Corn And Nail Presentataion To Residents
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The document discusses various common and uncommon nail, corn, and callus problems of the foot. It addresses topics such as: 1) The definition and treatment of common corns, including when to stop cutting them and how to prevent recurrence. 2) Distinguishing corns from other conditions like hammer toes that present similarly but require different treatment. 3) Uncommon conditions like Charcot foot deformity and intractable plantar keratosis that result from neuropathy or structural abnormalities. 4) Nail problems in diabetics or due to fungus, and treatments ranging from thinning the nail to surgical removal or matrixectomy for ingrown nails.
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A Colle's fracture occurs when the radius bone in the forearm breaks near the wrist. This causes pain and swelling in the wrist and prevents normal movement. It typically affects older people with osteoporosis. Treatment involves immobilizing the wrist with a splint or cast to stabilize it while it heals, which can take several weeks. Surgery may be needed if the bones are not properly aligned.
Hammertoes
Call Now (412) 486-5100 - At Dr. Nigro Ankle and Foot Care we have been committed to providing you with the most advanced podiatric care in a compassionate and caring environment since 1990. Dr. Nigro Foot and Ankle Care physicians take a whole-person approach to your feet and ankles, because your overall wellness can influence the health of your feet. Visit us at http://PittsburghFootandAnkle.com
Hammer Toes: Causes, Symptoms and Treatments
Hammer Toes: American college of foot and ankle surgeons. An insight into what a hammertoe is and possible treatments for hammertoes including hammertoe correction surgery. via American College of Foot and Ankle Surgeons
Rare Bone Tumours
The document discusses several rare bone tumors including:
- Synovial chondromatosis, which involves cartilaginous metaplasia within joints that can lead to loose bodies. Symptoms vary depending on location and stages of the disease. Treatment includes surgery.
- Desmoid tumors (fibromatosis), which are locally aggressive proliferative lesions of connective tissue that infiltrate muscle but do not metastasize. Surgery is the main treatment.
- Hemangiomas, which are benign tumors of blood vessels that can be painful and recur without complete removal. Location and invasiveness vary.
- Osteoid osteoma, a benign bone tumor most common in young males. Presentation includes pain
DEFORMATIES IN LEPROSY.pptx
Deformities in leprosy arise due to tissue infiltration and nerve damage. Primary impairments are loss of sensation and claw hand due to nerve damage. Secondary impairments include joint stiffness and skin contractures. Splinting and reconstructive surgery are used to manage deformities. Splints immobilize parts to relieve pain and prevent worsening of contractures. Microcellular rubber footwear and self-care including daily foot inspection are emphasized to prevent plantar ulcers.
Fractures toes metatarsals
Call Now (412) 486-5100 - At Dr. Nigro Ankle and Foot Care we have been committed to providing you with the most advanced podiatric care in a compassionate and caring environment since 1990. Dr. Nigro Foot and Ankle Care physicians take a whole-person approach to your feet and ankles, because your overall wellness can influence the health of your feet. Visit us at http://PittsburghFootandAnkle.com
Trauma 4
This document discusses dentoalveolar injuries, which involve trauma localized to the teeth and supporting structures of the alveolus. It classifies different types of injuries including those involving the hard dental tissues, periodontal tissues, supporting bone, and soft tissues. Treatment depends on the type and extent of injury, and may include procedures like splinting, extraction, endodontic treatment, or reimplantation of avulsed teeth. Complications can arise if injuries are not properly treated.
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Foot Health 101 - Ali El-Saheli DPM,FACFAS - April 23, 2019
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Warts And Lesions
This document discusses different types of warts and wart treatments. It covers:
- HPV types I-IV that cause different wart lesions like plantar warts, mosaic warts, and seed corn lesions.
- Warts are more common in children due to immune system development and can spread through skin cuts.
- Common wart treatments include burning, freezing, surgery, or immune system modification/stimulation. Treatments aim to remove the wart but have high recurrence rates.
- Other lesions discussed include porokeratosis plantaris discretum, intractable plantar keratosis, and their distinguishing characteristics and treatments. Success rates of different treatments are provided.
New Dm Lecture
Diabetes mellitus is a disease that affects 21 million people in the US, with 1 million new cases diagnosed each year. Poor diet and obesity are the primary causes of type 2 diabetes. Diabetes is treated through diet, exercise, oral medications, and insulin injections to control blood glucose levels. Uncontrolled diabetes can lead to serious side effects by damaging tissues and blood vessels over time like retinopathy, nephropathy, and cardiovascular disease. Proper foot care and glucose management can help prevent complications.
Neuropathic Pain Lecture
The document discusses neuropathic pain, its etiology and treatment. It notes that chronic pain often has an unknown cause, persists after healing for at least 3 months, and requires treatment of both the underlying disease and pain disorder. It also categorizes neuropathies as focal like mononeuritis or entrapment, or diffuse like proximal or distal neuropathies affecting large or small fibers. Additionally, it states that many neuropathic pain patients continue suffering despite therapy and developing new rational treatments has been slow.
Mri In Stress Fractures
A 48-year-old woman reported foot and ankle discomfort for 2-3 months but plain films showed no pathology. Though she had continued pain after treatment, a bone scan detected increased activity in the calcaneus. Magnetic resonance imaging then clearly revealed a through and through fracture of the calcaneal midbody that had not been detected on prior tests. The MRI allowed visualization of the fracture when plain films were negative, and proved more cost-effective than the bone scan that did not locate the fracture despite detecting increased calcaneal activity.
Giant
Giant cell tumor of bone is a benign but aggressive tumor comprising 5% of bone tumors. It typically occurs in the long bones of the lower extremity in 20-40 year olds. Diagnosis is made based on imaging showing an eccentric, osteolytic lesion extending into the subchondral bone. Treatment involves curettage with phenolization or cryosurgery to minimize the high recurrence rate of 40-60%.
Emergency Room Notes
This document provides guidelines for emergency room treatment of lower extremity injuries such as puncture wounds and fractures. It outlines how to classify and treat puncture wounds based on depth and contamination risk. All puncture wounds should be explored, treated with antibiotics, and deeper wounds should undergo irrigation and debridement. For fractures, the document stages injuries based on location and provides treatment guidelines, emphasizing the need for splinting, casting, and keeping the area non-weight bearing to prevent complications. Missed or improperly treated fractures can result in poor healing, infection, or need for later surgical fixation.
Electronic Imaging Presentation
Electronic correction is an actual procedure used to correct errors in documents. It allows for mistakes to be fixed digitally rather than through physical means like using whiteout or retyping pages. The digital process is more efficient and helps save time and resources compared to traditional correction methods.
Diabetes Lecture
Poorly controlled diabetes can lead to four changes in the feet: neuropathy, angiopathy, immunopathy, and dermopathy. Neuropathy involves damage to nerves and can be autonomic, motor, or sensory. This nerve damage means injuries and issues with the feet may not be noticed or felt. Combined with reduced blood flow from angiopathy, this makes diabetics more susceptible to foot ulcers and infections. Left untreated, these issues can lead to amputation. The document emphasizes the importance of checking feet daily and seeing specialists regularly to monitor for any injuries, color changes, or other issues in order to catch problems early and prevent amputations.
Cutaneous Presentations Of Systemic Diseases
1. The document discusses various cutaneous manifestations of systemic diseases, including bacterial infections like gonorrhea, fungal infections like candidiasis, and various cancers that can present with lesions on the skin, nails, or mucous membranes.
2. Specific conditions covered include subacute bacterial endocarditis, various forms of leukemia, graft-vs-host disease, lichen planus, dermatomyositis, acanthosis nigricans, and others that have characteristic skin findings and associations with internal malignancies.
3. Many infectious diseases are also detailed, such as syphilis, meningococcemia, tuberculosis, and their cutaneous presentations. Internal conditions like diabetes and pancreatic diseases can
Burn Lecture
This document discusses the management and treatment of burn injuries. It covers topics such as the pathophysiology of different burn depths including superficial, partial thickness, and full thickness burns. Treatment approaches are described for different burn depths, including cleansing, debridement, topical antibiotics, temporary skin substitutes, excision and grafting. Special care areas like the face, ears, hands and feet are discussed. Burn wound infection, advanced products like silver dressings, skin substitutes and negative pressure wound therapy are also summarized.
BroströM Procedure Presentation
The document describes the Modified Broström Procedure for treating unstable ankles. It discusses how ankle instability is graded from I to III based on the amount of instability present. It notes that grade I and some grade II ankles may be treated conservatively through physical therapy and bracing, while grade III typically requires surgical reconstruction. The Modified Broström Procedure is described as restoring stability through anatomic repair of the ligaments while preserving range of motion and the peroneal tendons. It involves attaching the extensor retinaculum to reinforce the repaired ligaments and correct subtalar instability.
Wound Vac Lecture
This document discusses diabetic wound management concepts and treatment. It notes that diabetes affects over 23 million Americans and costs over $100 billion annually to treat. Up to 51% of lower extremity amputations are due to diabetes. The document covers diabetic wound etiology such as neuropathy, immunopathy, and vasculopathy. It discusses testing, debridement, culture, grading scales, and the phases of wound healing. The goal of treatment is reducing further deformity and infection while retaining viable extremities through biomechanical and nutritional considerations.
Arthroereisis Lecture
This document discusses the history and application of subtalar arthroereisis, a surgical procedure used to treat flatfoot deformity. It begins by describing different types of flatfoot and the goal of subtalar arthroereisis to restrict excessive joint motion while preserving some functionality. The document then details the evolution of various implant designs used for arthroereisis from the 1940s to present day. It provides classifications for implants and discusses their materials, locations of placement, fixation methods, and biomechanical effects. Potential indications, contraindications, and complications of the procedure are also summarized.
Bite Wound Lecture
Management of Human and Animal Bite Wounds provides an overview of bite wound infections. Over 1 million animal bites occur annually in the US, with dog bites accounting for 80-90% and resulting in over a dozen deaths each year. Bite wounds can become infected by bacteria from the biting animal's mouth and skin flora. Common complications are lymphangitis, septic arthritis, and osteomyelitis. Proper management includes thorough wound cleansing, debridement if needed, antibiotics, and tetanus prophylaxis. Cultures may be taken to guide antibiotic selection.
Bone Tumors
The document discusses how to identify benign and malignant bone tumors in the foot and ankle based on imaging characteristics. Benign tumors typically present with well-defined borders, geographic bone destruction, and solid periosteal reactions, while malignant tumors usually have poorly defined borders, moth-eaten bone destruction, and interrupted periosteal reactions. Both primary and secondary bone tumors can occur in this location and staging involves imaging like x-rays, CT, MRI and biopsy to determine the tumor type before treatment with surgery, radiation or chemotherapy.
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Corn And Nail Presentataion To Residents
- 1. Nails, Corns and Stuff* *(or how I spent an afternoon listening to the most boring lecture topic on the planet)
- 2. The Common Corn • Also known as an heloma dura lesion on the toe or a tyloma on the bottom of the foot • Commonly have bursa underneath with nerve entrapment
- 3. The Common Corn How do you cut these things (and what’s the big deal)? When do you stop? [blood is a good guide that you’re done, bone is a definite] What if they’re too painful to cut? [possible use of local block before and cortisone in the bursa after] What makes these things occur [bone spur and contractures with poor shoes] How can I keep them from coming back? [Δ in shoe gear and padding if minor, surgical resection of spur if chronic and debilitating]
- 4. The Common Corn • What if it walks like a corn and quacks like a corn, but isn’t a corn? [hammer toe without heloma dura lesion formation] • How do you treat stuff like this? [padding, shoes, emollients] • Can you keep it from coming back? [pressure causes the problems, relieving pressure will ameliorate it if not alleviate it]
- 5. The Uncommon Corn • This is Charcot neurotrophic osteoarthropathy with sub-navicular prominence and callus from weight- bearing.
- 6. The Uncommon Callus • The IPK (intractable plantar keratosis) • Deep core • Associated with plantarflexed metatarsal head and contractures
- 7. Callused skin • Xerotic skin • Can be associated with genokeratosis disease states such as Diabetes Mellitus, Unna-Thost and variants, certain heavy metal poisoning • Do you debride this?
- 8. Nail Problems • Thick, nasty, brittle and hard • Often seen in Diabetes Mellitus patients • Pressure upon nail bed can lead to ulceration • Either thin the nail or surgically remove
- 9. Nail Problems • Fungus allows lysis from the underlying nail bed • Definite hazard to catching on sock and traumatically avulsing
- 10. Nail Problems • Ingrown nails can cause a more involved infection • Long-term relief involves surgical resection and cautery of the matrix • Procedure is painless if the initial block is good
- 11. Nail Problems • After care includes Epsom salt soaks and light dressing with antibiotic. • If adequate matrixectomy was done, the nail shouldn’t regrow
- 12. Thank you!