Wednesday, September 26, 2012

My Fourth Toe Is Very Short!

Brachymetatarsia is a condition in which one of the bones of the foot is significantly shorter than the others.
This condition typically affects the fourth toe. When looking at the foot, the fourth toe is much shorter than those surrounding it, and it may also appear as if it is raised up, with the third and fifth toes touching below.
The condition may be as a result of a congenital defect or an acquired defect. Congenital causes include Aarskog syndrome and Apert syndrome among others, along with acquired trauma. Simply, the metatarsal bone fails to develop fully, or the growth plate closes prematurely. This condition appears 25 times more in women (1 in 1820) than men (1 in 4586). 
Diagnosis is easily done with an x-ray of the affected toe. Usually patients come in with concerns about the toe's appearance, looking for cosmetic surgery to correct the abnormal shape and size, but often learn that there is a significant defect in the bone. Patients may notice that the toe is not carrying its share of the weight, which results in pain and discomfort. They may also have a difficult time selecting shoes because of the toe's shape. 
In many cases brachymetatarsia causes no pain or discomfort and will require no treatment beyond careful shoe selection. For some, surgery may be needed. 
If you are experiencing some of these symptoms, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.

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Wednesday, September 19, 2012

Does Your Child Have A Clubfoot?

Clubfoot, one of the most common birth deformities, occurs in 1 out of every 1,000 live births and is when the foot turns inward and downward. It is congenital and may be passed down through families in some cases. Risk factors include a family history and being male.
The condition can range from mild and flexible to severe and rigid. Each case of clubfoot may appear different from child to child. It may also be difficult to place the foot in the correct position. The calf muscle and foot may also be smaller than normal.
The deformity is often diagnosed right after birth, when a foot x-ray may be performed to view the extent of the disorder. Often the problem is a very tight Achilles tendon, and a simple procedure can be done to release it.
Treatment should be started as early as possible, ideally right after birth when it is easiest to reshape the foot. The best method of treating clubfoot is moving the foot into the correct position and casting the limb to hold it in place. Recasting and gentle stretching will be done every week to improve the position of the foot. 5 to 10 casts are typically needed, with the final cast left on for 3 weeks. After the foot is in the correct position the child will wear a special brace all day for 3 months, then at night and during naps for up to 3 years.
Severe cases of clubfoot will require further surgery to correct the deformity if conservative treatments do not work or if the problem returns. A small number of defects may not be completely fixed and treatment will only improve the appearance and function of the foot. These cases are usually associated with other birth disorders. The child should be monitored by a podiatric physician until the foot is fully grown. Most cases are resolved with conservative treatment and the outcome is excellent.
If your child is being treated for clubfoot, call your podiatrist if you see any of the following:
  • The toes swell, bleed, or change color under the cast. 
  • The cast is causing the child pain.
  • The toes disappear into the cast.
  • The cast slides off.
  • The foot begins to turn in again after treatment.
For more information about clubfoot, visit our website, or make an appointment in our Glastonbury or Middletown locations.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, like our page on Facebook, and follow my tweets on Twitter.


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Wednesday, September 12, 2012

What Are My Options For Bunion Surgery?

You and your podiatric surgeon have decided that your painful bunions need to be surgically removed. Since there are so many options for removing the bunion, how does your podiatrist decide which one is best for you?
There are two ways a podiatrist selects which procedure is best suited for you. First, they will give you a clinical exam, which shows the range of motion available, the pain experienced with motion and footwear, and the mobility of the big toe and associated joints. Then, they will look at your x-rays. From this they will see the positive or negative findings of arthritic change due to joint cartilage and bone, the angle between the big toe and the second toe, and finally the length and position of the big toe.
Most procedures will include a "bumpectomy", which shaves off the part of the bone that is sticking out beyond the natural line of your foot. Inner muscles of the great toe may also be cut to prevent the big toe from crossing over to the second toe.
In a situation where the joint is severely arthritic and painful, one of the joint resection procedures would be the best option for you. Joint replacement is an implant that allows for minimal and pain-free motion. Joint fusion is a fusion of the metatarsal bone and the big toe. Joint resection procedures greatly reduce and even eliminate the pain associated with the bunion, but can also greatly decrease the range of motion.
For those who have a mild to moderate bunion, with a slight angle between the first and second toes, the surgical procedure usually involves moving the head of the metatarsal inward by making a sideways triangular cut called an Austin, or modified Austin. Once the cut has been made, the first toe is moved back towards the second toe and fixated. The benefits of this procedure is that there is a faster recovery time, easier healing, and the correction is very stable. The downside is that this procedure is only for mild to moderate bunions.
Moderate bunion procedures involve the shaft of the metatarsal. If the angle of the metatarsal is too great for a head procedure, meaning that the head could not be moved over for correction and be considered stable, then your podiatrist will instead make a cut in the shaft of the metatarsal, allowing for less movement and more correction. The benefit of having this procedure done is the angle of your big toe will be closer to what it used to be and the base of the toe will likely be hypermobile. Cons include a longer recovery, less stability, and a greater surgical expertise.
A base procedure is done when there is a very high angle between the first and second metatarsal. A metatarsal base procedure allows for slight movement inwards and great angle correction.
If you are suffering from a bunion, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.


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Wednesday, September 5, 2012

6 Myths About Bunion Surgery

This article was adapted from Dr. Neil Blitz's article that appeared in the Huffington Post.
Myth 1: Bunion surgery is extremely painful.
Overall, bunion surgery is not more painful than other general surgeries. Foot surgery can lend itself to post-operative pain because of the foot's location below the heart and the likelihood of blood rushing to the area,
creating that throbbing feeling. There is also not a lot of soft tissue surrounding the bones on the foot, so post-operative swelling can aggravate the nerves. However, most patients who experience post-operative pain find relief with pain medication.
Myth 2: Even after surgery, bunions can come back.
Not necessarily! It's not likely bunions will recur, like warts or fungal toenails. Some patients however have excessive motion in the foot that predisposes them to bunions. Others continue to wear improper footwear and bad habits. As well, the surgery that was performed the first time may not have been suitable for the bunion's severity.
Myth 3: You'll have to wear an ugly cast and go on crutches.
Maybe that was true back in the 1970's or 1980's, but podiatry has made many advancements and improvements over the past 30 years. Modern technology allows podiatrists to get their patients walking much quicker. For mild bunions, you can expect to wear a surgical shoe for six weeks (not stylish, we know, but much better than a cast!). Larger and more severe bunions sometimes require a cast and crutches, but that's because setting the bones is very complex. Some podiatrists don't even cut the bone anymore but perform instead a procedure called Lapidus bunionectomy, a fusion that allows for the realignment of the deviated bone.
Myth 4: You'll be out of work forever.
If you have a desk job, expect to be back at work within two weeks. Jobs where you are on your feet, require excessive walking or physical activity may require a leave of absence up to two months. Driving may be a problem if your right foot is operated on.
Myth 5: A bunion shouldn't be fixed unless it's painful.
Not always. Bunions that continue to grow, interfere with activity, or certain shoes cannot be worn anymore, can be removed. It is the preference of our podiatrists that the bunion be painful before we remove it.
Myth 6: You'll have gross scars after surgery.
As with most surgeries, there will some scarring afterwards. The incision for the surgery is either on the top of the foot or the the side of the foot. Your surgeon's methods of closing will vary by the individual; some may perform a plastic-surgery type closure.
If you are suffering from a bunion, call our Glastonbury or Middletown office to make an appointment.
Ayman M. Latif, DPM
Connecticut Foot Care Centers
Foot Deformity Doctor in CT
Podiatrist in Glastonbury and Middletown, CT
Visit our website, friend and like our page on Facebook, and follow my tweets on Twitter.

Reference: http://www.huffingtonpost.com/neal-m-blitz/bunion-surgery_b_1349607.html
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