Common Foot and Ankle Injuries: You Don’t Have to Suffer!

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Join us for a lecture on common foot and ankle injuries, diseases, and conditions, including skin lesions/soft tissue masses, fungal nails, plantar fasciitis, bursitis, hammertoes, bunions, tendonitis, ankle sprains, and arthritis. In addition to discussing causes, the lecture will focus on treatments that can help you get back on your feet!

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Common Foot and Ankle Injuries: You Don’t Have to Suffer!

  1. 1. Warren A. Chiodo, DPM Summit Medical Group- Berkeley Heights Bensley Pavilion, 2nd Fl.
  2. 2.     Understand what a Podiatrist is and how they can help you Understand that painful feet and ankles are not normal and can indicate/lead to bigger issues Understand why you are having foot and ankle pain Understand what treatment options are available to resolve your foot and ankle pain
  3. 3.  Dermatological ◦ Plantars warts ◦ Fungal nails and Athlete’s feet ◦ Melanomas and other cancerous lesions     Biomechanical Bunions and hammertoes Heel pain Flat Feet and High arches
  4. 4.  Sports Medicine and Trauma ◦ ◦ ◦ ◦ Ankle Sprains Achilles Tendonitis Ankle Fractures Foot fractures  Pediatrics ◦ Clubfoot ◦ Flat feet ◦ Calcaneal Apophysitis (heel pain) ◦ Foreign bodies
  5. 5.  Systemic Problems ◦ Diabetes Mellitus  Peripheral Vascular Disease  Neuropathy ◦ Rheumatoid Arthritis ◦ Gout
  6. 6.  Plantar Warts ◦ Caused by virus ◦ Can be found in gyms, locker rooms, pools, salons ◦ Can be painful if on weight bearing surface of foot
  7. 7.  Treatments ◦ 1st Visit: Biopsy and topical treatment ◦ Subsequent Visits: Debridement and repeat applications of topical treatments ◦ Possible surgical excision, oral antiviral, or topical antiviral as needed
  8. 8.  Onychomycosis ◦ Fungal infection of nails  Generally occurs after any microtrauma to nail plate that exposes nail bed  Athlete’s Foot (Tinea pedis) ◦ Fungal infection of skin
  9. 9.  Onychomycosis  Tinea Pedis ◦ Prescription topical anti-fungal solutions, gels, crea ms, lotions ◦ Over-the-counter creams and powders ◦ Soak in tea tree oil or tanic acid (black tea)
  10. 10.  Melanomas and Other Cancerous lesions  Benign Skin Lesions
  11. 11. PUNCH BIOPSY!!   May require surgical intervention or referral for further oncological workup If benign, can continue to observe or excise
  12. 12.  Bunions and Hammertoes
  13. 13.  Bunions and Hammertoes ◦ Conservative Care     Injection therapy Toe sleeves Alternative shoe gear Custom Molded Orthoses ◦ Surgical Intervention  Generally considered the only long-term treatment for symptomatic bunions and hammertoes
  14. 14.  Bunion surgery
  15. 15.  Heel Pain a.k.a Plantar Fasciitis ◦ Caused by excessive strain on the ligament on bottom of foot ◦ May develop a heel spur ◦ Generally worst when getting up from rest or after long periods of activity ◦ Pulling, sharp pain in bottom of heel or throughout the arch
  16. 16.  Plantar fasciitis ◦ Injection therapy  1-3 injections ◦ Stretching  Daily ◦ Icing  Frozen bottle of water ◦ Custom Molded Orthoses ◦ Night splint ◦ Physical Therapy
  17. 17.  Plantar fasciitis ◦ 90% of people get resolution of symptoms with conservative care  The unlucky 10% have minimally invasive options ◦ ◦ ◦ ◦ Radiofrequency Platelet rich plasma Shockwave therapy Fasciectomy with or without heel spur resection
  18. 18.  Ankle Sprains ◦ Generally caused by twisting ankle towards outside (inversion) ◦ Can damage ligaments and tendons ◦ Common in sports or when you least expect it
  19. 19.       X-rays Ambulatory cast CAM Walker Gameday Brace REST, ICE, ELEVATIO N Physical Therapy
  20. 20.  Ankle Sprains ◦ Generally 4-6 week recovery ◦ Should see steady improvement ◦ If no improvement, may need an MRI
  21. 21.  Achilles Tendonitis ◦ Pain at insertion on posterior heel or lower leg ◦ Due to overuse and/or excessive tightness ◦ Could lead to rupture if chronic degeneration of tendon
  22. 22.  Achilles Tendonitis ◦ Immobilization with heel lift ◦ Stretching and icing ◦ Prolotherapy Injection therapy ◦ Night Splint ◦ Physical Therapy ◦ Surgical Intervention
  23. 23.  Ankle Fractures  Foot Fractures
  24. 24.  Foot Fractures    If no displacement, can try conservative care If displaced or unstable, requires surgical intervention Complications: nonunions, malunions, posttraumatic arthritis
  25. 25.  Clubfoot ◦ Typically 1st born child ◦ Requires serial casting ASAP ◦ May require surgical intervention  Flat Feet ◦ All foot bones are not developed until 6 yrs of age ◦ Can be flexible or rigid ◦ If rigid, may require CT or MRI
  26. 26.  Flat feet ◦ Normal ligamentous laxity ◦ How do I know if my child’s flat foot is a problem or normal? ◦ If rigid  Coalition- abnormal joint fusion  Tendon spasm     Stretching Physical Therapy Orthotics Surgical Intervention??
  27. 27.  Calcaneal Apophysitis ◦ Heel pain in children ◦ Generally seen in active children during activities ◦ May occur in overweight children
  28. 28.  Foreign Bodies  ◦ Splinters, needles, gl ass May be taken out and irrigated in office ◦ Aftercare may include soaking and topical antibiotic vs. oral antibiotic  May require surgical procedure if deep
  29. 29.  Diabetes Mellitus ◦ Routine foot examinations ◦ Vascular studies ◦ Nerve conduction studies ◦ Wound Care ◦ Diabetic Shoes and Insoles
  30. 30.  Rheumatoid Arthritis ◦ Leads to foot deformity  Custom molded orthoses  Injection therapy for pain  Possible Surgical intervention  Gout ◦ Uric Acid causing inflammation of joint ◦ Generally seen in big toe joint ◦ Treated with injection therapy or antiinflammatories
  31. 31. Thank you!!! Any Questions???

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