Young People Considering Surgery For Bunions

When you think of bunions, you likely think of older people who can't get their shoes on because of the bony prominence.
But bunions are a foot condition that attacks both young and old people. Take Kacey Barker, 26, of , who found herself with a pretty bad bunion. "Mine got progressively worse over the years. With all the sports and wear and tear... anything and everything was bothering it," Barker told the Wall Street Journal.

Haverhill, Massachusetts
The pain from the bunion had become so severe that Barker had to stop all athletic activities, including running, field hockey, and softball. After a charity walk last fall, she couldn't take the pain any longer and decided to have surgery to correct the deformity. She went to see Dr. James Ioli, chief of podiatry at Boston's Brigham and Women's Hospital, who performed a chevron, which involves cutting the front part of the first metatarsal into a "V", moving the bone, and holding the sections together with screws. Six weeks later, she's still in a surgical boot and has another six weeks to recover. Barker's goal is to be pain-free on the dance floor at her wedding in September.
"A lot of my friends thought bunions were for women who are old or who wear high-heeled shoes for decades," says Barker, who normally wears sensible, supportive shoes. "It's definitely not something to take lightly. But for me, I'm excited to just be able to get back into a normal routine."
Claudia Ngo, 22, went to see Dr. Neil Blitz, chief of foot surgery at Bronx-Lebanon Hospital Center for her bunion in July. She received a bunionplasty, which is a cosmetic approach to the correction of bunions. "I always tried to hide, wearing socks and shoes around my friends or a blanket on the couch. In college I would wear heels... so they actually got bigger," said Ngo, of Bethesda, Maryland.
The first podiatrist she went to recommended she wait for bunion surgery and to only have them corrected if they were causing her pain. Ngo had pain after she wore heels all day or after working out, but not on a regular basis.
After Dr. Blitz performed the surgery on her right foot, she was able to walk with a surgical shoe right away. "After four weeks I was wearing regular shoes. Now I'm really happy with the results, it looks perfect," says Ngo, who plans on having the procedure done on her left foot this year.
Meghan Morrison's bunions haven't progressed to the same degree that Ngo's and Barker's did, but she's keeping an eye on them. So far the 27 year old graduate student from Nashville, Tennessee is using conservative treatment therapies, like avoiding high heels, wearing flat, wide shoes with support and padding. But if the bunions get worse, she will have surgery. "I don't want my feet to end up looking insane and horrific. And if it ever got to a point where I couldn't walk or be active I would definitely do it," says Morrison.
Reference: Wall Street Journal.
If you have 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.

My Baby's Toe Curls- Is That Normal?

Your child may have been born with curly toe, which describes a toe with a flexion contracture, which

causes the toe to flex and bend under the adjacent toe. The deformity is characterized by flexion and medial deviation of the proximal joint of the toe and lateral rotation of the distal joint. The cause is congenital tightness of the flexor tendons. The second and third toes are the most common toes that curl, with the pinky toe being the least common.
It is uncommon for curly toe to cause problems. 25% of toes resolve by the child's first birthday. Some toes will spontaneously resolve by the age of six. There is often a family history of curly toe, consistent with autosomal dominant transmission.
Some children will have pressure between the toes, which can cause pressure sores or blisters. The adjacent toe may develop corns because of pressure from the other toe. Shoes with extra padding or space will be required. If the child continues to have skin problems, a simple procedure is available to improve the toe position.
Diagnosis is made by physical examination. Curly toes are typically present bilaterally and x-rays will often be used to rule out other deformities and abnormalities.
Treatment sometimes involves taping of the toe, but the deformity usually recurs once the taping is taken off. Surgery is recommended for children over the age of 6 who have a persistent deformity. A simple open flexor tenotomy leads to relief of symptoms and does not lead to hyperextension.
If your child has curly toe, 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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Trevor's Disease

Trevor's Disease is an extremely rare congenital bone developmental disorder that occurs in one case per million. It is three times more common in males than females.

This disease is characterized by an asymmetrical limb deformity due to localized overgrowth of cartilage, resembling osteochondroma. It usually affects the lower limbs and it is also known as dysplasia epiphysealis hemimelica (DEH) or Fairbanks Syndrome. It affects the epiphyseal plate, or growth plate, at the end of a long bone. The plate is found in children and adolescents, but not adults, whose epiphyseal plate is replaced by epiphyseal line. The disease was named after researcher David Trevor, who believed the disease to be a congenital error in epiphyseal development that affects limb buds during early fetal life.
Trevor's Disease is a benign disorder, and no cases of malignant transformation have been reported. The causes are not known and the disease does not appear to be genetically transmitted. Typically a lesion will grow in size until skeletal maturity with a progression toward pain and arthrosis.
Patients with Trevor's Disease will have painless swelling or a mass on one side of the joint, limitation of motion, angular deformity, concomitant regional muscle wasting, and recurrent locking of the joint. It may be commonly confused with chondroblastoma, osteochondroma, or enchondroma.
Trevor's Disease should be treated if the lesion is causing pain, deformity, or interference with function.
If you have Trevor's Disease, 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.

Related articles

• When To Call A Podiatrist
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• You Don't Have To Be A Bird To Have Claw Toes
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• Can My Child Have A Bunion?
• I Have A Long Second Toe!
• Overlapping and Underlapping Toes

I've Got An Extra Toe!

Polydactyl is a deformity present at birth, when the baby is born with extra fingers or toes. It usually occurs in single duplication, meaning just one extra digit.
Associated anomalies include duplications bilaterally (both feet) in 40-50% of patients, but often duplications are not symmetrical. Syndactyl (webbing) of the toes occurs in 1/5 of patients, and Down's Syndrome is present in a minority of patients. Only 30% of patients will have a positive family history of polydactyl.
It occurs in 1 to 2 of 1,000 births, in 0.3 to 1.3 of 1,000 caucasian births, and 4 of 1,000 black births, and males more than females.
Polydactyl occurs when the body follows a different set of directions when forming the feet during development. Researchers are still learning about the genes that cause polydactyl. It may be caused by an associated syndrome, like Greig Cephalopolysyndactyly Syndrome (GCPS) or Bardet-Biedl Syndrome (BBS).
Extra digits are often poorly developed and attached by a small stalk, generally on the little toe. Some are well-formed and may even function. Poorly formed digits are usually removed. If there are no bones in the toe, tying a string around it will cause the toe to fall off over time.
In older patients, the main complaint is difficulty with shoe gear.
Treatment of polydactyl is typically surgery, which excises the toe, providing the toe with the most normal contour, to facilitate shoe wear. Typically the most lateral toe is excised, depending on whether the deformity is pre or post axial. Pre-axial means the extra toe is adjacent to the big toe, while post-axial means they are adjacent to the pinky toe. Most surgeons will recommend surgery after 1 year, to reduce aesthetic risks, and prior to walking, allowing for the greatest potential for remodeling. Patients are often referred in at ages 4 or 5 because of difficulty with shoe wear.
If your child is born with extra toes, 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.

 Related articles

• I Have A Long Second Toe!
• When To Call A Podiatrist
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• Mallet Toes: Not Something You Hammer With
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• Can My Child Have A Bunion?
• Overlapping and Underlapping Toes
• You Don't Have To Be A Bird To Have Claw Toes
• My Toes Are Webbed Like A Duck!

Freiberg's Disease

Freiberg's Disease is a painful condition that affects the second metatarsal head. This is the bony knuckle in the ball of the foot behind the second toe. It can also affect the third and fourth metatarsal bones, but they are less commonly affected.
More than 80% of cases are females, and most of those are women up to the age of 20 years. Children who are athletes are often most commonly affected, especially those who are on their toes a lot in sprinting or jumping. The primary complaint is often vague forefoot pain, worsened by activity and weight-bearing and relieved with rest.

Freiberg's Disease occurs in children when there is a disruption of blood flow to the tip of the bone because of excessive pressure. It happens at the site of the growth plate, which closes in adolescence and therefore does not affect adults. In some cases a mechanical cause is thought to be the reason for the condition. A traumatic event, such as a heavy blow, or several small incidents can also cause Freiberg's Disease.
Freiberg's Infarction is the term applied when it occurs to children. Infarct means tissue death because of lack of blood. It is likely the excessive pressure causes a small fracture to occur within the cartilage growth plate that is between the long shaft of the metatarsal bone and the head, cutting off the blood flow. On an x-ray the area will be transparent as calcium leaves the bone, which will collapse on itself. The process takes about a year and when it is complete, the bone will be denser and whiter. An x-ray will also show the flattening of the rounded tip of the metatarsal bone and thickening of the shaft.
Freigberg's Infraction is applied to adults where the x-rays are similar. Most people have two or three arteries supplying blood to the area, but some have only one artery, making possible bone death. In others, the first metatarsal does not function properly and shuns its share of the body weight over the second, third, and fourth bones.
Treatment includes examination of the foot, which should show the area to be swollen, stiff, and painful. To find the tender spot, the podiatrist will flex the toe back as far as possible to expose the end of the metatarsal as well as the bottom surface. Treatment will focus on reducing the pressure on the second metatarsal head, by deflecting the pressure away from the area, causing the first metatarsal to take its share of the weight.
If your child has Freiberg's Disease, 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.

 Related articles

• I Have A Long Second Toe!

Kohler's Disease In the Foot

Kohler's Disease is a rare bone disorder of the foot found in children between the ages of 6 and 9, affecting boys more than girls. It was first described in 1908 by Alban Kohler a German radiologist.
It is caused when the navicular bone temporarily loses its blood supply and as a result, the tissue in the bone dies and the bone collapses.
Symptoms include pain and swelling in the middle of the foot and usually a limp. Patients who limp tend to put increased weight on the lateral side of their foot. They may also experience tenderness over the navicular and pain over the apex.
In February 2010 the Journal of the American Medical Association reported that Egyptian boy king Tutankhamun may have died from complications of the disease along with malaria.
Your podiatrist will take an X-ray of the affected foot to diagnose the disease. The affected foot will have a sclerotic and flattened navicular bone.
When treated, this disease has no long term affects, but rarely it can return in adults. Treatment includes resting the affected foot, taking pain relievers, and avoiding putting pressure on the foot. In severe cases, the patient wears a cast, worn between 6 and 8 weeks. After the cast is removed, arch supports are worn for about 6 months. Children may benefit from moderate exercise and physical therapy. Children who follow the prescribed treatment will heal quickly. Kohler's Disease may persist for some time, but most cases are resolved within two years.
If your child has Kohler's Disease, 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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• 10 Tips For Bunion Surgery Recovery
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Adult Cavovarus Foot

Adult cavovarus foot is the result of an imbalance of muscle forces, usually from motor sensory neuropathies. It is seldom seen at birth, but the deformity becomes apparent as the child, or the deformity grows. Other causes include cerebral palsy, cerebral injury (stroke), anterior horn cell disease (spinal root injury), talar neck injury, and residual clubfoot.
In this foot deformity, the strong peroneus longus and tibialis posterior muscles cause the hindfoot varus and forefoot varus (pronated) position. Hindfoot varus causes overload of the border of the foot, which results in ankle instability, stress fractures, and peroneal tendonitis. In overloaded joints, degenerative arthritis can develop. Claw toes may also be a symptom of this deformity.
Your podiatrist will do a gait examination, which allows for the planning of tendon transfers to correct the stance and swing-phrase deficits. They will also inspect the forefoot and hindfoot to determine the need for soft-tissue release and osteotomy. The Coleman block test assesses the cause of hindfoot varus.
Oddly enough, prolonged use of orthotics and supportive shoes can result in muscle imbalance, creating the deformity and causing irreversible damage to the tendons and joints. Your doctor will have to rebalance the tendons to avoid deterioration of the foot. Muscle imbalance can be rectified by tendon transfer, corrective osteotomy, and fusion.
If you have cavovarus foot, 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.

 Related articles

• You Don't Have To Be A Bird To Have Claw Toes
• Overlapping and Underlapping Toes