Traumatic Nails
Traumatic Nails- Trauma can occur to the toenail as a result of chronic trauma or from acute injuries. Chronic or low grade trauma can be caused by tight shoes that place pressure on the toenail or from running with improper shoes. This can injure the toenail and may cause the nail to form a blister under the nail plate which can lead to a paronychia. This can be a painful condition and may necessitate the need to have the toenail taken off.
Acute trauma often is the result of dropping an object onto the toe or stubbing the toe against something that forces the nail plate to become separated from the nail bed. Blunt trauma can cause a subungual hematoma which is a collection of blood from under the nail plate. This can cause pain and also can lead to infection. If a subungual hematoma develops, the collection of blood will need to be drained by either creating a hole in the nail plate by using a needle, cautery or a laser or by removing the toenail. If it is not drained, the pressure will continue to build up and cause pain to the toe.
Blunt trauma can also lead to laceration of the nail bed that would warrant repair. In addition, blunt trauma can cause a fracture to the underlying bone (distal phalanx) that would also require treatment. If the nail bed is traumatized along with a fracture to the distal phalanx, it is classified as an open fracture.
Dr. Eric Silvers is a highly-trained foot and ankle surgeon specializing in the treatment and resolution of toenail pathologies.
He has offices located at both McKinney, TX & Prosper, TX.
Please call 972-542-2155 to schedule an appointment today!
Infracalcaneal Exostosis
An infracalcaneal exostosis is a term that describes a large bony prominence or spur on the bottom of the heel bone or calcaneus. In some patients, this bone spur can actually be large enough to be felt on the bottom of the heel.
The bone spur is caused by traction or pulling on the heel bone or calcaneus by tiny muscles on the bottom of the foot. Many people correlate “heel spurs” with plantar fasciitis. This is a false statement. The plantar fascia in actuality, inserts just lateral to the plantar heel spur.
Most patients have 1 – 1.5 inches of fat pad on the bottom of the heel that aids in cushioning and shock absorption for the calcaneus. In older patients who have experienced atrophy or thinning of the fat pad, the bone spur can be prominent and very painful.
Treatment includes cushioning of the infracalcaneal exostosis, wearing appropriate shoe gear to soften the impact of the heel with walking or running.
For those patient who cannot find relief cushioning, padding or shoe therapy, surgery is a viable option. Surgery involves removing the plantar heel spur or infracalcaneal exostosis and making the bottom surface of the heel bone flat and smooth. A extended period of non-weightbearing is suggested due to possible risk of stress fracture with early weight bearing following the surgery.
If you have a prominent heel spur on the bottom of the heel, please visit our office for a clinical evaluation. Call 972-542-2155 for an appointment today.
Traumatic Heel Pain
If you have had trauma to the heel, please click on the following link to read more:
Traumatic Heel Pain
Neurologic Heel Pain
Please click the following link to read about the various causes of heel pain caused by nerve disorders.
Neurologic Heel Pain
Mechanical Heel Pain
Please click the following link to learn about the various types of mechanical heel pain:
Mechanical Heel Pain
Facts about Diabetes Mellitus
This article contains statistics taken from numerous journal articles regarding the effect of diabetes and the problems that it can cause.
Incidence of Diabetes Mellitus
- 15% of the population of developed nations
- 16 million people in U.S have diabetes mellitus
- 15% of patients with diabetes will develop foot ulcers
- There are currently 2.4 million people with diabetic foot ulcers
- Foot and leg amputations are 15 times more likely in patients with diabetes
- 15% of people with foot ulcers will require amputations
Morbidity and Mortality
- Half of the non-traumatic foot amputations in the United States are the result of diabetes
- The 3 year survival rate after a leg or foot amputation is 50% in diabetic patients
- 50% of diabetic amputees will develop ulcers on the opposite limb
- 50% of those diabetic patients will lose the other limb in 3 years or die
Cost
- Total cost for diabetic care in 1997 = $98,000,000,000.00
- Diabetic foot care in 1997 = $6,000,000,000.00
- Non-operative care of a single foot ulcer = $7,000.00
- Average cost of care for an infected foot ulcer = $17,000.00
- Average cost of amputation and rehab = $45,000.00
Misconceptions
- 68% of patients with diabetic foot ulcers have neuropathy
- 32% of patients with diabetic foot ulcers have normal sensation
How effective are orthotics?
- Re-ulceration rate at one year = 58% if return to street shoes, 28% if return to therapeutic shoes with in soles
If you are a diabetic with a foot sore or ulceration, please come see us at Advanced Foot & Ankle Center for evaluation and immediate treatment. It is also advised that you seek foot and ankle evaluation if you are a diabetic and are not aware of any current foot or ankle issues. Dr. Eric Silvers has treated many diabetics with all types of foot and ankle problems for over 15 years. Please call 972-542-2155 to set up an appointment now.
