Yao Ming Retires due to foot injuries
Posterior Heel Pain
Heel pain along the back of the heel can be very debilitating. This type of heel pain can be very frustrating to treat for both the patient and also the physician. Dr. Eric Silvers and the staff at Advanced Foot and Ankle Center have successfully treated posterior heel pain (heel pain to the back of the heel) for over 14 years.
Some causes of posterior heel pain can be trauma that results in a fracture or a boney bruise with or without inflammation to the Achilles tendon (tendonitis). The pain can also be due to mechanical problems such as a tight heel cord (Achilles tendon). In addition, bone spurs that result from long term pulling (traction) of the Achilles tendon can develop and produce a bump or prominence along the back of the heel. Some types of arthritis can also cause spurs to the heel.
Many times bone spurs along the back of the heel are not painful. When they do become painful, the experts at Advanced Foot and Ankle Center in McKinney and Prosper, Texas can help you find relief. Our treatment plans for posterior heel pain are conservative yet aggressive. Dr. Silvers will evaluate your heel pain both clinically and radiographically (x-rays, CT and/or MRI if needed). He may choose to have some blood work taken after conducting a history and physical examination. Some conservative treatment options include heel lifts, walking boots, casting, oral steroids, oral or topical anti inflammatories, shoe modifications, physical therapy, and altering activity.
If a course of aggressive conservative treatment fails after 3-9 months, then surgical options for patients who are surgical candidates may be explored. Such surgical treatments involve addressing the heel spur and the Achilles tendon. If Dr. Silvers finds that the Achilles tendon is short or tight, he will suggest lengthening in addition to removing the heel spur. Dr. Silvers uses the most advanced techniques for treating heel spurs along the back of the heel. Today, Dr. Silvers utilized the Arthrex Speed Bridge System. “I like the Speed Bridge because it provides a stable and strong means of reattaching the Achilles tendon to the heel after bone spur resection. In the 14 years since I have been performing poserior heel spur surgery, I have yet to find an anchoring system that matches up to the Arthrex Speed Bridge. The speed bridge is nice not only that if utilizes 4-3.5 mm bioabsorbable anchors, but it is also a knotless system. That means that we no longer have to bury knots within the tendon as it is reattached to the heel bone. In addition, the criss crossing of the sutures attached to the anchors provides a wide surface area of compression to the Achilles tendon and the heel bone.”
Despite the great advancements to reattaching the Achilles tendon to the heel bone, recovery does take a minimum of 6 weeks of non weight bearing on the involved foot. After the six week period, another 2-6 weeks of utilizing a walking boot is required.
If you suffer from posterior heel pain (pain along the back of the heel) call Advanced Foot and Ankle Center to schedule an appointment to see Dr. Eric Silvers. Dr. Silvers has patients that have come to Texas from all over the country to see him including, Florida, California, Arkansas, Oklahoma, Michigan, Illinois, just to name a few.
You can reach us by calling 972-542-2155. Our friendly staff is sympathetic to your heel pain needs and will do their best to get you into our office for a personalized consultation with Dr. Silvers directly.
Tots in Heels
See Dr. Silver’s TV interview Channel 33 News in Dallas concerning the problems of high heels in children and adults – from October 2010.
Chemical Matrixectomy Procedure for Ingrown Toenails
Chemical Matrixectomy - Sodium Hydroxide Chemical Matrixectomies are the preferred method of chemical matrixetomies performed at Advanced Foot and Ankle Center. The advantages of this procedure outweigh the disadvantages and the success rate is very high. Documented success rates are over 98%. Another advantage is little to no post operative discomfort for most patients. Surgical matrixetomies on the other hand tend to be very painful post operatively despite faster healing time. Yet another advantage of chemical matrixectomies is a lack of disability after the procedure. Often, one can return to work after the procedure. The fact the chemical matrixectomies do not require any incisions, cosmesis is yet another advantage. This procedure is performed in the office most of the time with the use of special instruments designed specifically for the procedure.
A disadvantage of chemical matrixectomies is the healing time. The process of healing is an inflammatory reaction from the chemical that causes the surgical area to drain. If the entire nail is removed and a chemical matrixectomy is performed, healing time can be 3-8 weeks. Partial nail removal with a chemical matrixectomy take 2-4 weeks to heal.
Some complications of the procedure include a recurrence of the nail spicule. Sometimes the entire nail may be lost with performing partial nail removal on both sides of the nail plate. This is especially true if the nail is already thick and very curved prior to the procedure. Formation of an abscess also may occur after a matrixectomy. This occurs due to failure of the toe to drain. This is why post operative follow up visits are very important.
Post operative care of a chemical matrixectomy is very important. At Advanced Foot and Ankle Center, our physicians advise daily cleaning in the shower or bath with liquid soap and a wash cloth. In addition, daily application of a wound gel known as Amerigel is important until the toe is completely healed. One may also soak the involved foot twice daily in warm water mixed with epsom salt and vinegar for 15 minutes twice daily and then cover the toe ointment and band aid.
Phenol and Alcohol chemical matrixectomies are another method of performed the procedure. At Advanced Foot and Ankle Center our physicians choose to use sodium hydroxide over Phenol due to decreased recovery time with sodium hydroxide.
The physicians at Advanced Foot and Ankle Center in McKinney and Prosper, Texas have years of experience in performing ingrown nail procedures. Our team will make you feel at ease as we treat your toenail condition. Please call us at 972-542-2155 to schedule an appointment with one of our residency trained foot and ankle specialists.
Dr. Eric Silvers is a highly-trained foot and ankle surgeon specializing in the treatment and resolution of toenail pathologies.
He has offices located in McKinney, TX & Prosper, TX.
Please call 972-542-2155 to schedule an appointment today!
Incision & Drainage Procedure for Ingrown Toenails
Incision and drainage is a procedure performed on infected toenails, such as paronychias. When performing an incision and drainage (I&D) on a infected toenail, it usually does not involve an actual incision.
The procedure is outlined below:
1. The toe with the infected toenail is numbed with local anesthetic at the base of the digit in order for the patient to be able to tolerate the drainage of the infection.
2. A small sliver of toenail from one or both sides (and sometimes the entire toenail) is removed. When the portion of the nail is appropriately removed, the nail border or nail bed is inspected for any remaining pieces of toenail that may be causing infection to be present. All pus and fluid is drained from the nail and disinfected.
It should be noted that when infection is present, a chemical matrixectomy cannot be performed. If a chemical is used to the kill or destroy the nail matrix from which the nail plate grows from, this can create a small “burn” area. If any residual infection decides to invade the area of the chemical burn, this can lead to a more serious infection and possible invasion of the bone underneath the nail plate.
It should also be noted that patients who have an I&D performed must realize that there is a high probability that the nail border may come back ingrown again. Therefore, it is important to return to our office before the toenail becomes infected again and have a chemical matrixectomy performed. This will ultimately prevent re-growth of the ingrown toenail.
If you have an infected toenail, please call 972-542-2155 to schedule an appointment immediately.
Dr. Eric Silvers is a highly-trained foot and ankle surgeon specializing in the treatment and resolution of toenail pathologies.
He has offices located in McKinney, TX & Prosper, TX.
Please call 972-542-2155 to schedule an appointment today!
Cancerous Toenails
Cancerous Toenails- Melanoma is the most common cancerous tumor or lesion present at the nails. There are 4 types of melanoma:
1. Acral Lentiginous Melanoma: 10% of all melanomas. This melanoma is aggressive and invades very quickly. This melanoma occurs primarily on the soles of the feet, often on the digits or underneath the toenails. If this melanoma occurs underneath the toenail, it is called melanotic whitlow. This type of melanoma is usually found on non-caucasian individuals.
2. Superficial Spreading Melanoma: 70% of all melanomas. Occurs in younger people. Spreads from side to side before invading deep. Usually darkly pigmented, painful with irregular, asymmetrical shaped borders.
3. Lentigo Maligna Melanoma: 5% of all melanomas. This melanoma is the slowest growing and the least likely to metastasize. It is patchy with mottled pigmentation. It enlarges from side to side before invading deep. Occurs in sun-exposed areas. It is more common in patient older than 60 y/o.
4. Nodular Melanoma: 15% of all melanomas. This melanoma has the worst prognosis and becomes invasive very early. This melanoma commonly ulcerates.
It is very important to know that if you have a suspicious lesion on the toenail or foot, please have either a podiatrist or dermatologist examine the lesion as soon as possible. Biopsy should be performed in order to receive an accurate diagnosis. Please call 972-542-2155 for an appointment today.
Dr. Eric Silvers is a highly-trained foot and ankle surgeon specializing in the treatment and resolution of toenail pathologies.
He has offices located in McKinney, TX & Prosper, TX.
Please call 972-542-2155 to schedule an appointment today!
