Advanced Foot and Ankle Center Blog

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February 13, 2018
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Foot and ankle injuries are very common while playing basketball.  If you watch basketball then you have probably already seen an injury first hand.  The amount of strain and stress that is placed on your feet and ankles is extremely high with all the cutting, twisting, jumping and running throughout the game.   The most common types of injuries include sprains, fractures, ligament/tendon tears as well as achilles tendon ruptures.  You can also develop injuries to the foot and ankle that start small and gradually worsen if you don’t address them.   This occurs more frequently as we age.  The first thing you need to do if you think you’ve hurt your foot or ankle is stop playing and see your podiatrist to be evaluated for an injury.  To determine the best treatment option for you, an X-ray will usually be obtained to rule out a fracture or dislocation.  An MRI can also be obtained to evaluate for soft tissue damage.  Once the diagnosis is made, we will discuss the best treatment option for you.  

 

The best ways to avoid injuries while playing basketball is proper warm up routines, taping and bracing the foot and ankle.  No matter how well you try to prevent an injury from occurring there is always a chance of a freak accident like landing on another players foot, diving for a loose ball or slipping on a wet spot on the court.  At Advanced Foot and Ankle, we have experience dealing with these injuries and can help you get back on the court and back in the game.  If you have any questions about this or any other foot or ankle issues, please call us at 972-542-2155.

 

Have a wonderful day,

 

Dr. Witt

 
January 31, 2018
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What is Turf Toe?

Turf Toe is a common sprain type injury of the great toe joint. The injury occurs either from a sudden jamming or repetitive upward bending of the great toe joint. Turf Toe injuries have historically been linked to sports activities on artificial turf, but it can occur with a wide range of sports or other activities.

The great toe joint is where the first metatarsal (long bone behind the toes) meets the first toe bone. The joint is surrounded by a number of strong ligaments and tendons. There are also 2 small sesamoid bones at the bottom of the joint which act similar to the knee cap. The sesamoid bones act to disperse weight bearing pressure evenly across the joint as well as give the joint more stability during motion.

Severity of Turf Toe injuries can range from a stretch of the ligaments causing pin point pain to a tear of the ligaments causing severe pain and instability with motion. Initial treatment is RICE therapy (Rest, Ice, Compression, Elevation). Over the counter pain medication such as tylenol, ibuprofen, or aleve can provide pain relief.

At your visit, your foot and ankle specialist will perform a thorough history and physical exam. The range of motion and stability of the great toe joint may be tested to ascertain the severity of the injury. Xrays may be obtained to determine any other injuries such as a fracture that may be present. Depending on the severity of the injury, an MRI may be ordered to evaluate for a tear or rupture of the ligaments/tendons. Treatment may include a specialized shoe or boot, orthotic inserts, as well as activity modification. Rarely, surgery may be needed depending on the severity and any other injuries present.

If you or a family member suffered from Turf Toe injury, make an appointment with Advanced Foot and Ankle Center in Mckinney and Prosper TX! Our convenient hours and locations allow us to better serve you. Most of the time we are able to accommodate same day appointments!

Jan M. Veloso, DPM
Advancedfoottexas.com
(972) 542-2155
January 29, 2018
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All of us have stubbed or dropped something on our toe at one time or another. It is very painful! Most of the time the pain resolves quickly and we don’t even notice it after a few minutes. But what about other times where the pain lingers for days or even weeks? Did you have a cut or bleeding after the injury? You may have fractured your toe or even worse suffered an open fracture!

Toes are anatomically similar to fingers but smaller and shorter. The great toe consists of 2 small bones while toes 2-5 consist of 3 small bones called phalanges. The toes aid in balance while standing and as a lever arm during the push off phase of gait.

Signs and symptoms of a toe fracture include swelling, pain, and bruising of the toe. If the toe is angulated or curled differently than before, the fracture may be displaced or dislocated. If you have bleeding from a cut or laceration, you have have a specific injury called an open toe fracture. Open fractures occur when a fracture site is exposed by a cut. These injuries are even more serious and require immediate medical attention to decrease the chance of a deep bone infection which can lead to amputation.

At your visit, your foot and ankle specialist will perform a thorough history and physical exam. X-rays to assess the injury/fracture may be ordered. A post op shoe or pneumatic cam boot may be ordered to immobilize the injury. If the fracture is displaced and needs correction, a fracture reduction may be performed in the office. If surgery is needed, we operate at several local surgery centers and hospitals.

If you or a family member suffer a toe injury, make an appointment with Advanced Foot and Ankle Center in Mckinney and Prosper TX! Our convenient hours and locations allow us to better serve you. Most of the time we are able to get patients in the same day!

Jan M. Veloso, DPM
Advancedfoottexas.com
(972) 542-2155
January 24, 2018
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Nail plate injuries occur due to direct trauma to the toe typically from stubbing the toe onto furniture or dropping an object on the toe. Common injuries associated with nail plate injury are subungual hematoma, nail bed laceration, and nail avulsion.

Subungual Hematoma

A subungual hematoma occurs from injury to the toe and toe nail. The injury causes the nail bed to bleed trapping blood deep to the toe nail. Without treatment the trapped blood under the toe nail causes pressure, pain, or worse, infection. Treatment depends on how much of the toe nail is affected. If less than 50% of the toe nail is affected, a sterile needle is used to puncture through the toe nail thereby releasing the trapped blood. If greater than 50% of the toe nail is affected, the nail plate is removed along with repair of laceration is performed under local anesthesia. Depending on severity and possible infection, a short course of antibiotics may be prescribed.

Nail Bed Laceration

Lacerations to the nail bed typically occur either through an intact toe nail or when the hematoma is greater than 50%. Under local anesthesia the toe nail is removed and the laceration is repaired with suture. A short course of antibiotics may be prescribed.

Nail Avulsion

A nail avulsion occurs when the toe nail is lifted up either partially or completely after an injury. When the nail lifts up it can damage the nail bed and/or the nail root. Treatment depends on the severity of the injury. If the injury is severe with a laceration then treatment is the same as a nail bed laceration. If the toe nail is only partially lifted with no other injury such as a laceration, treatment typically involves pushing the lifted toe nail back down in contact with the nail bed. This may allow the toe nail to grow normally without incident or sometimes the toe nail will fall off on its own and a new toe nail will grow. Sometimes the damage may cause the new toe nail to grow thick or have a split. With these injuries, it is difficult to determine the damage to the nail root at the time of the injury.

If you or a family member injured their toe nail, call us today and make an appointment with our foot and ankle specialists!

Jan M. Veloso, DPM
Advancedfoottexas.com
(972) 542-2155
January 22, 2018
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Stress fractures are a common overuse injury in athletes and weekend warriors of all ages. Stress fractures occur due to fatigue from repeated stress such as running or jumping over time. This is in contrast to “normal” fractures from a sudden severe impact or twisting motion.

Where and why do they occur?

Stress fractures most commonly occur in the tibia (shin bone), fibula (ankle bone), navicular (foot bone), and metatarsal (bones behind the toes). The pain is typically brought on by a rapid increase in exercise such as sports, running, or jumping. In the early stages, pain is present during activity but subsides with rest. In later stages or more severe stress fractures, pain may be present with any weight bearing activity. If left untreated the stress fracture may even displace, similar to a “normal” fracture, and require surgery.

Diagnosis

Your foot and ankle specialist at Advanced Foot and Ankle Center in Mckinney and Prosper will perform a thorough history and physical exam. X-rays during the early stage may show a faint line or “hairline fracture”. After 3 weeks from onset of pain, x-rays may show bone remodeling and healing with what is called callous formation.

Treatment

Stress fractures are typically treated by immobilization, partial weight bearing, and modification of activity. Your foot and ankle specialist may order a pneumatic cam boot to immobilize the foot, protect the stress fracture, thereby allow healing. For more severe and rare cases, complete non weight bearing may be necessary.

If you or a family member show the signs and symptoms of a stress fracture, call Advanced Foot and Ankle Center of Mckinney and Prosper to schedule your appointment!

Jan M. Veloso, DPM
Advancedfoottexas.com
(972) 542-2155