissue damage. Surgery for compartment
syndrome involves releasing the fascia between compartments to relieve the
pressure. This procedure is known as a
fasciotomy. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
There are four muscle compartments in the leg to release;
the superficial and deep posterior compartments, the lateral compartment, and
the anterior compartment. In the foot,
there are also four main compartments; the medial, lateral, central, and
interosseous. Some references will
divide the central compartment into a superficial, deep, and calcaneal compartment,
and also consider each of the interosseous compartments their own separate
compartment. When acute compartment
syndrome is diagnosed, both the leg and foot compartments will oftentimes be
opened together. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The incision sites are kept open, and local wound care is
performed to keep the sites clean and prevent infection. Compartment syndrome will generally keep a
patient in the hospital for at least several days, while their condition can be
monitored. Any other injuries must also
be addressed. <o:p></o:p></div>
<br />
<br />
<b>Central Florida Foot & Ankle Center, LLC </b><br />
<b>101 6th Street N.W.
Winter Haven, FL 33881 </b><br />
<b>Phone: 863-299-4551 </b><br />
<b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-52480089930835529422011-11-14T15:05:00.001-05:002011-11-14T15:20:33.540-05:00Equinus<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgACUIOtQVOoeEROb_-TRwJ9bKqeZQugARnv8Mli5BCCQ27DUzpMcSs1mujuVJRIg6egnzj15ksSAwS-zNKJ2t-U2wYA11zSNVkAUOjYLRY2jdz8Jz8hyG0zCpagrdcYasVuGhYzXDBhmA/s1600/New+Picture+%25281%2529.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgACUIOtQVOoeEROb_-TRwJ9bKqeZQugARnv8Mli5BCCQ27DUzpMcSs1mujuVJRIg6egnzj15ksSAwS-zNKJ2t-U2wYA11zSNVkAUOjYLRY2jdz8Jz8hyG0zCpagrdcYasVuGhYzXDBhmA/s1600/New+Picture+%25281%2529.jpg" /></a></div>
<div class="MsoNormal">
Equinus is a condition of the foot and ankle that refers to
a tight Achilles tendon. The Achilles
tendon is composed of the tendons of two muscles – the gastrocnemius and the
soleus. Together, these two muscles form
the strongest tendon in the entire body, which inserts into the calcaneus (heel
bone). </div>
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The Achilles tendon can become tight in one of several
ways. Spastic equinus is the oldest
recognized form of equinus, and is seen as a result of upper motor neuron
disease. This may include cerebral
palsy, stroke, or spinal trauma and disease.
Congenital equinus refers to equinus typically caused by a shortened
Achilles tendon, which is present at birth.
This may result in prolonged toe walking in the developing pediatric
patient. <o:p></o:p></div>
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<br /></div>
<div class="MsoNormal">
Most commonly, equinus is an acquired deformity, due to a
tightness of the gastrocnemius muscle, the soleus, or both. This tightness develops over time, and can be
worsened by wearing high-heeled shoes, being casted for a lengthy period of
time, or from overuse without stretching.
Bony equinus can also present, which is a block of both that prevents
the ankle from dorsiflexing, or moving upwards.
<o:p></o:p></div>
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<br /></div>
<div class="MsoNormal">
Equinus is possibly the most common cause of foot pathology. When the Achilles tendon is tight, the body
compensates for this in order to bring the heel to the ground. This is often done by pronating at the
subtalar joint, which is the joint located just below the ankle. This extra pronation can lead to a number of
foot problems, such as plantar
fasciitis, flatfoot, tendintis, arthritis, bunions, hammertoes, ankle pain, and
a number of other conditions. Thus,
equinus is not necessarily a painful problem, but the compensation for it can
cause several painful problems. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Treatment of equinus should begin with an aggressive
stretching program to address the tightness of the Achilles tendon. Because of it’s relationship to the plantar
fascia, the two structures forming a type of sling around the calcaneus,
plantar fascia stretches are often incorporated as well. Combined with the use of orthotics to
maintain foot structure when walking, conservative treatment is often helpful
for those with equinus. Heel lifts may
also be used to address some of the compensation for equinus at the subtalar
joint, as it effectively lessens the amount of space that must be compensated
for. <o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Occassionally surgery may be necessary if the equinus is not
relieved with conservative measures, and is causing significant foot pathology. Surgery may involve lengthening of the
Achilles tendon itself, or lengthening of either the gastrocnemius muscle, the
soleus muscle, or both. These procedures
are often combined with foot procedures such as flatfoot or bunion correction,
as they are often indicated as the deforming force in a foot deformity. <o:p></o:p></div>
<br />
<br />
<b>Central Florida Foot & Ankle Center, LLC </b><br />
<b>101 6th Street N.W. </b><br />
<b>Winter Haven, FL 33881 </b><br />
<b>Phone: 863-299-4551 </b><br />
<a href="http://www.flfootandankle.com/"><b>www.FLFootandAnkle.com</b></a>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-50681446386413378642011-09-28T08:38:00.000-04:002011-09-28T08:38:29.283-04:00Fractures of the Anterior Process<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidCvOW8SfYQLxdM2Qs2ov3lteQa_e1FYEYHzNf6zvR4anz7pvlGZ5tg0PpQJ9rCoAtJpXkbvytyS17O0gbtip3OHjdtTz9U6PojnuDZSv8fJ3jNofG4gBwnVE7PH6ny5JUnmg7UYKZQ9Y/s1600/New+Picture+%252833%2529.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEidCvOW8SfYQLxdM2Qs2ov3lteQa_e1FYEYHzNf6zvR4anz7pvlGZ5tg0PpQJ9rCoAtJpXkbvytyS17O0gbtip3OHjdtTz9U6PojnuDZSv8fJ3jNofG4gBwnVE7PH6ny5JUnmg7UYKZQ9Y/s1600/New+Picture+%252833%2529.jpg" /></a></div>
<div class="MsoNormal">
The anterior process of the calcaneus is an important
structure to consider in the incidence of ankle sprain.<span> </span>The bifurcate ligament attaches to this
portion of the calcaneus, and attaches dorsally to both the cuboid and
navicular.<span> </span>In a plantarflexion-inversion
injury, the most common mechanism of ankle sprain, the ligament is tensioned
and avulsion fracture of the anterior process can occur.<span> </span>The anterior process may be injured less
commonly in a compression type injury, where the foot is forced to dorsiflex
and evert, thereby crushing the bone.<span> </span></div>
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The calcaneocuboid joint is an important consideration in
assessing these types of fractures.<span> </span>The
articular surface of the anterior process of the calcaneus may become damaged
from this type of trauma.<span> </span>This can lead
to significant pathology at the joint.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Degan and colleagues pointed out in an article in 1982 that
the extent of damage to the anterior process directly effects the outcome of
treatment.<span> </span>They suggested a classification
system that took into consideration treatment options.<span> </span>Type I injuries consisted of fractures of the
anterior process that did not involve the joint, and were non-displaced.<span> </span>These types of fractures were treated
successfully with immbolization in a cast.<span>
</span>Type II injuries were also extra-articular, but were displaced.<span> </span>These fractures were also treated
conservatively with cast immobilization.<span>
</span>Type III injuries involved the calcaneocuboid joint, and led to
long-term disability.<span> </span>This was most commonly
treated with surgical excision of the fragment.<span>
</span>Prior to the publishing of this article, removal of fracture fragments
for anterior process injuries was controversial.<span> </span>Today, it is commonplace.<span> </span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Another point made in Degan’s article is that it may take a
long time for patients to be completely symptom-free following conservative
treatment, even when the joint is not involved.<span>
</span>In some cases, patients remained symptomatic for up to one year
following injury.<span> </span>When this is the case,
a small amount of local anesthetic can be injected into the fracture
fragment.<span> </span>If this is found to alleviate
the pain, the fracture fragment removal is indicated.<span> </span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Removal of the fragment involves a small incision placed
over the calcaneoocuboid joint.<span> </span>The
fragment is removed, along with any other diseased tissue that may be causing
pain within the joint.<span> </span>The surgical
wound is then closed with suture.<span>
</span>Typically this is enough to alleviate symptoms, however, some pain and
swelling is to be expected following surgery.<o:p></o:p></div>
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<br /></div>
<div class="MsoNormal">
Because of the propensity for these fractures to be missed,
it is quite common to see old fractures of the anterior process of the
calcaneus.<span> </span>Often times by the time they
present themselves, the fracture fragment has either healed in a poor position
or damage to the joint surfaces has already occurred.<span> </span><o:p></o:p></div>
<br />
<br />
<b>Central Florida Foot & Ankle Center, LLC </b><br />
<b>101 6th Street N.W. </b><br />
<b>Winter Haven, FL 33881 </b><br />
<b>Phone: 863-299-4551 </b><br />
<b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-76039617296275846542011-07-22T12:38:00.004-04:002011-07-22T13:14:56.126-04:00Paronychia<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhz_mvDpP1BAO6G6Oh7jRsU-M9Xb9XthcKfXFnBOzNAiV-eiLy0C4mp6zd4E39nCRy3qj5jHVFFvRaspDLTkqgA_zz3qlp-9VA2vL6lDIaKdylpafwbbaJNdU-M7jrF55qCvWFWAxHS_aE/s1600/New+Picture+%252823%2529.png" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 196px; height: 169px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhz_mvDpP1BAO6G6Oh7jRsU-M9Xb9XthcKfXFnBOzNAiV-eiLy0C4mp6zd4E39nCRy3qj5jHVFFvRaspDLTkqgA_zz3qlp-9VA2vL6lDIaKdylpafwbbaJNdU-M7jrF55qCvWFWAxHS_aE/s400/New+Picture+%252823%2529.png" border="0" alt="" id="BLOGGER_PHOTO_ID_5632223317682400066" /></a><div><p class="MsoNormal">When an ingrown toenail becomes infected, it is referred to as a paronychia.<span style="mso-spacerun:yes"> </span>This happens due to the nail literally digging into the skin, causing a breakdown in the soft tissue, which allows bacteria to penetrate the natural skin barrier. <span style="mso-spacerun:yes"> </span>The organism that is usually responsible for the infection is a staphylococcus species.</p> <p class="MsoNormal">Paronychia will appear as a small, localized area of redness that may spread up the toe.<span style="mso-spacerun:yes"> </span>It is generally quite painful, and there is usually a fair amount of pus and drainage from the site.<span style="mso-spacerun:yes"> </span>In patients that are immunocompromised, such as diabetics or patients on long-term steroid regimens, a paronychia can advance to a more complicated infection of the soft tissues.<span style="mso-spacerun:yes"> </span>These should be dealt with rapidly and aggressively by a doctor.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Treatment for paronychia includes incision and drainage of the infection site, which will help to relieve pain as well as remove much of the infection.<span style="mso-spacerun:yes"> </span>A bandage is applied, usually with a topical antibiotic, and oral antibiotics may be used as well.<span style="mso-spacerun:yes"> </span>Augmentin is a commonly prescribed oral antibiotic for paronychia, though it may not always be necessary.<span style="mso-spacerun:yes"> </span>The bandage may be changed once or twice a day for the first few days, and soaks in a dilute betadine solution may be beneficial as well.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">If ingrown toenails and paronychia are a chronic problem, they can be addressed with one of several more permanent procedures.<span style="mso-spacerun:yes"> </span>A podiatrist will typically be the type of doctor that deals with this problem.<span style="mso-spacerun:yes"> </span>After the infection resolves, a chemical matricectomy may be performed.<span style="mso-spacerun:yes"> </span>This procedure involves using a chemical, such as phenol or sodium hydroxide, to permanently remove a portion or the entire nail matrix.<span style="mso-spacerun:yes"> </span>The nail and nail matrix may also be surgically removed.<span style="mso-spacerun:yes"> </span>Both are relatively minor procedures, and allow for a quick recovery.<span style="mso-spacerun:yes"> </span>The recurrence of ingrown toenails after these surgical procedures is extremely low.</p> <p class="MsoNormal">Generally speaking, a paronychia is a minor infection, and is treated as such.<span style="mso-spacerun:yes"> </span>It is only in the diabetic or otherwise immunocompromised patient that it becomes an area of greater concern.<span style="mso-spacerun:yes"> </span>If not dealt with rapidly, a minor infection can become a more serious, even life-threatening infection.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">If you are experiencing pain from an ingrown toenail, show it to your doctor.<span style="mso-spacerun:yes"> </span>Even if it is not infected, it should be dealt with in an appropriate manner, to relieve pain, prevent regrowth of the ingrown portion of the nail, and prevent a pending infection.<span style="mso-spacerun:yes"> </span>With time, many ingrown toenails will ultimately become infected.<span style="mso-spacerun:yes"> </span><o:p></o:p></p></div><div><br /></div><b>Central Florida Foot & Ankle Center, LLC</b><div><b>101 6th Street N.W.</b></div><div><b>Winter Haven, FL 33881</b></div><div><b>863-299-4551</b></div><div><b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b></div>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-23303153885082591392011-05-23T08:48:00.002-04:002011-05-23T08:53:44.638-04:00Burning and Tingling in the Feet – Is it Neuropathy?<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzOgVVub_v4Q1AmtxUr-qkI-z8RUr7buIMXFmFpdfN2GRxnuFALVRfVHugZv-f25yvlbGc4HqJUPSuokH2mDNl5cSkPcSBiO-g-WgJKBXCxqWq0yi4wTzy9F09Lv8l3mTtWP0JHH-LJHE/s1600/New+Picture.jpg" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 160px; height: 152px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzOgVVub_v4Q1AmtxUr-qkI-z8RUr7buIMXFmFpdfN2GRxnuFALVRfVHugZv-f25yvlbGc4HqJUPSuokH2mDNl5cSkPcSBiO-g-WgJKBXCxqWq0yi4wTzy9F09Lv8l3mTtWP0JHH-LJHE/s400/New+Picture.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5609893515739671026" /></a><div><p class="MsoNormal">One of the most common complications of diabetes is the development of peripheral neuropathy.<span style="mso-spacerun:yes"> </span>Along with the retina in the eye and the kidney, the nervous system is particularly vulnerable to unregulated glucose levels in the blood.<span style="mso-spacerun:yes"> </span>This is because glucose, or free sugar in the blood, is able to freely move in and out of these cells without the use of glucose receptors.</p> <p class="MsoNormal">Diabetic neuropathy comes in a variety of forms, depending on which nerves are involved.<span style="mso-spacerun:yes"> </span>The sensory, motor, and autonomic (involuntary) nervous systems are all affected in diabetic neuropathy, but the sensory involvement is usually the first to become noticeably symptomatic.<span style="mso-spacerun:yes"> </span>This often begins with a burning, tingling, or feeling of numbness in the feet.<span style="mso-spacerun:yes"> </span>This may also occur in the hands at the same time.<span style="mso-spacerun:yes"> </span>This pattern of distribution is commonly referred to as the “stocking-and-glove” distribution.<span style="mso-spacerun:yes"> </span>Many theorize that the longest nerves are the first to be affected by peripheral neuropathy, hence the involvement of the hands and feet first.<span style="mso-spacerun:yes"> </span>The pain is generally worse at night or at rest.</p> <p class="MsoNormal">While the symptoms of numbness and pain of a burning or tingling nature may be uncomfortable, the later sequalae of peripheral neuropathy is certainly more of concern.<span style="mso-spacerun:yes"> </span>Once the sensation in the feet is diminished or absent, the foot becomes prone to injury.<span style="mso-spacerun:yes"> </span>This injury may go completely unnoticed, which can lead to an open, infected wound.<span style="mso-spacerun:yes"> </span>Ulcerations secondary to diabetic peripheral neuropathy cause enormous amounts of morbidity, and can become complicated by systemic infections.</p> <p class="MsoNormal">Signs of motor neuropathy in the diabetic patient include structural changes to the foot due to a loss of intrinsic musculature.<span style="mso-spacerun:yes"> </span>This may include hammering of the digits, as well as a noticeable loss of the abductor hallucis, a muscle found on the inside (medial) of the foot near the arch.<span style="mso-spacerun:yes"> </span>These changes may be more subtle than the subjective findings of pain due to sensory neuropathy.</p> <p class="MsoNormal">Autonomic neuropathy also causes changes to the foot that can be appreciated on physical examination.<span style="mso-spacerun:yes"> </span>Findings such as lack of hair growth to the digits, changes to the skin color or texture, changes in warmth, and decreased circulation to the foot can all be signs of autonomic neuropathy in the diabetic patient.</p> <p class="MsoNormal">Unfortunately, there is no cure for diabetic neuropathy.<span style="mso-spacerun:yes"> </span>The onset and progression of symptoms can be avoided by keeping tight control of blood glucose levels.<span style="mso-spacerun:yes"> </span>Avoiding hyperglycemic events will prevent the nerves from being damaged by excessive glucose in the blood.<span style="mso-spacerun:yes"> </span>In fact, many diabetics report an increase in pain after eating a carbohydrate-rich meal or if their glucose levels are running high.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Drugs that have been used to treat painful diabetic peripheral neuropathy are targeted at the symptoms rather than at the cause.<span style="mso-spacerun:yes"> </span>This includes antidepressants such as amitryptiline or nortriptyline, gabapentin, topical capsaicin, and sedatives and pain relievers such as opiates.</p> <p class="MsoNormal">A podiatrist will screen for neuropathy in diabetic patients.<span style="mso-spacerun:yes"> </span>This is often a very simple, noninvasive test in the office where the protective sensation in the feet is tested.<span style="mso-spacerun:yes"> </span>Further testing may be warranted for borderline cases, but is typically unnecessary.<span style="mso-spacerun:yes"> </span>If you are diabetic and are concerned about peripheral neuropathy, have a discussion with your podiatrist or primary doctor today.<o:p></o:p></p></div><div><br /></div><b>Central Florida Foot & Ankle Center, LLC</b><div><b>101 6th Street N.W.</b></div><div><b>Winter Haven, FL 33881</b></div><div><b>863-299-4551</b></div><div><b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b></div>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com1tag:blogger.com,1999:blog-9216740921622344465.post-57709444172684798442011-04-25T12:28:00.004-04:002011-04-25T12:34:21.960-04:00Endoscopic Plantar Fasciotomy<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaxL-SGuH36-Nb8lV6cYFb35iQqok8Ld3PsYQ-KX30Y97BvcqOLVl1oIrW6QTO0oTmfVz6iNKsF1CbMhwXqgXo_vwBbplX-pUjx9NlJXR49BDvjU3hRoLkvvXvn_fCizR15IuZSRqyfvg/s1600/New+Picture+%2528112%2529.jpg" onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 160px; height: 106px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjaxL-SGuH36-Nb8lV6cYFb35iQqok8Ld3PsYQ-KX30Y97BvcqOLVl1oIrW6QTO0oTmfVz6iNKsF1CbMhwXqgXo_vwBbplX-pUjx9NlJXR49BDvjU3hRoLkvvXvn_fCizR15IuZSRqyfvg/s400/New+Picture+%2528112%2529.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5599560034625018354" /></a><div><p class="MsoNormal">One of the most common conditions encountered by the podiatric physician is plantar fasciitis and other forms of heel pain that may present as plantar fasciitis.<span style="mso-spacerun:yes"> </span>In fact, one study suggested that up to a third of all Americans will experience this form of heel pain at some point in their adult lives.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">The plantar fascia describes a tough band of fibrous material found at the plantar surface of the foot.<span style="mso-spacerun:yes"> </span>This structure allows for integrity of the foot, and helps to contain the deeper structures within the foot.<span style="mso-spacerun:yes"> </span>It functions to assist in gait and maintain integrity of the musculature of the foot, and is therefore subjected to high levels of stress, particularly in the athlete or in the non-athlete that is on their feet for extended periods of time.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Plantar fasciitis is classically described as heel pain at the bottom of the foot, which may extend into the arch or even into the toes.<span style="mso-spacerun:yes"> </span>It is a chronic inflammatory condition, which some suggest is more appropriately described as plantar fasciosis, which indicates the chronic nature of the condition, rather than an acute inflammatory process.<span style="mso-spacerun:yes"> </span>Other causes of heel pain include stress fractures of the calcaneus, entrapment of the medial and/or lateral calcaneal nerves, tarsal tunnel syndrome, and certain forms of inflammatory arthritis.<span style="mso-spacerun:yes"> </span>It is very possible and quite likely that some cases of heel pain may be multi-factorial, and have elements of more than one of these causes of heel pain.</p> <p class="MsoNormal">Symptoms of plantar fasciitis include pain in the heel after long periods of rest, particularly in the morning.<span style="mso-spacerun:yes"> </span>This is often referred to as “first-step pain”, and describes the sudden stretching of the plantar fascia band after it is allowed to contract some during rest.<span style="mso-spacerun:yes"> </span>The pain may be relieved somewhat as the plantar fascia is “loosened”, but will return with increased activity.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Conservative therapy for plantar fasciitis revolves around exercise and stretching, corticosteroid injections, anti-inflammatory medications, icing, rest, and the use of orthotic devices.<span style="mso-spacerun:yes"> </span>Newer advancements in technology have led to ultrasound and shockwave therapy, platelet-rich plasma therapy, and other high-tech therapies.</p> <p class="MsoNormal">However, conservative therapy can often fail, and surgery becomes an option.<span style="mso-spacerun:yes"> </span>Surgical management is traditionally performed as an open procedure, with a small incision made into the medial foot and a resection of some of the plantar fascia, or a simple release.<span style="mso-spacerun:yes"> </span>Historically, the entire plantar fascia was commonly released.<span style="mso-spacerun:yes"> </span>However, this was found to destabilize the lateral foot, and would lead to pain in this area.<span style="mso-spacerun:yes"> </span>In fact, this complication was often more debilitating than the original plantar fascia pain.<span style="mso-spacerun:yes"> </span>This realization led to a more judicious release of the plantar fascia, usually only involving the medial one-third of the structure.<span style="mso-spacerun:yes"> </span>This led to much less instability and greater results.</p> <p class="MsoNormal">Another historical approach to plantar heel pain was the resection of a bone spur on the calcaneus.<span style="mso-spacerun:yes"> </span>For a long time it was believed that this was the source of the plantar fascia pain, and resection would lead to improvement.<span style="mso-spacerun:yes"> </span>Research into “heel spurs” as the cause of heel pain would later disprove this as an etiology of the pain.<span style="mso-spacerun:yes"> </span>Resection of heel spurs, or infracalcaneal exostoses, is not commonly performed as a result of this information.</p> <p class="MsoNormal">With a greater understanding of plantar heel pain, as well as advancements in surgical technique and technologies, the use of endoscopic methods of plantar fascia release became a popular option in the 1990’s.<span style="mso-spacerun:yes"> </span>With endoscopic plantar fasciotomy, one or two small incisions are made in the side of the foot, and a small camera is used to visualize this plantar fascia.<span style="mso-spacerun:yes"> </span>Then, a specialized blade is inserted and the plantar fascia is released.<span style="mso-spacerun:yes"> </span>This minimally invasive technique causes less damage to the surrounding tissues, and can lead to a faster recovery.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Post-operatively, however, a period of non-weight bearing or partial weight bearing is still recommended.<span style="mso-spacerun:yes"> </span>With the initial development of endoscopic plantar fasciotomy, the idea of a faster recovery led to a quicker return to normal shoes.<span style="mso-spacerun:yes"> </span>However, it was realized that this quick return to normal shoes led to increased instability and recurrence of pain.<span style="mso-spacerun:yes"> </span>It is now recommended that the patient remain non-weight bearing in a surgical boot until healing occurs.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">The endoscopic plantar fasciotomy remains a popular option for foot and ankle surgeons in the treatment of plantar fasciitis.<span style="mso-spacerun:yes"> </span>Advancements since its initial inception make it easier to operate and lead to greater outcomes.<span style="mso-spacerun:yes"> </span>Conservative therapy should be initiated and followed for some time before surgical intervention.<span style="mso-spacerun:yes"> </span>If you are experiencing heel pain or symptoms of plantar fasciitis, consult your podiatrist for evaluation.<span style="mso-spacerun:yes"> </span>Diagnosis can only be made after proper examination and evaluation.<o:p></o:p></p></div><div><br /></div><b>Central Florida Foot & Ankle Center, LLC</b><div><b>101 6th Street N.W.</b></div><div><b>Winter Haven, FL 33881</b></div><div><b>863-299-4551</b></div><div><b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b></div>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-28062668466034642682011-02-21T15:11:00.003-05:002011-02-21T15:21:10.065-05:00Metatarsus Adductus<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgX-XCMMWS3FF0jLnHOp024XafmWG1T4-yW7Swn-TGb_k7ed8Eyp-louZ_qQ82yxW5Q6DqP0AXqjRf1zlm-nJK_YXV0s70-xxvZItUDjjN3Mcaplywc7lpYjQAIv69R2OQ99uQMm6lLrWU/s1600/New+Picture+%25284%2529.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 160px; height: 128px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgX-XCMMWS3FF0jLnHOp024XafmWG1T4-yW7Swn-TGb_k7ed8Eyp-louZ_qQ82yxW5Q6DqP0AXqjRf1zlm-nJK_YXV0s70-xxvZItUDjjN3Mcaplywc7lpYjQAIv69R2OQ99uQMm6lLrWU/s400/New+Picture+%25284%2529.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5576238330706379634" /></a><div><p class="MsoNormal">A common cause of in-toeing in the pediatric patient is a foot deformity called metatarsus adductus.<span style="mso-spacerun:yes"> </span>This is a condition in which the metatarsals, the bones in the foot that connect the toes to the midfoot, are pointed towards the direction of the midline of the body.<span style="mso-spacerun:yes"> </span>Metatarsus adductus may be present on it’s own, or may be a component of a more extensive deformity, such as clubfoot.<span style="mso-spacerun:yes"> </span>It’s incidence is approximately one in every one thousand live births, which is roughly ten times as common as clubfoot.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">The exact cause of metatarsus adductus is not known, though there are several theories of how it develops.<span style="mso-spacerun:yes"> </span>An increase in intrauterine pressure and a position in the womb that causes the feet to drift inward is the cause that is most commonly accepted.<span style="mso-spacerun:yes"> </span>There also may be a familial pattern of metatarsus adductus, indicating that there may be genetic pre-disposition to the deformity.<span style="mso-spacerun:yes"> </span>Conditions that cause an increase in ligament laxity, such as Ehlers-Danlos Syndrome, may also contribute to the development of metatarsus adductus.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">The evaluation of metatarsus adductus typically involves clinical evaluation as well as x-rays of the foot to determine the position of the developing bones.<span style="mso-spacerun:yes"> </span>Clinically, the toes will be pointed inwards towards the midline of the body.<span style="mso-spacerun:yes"> </span>Sometimes only the great toe will be involved, in which case the condition is called metatarsus primus adductus.<span style="mso-spacerun:yes"> </span>More commonly, however, all five digits are involved.<span style="mso-spacerun:yes"> </span>The outside of the foot, or the lateral side, may show a prominent bump right in the middle of the foot.<span style="mso-spacerun:yes"> </span>This is most likely the styloid process at the base of the fifth metatarsal, a very good indicator of metatarsus adductus.<span style="mso-spacerun:yes"> </span>There also may be an increased gapping between the first and second toes when the child is standing, another classic finding.</p> <p class="MsoNormal">X-rays will often reveal the extent of the deformity.<span style="mso-spacerun:yes"> </span>The foot and ankle physician evaluating the patient will measure the angle that the forefoot points away from the midfoot and towards the middle of the body.<span style="mso-spacerun:yes"> </span>The higher the angle, the more severe the deformity.</p> <p class="MsoNormal">Important factors in determining the treatment of metatarsus adductus are the angle of deviation from the midfoot, the involvement of the midfoot and/or rearfoot in the deformity, and the reducibility of the deformity.<span style="mso-spacerun:yes"> </span>Reducibility refers to whether or not the forefoot can be corrected with manipulation.</p> <p class="MsoNormal">Conservative therapy is typically employed first, especially in children under the age of two years old.<span style="mso-spacerun:yes"> </span>Most commonly conservative therapy involves manipulating the foot into a corrected position, and casting the foot so it stays that way.<span style="mso-spacerun:yes"> </span>Depending on the degree of deformity, several rounds of casting may be used.<span style="mso-spacerun:yes"> </span>This is referred to as serial casting.<span style="mso-spacerun:yes"> </span>Besides casting, a splint such as a Ganley splint may be used as well as special shoes to prevent the deformity from recurring.</p> <p class="MsoNormal">Surgical therapy is sometimes necessary to correct the deformity in the older child, or a child that has a more severe deformity.<span style="mso-spacerun:yes"> </span>Surgical procedures involve both soft tissue and bone surgery, or a combination of both.<span style="mso-spacerun:yes"> </span>Soft tissue procedures may include tendon releases and/or ligament release.<span style="mso-spacerun:yes"> </span>These types of procedures will allow the foot to be manipulated more easily so that a corrected position can be attained.<span style="mso-spacerun:yes"> </span>Bone work may involve taking small wedges of bone out of either the metatarsals or the midfoot in order to straighten out the foot. </p> <p class="MsoNormal">After surgery, the patient is typically casted for a period of no less than 8-12 weeks in order to maintain the corrected position.<span style="mso-spacerun:yes"> </span>Special shoes may still be required for some time to prevent the deformity from recurring.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">There are a number of other musculoskeletal deformities that may be present in the lower extremity that lead to in-toeing.<span style="mso-spacerun:yes"> </span>A thorough evaluation of the legs, knees, and hips is warranted in any child that has significant in-toeing.<span style="mso-spacerun:yes"> </span>The incidence or torsional deformities of the tibia and femur is increased in the presence of metatarsus adductus, possibly due to the same reasons that the foot deformity develops in-utero.<span style="mso-spacerun:yes"> </span>An increased incidence of hip dysplasia has also been reported by some authors, though other refute this correlation.<span style="mso-spacerun:yes"> </span><o:p></o:p></p></div><div><br /></div>Central Florida Foot & Ankle Center, LLC101 6th Street N.W.Winter Haven, FL 33881Phone: 863-299-4551http://www.FLFootandAnkle.comCentral Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-36586492924634030262010-12-30T08:10:00.004-05:002010-12-30T08:16:56.166-05:00Thromboangiitis Obliterans<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6NlNeMF1cZ4BVRCvJt86s4_IORPfSXmYnDYMeB-vUgPaPsWJkcOSJ4mH2pXx-lWieDmBKIJTyHZlLUN-qP71bwldVOvWyziMZPRroMKOuiE54MqqzAtDo3AQfKxvifQ8t-ZHydgvMFu0/s1600/New+Picture+%25281%2529.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 160px; height: 128px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj6NlNeMF1cZ4BVRCvJt86s4_IORPfSXmYnDYMeB-vUgPaPsWJkcOSJ4mH2pXx-lWieDmBKIJTyHZlLUN-qP71bwldVOvWyziMZPRroMKOuiE54MqqzAtDo3AQfKxvifQ8t-ZHydgvMFu0/s400/New+Picture+%25281%2529.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5556462805813378274" /></a><div><p class="MsoNormal">Thromboangiitis Obliterans is a rare disease that causes occlusion of the arteries in the hands and feet.<span style="mso-spacerun:yes"> </span>It almost always affects men aged 20-40 with a history of cigarettes smoking or other tobacco use.<span style="mso-spacerun:yes"> </span>It was first described by Von Winiwarter in 1879 in a patient with the affliction.<span style="mso-spacerun:yes"> </span>It was later described by Leo Buerger, who documented and provided a full description of the disease.<span style="mso-spacerun:yes"> </span>For this reason, it is commonly referred to as Buerger’s Disease.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">The disease is caused by an inflammation of the blood vessels, particularly those of the hands and feet.<span style="mso-spacerun:yes"> </span>When the vessels become totally occluded, a lack of blood flow to the affected area occurs.<span style="mso-spacerun:yes"> </span>This can cause an immense amount of pain, and can lead to gangrene and ulcerations of the fingertips and/or toes.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">In those with thromboangiitis obliterans, symptoms may include cold hands or feet, with the extremity appearing pale, red, or blue.<span style="mso-spacerun:yes"> </span>Symptoms most commonly affect two or more extremities, but may also affect only one.<span style="mso-spacerun:yes"> </span>There is usually pain in the affected limb, which may range from burning or tingling at rest to acute, severe pain.<span style="mso-spacerun:yes"> </span>Symptoms are usually worsened by stress or cold.<span style="mso-spacerun:yes"> </span>Thromboangiitis Obliterans is commonly seen in association with Raynaud’s Disease.<span style="mso-spacerun:yes"> </span>The incidence is quite low, affecting approximately 6 in 10,000 people.<span style="mso-spacerun:yes"> </span><o:p></o:p></p> <p class="MsoNormal"><o:p> </o:p></p> <p class="MsoNormal">Treatment for thromboangiitis obliterans revolves around symptoms, as there is no cure for the disease.<span style="mso-spacerun:yes"> </span>Increasing blood flow to the area may be achieved with vasodilators such as oral medications or nitroglycerin patches.<span style="mso-spacerun:yes"> </span>Adding warmth and gently exercising the area can also increase blood flow.</p> <p class="MsoNormal">Prevention of thromboangiitis obliterans is key to treatment.<span style="mso-spacerun:yes"> </span>Quitting smoking and the use of tobacco products can prevent occlusions all together in many patients.<span style="mso-spacerun:yes"> </span>Removing stress and avoiding the cold can also help.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">The most serious complication of thromboangiitis obliterans is gangrene.<span style="mso-spacerun:yes"> </span>The lack of blood flow to the hands and/or feet can cause the tissue to become gangrenous and die.<span style="mso-spacerun:yes"> </span>If not cared for properly, this tissue can lead to serious infections, and possibly sepsis and death.<span style="mso-spacerun:yes"> </span>Therefore, it is essential that thromboangiitis obliterans be cared for aggressively by the treating physician.<span style="mso-spacerun:yes"> </span><o:p></o:p></p></div><div><br /></div><b>Central Florida Foot & Ankle Center, LLC</b><div><b>101 6th Street N.W.</b></div><div><b>Winter Haven, FL 33881</b></div><div><b>Phone: 863-299-4551</b></div><div><b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b></div>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-9347323836540681702010-10-27T10:23:00.006-04:002010-10-27T10:41:52.718-04:00Surgery for Lateral Ankle Stabilization<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhI8tWRKAd7Nm1vU5pVo2zI5A6s2rwx_buG0kI51uN-qTYcDoMdj6OiOofJ1FjDTc9LPTcYhlbAw6eM-qmnS_airSMcydbZ5H6FiIrylKWj6ZPxypZy9kTRoVuOCje7HUtPO63ikZsTkJo/s1600/New+Picture+(11).jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 400px; height: 331px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhI8tWRKAd7Nm1vU5pVo2zI5A6s2rwx_buG0kI51uN-qTYcDoMdj6OiOofJ1FjDTc9LPTcYhlbAw6eM-qmnS_airSMcydbZ5H6FiIrylKWj6ZPxypZy9kTRoVuOCje7HUtPO63ikZsTkJo/s400/New+Picture+(11).jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5532735046638708434" /></a><div><p class="MsoNormal"><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br /><br />Chronic ankle sprains are a problem that plagues many individuals.<span style="mso-spacerun:yes"> </span>Once the ligaments of the ankle have been compromised, they are subject to repeat injury.<span style="mso-spacerun:yes"> </span>A person with chronic ankle sprains will often report an initial injury, possibly one that was never treated.<span style="mso-spacerun:yes"> </span>There is usually constant swelling and pain at the ankle, and a feeling of instability, as if the ankle might give out at any time.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Chronic ankle instability can develop from damage to the nerve endings in the ligaments responsible for proprioception.<span style="mso-spacerun:yes"> </span>Proprioception is the body’s ability to know where a particular part lies in space.<span style="mso-spacerun:yes"> </span>Repetitive or chronic injury to the ankle ligaments can damage the proprioceptors<span style="mso-spacerun:yes"> </span>in the ankle, leading to that feeling of instability.<span style="mso-spacerun:yes"> </span>A person with chronic ankle injuries may also have attenuated, stretched out, and weakened ligaments, particularly of the lateral ankle.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Most commonly, the ligament that is damaged is the anterior talo-fibular ligament, or the ATFL.<span style="mso-spacerun:yes"> </span>The calcaneofibular ligament (CFL) or posterior talo-fibular ligament (PTFL) may also be involved, as well as the extensor retinaculum, peroneal tendons, or the joints in the area such as the calcaneocuboid, tarso-metatarsal joints, subtalar joint, or the ankle joint itself.<span style="mso-spacerun:yes"> </span>In high ankle sprains, the tibiofibular syndesmosis may also be injured.</p> <p class="MsoNormal">Conservative care for chronic ankle injury revolves around protecting the ankle with high-top shoes or braces.<span style="mso-spacerun:yes"> </span>These devices may work well in some individuals, but fail to offer enough support in others.<span style="mso-spacerun:yes"> </span>In particular, high-performance athletes may be candidates for surgical repair of the ligaments if and when conservative therapy fails.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Surgery for lateral ankle instability focuses on reconstructing the lateral ankle and adding stability to the joint.<span style="mso-spacerun:yes"> </span>There are a number of different techniques to do this.<span style="mso-spacerun:yes"> </span>Most frequently, cases of chronic ankle instability are due to injury of the ATFL, or a combination of the ATFL and CFL.<span style="mso-spacerun:yes"> </span>Depending on the extent of the injury, various procedures may serve to reconstruct and/or repair these ligaments.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Several procedures exist that use the peroneus brevis tendon, the extensor retinaculum, or both to reconstruct the ATFL and/or the CFL.<span style="mso-spacerun:yes"> </span>These procedures may involve drilling a small hole in the tip of the fibula or the talus, and re-routing the tendon through the holes.<span style="mso-spacerun:yes"> </span>When done correctly, this can add significant stability to the ankle joint.</p> <p class="MsoNormal">Another technique involves using soft tissue from another part of the body, such as the tensor fascia lata in the hip and thigh, as a graft to reconstruct the ligaments.<span style="mso-spacerun:yes"> </span>Cadaveric grafts or synthetic materials may also be used.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Many variables play into the decision-making of the surgeon and patient.<span style="mso-spacerun:yes"> </span>The goals of the patient and the surgeon should be clearly communicated, as well as possible complications of the surgery and shortfalls that may exist.<span style="mso-spacerun:yes"> </span>Lateral ankle reconstruction may not be an option for some patients, such as those with systemic conditions that may complicate the surgery or postpone healing.<span style="mso-spacerun:yes"> </span>A thorough discussion should be had with a foot and ankle surgeon to assess the situation.</p></div><div><br /></div><b>Central Florida Foot & Ankle Center, LLC</b><div><b>101 6th Street N.W.</b></div><div><b>Winter Haven, FL 33881</b></div><div><b>Phone: 863-299-4551</b></div><div><b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b></div>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-58673649488716080762010-09-03T16:38:00.004-04:002010-09-03T16:46:11.069-04:00What is Gout?<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYeXVpulmHeDC5ySHiMyw6W8Jqdt8tByt3R33ffpriHnpUkV8LXaBK8dG0gAMNO5-HiwOKAWBKUn5k16xXHPEO2F6MnuPtyiIaeEqJ9FgXX2Qi7EsaZr6CqAnxlzXFh_ZE4XwsIsviKos/s1600/gout.jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 160px; height: 155px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiYeXVpulmHeDC5ySHiMyw6W8Jqdt8tByt3R33ffpriHnpUkV8LXaBK8dG0gAMNO5-HiwOKAWBKUn5k16xXHPEO2F6MnuPtyiIaeEqJ9FgXX2Qi7EsaZr6CqAnxlzXFh_ZE4XwsIsviKos/s400/gout.jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5512791358848169618" /></a><div><p style="margin-bottom: 0in">Gout is a form of arthritis, characterized by an acute onset of extreme pain. Gout attacks most commonly occur in the foot and ankle, in particular at the first metatarsophalangeal joint, the joint that connects the great toe to the foot. Gout also appears in the ankle, and can theoretically occur in any joint of the foot.</p> <p style="margin-bottom: 0in">During an acute attack, the affected joint will appear red and swollen, and it will be hot to touch. It will also be extremely painful to touch. The simple touch of a bed sheet or even a slight breeze can cause an immense amount of pain. Evaluation by a doctor will be used to rule out other possibilities such as a fracture, infection, or other forms of arthritis. X-rays may be taken to visualize the effected joint as well. There are generally not any changes seen on x-ray with the first gout attack, but distinct changes may be seen with repetitive attacks. These changes include bony erosions seen around the joint, with the appearance of bone that has been chewed away. This is referred to as Martel’s sign.</p> <p style="margin-bottom: 0in">An excess of uric acid in the body causes a gout attack. Uric acid is a byproduct of many foods; in particular it found in high quantity in red meats, lobster, and beer. Because of its association with overindulgence of rich foods, it has been historically referred to as “the disease of kings”. The high volume of uric acid crystallizes at the level of the joints, causing a <i>tophus</i> to form. The crystallization most commonly happens overnight. Some believe that this is due to a drop in body temperature, particularly in the feet, while sleeping.</p> <p style="margin-bottom: 0in">A high level of uric acid in the body is a condition known as <i>hyperuricemia</i>. The excessive uric acid may come from several different sources. It may be dietary, as in the overconsumption of red meat, beer, and seafood. Hyperuricemia may also be associated with diabetes mellitus, hypertension, psoriasis, or congenital conditions such as Lesch-Nyhan syndrome. Excessive uric acid levels can also be caused by the use of some diuretics, particularly during their early use.</p> <p style="margin-bottom: 0in">The treatment of gout is twofold; it must address both the acute painful phase as well as controlling the hyperuricemia. Initially, patients may be given colchicine or indomethacin to alleviate pain. After the acute attack has subsided, the underlying hyperuricemia may be addressed with allopurinol a drug that blocks the enzyme that creates uric acid in the body. </p></div><div><br /></div><b>Central Florida Foot & Ankle Center, LLC</b><div><b>101 6th Street N.W.</b></div><div><b>Winter Haven, FL 33881</b></div><div><b>Phone: 863-299-4551</b></div><div><b>www.FLFootandAnkle.com</b></div>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-7085179239692326222010-08-02T11:52:00.005-04:002010-08-02T12:22:00.123-04:00Staying Hydrated While Running<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsTBO7s6gYkvr1XdkseEW-CmUVrWkoV70-5TGYI26ZILnyWvtzu2rVLZnlyWNZOiq56PQ891_T7tPIqHn9O9WmOVCdCYNCTdFzv62550wJFK89d6VrHzBGby4nWh2MtLNv_RU41uBEtgI/s1600/New+Picture+(4).jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 129px; height: 160px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsTBO7s6gYkvr1XdkseEW-CmUVrWkoV70-5TGYI26ZILnyWvtzu2rVLZnlyWNZOiq56PQ891_T7tPIqHn9O9WmOVCdCYNCTdFzv62550wJFK89d6VrHzBGby4nWh2MtLNv_RU41uBEtgI/s400/New+Picture+(4).jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5500845949644587202" /></a><div><p class="MsoNormal">As the dog days of summer roll by, the heat index stays high while the training period continues.<span style="mso-spacerun:yes"> </span>Whether you’re training for that fall marathon, or simply enjoy running outside, it is important to remain hydrated.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Depending on your type of workout, there are a number of options for hydration.<span style="mso-spacerun:yes"> </span>Water is the obvious choice, but sports drinks are numerous and heavily marketed to the athlete and casual exerciser alike.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Most sports drinks have added carbohydrates and electrolytes to help with rehydration.<span style="mso-spacerun:yes"> </span>The carbohydrates allow for added energy for your body as you are working out.<span style="mso-spacerun:yes"> </span>The electrolytes sodium and potassium are added to help maintain fluid retention in the body, as well as key functions of muscles.<span style="mso-spacerun:yes"> </span>For runners that are running for more than 30 minutes at a time, sports drinks are a good option to remain hydrated. </p> <p class="MsoNormal">For longer distances, especially for those training for a marathon that may be running for several hours straight, there are more advanced sports drinks available.<span style="mso-spacerun:yes"> </span>These drinks contain more complex carbohydrates that won’t breakdown as quickly, as well as protein for more sustained energy.<span style="mso-spacerun:yes"> </span>They too have plenty of electrolytes to keep the athlete hydrated.</p> <p class="MsoNormal">Enhanced and flavored waters offer vitamins and minerals in a sweetened package, but are usually not formulated for athletic hydration.<span style="mso-spacerun:yes"> </span>They are, however, a good alternative to water for those with an aversion to the natural stuff.<span style="mso-spacerun:yes"> </span>For workouts that last less than thirty minutes, water or an enhanced water are good choices.</p> <p class="MsoNormal">A common mistake made by runners in the heat is to over-hydrate.<span style="mso-spacerun:yes"> </span>Drinking too much water can make you sluggish and lethargic, and seriously slow down your pace.<span style="mso-spacerun:yes"> </span>A good way to avoid this is to drink two cups of liquids two hours before exercising.<span style="mso-spacerun:yes"> </span>This ensures that you are hydrated to begin with.<span style="mso-spacerun:yes"> </span>Once the workout starts, it’s important to take sips of water/sports drink every fifteen minutes or so.<span style="mso-spacerun:yes"> </span></p></div><div><br /></div><span class="Apple-style-span" style="color:#3333FF;">C</span><b><span class="Apple-style-span" style="color:#3333FF;">entral Florida Foot & Ankle Center, LLC</span></b><div><b><span class="Apple-style-span" style="color:#3333FF;">101 6th Street N.W.</span></b></div><div><b><span class="Apple-style-span" style="color:#3333FF;">Winter Haven, FL 33881</span></b></div><div><b><span class="Apple-style-span" style="color:#3333FF;">Phone: 863-299-4551</span></b></div><div><b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b></div>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-80635453174469070192010-06-28T10:12:00.004-04:002010-06-28T10:17:57.685-04:00Ultrasound Imaging in Podiatry<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_bY7O4aOfVKuyGybQcECnshhzFosy9LwlF6mu_Jf_5Johzc4OYtnIF5GSN40fnyd-XeTgy_EInum-9X6aKwhJta_rByTjlM3n_4S9T1m0oCgBgAa-3ddvhx-GYcmNlgeTZ7apwDfoiXw/s1600/New+Picture+(24).png"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 265px; height: 196px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi_bY7O4aOfVKuyGybQcECnshhzFosy9LwlF6mu_Jf_5Johzc4OYtnIF5GSN40fnyd-XeTgy_EInum-9X6aKwhJta_rByTjlM3n_4S9T1m0oCgBgAa-3ddvhx-GYcmNlgeTZ7apwDfoiXw/s400/New+Picture+(24).png" border="0" alt="" id="BLOGGER_PHOTO_ID_5487828089238712674" /></a><div><p class="MsoNormal">Ultrasound technology has been used for many years in the medical community, particularly for imaging studies.<span style="mso-spacerun:yes"> </span>For the past fifty years or so, ultrasound imaging has been used extensively in obstetrics to view the fetus. <span style="mso-spacerun:yes"> </span>This technology has given obstetricians the ability to diagnose congenital abnormalities that may pose a risk to the mother or the child, and to obtain the viability of the fetus.<span style="mso-spacerun:yes"> </span>While many may be familiar with this application of ultrasound, few are familiar with the wide range of imaging studies that can be performed with ultrasound technology.</p> <p class="MsoNormal">Ultrasound imaging, or sonography, has a particularly useful application in podiatry.<span style="mso-spacerun:yes"> </span>The ability for ultrasound to be used to image soft tissues such as tendons, ligaments, and muscles makes it a valuable diagnostic tool.<span style="mso-spacerun:yes"> </span>Some of the more common applications of ultrasound imaging in podiatry include imaging tendons and ligaments to diagnose ruptures and tears, evaluating the extent of plantar fasciitis, and evaluating soft tissue abnormalities such as ganglion cysts and neuromas.</p> <p class="MsoNormal">The technology can also be used to help with injections, as it gives a clear picture of exactly what structures a doctor is injecting medications into.<span style="mso-spacerun:yes"> </span>In some cases of plantar fasciitis, for example, a patient may benefit from an injection of cortisone into the area below the plantar fascia.<span style="mso-spacerun:yes"> </span>Ultrasound imaging allows for a guided injection, so that the medication can be placed in exactly the right area to treat the problem.<span style="mso-spacerun:yes"> </span> </p> <p class="MsoNormal">Ultrasound works by sending out sound waves at a frequency that is inaudible to the human ear.<span style="mso-spacerun:yes"> </span>These sound waves reflect off of the structures within the body, with different densities of tissue reflecting back different amounts of ultrasound waves.<span style="mso-spacerun:yes"> </span>This allows for a differentiation of the structures, which is then converted into an image on the screen attached to the system.<span style="mso-spacerun:yes"> </span>This technology is also used outside of medicine as SONAR technology, particularly in the sea when measuring the distance between two points.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Ultrasound has been shown to be a safe and effective tool in medicine.<span style="mso-spacerun:yes"> </span>Because there is no ionizing radiation involved, such as that from X-rays or CT scans, it is considered to be a very safe test.<span style="mso-spacerun:yes"> </span>It is also a relatively simple and quick test, which can be used to evaluate soft tissue disorders in the office.<span style="mso-spacerun:yes"> </span>When comparing it to magnetic resonance imaging (MRI), it is much quicker, and also much less expensive.<span style="mso-spacerun:yes"> </span>While it may not be able to produce the high quality images of an MRI, the use of ultrasound technology in evaluating soft tissues is clearly quite valuable.</p></div><div><br /></div><b><span class="Apple-style-span" style="color:#000099;">Central Florida Foot & Ankle Center, LLC</span></b><div><b><span class="Apple-style-span" style="color:#000099;">101 6th Street N.W.</span></b></div><div><b><span class="Apple-style-span" style="color:#000099;">Winter Haven, FL 33881</span></b></div><div><b><span class="Apple-style-span" style="color:#000099;">Phone: 863-299-4551</span></b></div><div><b><a href="http://www.flfootandankle.com/">www.FLFootandAnkle.com</a></b></div>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-78693848322631248632010-05-20T11:32:00.004-04:002010-05-20T11:44:45.305-04:00Hallux Limitus and Hallux Rigidus<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_HxxInVEZG54DDkp3GqFvRfTfExcfIpW2VSZP8ZOlh-VoZzQKxAo5JkM0ptkBVYt38VTTgD5JnR_21oAYaW3m0wW-AJuowaXqJwCW2FElaISzSWyzJoKQGJcXNdKc8sM8-tI9_PYKP2g/s1600/New+Picture+(17).png"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 265px; height: 199px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg_HxxInVEZG54DDkp3GqFvRfTfExcfIpW2VSZP8ZOlh-VoZzQKxAo5JkM0ptkBVYt38VTTgD5JnR_21oAYaW3m0wW-AJuowaXqJwCW2FElaISzSWyzJoKQGJcXNdKc8sM8-tI9_PYKP2g/s400/New+Picture+(17).png" border="0" alt="" id="BLOGGER_PHOTO_ID_5473378101316741266" /></a><div><p class="MsoNormal"><span><span class="Apple-style-span" style="font-size: medium;">Hallux limitus and hallux rigidus are two terms that are used to describe the progressive loss of motion that is seen in the first metatarsophalangeal joint.</span><span><span class="Apple-style-span" style="font-size: medium;"> </span></span><span class="Apple-style-span" style="font-size: medium;">For normal function of the big toe, a range of motion of between 50 and 90 degrees is required.</span><span><span class="Apple-style-span" style="font-size: medium;"> </span></span><span class="Apple-style-span" style="font-size: medium;">In hallux limitus, the range of motion is decreased.</span><span><span class="Apple-style-span" style="font-size: medium;"> </span></span><span class="Apple-style-span" style="font-size: medium;">In hallux rigidus, there is little to no motion at all at the first metatarsophalangeal (MTP) joint.</span><span style="mso-spacerun:yes"> </span></span></p> <p class="MsoNormal">The first MTP joint plays a critical role in normal gait.<span style="mso-spacerun:yes"> </span>It is the area of greatest propulsion during the gait cycle, and plays a large role in balance.<span style="mso-spacerun:yes"> </span>When the range of motion at the first MTP joint (located at the base of the big toe) is lost, significant secondary symptoms can occur, such as calluses across the bottoms of the feet.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Hallux limitus (and later, hallux rigidus) is a specific form of osteoarthritis localized to the first MTP joint.<span style="mso-spacerun:yes"> </span>Therefore, the signs and symptoms are similar to that of common arthritis.<span style="mso-spacerun:yes"> </span>This includes pain and stiffness in the joint when it is pushed upwards, such as when walking, running and squatting.<span style="mso-spacerun:yes"> </span>Swelling and inflammation may be seen as well, particularly on the top of the foot around the joint.<span style="mso-spacerun:yes"> </span>In particular, damp and cold weather may make the symptoms worse.</p> <p class="MsoNormal">Later findings that are consistent with hallux <i style="mso-bidi-font-style:normal">rigidus</i> include continuous pain in the joint, even when at rest.<span style="mso-spacerun:yes"> </span>A person with hallux rigidus may have a visual bump on the top of their foot over the joint.<span style="mso-spacerun:yes"> </span>This bump is actually a bone growth known as an osteophyte that can be seen on x-ray, and is common in osteoarthritis.<span style="mso-spacerun:yes"> </span>Another common complaint is difficulty wearing shoes, particularly shoes that are tight in the toes, such as high heels.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">When the joint becomes too painful to walk on, a limp may be apparent.<span style="mso-spacerun:yes"> </span>The attempt to keep weight off the joint can lead to problems with other areas of the foot that are not meant to bear the weight that the big toe is designed for.<span style="mso-spacerun:yes"> </span>Knee, hip, back and neck pain are also common conditions associated with hallux limitus and hallux rigidus.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Hallux limitus and hallux rigidus can be treated by either conservative or aggressive treatments, or a combination of both.<span style="mso-spacerun:yes"> </span>Conservative treatment relies on stabilizing the foot, taking weight off of the big toe, and alleviating some of the pain associated with the condition.<span style="mso-spacerun:yes"> </span>Stabilization of the foot is often achieved with a custom orthotic device or other form of padding.<span style="mso-spacerun:yes"> </span>Symptoms may be alleviated with anti-inflammatory medications (NSAIDs), icing, rest, and padding.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">More aggressive treatment is focused on the surgical management of hallux limitus/rigidus.<span style="mso-spacerun:yes"> </span>The joint can commonly be fused, which takes away motion at the joint and alleviates the pain associated with the motion.<span style="mso-spacerun:yes"> </span>Another option may be to use an implant, which can bring motion back to the joint.<span style="mso-spacerun:yes"> </span>There are a number of different factors that go into the surgical decision making, so talk to your doctor about the options.<span style="mso-spacerun:yes"> </span></p></div><div><br /></div><span class="Apple-style-span" style="color:#000099;"><b>Central Florida Foot & Ankle Center, LLC<br />101 6th Street N.W.Winter Haven, FL 33881<br />Phone: 863-299-4551<br /></b><a href="http://www.flfootandankle.com/"><b>www.FLFootandAnkle.com</b></a></span>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-46810106472197453472010-02-02T12:23:00.005-05:002010-02-02T12:30:51.375-05:00Hyperbaric Oxygen Chambers<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8uY5BiuuWv0_E8YKHVrayqlwCurS0nOtp5GaHBc6e4oaOuTvhQnIfHtZw4ZwLTq9suR05Cw6qJgwNddE4jprLCr2AIA969Gm3fWIhDZJ5LmN0VMWumIiQWneJ33uBIRKvQmqzq4i5esc/s1600-h/New+Picture+(7).jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 160px; height: 117px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8uY5BiuuWv0_E8YKHVrayqlwCurS0nOtp5GaHBc6e4oaOuTvhQnIfHtZw4ZwLTq9suR05Cw6qJgwNddE4jprLCr2AIA969Gm3fWIhDZJ5LmN0VMWumIiQWneJ33uBIRKvQmqzq4i5esc/s400/New+Picture+(7).jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5433699116625027234" /></a><div><p class="MsoNormal">Hyperbaric oxygen chambers can be very useful tools in treating difficult-to-heal wounds.<span style="mso-spacerun:yes"> </span>Ever wonder how they work?</p> <p class="MsoNormal">In order to really understand what is happening in a hyperbaric oxygen chamber, you’ll have to understand a little bit of how oxygen is transported through the body.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">All of the tissues in your body, from your skin to your muscles and bones, require oxygen.<span style="mso-spacerun:yes"> </span>It’s easy to think of it as your body needing to breathe.<span style="mso-spacerun:yes"> </span>In order to get oxygen to every tissue in your body, we must breathe in oxygen from the outside air into our lungs.<span style="mso-spacerun:yes"> </span>This oxygen gets bound to hemoglobin, a protein found in the red blood cells.<span style="mso-spacerun:yes"> </span>The red blood cells, now carrying oxygen, can transport that oxygen through the blood and to all of the tissues in your body.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">Normal atmospheric pressure at sea level is measured as 1 atm.<span style="mso-spacerun:yes"> </span>If we go up to the top of a mountain, the atmospheric pressure decreases; at the bottom of the ocean, the pressure will increase. At normal atmospheric pressure, it is only possible to transport a certain amount of oxygen through the body attached to hemoglobin.<span style="mso-spacerun:yes"> </span></p> <p class="MsoNormal">If we increase the pressure at which we are breathing, however, it is possible to increase the amount of oxygen transported through the blood.<span style="mso-spacerun:yes"> </span>In a hyperbaric oxygen chamber, the pressure is increased to 2 atm, or double the pressure at sea level.<span style="mso-spacerun:yes"> </span>This allows for us to actually breathe in more oxygen than we would in the outside environment.<span style="mso-spacerun:yes"> </span>The extra oxygen is actually dissolved into the plasma of the blood, making it possible to transport even more oxygen through the body.<span style="mso-spacerun:yes"> </span>Before, we could only transport as much as the red blood cells could hold with hemoglobin.</p> <p class="MsoNormal">Once there is an increase in oxygen in the blood due to it being dissolved into solution at higher pressures, the extra oxygen can drive the biochemical processes of wound healing.<span style="mso-spacerun:yes"> </span>Different proteins in the body rely on oxygen to regenerate – if we increase the amount of oxygen available, we can increase the time it takes for the wounds to heal.</p> <p class="MsoNormal">This idea of increased healing is especially important in patients with diabetes or peripheral vascular disease, two conditions that will slow the healing process.</p> <p class="MsoNormal">Keep in mind that the only way to use hyperbaric oxygen is to breathe it in through the air.<span style="mso-spacerun:yes"> </span>There are some products that are marketed as devices that will surround a wound with high-pressure oxygen, such as something that is wrapped around the leg.<span style="mso-spacerun:yes"> </span>These products do not work in the same way, as none of the oxygen is actually being breathed in.<span style="mso-spacerun:yes"> </span>In a true hyperbaric oxygen chamber, the patient will lie down completely enclosed in a tube.<span style="mso-spacerun:yes"> </span></p></div><div><br /></div><b><span class="Apple-style-span" style="color:#3333FF;">Central Florida Foot & Ankle Center, LLC<br />101 6th Street N.W.<br />Winter Haven, FL 33881<br />Phone: 863-299-4551</span><br /><a href="http://www.flfootandankle.com/">http://www.FLFootandAnkle.com</a></b>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0tag:blogger.com,1999:blog-9216740921622344465.post-48822664862923527912009-11-23T10:07:00.005-05:002010-02-02T12:30:38.528-05:00<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVIBouu6hajLmfIyiIAhdnJADH4OifzIwyWU9Z6YkuX7RnJZJ7eiFpzhNE_Kg51yz6NRDGARwOCom31j40UFsaXowCuMgcrwxbCVygtyQg-8b4xvPnRsSbXQArq2LimLpeK_JuFQDrmzY/s1600/New+Picture+(9).jpg"><img style="float:left; margin:0 10px 10px 0;cursor:pointer; cursor:hand;width: 143px; height: 160px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjVIBouu6hajLmfIyiIAhdnJADH4OifzIwyWU9Z6YkuX7RnJZJ7eiFpzhNE_Kg51yz6NRDGARwOCom31j40UFsaXowCuMgcrwxbCVygtyQg-8b4xvPnRsSbXQArq2LimLpeK_JuFQDrmzY/s400/New+Picture+(9).jpg" border="0" alt="" id="BLOGGER_PHOTO_ID_5407316993838205666" /></a><div><p class="MsoNormal"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">With cold weather approaching, it’s important to learn how to protect yourself from the bite of cold! Whether you know it or not, your skin is the largest bodily organ and comprises 15% of your total body weight!</span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">Your skin works to protect your body from a host of environmental assaults, but trauma in the form of hot or cold injury can compromise its protective properties.</span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">A cold injury, such as frostbite can cause fluid loss within the skin and increase its breakdown and the likelihood of infection.</span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">Although frostbite is used as a general term to cover all sorts of cold injuries, there are actually different and specific types of cold injury with frostbite being just one of them. The non-freezing types of cold injury are chilblains and immersion injury (trench foot). The freezing types of cold injury are frostnip, superficial frostbite and deep frostbite.</span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span></span></p> <p class="MsoNormal"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">Chillblains</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">The mildest form of cold injury is called chilblains and is the most commonly experienced. It occurs when bare skin is exposed to temperatures of 33 – 60 Fahrenheit.</span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">The typical places for chilblains to occur are the ears, fingers and the tip of your nose.</span><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">The best way to treat chilblains is prevention: avoiding the cold and protecting prone areas. Make sure to cover yourself adequately before going out! If chilblains do occur, the best way to treat it is via rapid rewarming and the application of moisturizers.</span></span></p> <p class="MsoNormal"><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">Immersion Injury</span></span><span style="font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"> </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span style="font-family:Arial;"><span><span class="Apple-style-span" style="font-size:medium;"> </span></span><span class="Apple-style-span" style="font-size:medium;">Immersion injury is also known as trench foot because in World War I, many soldiers who fought in the trenches experienced this type of cold injury. Unlike other cold injuries that are associated with cold air, immersion injury has to do with cold water. Cold water leads to much rapid heat loss than cold air by about 25-fold! As a result of the water penetrating the skin, trench foot can occur at much higher temperatures than the cold you may associate with frostbite. As a result of prolonged skin exposure to water in cold weather, your foot may look dusky and blue with swelling or blister formation. The best way to treat the affected area is to rewarm and dress the area with dry materials.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p></div><div><p class="MsoNormal" style="text-indent:.5in"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">Winter time conjures up memories of snow angels, snowball fights and snow men! However, care must be taken to prevent cold injuries as a result of prolonged exposure to the weather. Skin injuries due to the cold are due to ice crystal formation in the tissue. To prevent crystal formation from occurring in the vital tissues of your body such as your brain and heart, blood gets diverted from your extremities (arms and legs) into the core (trunk and head). The process of redirecting blood flow to more vital structures is called arteriolar shunting.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="text-indent:.5in"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">The process of transferring blood to the inner most aspect of your body means that your extremities are more prone to dying off with increased exposure to cold. In essence, your body sacrifices your limbs in order to keep its vital functions going. Without blood keeping the area supplied with oxygen, nutrients and warmth – it is easy to see why areas furthest away from the head and heart are most affected by the cold.</span></span></p> <p class="MsoNormal"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">Frostnip</span></span><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="text-indent:.5in"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">Frostnip is a freezing type of cold injury where reversible ice crystal formation occurs. This is the mildest form of frostbite and the nose, ears and extremities are the most likely areas to encounter it. When frostnip occurs your affected areas will become white and have a decreased sensation. Rapid rewarming in water over the boiling point (104-108) is the best way to rescue those areas from further damage. The reasons for the use of very hot water is to shorten the frozen state, increase the local blood flow to the area and decrease the time cells are exposed to ions in the blood.</span></span></p> <p class="MsoNormal"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">Superficial Frostbite</span></span><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"> Extended exposure to the elements can turn a condition of frostnip into superficial frostbite! In this case, the cold has penetrated the area of skin and its underlying subcutaneous tissue. There are a variety of signs that indicate superficial frostbite has occurred: itching/burning that is lateral replaced by ache, swelling, cyanosis (blueness), excessive perspiration, and coldness of injured parts that occurs 2-3 weeks after the injury and lasts for many months! The cold did not kill off the nerves in the affected area so there is significant pain. </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"> With winter time upon us, it is important to discuss safety measures and treatment tips if you should encounter a cold injury. Cold injuries can be likened to burn injuries in that the trauma caused to the skin is very similar. In addition, frostbite is graded in stages just like a burn injury.</span></span></p> <p class="MsoNormal"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">Deep Frostbite</span></span><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"> Deep frostbite is the opposite temperature equivalent to a burn injury. Both burns and deep frostbite have degrees of severity and the greater the degree of burn, the more injury a particular area has sustained.</span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">First degree and second degree cold injuries are actually classified as superficial frostbite whereas third degree and fourth degree injuries are of the deep frostbite category. </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;"> First degree frostbite is painful and the affected area looks white with delayed vascular supply to the area. Second degree frostbite leads to big blister formation, burning and tingling sensation, and the area will become hot and dry to touch. After rewarming the area, swelling and burning pain may occur and last for several days. Healing of the areas will occur after 3-4 weeks and pain relievers prescribed by your healthcare professional will help with the pain. </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="text-indent:.5in"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">First and second degree frostbite occurs at the level of the skin and subcutaneous tissues. However, third and fourth degree frostbite (deep frostbite) involves skin and may extend to the bone! </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">Third degree burns are characterized by skin tissue death, blister formation, blue skin and excessive perspiration (hyperhidrosis). Throbbing/shooting pain will occur approximately 2 weeks after the injury due to nerve involvement. The fourth degree burns will involve tendon and bone with similar symptoms. </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">Despite healing, there will be no blood filling the affected areas with rewarming and as a result auto amputation of the area may occur. Auto amputation is basically complete tissue death and the body’s expulsion of that tissue or part! Treatment of deep frostbite requires physician supervision: rapid rewarming needs to occur and hospital admittance is the usual course of action. </span><span class="Apple-style-span" style="font-size:medium;"><o:p></o:p></span></span></p> <p class="MsoNormal" style="text-indent:.5in"><span style=" ;font-family:Arial;"><span class="Apple-style-span" style="font-size:medium;">With any cold injury to your lower extremity, it is important to consult with your podiatrist. They know the best way to evaluate the extent of injury and the resulting treatment. They will be able to prescribe you the appropriate medications to relieve your pain and help facilitate a recovery process. Remember that prevention is the best treatment so bundle up when you go outside into the cold this winter season! </span><o:p></o:p></span></p></div><b><span class="Apple-style-span" style="color:#3333FF;">Central Florida Foot & Ankle Center, LLC<br />101 6th Street N.W.<br />Winter Haven, FL 33881<br />Phone: 863-299-4551</span><br /><a href="http://www.flfootandankle.com/">http://www.FLFootandAnkle.com</a></b>Central Florida Foot and Ankle Centerhttp://www.blogger.com/profile/05989148682451340618noreply@blogger.com0