Yao Ming Retires due to foot injuries
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. In turn, 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 subungual hematoma’s 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 or by removing the toenail. If it is not drained, the pressure will continue to build up and cause pain to the toe. This can be done by using a needle, cautery or a laser. Even though the hematoma is evacuated, lysis or separation of the nail plate from the nail bed can still occur and the nail plate may come off prior or during the re-growth of a new nail plate.
Blunt trauma can also lead to laceration of the nail bed that would warrant repair but suture. 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.
Open fractures have a high risk for infection. If the bone becomes infected, IV antibiotics and/or removal of infected bone may be necessary. This could lead to loss of a toe in extreme cases.
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 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:
