Nail Fungus (Onychomycosis)
This condition is caused by common organisms that live on our skin. They enjoy a dark, warm environment with lots of dead skin like the soles of our feet and toenail plates. Diagnosis is important to distinguish the problem from eczemas like psoriasis. This is performed by sending a mall amount of nail clippings to the lab for analysis. If a fungus is present, topical agents can be used either over the counter or by prescription. The cure rate for topical agents are about 20%-30% and take at least one to two years of therapy to see any changes. Topical agents have the least effective cure rate. Oral anti-fungal agents have an 88%-92% cure rate after one year, but must be used with caution due to drug interactions and potential liver problems. Blood tests are ordered before and during the course of therapy. Laser nail therapy is very popular and has the same response to a cure rate after one year as the oral method. There is no pain, injection or bleeding. It takes about a half an hour of treatment for ten toenails and usually one treatment per month up to four months can cure the problem. Nail polish and shoes can be worn directly after the procedure.
A bunionectomy is the most common form of bunion surgery. It is performed to relieve the pain associated with bunions that have not responded to conservative treatment methods. This procedure aims to remove swollen tissue from the big toe joint, remove part of the bone to straighten the big toe, and to permanently join the bones of the big toe joint. Most bunion procedures are performed on an outpatient basis under local anesthesia.
Reconstructive foot surgery can help repair birth defects, diseases, injuries and other foot problems. The surgery performed depends on the type and severity of the condition, but can restore function, stability and proper appearance to the foot, as well as relieve pain. Surgery can involve any part of the foot and may involve tendon, bone, joint, tissue or skin repair. Screws, pins, wires and plates may be required to help the foot heal and ensure a full recovery.
Total joint replacement involves removing the damaged bones and tissues and replacing them with synthetic materials to stimulate the natural behavior of the joint. While this is the most complex and advanced procedure, it is very successful and can last for several years. Less complex joint procedures include arthrodesis, arthroplasty, osteotomy, resection and synovectomy, which relieve pain by removing or repairing damaged joint materials.
The gait with which you walk is in large part determined by the mechanics of your body and the height of your arch. People with flat feet often overpronate, with the foot rotating too far inward, and those with very high arches often underpronate, with the foot not rotating enough. Both of these problems can result in poor shock absorption and stress on certain parts of the feet.
Incorrect pronation can result in foot pain, corns, calluses, shin splints and leg or back pain. A podiatrist can perform a full gait analysis to determine whether your pronation is off. If it is, changes to your footwear will be recommended and you may require orthotic inserts.
Scars on the feet can be a result of many types of trauma. If they are thick and unsightly or cause discomfort, there are treatment options to reduce the amount of scar tissue. Sometimes, over-the-counter products containing alpha hydroxy acids can shrink the scar by sloughing off dead skin cells and promoting the growth of new cells. Another successful technique is non-invasive laser therapy, which can repair the skin at the site of the scar, loosening painfully tight skin and making the scar less prominent.
Plantar warts are noncancerous growths that develop on the soles of the feet as a result of the human papillomavirus (HPV). HPV enters the body through tiny breaks in the skin, which are often present beneath pressure points in the feet on the heels or balls. These warts appear on the skin as a small, hard bump that may be gray or brown with well-defined boundaries. In some patients, they may cause pain or tenderness when walking.
While plantar warts are not usually a serious condition, many patients experience pain or embarrassment regarding this condition. Plantar warts can be removed through several different noninvasive procedures, including cryotherapy (freezing), laser surgery, cantahridin, immunotherapy and medication injections.
Wounds & Infections
People with diabetes are at high risk for developing wounds. Ulcers and other wounds commonly form on the bottom of the foot and can easily become infected or lead to other serious complications. Ulcers may develop as a result of poor circulation, lack of feeling in the feet, irritation or trauma.
Once a wound has been detected, it should be treated immediately. Diabetic wound treatment focuses on relieving pressure from the area and removing dead skin cells and tissue through a process called debridement. The wound is then medicated and dressed to prevent infection and promote healing. For more severe wounds, patients may be required to wear special footwear or a brace to relieve pressure and irritation to the wound.
To learn more about the conditions we treat, click here to contact Dr. Weissinger or call 631.271.8500 to make an appointment.