Infracalcaneal Exostosis
An infracalcaneal exostosis is term that describe 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 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. It is the small musculature that causes formation of the bone spur. The reason why the muscles do this is secondary to abnormal and uncontrolled foot mechanics.
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. Although not available in our office, some plastic surgeons and aestheticians are offering collagen injection therapy to the plantar aspect of the heel to aid in cushioning. It must be known that this is only a temporary solution and often requires multiple periodic injections.
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 walking 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 have diabetes and you have a diabetic foot ulcer, please come see us at Advanced Foot & Ankle Center to be looked at. Even if you do not have have a foot ulceration, but you have diabetes, there are things that can be done by Dr. Kory Williams and Dr. Eric Silvers to prevent future problems. Act now. The future of your foot health depends on it. Call 972-542-2155 to set up an appointment now.
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 opposite direction of the 2nd digit. Hallux varus can be a problems 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.
Literature provides many options and methods on fixing hallux varus and my intentions are to inform you (in basic terms) how it can be fixed.
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.
Please be aware that this 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 from an old botched bunion procedure, please come see us. Dr. Kory Williams and Dr. E. Silvers are well-versed in revisional and reconstructive repair of failed surgeries.
Please call 972-542-2155 for an appointment today.
