Yusuf Opakunle

What you most likely have is Brachymetatarsal. Brachymetatarsal affects mostly the 4th metatarsal, which is seen clinically as the toe next to the little one. The cause is congenital, meaning you were born with it, which is the most common etiology. Other causes of brachymetatarsal include post-traumatic, post-surgical, or secondary to a disease-state such as downs syndrome. Furthermore, a familiar pattern of inheritance can be seen and it is more common in females.
Is this normal: The only thing abnormal is the short metatarsal bone. Brachymetatarsal is usually harmless however patient seek medical attention for mainly 2 reasons - functional limitation (pain) and or cosmetic concerns.
A variety of surgical procedures have been described to treat brachymetatarsal and can be grouped into callus distraction via external fixation or bone grafting techniques. A thorough history & physical, education and patient understanding is key before undergoing either surgical procedure.

Depending on the history and physical exam, a variety of pathologies could make the foot swollen outside of Trauma such as stress fracture, neuritis, metatarsalgia, capsulitis, acute Charcot if diabetic. Let us assume you are young and healthy however at work you tend to stand on your feet a lot on concrete or hard surface, or you are very athletic, or in active military then you most likely have a stress fracture (2nd metatarsal most common) which won't show up on X Ray until about 3-4 weeks after the onset of symptoms. Stress fracture is also seen in post menopausal women.

I assume an X Ray was taken and let us assume there is no break in the bone seen on x ray, then we believed there is soft tissue injury which is never seen on X Ray. The most common ligament affected after an ankle sprain is the anterior talo fibular ligament. For an acute ankle sprain, the first step of treatment is the RICE therapy and immobilization, to help reduce pain and swelling. In terms of healing, a bone break is more predictable than a ligament sprain. Ligaments usually takes longer to heal (about 6-8 weeks) and even after that time period, some patients continue to have lingering pain and some ankle instability. Conservative therapy are also involved before any surgery such as an using an ankle brace, ankle exercises, some patients also benefit from physical therapy. If ever a decision is made to go to surgery, then various surgical procedures are done for lateral ankle instability from the direct repair called Brostrum to using various implanted devices to help reconstruct the tendon.

After twisting an ankle, first thing I would recommend is to get an X Ray to make sure there is no broken bone or even a chip fracture. Let us assume there is no broken bone, then you can use the RICE therapy and immobilization, allowing the ankle to heal. Most commonly affected ligament after an ankle sprain is the anterior talo fibular ligament. Most simple ankle sprain should heal on it own however there a few that continues to cause lingering pain or ankle instability. That is when you need to see a doctor because you don't want it to become chronic ankle instability. A doctor would do a thorough history and physical exam and decide on the best treatment for you. Conservative therapy include ankle brace, home exercises and some physical therapy. If that fails, an MRI can be ordered and then there are various surgical options to address the pathology.

I tell all my patients after any foot surgery, it is normal for the foot to be swollen 3-6 months after the surgical procedure. Elevating the leg and some light compression socks will help with the swelling.

When treating toenail fungus, I tell my patients, no matter the cream or nail gel you choose to use or apply, the key is to be patient and stay the course. it takes about 6-9 months (even a year) for toe nail fungus to clear away. Most important is the life style changes. No more walking barefoot, always wear clean socks (buy new socks, those old socks are already infected with fungus), spray shoe with Lysol or any fungal spray. If all that fails, then we can remove the nail entirely and let a new nail grow back. I also recommend taking a biopsy of the nail and we can also consider oral antifungal treatment.

The feet, besides the groin, is likely one of the dirtiest part of the body. The feet also tend to get the least care in the body while the face gets the most attention. Walking barefoot around the house, the feet is exposed to all kinds of bacteria. Furthermore, after a shower, all the bacteria gets washed down the feet and most of us walk barefoot in the shower tub so the feet gets exposed to all the bacteria and germs washed down from the body. The toe nails itself harbor some bacteria which are normally not harmful to us but when there is an opening, such as an ingrown nail, then it is easy for the bacteria to penetrate the epidermal layer and cause an infection.