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Hammer Toe Fusion Recovery

July 11th, 2015 parašė louveniaalstrom

HammertoeOverview
A hammertoe is a deformity in the foot, causing the second, third, or fourth toe to be permanently bent in the middle joint, causing the toe to resemble a hammer (hence, its name!) or a claw. They are most commonly found in women who wear narrow shoes, such as high heels, that cause the toes to bend unnaturally for extended periods of time. A Hammertoes may be difficult or painful to move, and the skin may become callused from rubbing against the inside of the shoe. In fact, there are two types of hammertoe: flexible and rigid. Flexible hammertoes can still move at the joint and are indicative of an earlier, milder form of the problem. Rigid hammertoes occur when the tendon no longer moves, and at this stage, surgery is usually necessary to fix the problem.


Causes
People who are born with long bones in their toes are more likely to develop hammer toe. Children who wear shoes they have outgrown may develop this condition. People who wear very narrow shoes or high-heeled shoes are also more likely to develop a hammer toe. Sometimes, pressure from a bunion can cause hammer toe. Rheumatoid arthritis is another a risk factor.

Hammertoe

Symptoms
People with a hammer toe will often find that a corn or callus will develop on the top of the toe, where it rubs against the top of the footwear. This can be painful when pressure is applied or when anything rubs on it. The affected joint may also be painful and appear swollen.


Diagnosis
A hammertoe is usually diagnosed with a physical inspection of your toe. Imaging tests, such as X-rays, may be ordered if you have had a bone, muscle, or ligament injury in your toe.


Non Surgical Treatment
In the earlier stages of hammer toe, when the toes can still be manually straightened, then conservative treatment is appropriate. This means wearing shoes which are a half size bigger than normal and which are not narrow around the toes. Exercises to stretch the toes out and strengthen the muscles under the foot which balances the tightness of the top tendons are important. Padding or corn plasters can be used to ease the discomfort of any associated corns and calluses.


Surgical Treatment
If your toe is not bendable, your doctor may recommend surgery. The type of surgery that will be performed will depend on the severity of the condition. You should expect blood and urine studies before the procedure, as well as x-rays of your feet. Your doctor will inject either a local or regional anesthetic. If your toe has some flexibility, the doctor may be able to straighten it by simply making an incision in the toe to release or lengthen the tendon. If the toe is not flexible, your doctor will probably make the same incision to release the tendon, but he or she may also remove some pieces of the bone so that the bone can be straightened. A k-wire is placed in the toe to help hold it straight while it is healing. This is taken out after about four weeks.

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Recovery After Bunion Hammer Toe Surgery

July 9th, 2015 parašė louveniaalstrom

HammertoeOverview
Hammer, claw, and mallet toes are toes that do not have the right shape. They may look odd or may hurt, or both. Tight shoes are the most common cause of these toe problems. A Hammertoe is a toe that bends down toward the floor at the middle toe joint. It usually happens in the second toe. This causes the middle toe joint to rise up. Hammer toes often occur with bunions. Claw toe often happens in the four smaller toes at the same time. The toes bend up at the joints where the toes and the foot meet. They bend down at both the middle joints and at the joints nearest the tip of the toes. This causes the toes to curl down toward the floor. A mallet toe often happens to the second toe, but it may happen in the other toes as well. The toe bends down at the joint closest to the tip of the toe.


Causes
Hammer toe is often caused by wearing shoes that do not fit properly. If shoes are too small either in length or width, then the toes are held in a shortened position for long periods and the muscles eventually shorten and pull the toes into the bent position. Alternatively it can be caused by overactivity in the extensor digitorum dongus muscle (right) and a weakness in the counteracting muscle under the foot, such as flexor digitorum longus. Sometimes it can be a congenital condition, meaning it is present from birth. It is also more common in those with arthritis in the foot or diabetes.

Hammertoe

Symptoms
The most obvious symptom of hammertoe is the bent, hammer-like or claw-like appearance of one or more of your toes. Typically, the proximal joint of a toe will be bending upward and the distal joint will be bending downward. In some cases, both joints may bend downward, causing the toes to curl under the foot. In the variation of mallet toe, only the distal joint bends downward. Other symptoms may include Pain and stiffness during movement of the toe, Painful corns on the tops of the toe or toes from rubbing against the top of the shoe’s toe box, Painful calluses on the bottoms of the toe or toes, Pain on the bottom of the ball of the foot, Redness and swelling at the joints. If you have any of these symptoms, especially the hammer shape, pain or stiffness in a toe or toes, you should consider consulting your physician. Even if you’re not significantly bothered by some of these symptoms, the severity of a hammertoe can become worse over time and should be treated as soon as possible. Up to a point hammertoes can be treated without surgery and should be taken care of before they pass that point. After that, surgery may be the only solution.


Diagnosis
Your doctor is very likely to be able to diagnose your hammertoe simply by examining your foot. Even before that, he or she will probably ask about your family and personal medical history and evaluate your gait as you walk and the types of shoes you wear. You’ll be asked about your symptoms, when they started and when they occur. You may also be asked to flex your toe so that your doctor can get an idea of your range of motion. He or she may order x-rays in order to better define your deformity.


Non Surgical Treatment
Hammer toes usually get progressively worse over time, especially if you avoid seeking care. Not all cases are the same, so it is important to get your podiatrist or foot surgeon to evaluate your condition so that you can get the treatment you need as soon as possible. Your treatment options will vary depending on the severity of your hammer toe. You may not require surgery to treat your hammer toe. Your doctor may suggest one of these less invasive measures. Instead of wearing shoes that are too high or too short, wear comfortable shoes that have plenty of room and are flat or low-heeled. Your doctor can prescribe pads that will prevent your corns or calluses from getting irritated. Avoid over-the-counter medicated pads, as they contain acid that can worsen your condition. An orthotic device can be customized to fit your shoe and foot. It can help control your tendon and muscle imbalance, which in turn may ease your pain. NSAIDS (nonsteroidal anti-inflammatory drugs) such as ibuprofen can reduce inflammation. By relieving swelling in your toe joint, you can alleviate your pain. Splints or small straps can be placed on your toe by a foot surgeon to realign your bent toe. Applying ice packs wrapped in cloth on your hammer toe can reduce inflammation and swelling. Gently massaging your toes can assist in alleviating your pain caused by hammer toes. Try exercises that stretch your feet as these can help restore your muscle balance. A simple exercise that can help is to pick up a cloth or small object from the floor by curling your toes. This action will help your feet and toes by stretching them.


Surgical Treatment
If these treatments are not sufficient at correcting the hammer toe, an operation to straighten the toe may be necessary. This is often performed in conjunction with surgery for a bunion deformity. The surgical treatment of a hammer toe can consist of either cutting the tendons to relieve the pressure that causes the deformity, or fusing the toe so that it points straight permanently.

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Do Bunions Ever Need Surgery Treatment?

June 18th, 2015 parašė louveniaalstrom

Overview
Bunion Pain
A bunion is a deformity of the metatarsophalangeal (MTP) joint of the big toe in which the metatarsal bone shifts inward, away from the rest of the foot and the big toe shifts outward, towards the other toes. This results in a “crooked” big toe. As a result, the tissues around the MTP joint can become irritated and painful. A small fluid filled sac called a bursa sits on the inner side of the MTP joint. This bursa decreases friction between the skin and the underlying bone. It can also become irritated and painful.


Causes
Bunions are a result of complex biomechanical changes that occur in your feet. The type of footwear that you wear does cause bunions. We know that foot bunions occur in about 30% of the population of most Western countries but only 3% in Eastern countries. They are seen most commonly in women and become more common as people get older. Tight-fitting shoes are thought to be the main cause of bunions.. Shoes such as high heels and shoes with tight toe boxes (eg womens fashion shoes and cowboy boots) are particularly damaging to the toes. These shoes have a sloping foot bed and a narrow toe box. The slope causes the front of the foot to bear your weight, which encourages your forefoot to widen. Also, the angle pushes your toes into the narrow toe box, causing the toes to become angled and squeezed together.


Symptoms
Red, thickened 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 and may cross over the second toe.


Diagnosis
A doctor can very often diagnose a bunion by looking at it. A foot x-ray can show an abnormal angle between the big toe and the foot. In some cases, arthritis may also be seen.


Non Surgical Treatment
Wearing good footwear does not cure the deformity but may ease symptoms of pain and discomfort. Ideally, get footwear advice from a person qualified to diagnose and treat foot disorders (podiatrist - previously called a chiropodist). Advice may include wear shoes, trainers or slippers that fit well and are roomy. Don’t wear high-heeled, pointed or tight shoes. You might find that shoes with laces or straps are best, as they can be adjusted to the width of your foot. Padding over the bunion may help, as may ice packs. Devices which help to straighten the toe (orthoses) are still occasionally recommended, although trials investigating their use have not found them much better than no treatment at all. Painkillers such as paracetamol or ibuprofen may ease any pain. If the bunion (hallux valgus) develops as part of an arthritis then other medication may be advised. A course of antibiotics may be needed if the skin and tissues over the deformity become infected.
Bunion Pain


Surgical Treatment
When early treatments fail or the bunion progresses past the threshold for such options, podiatric surgery may become necessary to relieve pressure and repair the toe joint. Several surgical procedures are available to the podiatrist. The surgery will remove the bony enlargement, restore the normal alignment of the toe joint, and relieve pain. A simple bunionectomy, in which only the bony prominence is removed, may be used for the less severe deformity. Severe bunions may require a more involved procedure, which includes cutting the bone and realigning the joint. Recuperation takes time, and swelling and some discomfort are common for several weeks following surgery. Pain, however, is easily managed with medications prescribed by your podiatrist.

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What Are The Chief Causes Of Hallux Valgus?

June 6th, 2015 parašė louveniaalstrom

Overview
Bunions
The foot is made up of many small bones that sit perfectly together forming many joints. The big toe joint comprises of the first metatarsal and the proximal (close) phalanx of the toe. A bunion forms when base of the toe (first metatarsal) drifts away from the second metatarsal. The 1st metatarsal rotates and drops and so no longer sits in its correct alignment. The tip of the first toe then rotates and drifts inwards. Overtime, under the continuing stress of this altered position of the joint and the irritation that this causes, the joint can become inflamed.


Causes
Bunions are among the most common problems of the foot. They are several possible reasons a bunion may develop, though a biomechanical abnormality (improper function of the foot) is the most common cause. In an unstable flat foot, for example, a muscular imbalance often develops that, over time, causes bunions. Bunions tend to run in families, and most podiatrists believe that genetic factors play a role in predisposing some people to develop bunions. Poor shoes, like high heels and pointed toe boxes–exacerbate the condition by speeding up the development of bunions, and by making bunions more painful. Poor shoe choices is at least one of the reasons bunions are much more common in women than men.


Symptoms
Bunions are readily apparent, you can see the prominence at the base of the big toe or side of the foot. However, to fully evaluate your condition, the Podiatrist may take x-rays to determine the degree of the deformity and assess the changes that have occurred. Because 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. There is no clear-cut way to predict how fast a bunion will get worse. The severity of the bunion and the symptoms you have will help determine what treatment is recommended for you.


Diagnosis
Diagnosis begins with a careful history and physical examination by your doctor. This will usually include a discussion about shoe wear and the importance of shoes in the development and treatment of the condition. X-rays will probably be suggested. This allows your doctor to measure several important angles made by the bones of the feet to help determine the appropriate treatment.


Non Surgical Treatment
Sometimes observation of the bunion is all that’s needed. A periodic evaluation and x-ray examination can determine if your bunion deformity is advancing, thereby reducing your chance of irreversible damage to the joint. In many other cases however some type of treatment is needed. Early treatments are aimed at limiting the progression of the deformity and easing the pain of the bunion or an associated joint. Conservative treatments such as orthotics can achieve this but they won’t reverse the deformity itself. These options include changes in shoe wear. Foot Mechanics Podiatrists are experts in shoe recommendation. Padding. Pads placed over the area of the bunion can help minimise pain, but will not stop the progression of the bunion. Activity modifications. Avoid activity that causes bunion pain, this could include standing for long periods of time. Medications. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen may help to relieve pain. Icing. Applying an ice pack several times a day helps reduce inflammation and pain. Orthotic devices. Orthotics are the mainstay of non-surgical treatment for bunions.
Bunions


Surgical Treatment
There are many different surgical procedures that can be performed. The decision to perform one type of surgery or another is based upon the extent and magnitude of the bunion deformity, the presence of arthritis in the big toe joint, and the space between the first and second metatarsals, which is called the intermetatarsal angle. It is very rare that a bunion can be treated by simply shaving down the bump of the bone. Invariably, the deformity will recur and both the bunion and the hallux valgus will return. Therefore, the shaving of the bunion, called an exostectomy, is performed in conjunction with a cut of the first metatarsal bone (which is called an osteotomy).

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Causes Indications And Dealing With Achilles Tendon Ruptures

May 2nd, 2015 parašė louveniaalstrom

Overview

The Achilles tendon is found in the back of the leg above the heel, and is the largest tendon in the body. It connects the calf muscles to the heel bone and is used when walking, running and jumping. A rupture of the tendon is a tearing and separation of the tendon fibers. When a rupture of the tendon occurs, the tendon can no longer perform its normal function. A common issue related to a tear is the inability to point your toe.


Causes
Repeated stress from a variety of causes is often the cause of Achilles tendon injury. The stress may occur from any of the following. Excessive activity or overuse. Flat feet. Poorly fitting or inadequate shoes. Inadequate warm-up or proper conditioning. Jogging or running on hard surfaces. Older recreational athlete. Previous Achilles tendon injury (tendonitis/rupture). Repeated steroid injections. Sudden changes in intensity of exercise. Use of fluoroquinolone antibiotics (especially in children). Trauma to the ankle. Tense calf muscles prior to exercise. Weak calf muscles.


Symptoms
Patients who suffer an acute rupture of the Achilles tendon often report hearing a ?pop?or ?snap.? Patients usually have severe pain the back of the lower leg near the heel. This may or may not be accompanied by swelling. Additionally, because the function of the Achilles tendon is to enable plantarflexion (bending the foot downward), patients often have difficulty walking or standing up on their toes. With a complete rupture of the tendon, the foot will not move. In cases where the diagnosis is equivocal, your physician may order an MRI of the leg to diagnose a rupture of the Achilles tendon.


Diagnosis
During the physical exam, your doctor will inspect your lower leg for tenderness and swelling. In many cases, doctors can feel a gap in your tendon if a complete rupture has occurred. Achilles tendon rupture can be diagnosed reliably with clinical examination, but if there?s a question about the extent of your Achilles tendon injury then your doctor may order a magnetic resonance imaging (MRI) scan.


Non Surgical Treatment
Pain medicines can help decrease pain and swelling. A cast may be needed for 2 months or more. Your foot will be positioned in the cast with your toes pointing slightly down. Your caregiver will change your cast and your foot position several times while the tendon heals. Do not move or put weight on your foot until your caregiver tells you it is okay. A leg brace or splint may be needed to help keep your foot from moving while your tendon heals. Heel lifts are wedges put into your shoe or cast. Heel lifts help decrease pressure and keep your foot in the best position for your tendon to heal. Surgery may be needed if other treatments do not work. The edges of your tendon may need to be stitched back together. You may need a graft to patch the tear. A graft is a piece of another tendon or artificial material.


Surgical Treatment
Regaining Achilles tendon function after an injury is critical for walking. The goal of Achilles tendon repair is to reconnect the calf muscles with the heel bone to restore push-off strength. Those best suited for surgical repair of an acute or chronic Achilles tendon rupture include healthy, active people who want to return to activities such as jogging, running, biking, etc. Even those who are less active may be candidates for surgical repair. Non-operative treatment may also be an option. The decision to operate should be discussed with your orthopaedic foot and ankle surgeon.


Prevention
To prevent Achilles tendonitis or rupture, the following tips are recommended. Avoid activities that place an enormous stress on the heel (for example, uphill running or excessive jumping). Stop all activity if there is pain at the back of the heel. If pain resumes with one particular exercise, another exercise should be selected. Wear proper shoes. Gradually strengthen calf muscles with sit-ups if prior episodes of Achilles tendonitis have occurred. Always warm up with stretching exercises before any activity. Avoid high-impact sports if prior episodes of Achilles tendon injury.

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May 2nd, 2015 parašė louveniaalstrom

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