Bunions, Hammertoes, Flat feet & Other Foot Problems
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Flat Foot

Flat Foot | Bunions, Hammertoes, Flat feet & Other Foot Problems | Scoop.it

Flatfeet can be braodly classified into flexible and rigid in nature. The type of flatfoot is determined through clinical testing.

 

Most flatfeet are flexible and can be treated well with orthoses and specific exercises. Mr. Ozan Amir works closely with Podiatrists and will refer you to one of his colleagues near your area to have orthoses fabricated.

 

In a minority of cases, conservative care does not alleviate the symptoms that can be associated with flatfeet. When this is the case Ozan will order the appropriate x-rays to evaluate the severity of deformity.

 

There are a number of surgical procedures available to correct and restore the alignment of the flatfoot, inlcuding minimally invasive procedures such as the hyprocure extra-articular subtalar joint implants and a multitude of other 'traditional open' tendon and bone re-alignment procedures.

 

Ozan will discuss in depth with you which procedure(s) would be suitable for you, so you can make an informed decision on how to proceed.

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Arthritic Big Toe

Arthritic Big Toe | Bunions, Hammertoes, Flat feet & Other Foot Problems | Scoop.it

WHAT IS HALLUX RIGIDUS?

 

Hallux rigidus is a disorder of the joint located at the base of the big toe. It causes pain and stiffness in the joint, and with time it gets increasingly harder to bend the toe. „Hallux” refers to the big toe, while “rigidus” indicates that the toe is rigid and cannot move. Hallux rigidus is actually a form of degenerative arthritis.

This disorder can be very troubling and even disabling, since we use the big toe whenever we walk, stoop down, climb up, or even stand. Many patients confuse hallux rigidus with a bunion, which affects the same joint, but they are very different conditions requiring different treatment.

Because hallux rigidus is a progressive condition, the toe‟s motion decreases as time goes on. In its earlier stage, when motion of the big toe is only somewhat limited, the condition is called “hallux limitus.” But as the problem advances, the toe‟s range of motion gradually decreases until it potentially reaches the end stage of “rigidus,” in which the big toe becomes stiff, or what is sometimes called a “frozen joint.”

 

CAUSES

 

Common causes of hallux rigidus are faulty function (biomechanics) and structural abnormalities of the foot that can lead to osteoarthritis in the big toe joint. This type of arthritis – the kind that results from “wear and tear” – often develops in people who have defects that change the way their foot and big toe functions. For example, those with fallen arches or excessive pronation (rolling in) of the ankles are susceptible to developing hallux rigidus.

In some people, hallux rigidus runs in the family and is a result of inheriting a foot type that is prone to developing this condition. In other cases, it is associated with overuse – especially among people engaged in activities or jobs that increase the stress on the big toe, such as workers who often have to stoop or squat. Hallux rigidus can also result from an injury, such as stubbing your toe. Or it may be caused by inflammatory diseases such as rheumatoid arthritis or gout.

Mr. Amir can determine the cause of your hallux rigidus and recommend the best treatment.

 

DIAGNOSIS

 

The sooner this condition is diagnosed, the easier it is to treat. Therefore, the best time to see a foot and ankle surgeon is when you first notice symptoms. If you wait until bone spurs develop, your condition is likely to be more difficult to manage.

In diagnosing hallux rigidus, Mr Amir will examine your feet and move the toe to determine its range of motion. X-rays help determine how much arthritis is present as well as to evaluate any bone spurs or other abnormalities that may have formed.

 

WHEN IS SURGERY NEEDED?

 

In some cases, surgery is the only way to eliminate or reduce pain. There are several types of surgery for treatment of hallux rigidus. In selecting the procedure or combination of procedures for your particular case, Mr Amir will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors.

The length of the recovery period will vary, depending on the procedure or procedures performed.

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Hammer Toe

Hammer Toe | Bunions, Hammertoes, Flat feet & Other Foot Problems | Scoop.it

WHAT IS HAMMERTOE?

 

Hammertoe is a bending of one or both joints of the second, third, fourth, or fifth (little) toes. This abnormal bending can put pressure on the toe when wearing shoes, causing problems to develop.

Hammertoes usually start out as mild deformities and get progressively worse over time. In the earlier stages, hammertoes are flexible and the symptoms can often be managed with non-surgical measures. But if left untreated, hammertoes can become more rigid and will not respond to non-surgical treatment.

Hammertoes are progressive – they don’t go away by themselves and usually they will get worse over time. However, not all cases are alike – some hammertoes progress more rapidly than others.

 

COMMON CAUSES

 

The most common cause of hammertoe is a muscle/tendon imbalance. This imbalance, which leads to a bending of the toe, results from mechanical (structural) changes in the foot that occur over time in some people.

Hammertoes may be aggravated by shoes that don’t fit properly. A hammertoe may result if a toe is too long and is forced into a cramped position when a tight shoe is worn.

Occasionally, hammertoe is the result of an earlier trauma to the toe. In some people, hammertoes are inherited.

 

YOUR DIAGNOSIS

 

Ozan will obtain a thorough history and physical examination of your foot. During the physical examination, Ozan will evaluate the cause and extent of the contracture of the toes and will correlate the finding s with x- rays.

 

WHEN IS SURGERY NEEDED?

 

In some cases, usually when the hammertoe has become more rigid and painful, or when an open sore has developed, surgery is needed.

Often patients with hammertoe have bunions or other foot deformities corrected at the same time. In selecting the procedure or combination of procedures for your particular case, Ozan will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.

 

 

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Neuroma

Neuroma | Bunions, Hammertoes, Flat feet & Other Foot Problems | Scoop.it

Interdigital Neuroma

 

Perineural Fibrosis

Interdigital neuroma (Morton’s Neuroma) of the foot includes common, paroxysmal, neuralgia affecting the web spaces of the toes. It involves entrapment neuropathy (nerve compression) of the common digital nerve below and between the metatarsal heads, typically between the third and the fourth metatarsal heads. The pain is most commonly felt between the third and fourth toes but can also occur in the area between the second and third toes.

 

Symptoms of interdigital neuroma typically manifest as a sharp, burning or tingling sensation in the forefoot. The pain radiates toward the lesser toes and is aggravated by shoe wear. The pain is relieved when the shoe is removed and the forefoot is massaged. Sometimes the symptoms involve specific toes. The cause of this problem is often due to impingement of the plantar nerve fibres between the metatarsal heads and the intermetatarsal ligament. It is entirely a biomechanical phenomenon. Differential diagnoses include stress fracture, capsulitis, bursitis or ligament injury at the metatarsal-phalangeal joint, a tendon sheath ganglion, foreign-body reaction and nerve-sheath tumour.

 

Diagnostic Procedures for Interdigital Neuroma

 

The diagnosis of interdigital neuroma is usually made by physical examination and review of the patient's medical history.MRI ad High Definition Ultrasound examination may be useful to confirm the diagnoses however they may still not be 100% reliable. The commonest reason for this is de to natural substances present in between the metatarsal heads and between the fat pad and the intermetatarsal ligament. These natural substances i.e. bursa, fat, capsular thickening and even bony growths, can all be a factor in the impingement process and may need to be surgically cleared.

 

Treatment

 

Conservative treatment involves a reduction in the inflammation and removing the impingement factor. Reduction in inflammation is achieved via rest, elevation, ice, and massage with anti-inflammatory gels. Removing foot wear and and/r wearing broad type footwear would also help. Injection therapy is useful in reducing symptoms.

 

Surgery

 

Majority of publications including peer review journal articles, surgical technique description and textbooks promote surgical excision as a gold standard treatment. Surgical excision is described as the most definitive mode of treatment for symptomatic Morton’s neuroma with reported success rates varying between 79% and 93%.

 

Various surgical techniques are described, essentially categorised as dorsal versus plantar incision approaches. Beyond this the commonest technical variation described as influencing the outcome of surgery involves burying and anchoring transacted nerve into soft tissue such as muscle.

 

What Is Involved In Neuroma Surgery?

 

Surgery to excise the neuroma is usually performed under general anaesthetic in a day surgery facility. After surgery you will have to keep your foot dry for two weeks. Generally neuroma surgery allows for early weight bearing and protection in some type of post op shoe gear. Some neuromas may reoccur, but this is rare. Most studies on patient satisfaction after neuroma surgery show approximately 90% reduction of pain and about 85% of all patients rated the overall satisfaction with the results as excellent or good.

 

Interdigital neurectomy (removal of the diseased nerve) in right hands, should give satisfactory results almost all the time. Some of the reasons behind failure is when not enough nerve is dissected, mistakes in initial diagnosis, or bad handling of adjacent nerves, tendons and joint capsules during the operation. It is very common and acceptable to have some numbness in the area where the nerve used to be. This never causes any discomfort and often gets better in few years.

 

It is crucial to address the biomechanical pathologies underlying the impingement of the nerve during and after the surgery. Ozan will work closely with your Podiatrist in providing appropriate orthotic therapy to address these biomechanical issues.

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Ingrown Toe Nail

Ingrown Toe Nail | Bunions, Hammertoes, Flat feet & Other Foot Problems | Scoop.it

WHAT IS AN INGROWN TOENAIL?

 

When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe.

If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odour. However, even if the toe isn’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.

 

PODIATRY CARE:

 

After examining the toe, Ozan will select the treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed.

Sometimes a minor surgical procedure, often performed in the office, will ease the pain and remove the offending nail.

After applying a local anesthetic, Ozan removes part of the nail’s side border. Some nails may become ingrown again, requiring removal of the nail root.

Following the nail procedure, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day.

 

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Bunions

Bunions | Bunions, Hammertoes, Flat feet & Other Foot Problems | Scoop.it

Bunions or hallux valgus can be treated by Ozan Amir at the podiatric surgery centre...

Even though bunions are a common foot deformity, many people may unnecessarily suffer the pain of bunions for years before seeking treatment.

 

WHAT IS A BUNION?

 

A bunion is often described as a bump on the side of the big toe. But a bunion is more than that. The big toe leans toward the second toe, rather than pointing straight ahead. This throws the bones out of alignment – producing the bunion’s “bump.”

Bunions are progressive , they don’t go away, and will usually get worse over time. But not all cases are alike – some bunions progress more rapidly than others. Osteoarthritis can develop in the big toe joint as the bunion worsens over time, causing increased pain and stiffness in the joint.

 

CAUSES

 

Bunions are most often caused by an inherited faulty mechanical structure of the foot. It is not the bunion itself that is inherited, but certain foot types that make a person prone to eveloping a bunion. Footwear can cause pressure on the bump leading to pain, but do not actually cause the bunion

 

WHEN IS SURGERY NEEDED?

 

If non-surgical treatments fail to relieve bunion pain and when the pain of a bunion interferes with daily activities. The goal of surgery is the reduction of pain.

A variety of surgical procedures is available to treat bunions. In selecting the procedure or combination of procedures for your particular case, Mr. Ozan Amir will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors.

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