PTTD is typically seen in conjunction with a flat foot. So inherent in the surgical correction of PTTD is stabilization of the foot. Sure, you can do a primary repair on the PT tendon but without stabilization of the foot, your PT tendon repair is often doomed to failure.
So what procedure is best? Podiatry seems to favor subtalar arthroeresis using CSI, MBA of STA Pegs. Orthopedics seems to favor The All American Procedure. Which is best? Join us in the discussion.
When evaluating foot pain, podiatrists need to keep in the back of their minds the differential diagnosis of radiculopathy. Radiculopathy is pain that is referred to the extremities due to compression of the nerve as it leaves the lumbar and sacral spine. There’s a number of different reason why we develop radiculopathy, but what’s important for us foot docs is to keep in mind that question during the physical exam; any history of low back pain, low back injury or lumbar surgery? If yes, that becomes an issue that may be a contributing cause of foot and leg pain. And in many instances, foot pain may be the primary symptom of radiculopathy.
How do we diagnosis foot pain caused by radiculopathy and how do we treat it? Please join us in the discussion. We’d appreciate your comments.
Haglund’s deformity refers to a bump on the posterior lateral aspect of the heel. This condition is also known as a pump bump, the later definition being coined in the ’50’s when pumps were so popular. We tend to think that pump bumps are the result of direct pressure to the heel by the shoe. Pump bumps seem to be found in cases of calcaneal varus (a slanting of the heels). Calcaneal varus looks like this…. \ /…. when viewed from the back. So the formation of the pump bump comes from the calcaneal varus pressing against the rim or counter of the heel of the shoe. We’ll often see a Haglund’s deformity in figure skaters and hockey players. The rigid heel counter of the skate seems to make these athletes more prone to pump bumps.
What can we do to treat a pump bump? Join the discussion for more information.
Peripheral neuropathy is the loss of sensation in the feet, and to a lessor degree in the hands. The cause of peripheral neuropathy can be from a number of different factors. In foot care, I look at peripheral neuropathy (PN) as a metabolic, physical or toxic issue.
The most common metabolic condition that contributes to PN is diabetes. But PN can also be the result of impingement of the nerve secondary to problems such as lumbar radiculopathy or focal nerve entrapments. And finally, PN can be secondary to toxic exposure such as alcohol abuse or exposure to toxic chemicals such as chemotherapy agents.
Idiopathic peripheral neuropathy is also found. The term idiopathic referres to a condition for which we cannot find a reason or etiology.
This discussion is interesting in that peripheral neuropathy contributed to joint instability and resulted in a subtalar joint dislocation. A subtalar joint dislocation is a rare injury that, in this case, was likely brought on by the lack of sensation surrounding the subtalar joint.
Chronic Achilles tendonitis is common and affects many active folks, particularly in their thirties and forties. The 4th and 5th decades of life seem to be most susceptible to Achilles tendonitis due to the fact that that’s where we’re still active but just don’t have the capacity to heal quite as well as we may have in years gone by.
So how is chronic Achilles tendonitis treated? Join the conversation. We’re talking about conservative care vs surgical care. We’re also talking about the Topaz coblation technique.
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