Items filtered by date: September 2012

As cooler weather returns to Columbus, with the official first day of fall this past Saturday, many people will be transitioning from their open to closed-toed shoes. While toenails may be out of sight in closed-toed shoes, they also may be more prone to developing painful ingrown toenails.

Onychocryptosis is the term that describes toenails that puncture the skin surrounding the nail. The feet and toes come in contact with a multitude of bacteria, and these areas of skin punctured by curved nails have a propensity to become infected. Nails that are naturally curved are at a higher risk for irritating or piercing the skin. Onychocryptosis is most commonly caused when an individual attempts to trim nails in a way that rounds the corners of the nail. When rounding the toenail, a barb or small angular piece may remain and cause irritation to the skin. If allowed to progress, the irritation may become infected. Signs of an infected ingrown toenail include swelling, redness, pain, warmth and drainage from the affected nail border. These infections in the skin surrounding the nail are referred to as paronychia. Because the bone comprising the tip of the toe lies directly underneath the nail bed, paronychia can spread down to bone causing osteomyelitis, or bone infection.

With such serious consequences, infected ingrown toenails should be avoided if possible and treated by your podiatrist when if they do occur. Preventative measures against ingrown toenails include: trimming toenails straight across, keeping feet clean and choosing shoes with an appropriately wide toebox. When an ingrown toenail does occur, warm soaks of the toe may offer some temporary relief, but the problem will not be resolved until the nail piece causing the irritation is removed. There are several options when it comes to the treatment of ingrown toenails. A partial nail avulsion may be performed in which the offending strip of nail is removed. Another more permanent option is known as a partial chemical matrixectomy. The procedure removes the offending portion of the nail and your podiatrist then applies a chemical that will kill the area that the nail grows from. This prevents the regrowth of a section of the nail and thus future occurrences of ingrown toenails. In some cases, the skin surrounding the nail may be enlarged from repeatedly being irritated by the nail. When this occurs, the skin can be reduced along with a partial removal of the nail growth center, or matrix – a technique known as a Winograd surgery. Whichever treatment course you and your podiatrist decide upon, this fall can end the cycle of repeated painful ingrown toenails!

Please visit www.ColumbusFoot.com for more information or call 614-885-3338 (FEET) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

As kids reunite with their friends for the new school year in Columbus, there is bound to be some extra zealous recess playtime. While many parents may worry about injuries in their growing kids, parents will be relieved to know that foot fractures account for only around five to eight percent of pediatric fractures. By properly preparing children for physical activity at school and knowing what injuries can occur, parents can keep their kids healthy and enjoying the playground!

Growth plates are unique to children’s bones. All bones in the lower extremity begin as a cartilage structure that is, over time, ossified or transformed completely to bone. A growth plate is a small section of cartilage that remains ossifying between two sections of bone. In the foot and leg, most bones begin to ossify while the child is still in the womb and growth plates do not close until the child is done growing. For most bones, growth plates close around 18 to 20 years of age. Injuries in children’s feet must always be carefully evaluated to avoid or minimize damage to a growth plate. If a growth plate suffers an injury, whether it be a bruise, crush or separation from the ossified bone, the bone may not develop to its full length which can result in deformity and loss of function for the child.

The presence of cartilage and the structure of newly formed bone in children lowers the incidence of fractures compared to adults. Bones are less brittle but may fracture in different ways than adult bones. Children’s bones may receive a buckle fracture or what is known as a “greenstick fracture”. These fractures bring to mind the image of how a toothpick or piece of wood splinters when it is bent. In small children, if fracture is suspected but not visualized on x-ray, an occult or “hidden” fracture may still be present. If a podiatrists suspects an occult fracture based on clinical exam, the foot will be treated as if there is a fracture with a cast for two to five weeks in most cases.

Children are very resilient and while parents should be on the lookout for any bruising, swelling or tales of school yard trauma, foot injuries typically heal with minimal long term damage. Many fractures and even minor growth plate injuries can typically be healed with an immobilizing boot cast. Parents should ensure that their children wear properly fitted athletic sneakers and that they contact their podiatrist if they notice any disturbances in ambulation including tripping or limping.

Please visit www.ColumbusFoot.com for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

With the NFL regular season beginning this week and college classes recently beginning, Buckeyes, Browns and Bengals fans will be on their toes at the first sign of any serious football foot injuries. Ankle injuries including ankle sprains and ankle fractures are two of the most common athletic injuries. This year, Cincinnati Bengal center Kyle Cook has already been placed on injured reserve following an injury to his right foot and ankle. While this injury may allow Cook to potentially return to the field this year, coaches and medical staff for the Bengals are certainly on the lookout for an injury to the lower bone of the ankle known as an osteochondral defect.

Osteochondral defect, or osteochondritis dissecans, is an injury to the cartilage and often underlying bone of a joint. While these injuries most commonly occur in the knee, they also occur in the ankle in up to 50% of acute ankle fractures and ankle sprains. In order for the ankle to function at its optimal level, as is definitely required for a professional athlete, the cartilage of the talus, which is the lower bone of the ankle joint, must be smooth and intact. When an injury tears at the smooth cartilage of the talus, pain, locking and clicking sensations and loss of range of motion occur in the ankle. In patients with chronic ankle pain after a previous ankle injury has been treated or ankle pain without previous trauma, these injuries should be evaluated by your podiatrist as a possible diagnosis. Following an ankle sprain or fracture, osteochondral defects may not appear on x-ray. Magnetic resonance imaging, or MRI, or direct visualization of the joint through arthroscopy may be necessary.

Luckily, with the thorough and prompt treatment professional athletes such as Kyle Cook receive, osteochondral defects of the talus can be identified rapidly. Early treatment will lessen the likelihood of lasting problems and loss of function of this important joint that is subject to more load per unit of area than any other joint in the body. Depending on the severity of the cartilage injury, the ankle may need to be immobilized or operated upon. Studies in recent years have shown that following surgery for osteochondral defects of the talus in elite athletes, almost all individuals were able to return to their normal activity level in four to five months and continue participating in the activities they enjoy!

Please visit www.ColumbusFoot.com for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

Over half of all amputations in the United States each year are caused by diabetes mellitus and most of these amputations are of the lower extremity. Trauma, infection and severe deformity of the foot and ankle can all be reasons that an amputation may be needed to allow an individual to continue to have a healthy life with the best possible function of their lower extremity. However, in 11 year old Gabriel Muniz’s case of living without either of his feet, they were not amputated. Muniz was born without feet and has been making news recently for the soccer skills he possesses without the aid of a prosthetic limb.

Muniz’s condition is likely the limb deficiency known as “apodia” in which the distal portion of his lower extremities, the feet, simply did not develop. The causes of this lack of development are not well known but can include genetic factors, nutrient deficiencies, deviations from the normal distribution of sensory nerves in bone and external factors, such as viruses.

Apodia is certainly not the only foot deformity that children may be born with. Another condition called “talipes equinovarus” or more commonly “clubfoot” affects one in 1,000 live births in the United States. Newborn feet with clubfoot appear rotated so the bottom of the affected foot faces towards the other foot, instead of towards the ground. Luckily, like to Gabriel Muniz, children born with clubfoot typically can recover to have an active and healthy foot. As with most conditions of children’s feet, the earlier treatment begins of clubfoot, the better the chances are for a complete recovery. The treatment for clubfoot involves casting the baby’s foot repeatedly over the course of weeks to progressively correct the deformity. Foot surgery may still be required for complete correction after casting. However, casting typically reduces the amount of deformity enough so that the surgery is minor compared to what would be needed if casting were not performed early on.

Gabriel Muniz should be an inspiration to any individual born with foot deformity or struggling after a lower extremity amputation that a happy and healthy lifestyle is possible!

Please visit www.ColumbusFoot.com for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.