Advanced Foot & Ankle Specialists office remains open during this time. We are an essential healthcare operation, and it is safer for our patients to see us in our controlled environment than allow their issues to progress to a point where they require treatment at a hospital which may expose them to viral infection. We have taken additional measures to ensure your safety, such as limiting the number of people in our waiting rooms, asking patients and families to wait in their car, and rooming patients immediately. We also plan on implementing a telemedicine service, so please let us know if you are interested. If you are exhibiting any flu-like symptoms, such as nausea or fever, or have questions, please call Advanced Foot & Ankle Specialists at 281-242-3338 to reschedule your appointment. Otherwise, we are open and available to serve you. Thank you for your patience and cooperation as we work through the impact of the coronavirus epidemic. Please contact us at 281-242-3338 with questions or to schedule an appointment.
Bryan Lee, DPM and the Staff at Advanced Foot & Ankle Specialists
Foot bunions are deformities that are characterized by the protrusion of a bony bump at the base of the big toe. Sometimes, bunions can be painful, especially if they’re large enough to rub against the shoe. There’s no cut-and-dry rule regarding an age limit for bunion surgery. Seniors can visit a podiatrist serving the Sugar Land area to find out if the procedure might be right for them.
If the deformity isn’t severe, doesn’t interfere with day-to-day activities, and is manageable with conservative treatments, then surgery isn’t necessary. If surgery could be beneficial, then the podiatrist will consider whether a senior is generally healthy enough to tolerate it. Seniors in particular may be at an increased risk of blood clots, adverse reactions to the anesthesia, poor healing, and an unfavorable outcome. Adding to the complexity of this decision is the fact that many seniors have underlying medical conditions, and they may take multiple medications. These factors don’t automatically disqualify them for surgery, but they can increase the risks.
In some cases, one surgery alone isn’t enough to fix a foot or ankle problem. It’s possible that the original surgeon made mistakes, or that the medical condition recurred after the surgery. One example is when complications occur with foot surgical hardware. A podiatrist in Sugar Land may need to remove surgical plates, screws, or rods because of these complications. During this revision surgery, the foot surgeon may also correct other anatomical problems.
Podiatrists differ in opinion as to whether surgical hardware should be routinely removed, even when it isn’t causing any problems. Once the area has healed, and the hardware has fulfilled its function, there’s no need for it to remain. Some foot specialists prefer to remove it preemptively before it potentially causes complications. Others prefer to leave surgical hardware in place, due to the risks inherent with subsequent surgery.
It isn’t possible for the surgical hardware itself to get an infection, as it isn’t living tissue. However, hardware can sometimes accumulate bacteria. It can then infect nearby bone or soft tissue. A post-surgical infection is more common among patients with the following risk factors:
- Intravenous drug use
- Immunocompromised due to medications or medical conditions
- The septic joint near the implanted hardware
- Hardware that partially exits the skin (pins or Kirschner wires)
Infections at the surgical site are one reason why a foot doctor would remove the hardware. During the revision surgery, debridement to remove the infection may be necessary.
Atypical Immune Response
Some patients are sensitive to certain metals, such as nickel, cobalt, and chromium. It’s possible to have an adverse immune response to surgically implanted hardware. It’s uncommon, but possible for metal hypersensitivities and allergies to result in the breakdown of bone tissue and the loosening of the hardware.
In some cases, revision surgery to remove the hardware is necessary because the original procedure failed to correct the problem. “Non-union” is the medical term for the incomplete healing of the bone after surgery. During the revision surgery, the podiatrist may need to stabilize the area further, such as by using bone grafts or different surgical hardware.
Patients with diabetes should have a foot specialist on their care team. You’ll learn why when you watch this featured video. It explains that podiatrists in Sugar Land often treat patients with diabetes who sustained foot injuries without realizing it. This is because diabetic neuropathy, or nerve damage, can dull sensation in the foot to the point at which it isn’t possible to sense an injury. Additionally, diabetes inhibits blood circulation, and a constant supply of oxygenated, nutrient-rich blood is necessary for wounds to heal.
Without proper treatment, even a minor wound on the foot can quickly become infected. The infection can spread, the wound can become worse, and eventually, the patient may need to have the toe or foot amputated. By seeing a foot doctor for specialized care, patients with diabetes can avoid these problems, or treat them in time to prevent permanent disability.
Morton’s toe gets its name from the first orthopedic surgeon to officially describe the condition—Dudley Morton. If your second toe is longer than your big toe, then you have Morton’s toe . Usually, this congenital condition doesn’t cause any problems. If yours does, a foot specialist in Sugar Land can give you the expert guidance you need. Podiatrists tend to recommend nonsurgical treatment options before considering surgery.
Understanding Morton’s Toe
Your foot has five long bones that connect each toe to the midfoot. These bones are called metatarsals. Your big toe is connected to the first metatarsal, and your second toe is connected to the second metatarsal, and so on. Morton’s toe doesn’t involve an anatomical abnormality with the second metatarsal, but rather with the first. If the first metatarsal is shorter than usual, then the big toe will be shorter—consequently, the second toe looks longer than it should be.
Identifying Possible Complications
Many people with Morton’s toe never see a foot doctor for this condition, as it doesn’t always cause symptoms. In severe cases, Morton’s toe can cause changes in the way a person walks. This imbalance results in excess pressure placed on the second toe or the ball of the foot. The complications that can occur from changes in gait can range from calluses and corns to hammertoes. Hammertoes are characterized by the bent position of the toes. Initially, it’s possible to stretch out hammertoes. Over time, the muscles tighten to the point at which they cannot be manually flexed. If hammertoes become permanent, corrective surgery may be needed.
Trying Nonsurgical Treatment Options
Most patients with Morton’s toe will do well with a change in footwear. Foot doctors recommend wearing comfortable shoes that feature a wide, deep toe box. This will give the toes plenty of space. You may also need metatarsal pads, or custom orthotic inserts to achieve proper foot alignment.
Exploring Surgical Correction
If Morton’s toe is causing significant problems, and a change in footwear isn’t enough, a foot surgeon may perform a surgery that involves shortening the second metatarsal bone. This is an outpatient surgery, during which the doctor will excise a small portion of the bone, and then use surgical hardware to hold the ends of the bone together as they heal.
After you have undergone bunion surgery in Sugar Land , it’s normal to be anxious to determine if the procedure was effective. Because bunions sometimes reappear after treatment, patients often want to know as soon as possible if they can consider their bunions a thing of the past. Although your foot doctor will examine your bunion and talk to you about your procedure results, you may be able to evaluate your own foot by considering a few criteria.
The first sign of a successful bunion surgery is that your foot pain has been resolved. Successfully treating foot pain and helping you achieve full mobility is a significant surgical milestone. You should also consider the cosmetic changes to your foot. Many patients find bunions aesthetically unappealing, so if you can’t see your bunion any more after surgery, you will have achieved an important result. Your foot doctor will also use imaging tools to determine if any foot deformities associated with the bunion were adequately corrected. When these guidelines are met, you can consider your surgery a success.
Surgical hardware is often a part of foot surgery. There are a few different types of hardware that your foot surgeon in Sugar Land may use, depending on the nature of the problem you’re experiencing. In many cases, the hardware works flawlessly to help patients get over their foot pain and regain their mobility, but in some cases, hardware has to be removed during revision surgery. Here are the facts you need to know about surgical hardware and how it is used during foot surgery.
What is surgical hardware?
Surgical hardware consists of implants your surgeon uses during a procedure. The implants can be made of metals, plastics, and composite materials. In foot surgery, the most common types of hardware used are screws, rods, and plates. Your doctor will help you decide which implant material is right for you. Metal implants are visible on imaging tests, so it is easy to see if they could be causing a problem if you experience pain in the future. The downside is that they cover up the bone underneath. Plastic and composite materials are difficult to see on imaging tests, so it’s harder to diagnose a problem with them, but because they don’t cover the bone, it’s easier to see if damage to a bone is causing an issue.
How is hardware used?
Hardware can be used in many different ways in foot surgery, depending on your needs. Screws may be used to hold bones together after they have been broken. Plates and rods can be used for treating fractures. In some cases, hardware is used to strengthen tendons and ligaments or to replace bone that has been lost or is deformed.
When does hardware need to be removed?
Most patients will never need to have their hardware removed. However, if pain persists after surgery or incomplete healing has occurred, your foot surgeon may remove the hardware during revision surgery. Occasionally, scarring after surgery can cause nerve damage. If this happens, your surgeon may opt to remove the hardware.
Bunions are more than unsightly. They can also be painful and make it difficult to walk or wear shoes. Although bunions are notorious for coming back after treatment, your foot doctor in Sugar Land can now provide care that reduces that chance by addressing the underlying issues that contribute to bunion growth.
Watch this video to learn more about how foot specialists are beating bunions by treating misalignment issues that are at the root of some cases. Doctors now understand that some bunions are caused by misalignment issues in the feet. Bunion surgery that involves both removal of the bunion and treatment of instability or alignment issues can drastically reduce the chances of bunions returning after removal.
Ganglion cysts are benign, fluid-filled lumps that appear just below the skin. If you develop one on your foot, your doctor may recommend an aspiration to remove the fluid in the cyst so that it goes down. If your foot doctor in Sugar Land has recommended that you undergo a ganglion cyst aspiration, it’s natural to feel a little anxious. This information will help you feel more confident when you walk into your appointment.
What happens during ganglion cyst aspiration?
During the procedure, your foot doctor will wipe the area with an antiseptic cleanser and then administer a local anesthetic for your comfort. Once the area around the cyst is numb, your foot doctor will use a fine needle to puncture the cyst so that the fluid comes out. The process is very fast and is usually completed within minutes. There is no required recovery time, and you should be able to return to your normal activities right away.
Is it painful?
Your doctor will use a local anesthetic so that you are comfortable during the procedure. You may feel pressure, but you shouldn’t feel pain. In some cases, you may experience some minor swelling or discomfort around the site of the aspiration when the anesthesia wears off. These symptoms should be short-lived and can easily be managed with ice and over-the-counter pain medicines. Most people are in less pain after the procedure, since releasing the fluid eases the pressure within the cyst. If you are concerned about pain, talk to your foot doctor about your worries. In some cases, you could benefit from taking a sedative before the procedure, under the management of your doctor.
Am I a good candidate?
Ganglion cyst aspiration is not right for everyone. If your cyst is small and not causing any symptoms, then your doctor may recommend watchful waiting before trying any treatment. There is also a risk that cysts can grow back after aspiration. If your foot doctor thinks that your cyst won’t be effectively treated by aspiration, he or she may recommend a different treatment plan.
Bunions are foot deformities that cannot be reversed non-surgically. If a bunion specialist in the Sugar Land area diagnoses you with this condition, it means that you have an abnormal, bony bump that protrudes away from the foot. This bump develops at the base of the big toe. Even if you’re not sure if you’re ready to have surgery, you should talk to a specialist about your conservative treatment options. Simple lifestyle changes, like a change in footwear, can help prevent bunions from getting worse.
Asymptomatic bunions might not require surgery.
The surgical realignment of the toe is a serious procedure. If your condition isn’t causing painful symptoms, your doctor will likely recommend that you avoid surgical intervention. It’s possible to develop chronic pain in the area after surgery, even if you didn’t have pain there beforehand. On the other hand, your doctor may determine that surgery is an appropriate option for you if any of the following problems apply to you.
- You have chronic inflammation that isn’t relieved with rest or medicine.
- You’re no longer able to bend and straighten the affected toe.
- You’re experiencing pain despite lifestyle modifications and medications.
- You suffer from significant foot pain that interferes with your daily activities.
There are several types of bunion surgery.
Bunion surgery is complex, and there are several approaches your doctor could use. The technique used on your foot depends on the underlying cause of the deformity. An osteotomy involves cutting the bone and realigning the ends. The bone pieces are held in place with surgical hardware like screws or pins. An osteotomy may be performed in combination with soft tissue correction, if your soft tissues are too tight on one side of the toe, and too loose on the other side. Other surgical options include arthrodesis and resection arthroplasty.
You have a few anesthesia options.
It usually isn’t necessary to have general anesthesia for bunion surgery. Some patients have the operation with just local anesthesia, which numbs the foot. Regional anesthesia is injected at the knee area to numb some of the leg above the foot. Spinal anesthesia eliminates all feeling below the waist. If you choose local, regional, or spinal anesthesia, you may decide to request a sedative to help you stay relaxed during the procedure.
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