Jennifer Grey has Neuroma Surgery!
Jennifer Grey, recent Dancing with the Stars contestant and star of Dirty Dancing and Ferris Bueller’ s Day Off, recently underwent surgery to remove a painful neuroma in her foot.
Neuromas can be quite painful. Please read the following blog about neuromas to know what Jennifer had taken out of her foot.
Click here: Neuroma!
If you have a neuroma, please come see us at Advanced Foot & Ankle Center in one of our offices in McKinney, TX or Prosper, TX today.
Call 972-542-2155 for an appointment.
Syndactyly
Syndactyly is a condition in which the toes do not completely separate at birth. It occurs every 1 in 2,500 births. Syndactyly is synonymous with “webbed toes”. There is various types of syndactyly. The toes can be partially webbed or completely webbed.
This condition is usually not painful. Cosmetic issues are typically the problem that most people have. Some people are self conscious about their toes and this blog is to inform those people of their options regarding correction of the toe deformity.
Syndactyly typically does not affect the ability to walk or run. However, webbed toes can limit flip-flop use.
Surgery can be performed to separate the toes. This surgery is meticulous and intricate. Surgery entails separation of the toes and the usage of rotational skin flap or use of skin grafts to replace the areas void of skin. Often times, the blood vessels and nerves in between the fused digits are shared, therefore, numbness or tingling can occur between toes after separation and healing can be slow if the blood flow to one of the digits is disrupted. Scarring can be complication of this procedure. However, the surgery is very successful. Further details can be explained in our office.
If you have webbed toes, schedule an appointment to discuss your options with Dr. Eric Silvers at Advanced Foot & Ankle Center with offices in both McKinney, TX and Prosper, TX.
Call 972-542-2155 for an appointment today.
Retrocalcaneal Exostosis
A retrocalcaneal exostosis is a painful bump or bone spur on the back of the heel bone (calcaneus). This painful bone spur often involves the achilles tendon. A Haglund’s deformity is a painful bone spur on the back of the heel that does not involve the achilles tendon.
Patients will often complain of pain, redness, tenderness and swelling along a bony prominence on the posterior aspect of the heel. Usually the pain is worse with activity and with shoes that rub the back of the heel.
The patient typically has pain at the insertion site of the achilles tendon on the back of the heel bone. Sometimes the achilles tendon will feel thick, hardened, or rubbery where it inserts on the posterior aspect of the heel. This may be due to the tendon becoming calcified or a possible tear of the tendon.
This particular problem most often affects adults. Women are typically more affected than men because of the types of shoes they wear. High heeled shoes or pumps irritate the spurs the most.
A retrocalcaneal exostosis can occur with other problems along the back of the heel. These issue can include: tight or short achilles tendon, bursitis or an inflamed pad, achilles tendonitis or inflammation and a Haglund’s deformity.
If a patient has equinus or a tight or short achilles tendon, this lack of flexibility of the achilles tendon puts increased tension on the back of the heel.
A bursa is an inflamed sac of fluid that develops as a way of your own body cushioning the back of the heel. There are 2 types of bursae that can form. One is superficial and lies in between the skin and the achilles tendon. The other type of bursa is sandwiched between the achilles tendon and the heel bone or calcaneus. When they become inflamed, it can become tender with even the lightest pressure.
If the achilles tendon itself is inflamed and swollen, it may be due to a tear or partial rupture of the achilles tendon.
Treatment of Retrocalcaneal Exostosis depends on the severity of your pain level. Treatment includes:
1. A prescription for an oral NSAID or steroid. This will help with inflammation of the tendon, bursa, skin other structures in the area.
2. Prescription for a pain gel or adhesive pain patch to apply to the back of the heel. These medications are diffused through the skin into the tissues.
3. Heel lifts are usually dispensed to the patient. Heel lifts are a wedge that goes under the heel to lift the heel. By raising up the heel an inch or so, the tension on the achilles tendon is decreased. The heel lift can also raise the patient’s heel out of the shoe slightly to keep the back of the shoe from rubbing on the heel.
4. Cushioning or padding of the back of the shoe or the heel counter. Adhesive felt pads can be used to stick on the inside of the heel of the shoe to provide some cushioning.
5. If the pain is severe, immobilization in a boot is warranted. By decreasing stress and strain of the achilles tendon, the pain and inflammation at the back of the heel will decrease significantly.
6. The last conservative option for severe pain is cast immobilization. Crutches would be warranted for non-weightbearing of the extremity.
7. Steroid injections are not customarily performed along the back of the heel due to increased risk of possible rupture of the achilles tendon, especially if the tendon is already inflamed and diseased.
8. Sometimes physical therapy is warranted to help increase flexibility of the achilles tendon and to decrease inflammation of the tendon using techniques customized by the physical therapists.
9. MRI is typically performed if the tendon continues to be painful. The MRI can help determine if the achilles tendon is inflamed or torn. The MRI can also help identify an inflamed bursa, or some other soft tissue pathology.
10. If the previously mentioned conservative methods are unsuccessful at relieving the pain, then surgery may be warranted. Surgery along the back of the heel can involve the following: Debulking of the achilles tendon or trimming away of the disease portions of the tendon, removal of the bone spurs on the back of the heel, removal of the bursa, lengthening of the achilles tendon and reattachment of the tendon to the heel using bone anchors and strong sutures. Dr. Silvers has been performing these procedures for many years with favorable results.
All conservative treatments must be exhausted prior to surgery.
If you have a spur on the back of your heel and it is causing you pain, please come see Dr. Eric Silvers at Advanced Foot & Ankle Center for diagnosis and treatment.
Please call 972-542-2155 for an appointment today.
Hallux Varus
Hallux varus is a deformity that can occur one of two ways. The most common way of developing hallux varus is after having surgery, specifically a bunion surgery in which the deformity was over-corrected. The second way of getting hallux varus is that you were born with it.
Hallux varus occurs when the great toe is deviated medially or in the opposite direction of the 2nd digit. Hallux varus can be a problem especially when wearing shoegear, as the great toe tends to rub against the shoe and create pain, blisters, or ulcerations. If the great toe joint is very unstable, the great toe may dislocate and cause severe pain.
Conservative treatment includes using taping or strapping to hold the hallux in a stable position as it heals. Padding can be added to the inside of the shoe to prevent rubbing and discomfort. The patient must realize that the splinting of the toe in a corrected position, must be in place at all times.
If conservative treatment fails to correct the deformity, surgery can be performed. Depending on the severity of the deformity, the surgery is tailored to what is necessary to correct the deformity. If the deformity is mild, the soft tissue structures such as ligaments, tendons and joint capsule can be repaired. If the deformity s quite severe, then bone work must be performed. Bone work can consist of performing a reverse bunion procedure, using joint implants, and even joint fusion.
The deformity can be mild, moderate or severe. The treatment is geared toward doing the least invasive amount as possible to achieve the best results.
If you have hallux varus that is congenital or as a result of a past surgical procedure, please call us for a consultation. Dr. Eric Silvers is well-versed in revisional and reconstructive repair of surgical complications.
Please call 972-542-2155 for an appointment today.
Malignant Melanoma of the Foot and Ankle
ADVANCED FOOT AND ANKLE CENTER
Dr. Eric Silvers
McKinney, Texas Prosper, Texas
Melanoma is a serious and potentially life-threatening skin condition. In the foot, there are basically 4 types of malignant melanoma that can form. This blog will discuss those 4 common types.
1. Superficial Spreading Melanoma – this is the most commonly seen malignant melanoma. It can affect people of all ages and has a tendency to affect females more often. This type of melanoma has irregular borders (not symmetrical), and can range in color from black, brown, blue, pink, red, and white. They will often look like a mole or freckle that appears to grow sideways. The lesion will often become dark, however may fade as the body tries to fight it. This lesion can progress quickly.
2. Nodular Melanoma – although not the most common, this melanoma is the most aggressive. This melanoma is most often seen in people age 60 or older. This melanoma grows more vertically down into the skin while the diameter of the lesion stays more or less consistent. It usually appears in an area isolated from other skin lesions, like moles or freckles. These lesion are usually very dark and often bleed or ulcerate.
3. Lentigo Maligna Melanoma – this melanoma usually affects the middle aged or elderly patients who have increased exposure to the sun. This lesion is often mistaken for “liver spots” or “sun spots”, especially on the face. They can feel lumpy and often spread vertically deep into the skin. They will also have irregular borders.
4. Acral Lentiginous Melanoma – although the most rare, this melanoma is often found in African Americans and people of Asian descent. These lesion appear on the bottom of the feet, under the toenails and even inside the mouth. This lesion, when on the sole of the foot, looks like a black or tan spot with misshapen borders. When under the toenails, it appears as a dark streak. It may also appear like a wart.
If you have an area of your foot or ankle that looks suspicious, schedule an appointment with the foot and ankle specialists at Advanced Foot and Ankle Center in McKinney and Prosper, Texas.
Call 972-542-2155 for an appointment today.
Porokeratosis of the Foot
Some people have growths on the bottom of their feet. They can range from moles to calluses or melanoma to warts. However, one particular skin lesion is often mistakened for some of the previously mentioned problems. Porokeratoses are hard, seed-like calluses. They are typically about the size of a sesame seed. Oftentimes, porokeratoses feel like a splinter in the foot. They usually develop on the bottom of the foot at the ball of the foot or the heel. Some people call them “seed corns”.
Many podiatrists feel that porokeratoses are sweat glands that are plugged up with callus tissue. There are approximately 300,000 sweat glands on the bottom of the feet, so there is a large opportunity for at least one of the sweat glands to become plugged off.
These lesions are not malignant or dangerous, but they should be examined by a professional to determine the correct diagnosis.
Some patients have several porokeratoses and others may have only 1 or 2. These lesions can become more painful when the person wears shoes with little or no padding or walk around barefoot. Also if the patient has very little fat pad on the bottom of the foot, they may experience increased pain.
At Advanced Foot & Ankle Center, the doctors will attempt to gently carve out the porokeratoma with a currette or a sharp instrument. Anesthesia is usually not needed.
Sometimes, the doctors will place a mild blistering agent on the lesion to cause exfoliation of the lesion and allow it to “pop out”.
If you have a porokeratoma, please come see Dr. Eric Silvers at Advanced Foot & Ankle Center in either McKinney, TX or Prosper, TX. Our office has years of experience with treating porokeratomas.
Please call 972-542-2155 for an appointment today.
