antimicrobial solutions as well as distilled white vinegar soaks. Infections of the nail can be addressed with the cold salve Vicks vapor rub as this does contain camphor oil which has been shown to have inhibitory effect on fungus.
procedures directly served as a translational correction, which means, cutting and shifting the bone over. Unfortunately, this fails to address the rotational deformity that is appreciated. There has been a greater emphasis in recent years to address both the translation but also the rotation of the bone. We have embraced again treating the deformity at the base of the metatarsal where it forms a joint with the midfoot cuneiform bone. By fusion this joint we can derotate and move the bone over and maintain it in this corrected position. It is essentially placing a crooked building straight again on its foundation. The advent of newer orthopedic plates and screws have allowed this procedure to gain significant traction as the need for prolonged immobilization and limited weight bearing has been mitigated. Ultimately, the success of the surgery not only depends on the selection of a correct procedure for the particular circumstance, but the native tissue of the individual. Meaning the preservation of correction requires the individual to have healthy tissue to support prolonged repair. If this is not the case, then success may be limited, and other options should be considered to include nonsurgical treatment or joint fusion of the great toe.
is commonly a self-limiting condition that may take several weeks to months to recover. If pain does not improve, seek a medical opinion.
common athlete's foot or nail fungus. Further, it is formulated as an ointment based product which occludes and moistens skin which is more hospitable for fungal growth. There are studies demonstrating improvement in nail fungus when used for up to 48 weeks applied several times a day to affected nails. With all of this in mind, there are many readily available
over-the-counter antifungals available that specifically address those organisms that commonly produce athlete's foot, and I would encourage their use over Vicks.
idiopathic (no defined explanation). There are a variety of treatments to include shoe modifications, foot orthos with metatarsal pad to relieve pressure from the area, physical therapy, nerve block with corticosteroid, and finally surgery for either decompression or excision. There are other less investigated procedures to include ablations of nerve with chemical or
thermal probe and shock wave treatment.
Initial management includes shoe modification, metatarsal pad with or without supportive insole, activity modification and judicious use of anti inflammatory such as ibuprofen if permitted. If this does not produce improvement, I would recommend x-rays to rule out differential causes of pain to include stress fracture, joint disorder. Other imaging techniques for neuroma include ultrasound and MRI. If definitively neuroma then consider nerve block with cortisone and physical medicine. If this all fails, you may need to investigate more invasive treatment such as surgery and if this does not appeal to you some of the other less investigated approaches mentioned.
be reduced and biopsied.
I have pain in my ankle and it may need surgery. Will my diabetes make it difficult to heal my ankle?
secondary infection risk, and bone healing. Elevated blood sugars impact healing at the cellular level and influence compromised immune response. Blood sugars can be monitored acutely with finger sticks and getting a snapshot understanding of current control, but more frequently, we utilized a test known as the hemoglobin A1c to get a better understanding of her overall glycemic control over an extended period of time. Although there is no consensus, we do appreciate that a hemoglobin A1c representing normal glycemic control is ideal. In my own practice, I typically utilize an A1c of 7.5 mg/dL as a cutoff point for elective surgery. As a side other factors that are looked at particularly when it comes to bone and joint
surgery include the health of the bone from the standpoint of vitamin D as well as social factors such as smoking, which can also impact wound healing and bone healing.
specialist such as a primary physician, dermatologist, or podiatrist.