Why and how do we acquire a fungal infections of the nail ? Fungal infections of the nail are called onychomycosis. And in 9 out of 10 cases, we can document some form of trauma to the nail. It seems that ‘the door of susceptibility swings open’ following an injury to the nail allowing a fungal infection to set up shop in our nails.
How can we fight back? Join us in a discussion about onychomycosis.
The first thing to recognize about Morton’s neuroma is that we know what a Morton’s neuroma is, but we really have a weak sense of what causes it. Some theories include the tight shoes, biomechanical instability of the foot or an entrapment of the nerve by a ligament. But what really causes it and why does one person have it and not another? We really don’t know.
So without knowing what’s really causing Morton’s neuroma, how can we comment on the best shoes to use to treat Morton’s neuroma? Here’s an interesting conversation.
Equino varus is usually looked upon as a version of clubfoot. but occasionally we’ll see an adult onset equino varus deformity. Most seem to be due to a traumatic incident that could include loss of function of the peroneus longus tendon.
The biggest consideration in treatment is flexibility.
Peripheral nerve is vastly different from central nerve. The response of peripheral nerve following an injury is to regenerate and grow. If the injury to the nerve effects the sheath of the nerve so that the integrity of the sheath is compromised, then the nerve potentially can develop problems.
In severe cases where the nerve has grown into a mass of poorly differentiated tissue, the nerve will often be cut and buried to inhibit neuroma formation. I’ve tried nerve caps, nerve wraps, cautery of the nerve, injection of the nerve with cortisone…nothing seems to work as well as the old, tired and true method of burying the nerve.
The anterior/lateral ankle is a complex little location at the junction of the foot and ankle. In this location, a number of different functions of the foot and ankle intersect. The primary stability of the lateral ankle is here along with the sinus tarsi, or entry to the subtalar joint. How do you go about differentiating anterior/lateral ankle pain? Join us for the discussion.
Ganglionic cysts are a common tumor of the foot. The differential diagnosis of a ganglionic cyst can be a number of soft tissue tumors to include synovitis, lipoma or even normal anatomy such as the extensor digitorum brevis muscle belly. So how do you know what the cyst could be? The only definitive way to tell is to look at the cyst under a microscope, but there’s a few clinical signs that can usually give away the diagnosis of a ganglionic cyst.
What’s the best way to correct Freiberg’s Infraction? I’ve always struggled with that question. I think my success rate at surgical correction of Freiberg’s is comparable to the general medical community in that Freiberg’s Infraction surgery is not considered to be highly successful.
The problem lies in the fact that Freiberg’s infraction surgery is an attempt to rebuild the metatarsal head following infarction. an infarct is the loss of blood to the metatarsal head with the subsequent death of the bone. In most cases, the death of the bone results in the collapse of the metatarsal head. Cases of Freiberg’s will display varying degrees of collapse of the metatarsal head and loss of cartilage.
Implants have proven to be ineffective with Freiberg’s. So what works best?
The procedures used in foot and ankle surgery vary dramatically, so there’s really no single set of guidelines that can be used universally. But how do you know what to do and how much to do post foot surgery?
First and foremost is following your doctors orders. Your doctor knows your case best and will know what the best course of rehabilitation will be. But as your doctor starts to cut you loose, how much activity is too much?
Being in a cast for a broken bone or following a surgery seems like a pretty straight forward and traditional way of treating injuries. But some folks, a cast just puts them over the top. Patients who have never experienced claustrophobia can develop increasingly worse claustrophobia as they become more focused on the cast. And for most, removal of the cast results in instant relief.
So is a hard cast a must? Not really. For most folks there are alternatives.
The answer? It depends. For some folks, ankle joint replacement seems to be a success. But for many, ankle joint replacement just doesn’t seem to work too well. There’s still some problems with the biomechanical properties of the ankle replacements.
Ankle fusion is an old reliable. Plain and simple it works.
So do you take a chance or use the old reliable…it depends.
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