Advanced Foot and Ankle Center Blog

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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.  

November 09, 2017
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The ankle joint is made up of 3 bones: the tibia, fibula, and talus. The ends of these bones are covered with cartilage and are connected by strong ligaments to form the ankle joint. Cartilage is the smooth surface that allows the joints in our body to glide and function. The ligaments surrounding the ankle joint assures proper alignment and proper function. When either of these components are damaged or worn out, this can lead to arthritis.


The most common cause of ankle joint arthritis is post-traumatic arthritis due to a prior injury such as an ankle fracture or ankle sprain, 2nd most common cause is primary osteoarthritis or wear and tear arthritis. Other less common causes include gout, rheumatoid arthritis, neuropathy, osteonecrosis, hemophiliac.


Symptoms of ankle joint arthritis include pain with weight bearing and decreased motion. Exam findings include joint effusion or swelling, pain with motion or loss of motion, crepitus or grinding with motion, and deformity. X-rays will show signs of arthritis including loss of joint space, sclerosis or increased density of the bone underlying the cartilage, cysts or pockets of bone loss to the bone under the cartilage, as well as angular deformity.


Treatment includes conservative as well as surgical options. Conservative options include activity modification, bracing to immobilize the ankle joint, injections, and NSAIDs for pain control. If conservative treatment fails then surgical options are explored. Surgical treatment options vary based on severity and symptoms. For less severe cases, an ankle arthroscopy may be performed to clean up the joint and remove any spurring surrounding the joint that may be causing pain. This may also be performed along with a new procedure called a subchondroplasty which is a minimally invasive procedure that has shown effectiveness in treating pain and preventing or delaying the need for more invasive surgical options. For more severe cases an ankle joint fusion or ankle joint replacement may be an option.


Ankle joint fusion involves removing the remaining cartilage within the ankle joint and placing screws and/or plates to fuse the joint. Fusing the ankle joint prevents any further motion and thereby any pain associated with arthritis. Despite the inability to move the ankle, many patients lead healthy and functional lives without the pain of ankle joint arthritis.


Ankle joint replacement involves a procedure similar to a knee or hip replacement. This involves replacing the joint with a metal implant and polymer spacer. The advantages of ankle joint replacement is the maintenance of joint motion and function. The disadvantages are that ankle joint replacements are a relatively new procedure. Recent 5-10 year studies of newer generation ankle joint implants have shown good to excellent results, but long term outcomes are still pending. As with any artificial joint, there is increased risk of failure and revision with patients that are younger, higher BMI, and higher activity level. These are compounded by the increased forces within the ankle joint and decreased surrounding muscle and soft tissue compared to the knee or hip.


Your foot and ankle specialist at Advanced Foot and Ankle Center in Mckinney and Prosper TX will perform a thorough examination along with x-rays and other imaging and recommend the best course of treatment. Call us today at 972-542-2155 to set up your appointment!


Look out for our next blog post about Peroneal Tendon injuries, and other related conditions.