Foot & Ankle Conditions
Alpharetta Foot and Ankle Specialists seeks to provide the highest level of care to keep our patients healthy and active on their feet. We always strive to cure our patients with conservative methods first, offering minimally-invasive procedures when needed utilizing the latest technologies in surgery to promote healing, shorten recovery times, and return our patients to activity as soon as possible.
Ankle arthroplasty is surgery to replace the damaged parts of the three bones that make up the ankle joint. Your symptoms may be pain and loss of movement of the ankle, and the causes of the damage may include osteoarthritis, rheumatoid arthritis, infection, bone fracture or arthritis caused by ankle surgery in the past. Artificial joint parts are used to replace your own bones, and they come in different sizes for different sized people.
- Your surgeon will remove the damaged bone and will reshape three of your bones that will remain in place
- The lower end of your shin bone (tibia)
- The lower end of your smaller lower leg bone (fibula)
- The top of your foot bone (talus) that the leg bones rest on
- The parts of the new artificial joint are then attached to the cut bony surfaces. A special glue/bone cement may be used to hold them in place. Often, screws are also placed through the two leg bones (fibula and tibia) to help support the artificial ankle. A bone graft is created between the ends of the fibula and tibia. This makes your new ankle more stable.
- After putting the tendons back into place, the surgeon closes the wound with sutures (stitches). You may need to wear a brace for a while to keep the ankle from moving.
After surgery, you will go home the same day. Your ankle will be in a cast or a splint after surgery. To keep swelling down, keep your foot raised higher than your heart while you are sleeping or resting. Your doctor may recommend physical therapy to teach you exercises that will help you move more easily.
A successful ankle replacement will get rid of your pain and allow you to move your ankle up and down. Usually, total ankle replacements last 10 or more years. How long yours lasts will depend on your activity level, overall health, and the amount of damage to your ankle joint before surgery.
Tendon repair is surgery to repair damaged or torn tendons to bring back normal function of joints or surrounding tissues. The surgeon makes a cut on the skin over the injured tendon. The damaged or torn ends of the tendon are sewn together.
If the tendon has been severely injured, a tendon graft may be needed.
- In this case, a piece of tendon from the foot, toe, or another part of the body is often used.
- If needed, tendons are reattached to the surrounding tissue.
- The surgeon examines the area to see if there any injuries to nerves and blood vessels. When complete, the wound is closed.
Tendon repairs can often be done in an outpatient setting. Hospital stays, if any, are short.
- Healing may take 6 - 12 weeks. During that time the injured part may need to be kept still in a splint or cast. Typically, movement is returned gradually with therapy to protect the tendon as it heals.
- Treatment after surgery is often needed to minimize scar tissue and maximize the use of the injured area.
If the tendon damage is too severe, the repair and reconstruction may have to be done at different times. The surgeon will perform one operation to repair part of the injury, and then allow the hand to heal for a few weeks. Another surgery will be later done to complete the reconstruction and repair the tendon.
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A bunion is when your big toe points toward the second toe. This causes a bump to appear on the outside edge of your toe. Bunions are more common in women and can sometimes run in families. People born with abnormal bones in their feet are more likely to form a bunion.
- Wearing narrow-toed, high-heeled shoes may lead to the development of a bunion.
- The condition may become painful as the bump gets worse, and extra bone and a fluid-filled sac grow at the base of the big toe.
- Red, calloused skin along the inside edge of the big toe
- A bony bump at this site
- Pain over the joint, which pressure from shoes makes worse
- Big toe turned toward the other toes
When a bunion first begins to develop, take good care of your feet.
- Wear wide-toed shoes. This can often solve the problem and prevent you from needing more treatment.
- Wear felt or foam pads on your foot to protect the bunion, or devices called spacers to separate the first and second toes. These are available at drugstores.
- Try cutting a hole in a pair of old, comfortable shoes to wear around the house.
If the bunion gets worse and more painful, surgery to realign the toe and remove the bony bump (bunionectomy) can be effective. There are more than 100 different surgical procedures to treat this condition. Not every bunion is the same, nor is every bunion surgery the same. We take an individualized approach to each patient’s condition.
Hammer toe is a deformity of the toe, in which the end of the toe is bent downward into a claw-like position. The most common cause of hammer toe is wearing short, narrow shoes that are too tight, which force the toe into a bent position. At first, you may be able to move and straighten the toe. Over time, you will no longer be able to move the toe and it will be painful.
- Pain when walking or wearing shoes
- Corn formation on the top of the toe
- Calluses present at the sole of the foot
Wearing the right size shoes and avoiding high heels can relieve symptoms associated with hammer toe. For people with severe hammer toe, surgery may be required. This involves cutting of bone and/or moving tendons and ligaments in the foot. Patients are able to go home the same day as surgery.
Diabetic (Charcot) Foot
Charcot foot is a condition in which the bones of the foot weaken as a result of nerve damage. The weakened bones may fracture, and can cause the foot to change shape over time. As the disorder becomes more severe, the joints may collapse and cause the foot to take on an abnormal shape. Patients with Diabetes and Charcot are at a significant risk for future amputations.
- Soreness and pain
- Redness and warmth
It is critical for Charcot foot to be identified early. Nonsurgical treatments are available depending on the severity of the condition, and consist of immobilization until the bones repair themselves, and using special shoes and inserts after the bones have healed. Surgery may sometimes be needed to repair the foot, although the procedures depend on the timing and severity.
Diabetic Foot Care Guidelines
Diabetes can damage the nerves and blood vessels in your feet. This damage can cause numbness and reduce feeling in your feet. As a result, your feet may not heal well if they are injured. If you get a blister, you may not notice, and it may get worse.
Check your feet every day. Inspect the top, sides, soles, heels, and between the toes. Look for:
- Dry and cracked skin
- Blisters or sores
- Bruises or cuts
- Redness, warmth, or tenderness
- Firm or hard spots
If you cannot see well, ask someone else to check your feet.
Call your doctor right way about any foot problems. Do not try to treat them yourself first. Even small sores or blisters can become big problems if infection develops or they do not heal.
Wash your feet every day with lukewarm water and mild soap. Strong soaps may damage the skin.
- Check the temperature of the water with your hands or elbow first.
- Gently dry your feet, especially between the toes.
- Use lotion, petroleum jelly, lanolin, or oil on dry skin. Do NOT put lotion between your toes.
Ask your health care provider to show you how to trim your toenails.
- Soak your feet in lukewarm water to soften the nail before trimming.
- Cut the nail straight across, because curved nails are more likely to become ingrown.
- Your foot doctor (podiatrist) can trim your nails if you are unable to.
Most people with diabetes should have corns or calluses treated by a foot doctor. If your doctor has given you permission to treat corns or calluses on your own:
- Gently use a pumice stone to remove corns and calluses after a shower or bath, when your skin is soft.
- Do NOT use medicated pads or try to shave or cut them away at home.
If you smoke, stop. Smoking decreases blood flow to your feet. Talk with your doctor or nurse if you need help quitting.
Do not use a heating pad or hot water bottle on your feet. Do not walk barefoot, especially on hot pavement or hot sandy beaches. Remove your shoes and socks during visits to your health care provider so that they can check your feet.
Shoes and Socks
Wear shoes at all times to protect your feet from injury. Before you put them on, always check the inside of your shoes for stones, nails, or rough areas that may hurt your feet.
Wear shoes that are comfortable and fit well when you buy them. Never buy shoes that are tight, hoping they will stretch as you wear them. You may not feel pressure from shoes that do not fit well. Blisters and sores can develop when your foot presses against your shoe.
Ask your doctor about special shoes that can give your feet more room. When you get new shoes, break them in slowly. Wear them 1 or 2 hours a day for the first 1 or 2 weeks.
Change your broken-in shoes after 5 hours during the day to change the pressure points on your feet. Do not wear flip-flop sandals or stockings with seams. Both can cause pressure points.
Wear clean, dry socks or non-binding panty hose every day. They will help protect your feet. Holes in socks or stockings can put damaging pressure on your toes.
You may want special socks with extra padding. Socks that move moisture away from your feet will keep your feet drier. In cold weather, wear warm socks, and do not stay out in the cold for very long. Wear clean, dry socks to bed if your feet are cold.
Sprained Ankle Care
A sprain occurs when the foot lands awkwardly, causing some ligaments to pull, stretch and tear. When the injury occurs to the middle part of the foot, it is called a foot sprain. Ankle and foot sprains are among the most common types of injuries, especially among athletes.
- Pain and difficulty when walking
- Swelling and bruising of affected part of the foot or ankle.
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Treatment for mild sprains is conservative and usually just involves resting, compressing, elevating and icing the affected area. Oral medications, such as ibuprofen, may also be used to help reduce inflammation. For more serious sprains, temporary bracing may be used to help reduce inflammation and help hold ligaments in place to heal properly. A brief course of physical therapy has also been shown to help in recovery. More serious injuries such as fractures of the foot and ankle can often be mistaken as common sprains. If your condition does not improve or you begin to experience increased pain, swelling, bruising, and difficulty walking, it's important to seek out care immediately.