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Foot Surgery and Related Techniques

Normally, foot surgery is reserved for cases where less invasive treatments have failed to succeed. Surgery may be necessary for many reasons. Surgery may be necessary in the following cases, but are not limited to: removing foot deformities (such as bone spurs or bunions), arthritis problems that have caused severe bone issues within the foot, reconstruction due to injuries caused by accidents, and congenital malformations (such as club foot and flat feet). Among all ages and races, foot surgery may be necessary.

Depending on what is wrong with your foot, this will dictate what type of surgery is necessary. Injuries, deformities, and skin conditions all require unique kinds of treatment. A bunionectomy is necessary if you have a growth, such as a bunion, that needs to be removed. Surgical fusion of the foot is recommended if your bones need to be realigned, or fused together. If you are enduring nerve issues or pain, you may need surgery in which the tissues surrounding the painful nerve are removed. Normally, other, less serious treatments are first applied when a problem is discovered, but if those treatments are found to be ineffective, surgical techniques are considered and used. Your doctor will go over your options with you and help you make decisions about when surgery is a good choice and what kind of procedure you’ll benefit the most from.

Though surgery is seen as a last resort in many cases, there are benefits of surgery to fix your problem, if you and your doctor choose that route. The first benefit is that the pain associated with your problem is normally relieved; therefore meaning you can resume the daily activities your foot problem was preventing you from participating in normally. The second benefit is once you have surgery the problem is generally eliminated since it has finally been addressed. Surgery is often seen as the most direct solution to a problem.

Podiatry history has shown that advancement in foot techniques continues to grow every year. In the field of foot surgery, endoscopic surgery is just one of the many advancements that has been made recently. Foot techniques will continue to improve as technology does. Many procedures require small incisions, and use better, more efficient tools. Because of this, surgery is no longer as invasive as it used to be, and recovery has become easier and faster. Therefore, you will be back on your feet in no time.



Morton's Neuroma

Morton's neuroma is a painful foot condition that commonly affects the areas between the third and fourth toe and the ball of the foot. Other areas of the foot can also be susceptible to this condition. Morton’s neuroma is caused by an inflamed nerve in the foot that is being squeezed and aggravated by surrounding bones.  Women are more likely than men to have an occurrence of this foot condition. When a person has Morton's neuroma, it can feel as if they are walking on stones or marbles.


There are risk factors that can increase a person's chance of having Morton's neuroma. Ill-fitting high heels or shoes can add pressure to the toe or foot area. Jogging, running and any other sports that involve constant impact to the foot area can make a person more susceptible to this condition. If a person has flat feet, bunions or any other foot deformities, it can put them at a higher risk for developing Morton's neuroma.

There is no one major sign that indicates a person has Morton's neuroma, but rather certain symptoms to look for. A person who has burning in the ball of the foot or tingling and numbness in the toe areas are signs they may have Morton's neuroma. The pain increases greatly when wearing shoes or being active. There usually is little or no pain at night.

If a person suspects that they have this condition, they should visit their doctor. A physician will check for palpable masses between the bones of the foot. A doctor will also apply pressure to the foot or toe area to replicate the pain a person experiences when active. Range of motion tests and X-rays are other options a doctor may offer a patient to rule out other conditions or problems.

Treating Morton's neuroma can be as simple as changing the type of shoes a person wears. Wear wider shoes or flat shoes with a soft sole. Doing this may help reduce the pressure on the nerve that is aggravated. If necessary, a person can have a cortisone injection to help reduce swelling and pain in the foot area.

If these methods don't relieve the symptoms, consulting with an orthopedic surgeon should be the next option. During a consultation, a patient will find out about the treatment methods available for Morton's neuroma. A surgeon can release the tissue around the nerve that is causing this pain, or they can remove a small area of the nerve completely. There is a short recovery time for this type of surgery, and afterward, patients can return to their normal lifestyle.


Athlete's Foot: The Sole Story

Do you suffer from itching, burning, dry, and flaking feet? It could be athlete's foot. Athlete's foot, also known as tinea pedis, can be extremely contagious, often infecting shower floors, gyms, socks and shoes, and anywhere else feet might contact. It's commonly found in public changing areas and bathrooms, dormitory style living quarters, around locker rooms and public swimming pools. "Commons" areas in prisons and residential care facilities are frequently caught feeding the fungus as well. One step in the wrong direction can be enough to start the fire that can be tremendously difficult to treat.
 

Athlete's foot is most often caused by the same fungus that causes ringworm (tinea). It can be spread by direct contact with an infected body part, contaminated clothing, or by coming in contact with other objects or body parts that have been exposed to the fungus. Although the feet are more frequently assumed to get athlete's foot, tinea can invade other parts of the body as well so long as the proper growing conditions are met.

Tinea thrives in a dark, warm, and moist environment. Body parts that are often infected include the hands, groin, and scalp. Although many people never experience athlete's foot, around 70% of the population suffers from tinea at some point in their lifetime. Like most ailments, some people are more likely to acquire this fungal infection than others. People with a history of tinea or other skin infections are more likely to suffer from recurrent, or even additional, unrelated infections. The extent to which a person is tormented by the fungus can vary greatly as well.

While some people are never even aware that they have been infected with athlete's foot, others are pestered with mild to moderate symptoms like dry and flaking skin, itching, and redness. Still others are bothered by more severe symptoms including cracked and bleeding skin, intense itching and burning, and even pain when walking. In the worst cases, tinea can cause blistering as well.

The treatment for athlete's foot begins with prevention. Changes in the environment infected with athlete's foot can prevent spreading. Keeping the area that is infected clean and dry with the use of medicated cleansers and powders is essential. Allowing the area to breathe is important in the treatment as well. Exposure to cool air and light can make conditions undesirable for tinea. Treating the infected area with miconazole, tolnaftate, or other medicated creams, ointments, or sprays not only helps to kill the fungus, but helps prevent recurrences as well. White vinegar-based foot soaks can also be beneficial. Seeing a podiatrist is often a good idea when treating athlete's foot, since more often than not, other skin infections can develop from the initial infection, and recurrences are common.


Diabetic Foot Care

Diabetes affects millions of people each year. Diabetes damages blood vessels in all parts of the body, including the feet. The legs and feet may have slow blood flow which causes neuropathy (nerve damage). Once a diabetic patient develops neuropathy, it is imperative that the feet are well taken care of to avoid amputation of the feet or legs.

It is important when caring for the feet of diabetics to always wash and thoroughly dry the feet, especially between the toes. Next, examine your feet and toes for any redness or sores that may be there, even if you do not feel any pain. You may also use a mirror to examine your feet from the bottom side. Avoid wearing colored socks to prevent infections that may occur from the dye used in them. Well-fitting socks are also highly recommended.

Anyone with diabetes should have their physicians to monitor Hemoglobin A1C levels as this test lets the physician know how well the blood sugar levels have been controlled during the past 3 months. It is very important to keep the blood sugar levels in the normal range (70-110mg/dl). There are medications that a physician may prescribe to help with neuropathy of the diabetic patient. It is also advisable to visit a podiatrist if the diabetic patient is experiencing any conditions involving the feet. Toe nails may need to be taken care of by a podiatrist as some patients may cut to deep or not deep enough around the cuticles and risk having an infection that could occur.

While at home a person can take care of their feet if they follow instructions given by their physician or nurse. An effective treatment is using creams and applying them to the heels due to the possibility of extreme dryness. Be careful when using tools to remove the calluses as severe diabetics may not be able to feel pain, and this can cause a severe wound to develop.

Diabetic feet absolutely need to be inspected on a daily basis. Always notify your health care professional with any concerns that you may have about the care of your feet. Waiting to see if a wound will get better is not a good idea as it can turn into a life threatening condition. Gangrene is a serious problem for diabetics and can lead to sepsis and amputation. Early treatment and daily inspection of the diabetic feet are keys to staying healthy.


Choosing the Right Running Shoe for Your Foot Type

While running seems like a simple activity, it is actually a complicated movement that puts a lot of stress on the joints, bones and ligaments of the body. Consequently, choosing the right shoe is an important step in increasing performance and decreasing injury risk. You should select running shoes based on your foot type. While other considerations are important, such as trail versus road shoes, your foot type dictates the amount of cushioning, stability and motion control you need. The best way to determine your foot type is to visit a local specialty running shop. Professionals there can measure your arch type, stride and gait and summarize your shoe needs for future reference.

Running shoe design is based on the idea of pronation. Pronation is the natural rolling of your ankle from outside to inside during foot strike. In other words, proper running mechanics involve striking the ground on the outside of your heel and rolling toward your big toe before pushing off again. Pronation is a good thing: it helps your lower extremities absorb shock and store energy. Neutral runners who pronate correctly do not depend on their shoes to correct their form. Neutral runners can select from a large variety of shoes, even minimal or barefoot models. However, runners with problematic foot arches or incorrect form may pronate too much or too little and require specific qualities from their running shoes.

Overpronators run with excessive ankle rolling. Even when standing, severe overpronators exhibit ankles that angle inward. They also tend to have flat feet or bowed legs. Overpronation can cause a plethora of injuries, especially in the knees, ankles and Achilles tendons. If you overpronate, you should select a shoe with extra stability and motion-control. Motion-control shoes are firm and straight; they do not curve at the tip. The lack of flexibility along the midsole prevents the foot from rolling too far inward during your foot strike.

Underpronation, also called supination, is less common than overpronation. Unlike overpronators, underpronators have inflexible feet and high arches. When they land, their feet are unable to roll inward. While this places less rotational stress on the ankles and knees, it prevents any kind of shock absorptions. This additional force can result in fractures, ligament tears and muscle strains as the legs compensate for the impact. Underpronators require shoes with increased cushioning and flexibility. If you underpronate, stability or motion-control shoes may compound the problem by further preventing pronation.

2014
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2013
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Dr. Mayer Salama and Dr. Daniel Salama
3408 West Rd (In Grange Plaza)
Trenton, MI 48183 -(734) 676-4664

2200 Monroe
Dearborn, MI 48124 - (313) 274-0990

6770 Dixie Hwy. Suite 101
Clarkston, MI 48346 - (248) 625-1110

23800 Orchard Rd Suite 201
Farmington Hills, MI  48336 - (248) 474-0040