Advanced Foot and Ankle Center Blog

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December 13, 2017
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Have you noticed a bony bump at the outside ball of your foot beneath your 5th toe?  If so, you may have a Tailor’s bunion.  This is a bony abnormality to the 5th metatarsal, the most outer long bone of your foot.  It is similar to a bunion which is on the inside of your foot. The bump can be there for several different reasons.  Usually it is caused by the 5th metatarsal either splaying too far outwart, the neck of the metatarsal bows out or the head of the 5th metatarsal is enlarged.  The bump can also be soft tissue inflammation of the bursa that is between the skin and the 5th metatarsal head.  Symptoms are usually pain, swelling, redness to the bony prominence.  To ensure this is your diagnosis, a thorough history is obtained, a lower extremity exam is performed and you will probably have X Rays obtained  to rule out any other bony pathology.  Treatment begins conservative to try to reduce pressure and pain.  This usually starts with OTC products to try to offload the area and possibly custom orthotics.  If these options fail than surgery can be done to help realign the 5th metatarsal bone and take away the prominence.  If you suffer from this condition or any other foot and/or ankle issues, please call us at 972-542-2155 for an evaluation.

There are a lot of different foot and ankle products available at your pharmacy, sporting goods store and especially the internet.  It is easy to self diagnose yourself and find products online that are “guaranteed” to help your problems.  Sometimes these products can help you but we also get a lot of patients that come in after they have tried multiple products that do not work.  We also see people whose symptoms have gotten worse after trying these items. 

Because of this, it is important to see us if you are experiencing any foot or ankle issue.  Not only will we obtain a thorough history and physical but we can also obtain X-rays in the office to accurately diagnose your pathology.  Once the diagnosis is established, we can help get you on your way to recovery with various treatment options that we have seen work for your specific condition.  You do not have to sift through reviews online hoping to make sure you’re not wasting your time and money on something that may not work.    We offer treatment options and products the office that we have seen work first hand. 

If you are experiencing foot and/or ankle issues, please call us at 972-542-2155.  

Regular foot evaluations are extremely important for diabetics.  This is because prevention is the key to avoiding complications to the feet and ankles that can be caused by diabetes.  Diabetes affects the nerves and the circulation to your feet.  Because of this, it is very important to monitor your feet and ensure that there are now new issues arising.  When you see us for diabetic foot checks there are three main categories that we are evaluating: circulation, sensation and skin problems. The pulses to the feet and the nerves are evaluated and documented in your chart.  Each has their own grading system and this ensures that no changes are occuring between your visits.  We also check and make sure there are no open lesions or prominent areas to the feet that could cause an open sore.  Things like bunions, hammertoes, bone spurs, dry skin, cracked web spaces, blisters, corns and calluses can all lead to ulcers to the feet.  If you have nerve and/or circulation problems because of your diabetes, this could lead to serious issues including infection and possible amputation.  Your physical exam findings will determine your return visit increments.  This also allows you to be established with our practice and same day appointments are available for any new or concerning problems.  Again, prevention is the key.   The Providers at Advanced Foot and Ankle Center all have extensive training related to diabetic issues with the foot and ankle.  Please give us a call at 972-542-2155 for an appointment.

November 15, 2017
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A subungual hematoma is a collection of blood beneath the nail and is usually from trauma to the nail unit.  This can be from obvious injuries like dropping something on the toe or stubbing it  or it can occur from repetitive microtrauma.  This is usually the case with runners or athletics when the toe is constantly and repetitively hitting the shoe.  A small sore develops beneath the nail plate and bleeds under the nail.  This then forms a blood blister beneath the nail which can be very painful and feel like there is a lot of pressure beneath the nail.  


Treatment options vary depending on the injury and the amount of nail involved that has the hematoma.  If there is any known injury, an Xray may be obtained to rule out a fracture to the underlying bone.  If the hematoma encompasses a small area and the nail is not painful, the area can typically be left alone and the bruising will slowly grow out of the nail.  If there is pain to the area and the hematoma involves a large portion of the nail, the pressure can be relieved by puncturing a small hole in the nail plate and allowing the fluid to drain or the nail is removed in its entirety and allowed to grow back.  This is done under local anesthesia in the office.


If you experience this or any other foot and/or ankle issue, please call us at 972-542-2155 for more information.  

November 09, 2017
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Are you starting to notice your second toe rising up and crossing over your big toe?  If so, you may be suffering from a plantar plate injury or pre-dislocation syndrome.  This usually occurs with a bunion deformity in which the big toe sways over and points torward the lesser toes.  The second toe has no where to go so it begins to rise up and cross over the big toe.  This can also occur without a bunion deformity if there is injury to the plantar plate. 

The plantar plate is a thick ligament on the bottom of your foot that connects the toe to the ball of the foot.  You can develop micro tears in the plantar plate from injury or abnormal foot biomechanics.  If you develop a small tear on portion of the ligament that is closer to the 3rd toe, the opposite portion of the ligament is now tighter and pulls the toe toward the big toe. 

If you have a plantar plate tear, it will most likely be painful at the ball of the foot beneath the 2nd toe and will probably be worse with increased activity or walking barefoot.  After a thorough lower extremity physical exam, an X-ray will be taken to ensure there is no bony pathology to the area.  Sometimes when the plantar plate tears, it takes a small portion of bone that it was attached to with it. 

Treatment of plantar plate tears begins conservatively and varies with orthotics, Non-Steroidal Anti-Inflammatory Drugs (NSAIDS such as Advil, Aleve) , walking boots, Injections  and a special device to wear that holds your  toe pointed downward to help faster healing.  If conservative  treatment fails and the area is still painful, the plantar plate may need to be surgically repaired.  This is performed outpatient at a surgery center. 

At Advanced Foot & Ankle Center, all of our providers have extensive experience with this condition.  If you are experiencing this issue or any other foot or ankle disorder, please call us at 972-542-2155.