Services

Bunion

The term bunion basically refers to a bump,

A female patient has been found to have a much higher incidence of the deformity. Even if shoes do not play a direct role in the development of a bunion, they certainly can act as an aggravating factor in the symptoms and possibly serve to enhance progression of deformity. Heredity and genetic factors undoubtedly play a role in the formation of a bunion. The condition may become painful as extra bone and a fluid-filled sac grow at the base of the big toe.

Symptoms

  • Red, calloused skin along the inside edge of the big toe
  • A bony bump at this site
  • Pain over the joint, aggravated by pressure from shoes
  • Big toe turned toward the other toes

Test

A foot x-ray can show an abnormal angle between the big toe and the foot.

Treatment

Treatment options for bunion deformity can be roughly broken down into one of three types: Observation, conservative care, and surgical management. Factors that may help to guide the doctor in this decision process may include the presence or absence of symptoms, the severity and duration of symptoms. If the bunion gets worse, resulting in severe deformity or pain, surgery to realign the toe and remove the bony bump (bunionectomy) can be effective.

Avoid compressing the toes of your foot with narrow, poor-fitting shoes.

Hammertoes

Toe contraction deformities include hammertoes, claw toes, and mallet toes. The deformities can be flexible or rigid. The most common cause of pathological digital contracture itself cause by late stance and propulsion phase hyperpronation. The most common cause of hammer toe is wearing short, narrow shoes that are too tight. The toe is forced into a bent position. Muscles and tendons in the toe tighten and become shorter.

Symptoms

Painful proximal interphalangeal joint motion, painful hyperkeratotic lesions.

Treatment

Wear shoes with wide toe boxes for comfort.

Wear soft insoles to relieve pressure on the toe

For severe contracted the toe, you will need a surgery to straighten the joint.

Gout

Acute gouty arthritis that occurs when uric acid builds up in blood and causes joint inflammation, and Presents as monoarticular, sudden onset and intensely painful inflammation (red, hot, swollen, excruciating pain) stiffness and antalgic guarding, and overly cutaneous desquamation.

If too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed

Tests

  • Synovial fluid analysis (shows uric acid crystals)
  • Uric acid - blood
  • Synovial biopsy
  • Uric acid - urine

Treatment

  • Take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or indomethacin as soon as your symptoms begin.
  • A prescription medicine called colchicine helps reduce pain, swelling, and inflammation.
  • Corticosteroids can also be very effective.Doctor may inject the inflamed joint with steroids to relieve the pain.

Daily use of allopurinol or probenecid decrease uric acid levels in your blood.
Some diet and lifestyle changes may help prevent gouty attacks:

  • Avoid alcohol
  • Limit how much meat you eat at each meal.

Heel pain/Plantar Fasciitis

Plantar fasciitis occurs when the thick band of tissue on the bottom of the foot is overstretched or overused. This can be painful and make walking more difficult.

This condition results from prolonged, excessive tension under the heel due to heel spur or calcaneal spur is an osteophyte outgrowth anterior to the medial calcaneal tuberosity.

Chronic inflammation of the fascia, with or without spur formation, may also be associated with distal calcaneal tunnel syndrome.

Symptoms

The most common complaint is pain and stiffness in the bottom of the heel. The heel pain may be dull or sharp. The bottom of the foot may also ache or burn, usually in the morning when you take your first steps.

Treatment

Stage I: local or oral steroid, low dye strap prefabricated orthotic, ice, Flexibility

Stage II: oral steroid, Custom orthotic, Roller sole.

Stage III: Immobilization, Night splint, dynamic splint, Extracorporeal Shockwave Therapy

Stage IV: Cold ablation microdebridement, Fasciotomy, Spur resection: bursectomy.

Physical therapy plays a useful but limited role. Icing after periods of activity and stretching of the Achilles tendon and plantar fascia appear helpful.

Shoes also play a role in the treatment regimen. Stiff soled shoes and a firm heel counter help to stabilize the foot and provide a secure platform for orthotic devices.

Diabetes Mellitus

DM affected about 16 million people in the US. It is a leading cause of blindness, renal disease, PVD, peripheral neuropathy, lower extremity ulceration and amputation, and death.

Successful intervention begins with an understanding of the risk factors for ulcerations and amputations, and developing a treatment algorithm that takes advantage of recent advances in antimicrobial therapy, wound healing strategies, and surgical intervention.

Patients with diabetes must be fully aware of how to prevent foot problems before they occur, to recognize problems early, and to seek the right treatment when problems do occur. Although treatment for diabetic foot problems has improved, prevention - including good control of blood sugar level - remains the best way to prevent diabetic complications. , and should learn how to examine their own feet and how to recognize the early signs and symptoms of diabetic foot problem.

Dr. Han is fully trained and experienced to treat the condition thoroughly and efficiently to reduce the risk of complications.

Neuroma

This condition is a common cause of metatarsalgia, and must be considered in cases involving pain in the ball of the foot. The patient relates sharp, shooting pain with associated aching, brought on by weight bearing load of the forefoot, insidious in onset, progressively worsening, and intermittent in nature, and seemingly relieved by sitting and massaging the unshod foot for a brief time.

The mechanism of nerve entrapment in the intermetatarsal sace involves repetitive irritation of the nerve by the neighboring ligament.

Non-surgical treatment measures involve the use of a metatarsal projection pad, orthoses, local infiltration of corticosteroid, ultrasound with metatarsal phalangeal joint range of motion exercises, use of a sneaker wit roller sole, oral steroid, ice after strenuous activity, and rest.

Surgical intervention involves around adequate external neurolysis of the involved plantar nerve and excision of the common plantar nerve proximal to the proximal margin of the deep transverse intermetatarsal ligament.

Take anti-inflammatory medications which can reduce swelling and relieve pain.

Try ice massage. Regular ice massage may help reduce pain.

Change your footwear. Avoid high heels or tight shoes. Choose shoes with a broad toe box and extra depth.

Wart/Verrucae

Plantar warts are caused by an infection with the human papillomavirus (HPV) in the outer layer of skin on the sole of your feet. HPV virus does thrive in warm, moist environments — such as shower floors, locker rooms and public swimming areas. Consequently, you may contract the virus by walking barefoot around pools or gyms

Symptoms

Callus over a well-defined on the skin, where a wart has grown inwards.

Black pinpoints bleeding which is actually small, clotted blood vessels.

Pain or tenderness when walking or standing.

Patients can use over-the-counter wart treatments along with these treatments or between visits to the office.

The first line of defense is to protect yourself by keeping foot clean and dry, and avoid walking barefoot in communal bathing areas.

Fungal nail infection

Fungal infections are extremely common in the foot. Fungi that infect humans are categorized as either dermatophytes (superficial) or deep pathogens.

Identification of the infecting fungus is made via skin shaving or nail fragment exam for hyphae or yeast using KOH(potassium hydroxide) to dissolve keratin from skin scrapings, or periodic acid Schiff’s(PAS) stain.

Palliative treatment of fungal nail includes nail plate debridement and regular application of topical antifungal, however cure rates are usually <75-80% with topical therapy, although debridement alone is known to improve foot related quality of live.

Cure is more likely with oral administration of either Lamisil (250mg oral daily for 3months) or itraconazole (200mg oral daily for 3 months).It is prevent to check liver enzymes and blood test, prior to initiating oral antifungal therapy.

Prevention of recurrent fungal nail may require periodic maintenance use of topical therapy, and concurrent debridement is a crucial part of any treatment plan.

Trauma/Fracture

The majority of nail and foot injurie result from blunt trauma, either stubbing or dropping something heavy on the foot, simple and complex nail bed lacerations.

Burn and Frostbite

Puncture wound, Animal bite, Achilles tendon rupture, Ankle sprain, Foot and Ankle fracture.

Treatment for fractures can begin with protective surgical shoe, posterior splint and weight bearing or non-weight bearing cast. In some cases, surgery may be required to restore proper bone alignment and promote healing. Surgery may involve the use of metal pins, screws and plates to hold the bones in place while they heal.