3. November 2016 07:26
A foot with an unusually high arch is referred to as the Cavus Foot. The condition may lead to excessive weight bearing on the heel and ball of the foot causing a host of physical inadequacies. Cavus Foot may affect one or both feet and may occur at any age irrespective of gender. This defect has the chances of progressing, specifically if it is accompanied by any neurological problems.
- It may be a result of a genetic abnormality in the foot structure
- Neurological diseases such as Cerebral Palsy, Spina Bifida, stroke or Muscular Dystrophy could eventually cause the development of a Cavus Foot
- Past injuries to the foot
- The abnormally high foot arch is noticeable when the person is standing
- Pain and instability while moving
- Frequent ankle and foot sprains
- Due to the lack of stability, the patient may tend to clench the toes while walking. This can result in the growth of Hammer Toes
- Muscular weakness may cause Foot Drop
- Change in gait as the person may start dragging the foot/feet while moving
- The patient’s genetic history and medical conditions in the past may be reviewed by the doctor
- X-ray examination may be required to assess the changes in the bone structure
- A neurological test may be required for accurate diagnosis
- The doctor may test the foot and limbs for loss of muscular strength and check for the range of motion
- Analysis of the gait
- The visible symptoms may be taken into consideration
- Customized orthotic devices such as shoe inserts may be used to provide support to the foot while walking or standing
- Bracing may be recommended in case of foot drop as well as to hold the ankle in the right position
- The shoes may be chosen as per the doctor’s recommendation to provide better support to the heel and ball of the foot
- Surgical intervention may be required if conservative methods of treatment do not provide relief. The procedure may be done to alter the bone structure permanently.
- Surgery may also be recommended in case of neurological defects that may be the cause of Cavus Foot
- Hammer or Claw Toes that develop as a result of Cavus Foot may require surgical treatment
- Exercises that aim at strengthening the leg and thigh muscles as well as improve the flexibility of the foot may be incorporated
- Activity modification and avoidance of weight bearing may be recommended post-surgery to allow the soft tissue and altered bone structures to heal
For complete diagnosis and treatment of Cavus Foot, visit OrthoTexas. To schedule an appointment with the orthopedic foot doctors in Flower Mound, TX, call at (972) 899 – 4679 or visit 4951 Long Prairie Rd, Suite 100, Flower Mound, TX 75028.
29. October 2016 06:35
Boutonniere Deformity (BD) is a condition characterized by a deformity in the finger with the middle joint bent downwards and the distal end pointed backwards. The finger joints are connected by tendons and ligaments which allow motion. Due to tearing of the ligaments in this condition, finger bends downwards (flexed) at the proximal interphalangeal joint (PIP) and hyperextended (bent backwards) at the distal interphalangeal joint (DIP).
- Rheumatoid Arthritis- In this case, the inflammatory cells are released into the synovium (joint lining) which result in the formation of the abnormal pannus tissue. This in turn secretes substances which can damage tendons, bones and ligaments causing deformities.
- Trauma or injury- The tendon that is attached to the middle joint of the finger gets damaged if a bent finger is jammed or hit by an external force. This prevents the straightening of the joint
- Bruise or cut- A cut at the top of the finger can tear the underlying tendon causing deformity
- Dislocations and fractures: Dislocations and fractures in the bones of the hand may also lead to this condition.
- Swelling and tenderness
- Visibly deformed finger
- Limited ability to stretch the finger
- Imaging Tests: X-ray imaging helps to diagnose broken bones and soft tissue structures.
- Elson’s Test: The patient is asked to straighten the injured finger to check for loss of motion.
- Ice packs and heat therapy: Ice packs can be applied for 24-48 hours at regular intervals. They help to relieve pain and swelling. Heat therapy can also be beneficial in relieving the symptoms.
- Medications- Corticosteroids and anti-inflammatory medicines may be prescribed if the patient is suffering from Arthritis.
- Splinting- The middle part of the finger is secured using a splint for 4-6 weeks to allow the ends of the tendon to regrow and join each other. The patient may be asked to continue wearing the splint at night after 6 weeks
- Exercises- The doctor may recommend specific stretching and strengthening exercises to improve functionality. It may help to restore the normal range of motion.
- Taping: Taping is recommended if the patient is likely to participate in sports even after the treatment as a precautionary measure. It can help to provide stability to the fingers.
- Surgical treatment- This is required if the patient is suffering from Rheumatoid Arthritis, the tendon is completely torn or a piece of bone gets detached along with the tendon. The tendon and the bone are put back into their correct anatomical position.
For effective treatment of Boutonniere Deformity, visit OrthoTexas. To schedule an appointment with the orthopedic doctors in Flower Mound, TX you can call at (972) 899 – 4679.
19. October 2016 04:26
Pigeon Toes (Intoeing) is a physical ailment which involves turning of the feet inwards. It may affect either one or both the feet. The condition may develop in the early phase of childhood or may become apparent in later stages when the child starts walking. In most cases, Intoeing can heal itself naturally over the time as the child grows. However, in severe cases, treatment from an orthopedic doctor is required. In most cases the patient responds to conservative methods of treatment. For the others, surgery is required.
- Gestational problems- The child may not get adequate space in the uterus which causes the legs to turn inwards
- Internal Tibial Torsion- The shinbone is turned inwards. This is generally the cause if Intoeing occurs in the first 2 years of life
- Medial Femoral Torsion or Anteversion- The thigh bone tends to turn inwards causing foot deformity which becomes apparent at the age of 4-5 years
- Other disorders: Neuromuscular disorders such as Cerebral Palsy may also be a cause of the condition
- Genetic factors: Intoeing can also be caused due to genetic factors
- Visible deformity
- Abnormal gait
- Difficulty in walking and running due to lack of balance
- The child is easily fatigued and may stumble very often
- Difficulty in wearing normal shoes
- Pain may be felt during activity
- A detailed examination of the symptoms, family history and the foot may be conducted
- X-ray imaging may be required to check the position of the bones and soft tissues
- The range of motion may be assessed through physical tests
- Bracing- The child may be asked to wear a night brace or a removable brace throughout the day to correct the position of the foot. It comprises of a special shoe made with connecting bars that is fixed on the leg. Bracing may be done even after birth if the baby is found to be deformed
- Orthotic devices- Special shoe inserts may be used to support the affected foot
- Plaster: Leg and the foot may be fixed in a plaster for a specific period of time.
- Surgery: The orthopedic doctors may recommend a surgery if the condition exists beyond 9-10 years of age. The procedure involves resetting of the tibia or the femur as well as the foot bones to improve the shape and create a proper gait.
Visit OrthoTexas for comprehensive diagnosis and treatment of Pigeon Toes. To schedule an appointment with the orthopedic doctor in Flower Mound, TX you can call at (972) 899 – 4679.
4. October 2016 10:29
Lisfranc fracture refers to a break in the bones that connect the mid foot to the forefoot. This part comprises of a group of bones and connective tissues called ligaments that form the arch on top of the foot. Five long bones called metatarsals extend out from the mid foot to the toes. The arch not only supports the foot while walking, but also helps to transfer the pressure exerted by the leg muscles to the forefoot. The lisfranc complex is important to maintain a proper gait and ensure even distribution of body weight through the lower extremities.
Lisfranc fracture may affect one or more joints in the foot and can be accompanied by a ruptured ligament. It is a serious injury that should be treated immediately as it may take months before the patient can regain complete functionality of the limb. Severe injuries may result in a permanent loss of arch (Flat Foot) or cartilage and Arthritis.
- Sudden twisting of the foot
- Sports injuries which may occur due to falling while the foot is flexed downwards
- A fall from a height can severely fracture or dislocate the bones
- Vehicular accident
- If a heavy or large object falls directly on the foot
- Diabetes and neurological defects may increase the chances of such injuries
- Swelling may occur on the top of the foot
- Pain may increase with movement
- Bruising, accompanied with discoloration above and below the foot
- Difficulty in bearing weight
- The foot may appear abnormally wide
- Thorough clinical examination of the injured foot and ankle
- Analysis of the patient’s symptoms, injuries and medical history
- Palpation may be done by the orthopedic doctor to check for tenderness and dislocations
- Piano Key Test- the toes are moved up and down to see if it causes pain
- Single limb heel rise test to check if the patient can stand on tip toes without pain
- X-ray imaging to evaluate changes in alignment of the Lisfranc joint
- MRI and CT scan may be done to obtain cross-section images of the foot and identify damage to soft tissues
- The foot may be immobilized for a few weeks using a cast. The patient may not be allowed to put weight on the foot. After the immobilization period, the cast may be replaced with a removable one and slight weigh bearing may be permitted
- Ice packs may be applied during the initial period to reduce pain and swelling
- The injured foot should be kept elevated to compress swelling
- Internal fixation of the broken or dislocated bones may be done. In this, the bones are put back in place and held together using metal screws and plates
- Surgical fusion of the damaged bones so that they are allowed to grow back into one single bone mass. This is done in case of severe injuries when internal fixation is not possible
- Surgical repair of torn or stretched ligaments may also be recommended in some cases
We, at OrthoTexas, offer complete diagnosis and treatment for lisfranc (midfoot) fracture. To schedule an appointment with the foot and ankle specialists in Flower Mound, TX, you can call us at (972) 899 – 4679 or visit 4951 Long Prairie Rd, Suite 100, Flower Mound, TX 75028.
10. August 2016 09:41
Breaking of the ankle bone (talus) is medically termed as Talus Fracture. The talus connects the leg bone to the foot and lies just above the calcaneus. The subtalar joint formed by talus and the heel bone enables us to walk as well as maintain balance on uneven surfaces. The joint is lined by protective articular cartilage which prevents the bones from rubbing against each other. Talus fracture may occur either in the middle or outer portion of the bone. Such fractures are generally serious and can lead to considerable damage to the joint. If not treated timely, it may eventually lead to complications such as Compartment Syndrome, Post Traumatic Arthritis and Avascular Necrosis.
- Automobile accident
- Falling from a height and landing on the feet
- Forceful outward pushing of the ankle
- Sports injuries
- Inability to bear body weight while standing
- Severe pain
- Fractured bone may be seen protruding out of the skin
- The joint may feel tender when touched
- Clinical examination of the injured foot
- The nerve conduction ability and blood supply to different parts of the foot and leg may be checked
- X-ray imaging may help to determine the location and severity of fracture. It may also reveal the severity of the fracture or any dislocation of the bone
- CT scan may help to detect damage to soft tissues and minute cracks in the bone
The methods of treatment may include one or more of the following.
- The foot may be put in a soft padded splint to keep it stable
- The foot needs to be rested while keeping it elevated at chest level
- Stable fractures with minimal displacement may be treated non-surgically by placing the foot in a cast to avoid putting any pressure on the joint
- Immobilization may be followed by physical therapy to restore movement, flexibility and strength of the joint as well as the adjoining muscles
- Medicines may be prescribed to combat pain and inflammation
- In case of multiple breaks in the bone or greater degree of displacement, surgery may be required. The procedure may involve realigning the bone parts to their actual position. Metal screws and wires may be used to fix the bone to its position.
- Use of a walking stick or cane may be recommended post surgery
- Specially designed boots to lift pressure from the talus can be worn for some time
The foot and ankle surgeons at OrthoTexas provide effective treatment for talus fracture. To schedule an appointment with our orthopedic doctors in Flower Mound, TX, you can call at (972) 899 – 4679.
16. April 2016 05:08
The heel bone (calcaneus) is the largest among all the bones in the foot and bears the maximum impact of body movement. It is protected by a thick covering of fatty tissues which not only protects but also gives it its shape. Heel pain is a common problem that affects people irrespective of age and gender.
- Running, walking and jumping on uneven or hard surfaces
- Wearing shoes that do not provide adequate support
- Being overweight
- Stepping on a hard or pointed object
- Direct injury to the heel bone
- Formation of bony outgrowths or heel spurs
- Sprains or strains which affect the tendons and ligaments
- Fracture of the heel bone
- Medical conditions such as Neuroma, Bursitis, Arthritis, Flat Feet, Sever’s Disease, Plantar Fasciitis, Achilles Tendonitis etc.
- Pain which can be mild to severe
- Inability to bear body weight
- Tenderness, redness, bruising may be observed
- Pain may aggravate in the morning while getting up from the bed
- Change in gait/ limp
- A feeling of warmth in the foot and heel
- Inability to bend the foot or turn the toes
- Numbness or tingling sensation
- Evaluation of the injured foot and heel by the orthopedic doctor
- Assessment of the patient’s medical history
- X-rays may be conducted to check for bone damage
- MRI and CT scans help reveal soft tissue, blood vessel, tendon and ligament damage
- Nerve conduction tests may be done to check for loss of sensation
- Wearing a splint over the heel at night
- Applying ice packs at regular intervals for 2-3 days
- Giving rest to the injured foot
- Wearing supportive shoes with proper cushioning
- Pain killers and anti-inflammatory medicines may be prescribed
- Avoiding any activity that may put stress on the heel or foot
- Strapping or taping may be advised to support the ligaments and tendons
- Shoe inserts, customized orthotics, heel wedges may be used for additional support
- Surgical intervention may be required in case of a fracture, for removal of bone spurs or torn ligaments and tendons
- Physical therapy and specific stretching exercises may be recommended to regain strength and motion
We, at OrthoTexas, provide effective treatment for heel pain and other foot conditions. To schedule an appointment with the foot specialists in Flower Mound, TX, you can call at (972) 899 – 4679 or visit 4951 Long Prairie Rd, Suite 100, Flower Mound, TX 75028.
29. March 2016 06:28
Drop Foot, also referred to as the Peroneal Nerve Injury, is a neuromuscular disorder that affects a person’s ability to lift his/her foot at the ankle joint. The peroneal nerve branches out from the sciatic nerve (located in the lower back) and is responsible for providing sensation to the frontal and top part of the feet besides the sides of the legs. It stimulates the muscles in the legs which help in lifting the ankle and toes in upward direction. This nerve passes through the outer part of the legs and hencecan get easily injured. Drop Foot is considered to be a symptom of an underlying disease and it can greatly hamper a person’s ability to walk as well as increases the risk of tripping or falling down.
- Spinal injury
- Medical condition such as Amyotrophic Lateral Sclerosis (ALS)
- Multiple Sclerosis
- Parkinson’s Disease
- Herniated disc
- Fracture or dislocation in the knee or hip joint
- Hip replacement or knee surgery
- Nerve compression
- Weak muscles due to prolonged immobilization of the leg
- Sitting in a cross legged position for too long
- Sports injury
- The toes cannot be lifted upwards (dorsiflexion)
- Development of steppage gait- the person tends to lift the leg higher than normal while walking
- Pain, weakness or numbness in the upper part of the foot or shin
- Loss of foot functionality
- A detailed physical check of the affected foot
- Evaluation of the patient’s medical history
- Neurological tests to assess loss of sensation and function
- Observation of abnormality in gait
- X-ray and MRI
- Electromyography (EMG) to assess electrical conduction within the nerves and muscles
- CT scans
- Ultrasound to diagnose presence of cyst, tumor or any other abnormality that may put pressure on the nerves
- Physical therapy to strengthen the leg muscles and improve gait
- Use of specifically designed foot brace or splints that can be customized to fit within the patient’s shoe
- Surgical decompression of the compressed nerve
- Surgical fusion of the ankle and foot joint
- Nerve grafting
- Tendons may be surgically transferred from healthy muscles to improve the condition
- Stimulation of the peroneal nerve may help improve the condition
- Stretching exercises may help to reduce stiffness in the foot
For treatment of Drop Foot and other medical conditions, visit OrthoTexas, to schedule an appointment with our orthopedic surgeons in Flower Mound, TX, call at (972) 899-4679.
2. February 2016 09:50
Tearing of ligaments in the ankle is referred to as an ankle sprain. Ligaments join the bones together and enable their movement. Although the ankle has many ligaments, the ATFL (anterior talofibular ligament) and the CFL (calcaneal fibular ligament) are most susceptible to injury. Ankle sprain most commonly affects the lateral side of the ankle and can occur as a result of any activity that leads to the twisting or rolling of the foot. The injury is common among sportspersons involved in running, jumping and activities involving physical collisions.
In most cases, the sprain heals through conservative methods of treatment and surgery is not required or recommended. A severe sprain makes the foot prone to more sprains and injuries in the future.
- Inversion- twisting of the foot under the ankle or leg
- People with Hindfoot Varus or inwardly turned heels are more prone to ankle sprain
- Instability of the foot due to weak supporting muscles
- Pain which can be mild to severe
- Tenderness at the point of injury
- Ecchymosis- discoloration caused due to rupturing of blood vessels under the skin
- Redness and swelling
- Inability to bear body weight while attempting to stand or walk
- Pain may get aggravated with movement
- Evaluation of the patient’s medical history, symptoms, mode of injury
- Physical examination of the injured foot may be conducted by the orthopedic doctor which also involves checking the range of motion intact
- X-ray scan may be conducted to see if there is any injury to the bone structure
- MRI imaging helps view damage to the soft tissues and ligaments
- Resting the injured ankle for a few days
- Cryotherapy- Applying ice packs at regular intervals to reduce swelling and pain
- Anti-inflammatory drugs may be prescribed to provide relief from pain and inflammation
- Keeping the injured foot elevated above the level of the heart
- Crutches or walking aids may be recommended to patients who are unable to bear weight on the foot.
- Physical therapy may help to restore motion, flexibility and strength of the ankle joint
- Ankle brace may be prescribed for use by sportsperson to provide additional support to the ankle
- Surgical treatment may be required if the injury involves multiple ligament tears or cartilage damage and if the ligaments do not become stable after weeks of conservative therapy
For treatment of ankle sprain and other orthopedic conditions, visit OrthoTexas. To schedule an appointment with the orthopedic doctors in Flower Mound, TX, call at (972) 899-4679.
8. January 2016 11:10
Posterior Tibial Tendon Dysfunction is a condition that affects the ankle and the foot as a result of the tearing or inflammation of the posterior tibial tendon, which connects the calf muscles in the leg to the bones on the inner side of the foot. The tendon helps to keep the foot arch intact and provides stability while walking or movement. An injury to the tendon results in loss of stability and gradual development of a Flatfoot. This ailment is found to be more prevalent in women particularly after the age of 40.
- Injury to the leg or foot resulting in tearing or damage to the tendon
- Sudden fall
- Stress, hypertension, Diabetes and Obesity increase the chances of developing this problem
- Sports or high impact activities such as basketball, soccer or tennis may result in repetitive use and consequent tearing of the tendon
- Pain which can get worse with movement or any activity involving walking, running or even standing for long duration
- The patient may develop swelling near the arch of the foot
- Gradual collapse of foot arch
- The outer ankle bone will develop pain with the shifting of the heel bone
- Too many toes will be visible from the rear of the foot due to inward rolling of the ankle
- Change in foot shape
- Analysis of the patient’s medical history
- Assessment and investigation of the time and process of injury
- Conducting a flexibility test to check the range of motion
- Several imaging techniques may be applied such as X-rays, CT scan, MRI or Ultrasound to analyze the bone and tissue damage
- The orthopedic doctor may recommend the patient to rest the injured foot or leg and strict avoidance of activities that pressurize the foot
- Application of ice packs at regular intervals 3-4 times in a day helps reduce swelling
- Prescription of anti-inflammatory drugs or pain killers
- Use of a cast or a special boot to immobilize the leg or to provide additional support to the tendon
- Orthotic devices such as a brace or a shoe insert may help alleviate symptoms of Flatfoot and provides adequate support to the patient
Surgical methods of treatment depend on the severity of the damage and location of the tendon. The following methods may be adopted:
- Damaged posterior tibial tendon may be removed and replaced by another tendon in the foot to restore function and stability
- Surgical removal of the inflamed tissues around the tendon
- Flatfoot can be treated by lengthening the calf muscles
- Osteotomy, i.e. surgical cutting of one or two bones to repair the Flatfoot and create a normal arch shape
For comprehensive treatment of Posterior Tibial Tendon Dysfunction, visit OrthoTexas. To schedule an appointment with the foot and ankle specialists in Flower Mound, TX, call at (972) 899 – 4679.
25. November 2015 08:54
Acquired Adult Flatfoot Deformity (AAFD), or Pes Planus, refers to a condition characterized by a progressive flattening or collapse of the arch of the foot. It generally occurs when the posterior tibial tendon, a muscle that attaches the ankle and the midfoot, becomes dysfunctional. This tendon is largely responsible for maintaining the foot’s alignment, arch and a proper gait. AAFD is termed progressive because the process of flattening occurs over a period of time and starts affecting the other soft tissues in the ankle as well as foot. The condition may start with pain in the ankle and lead to permanent deformity or development of Arthritis if not treated.
- Sudden injury to the posterior tibial tendon/ Posterior Tibial Tendon Dysfunction (PTTD)
- Existing Flatfoot that further stresses the ligaments and tendons
- Wear and tear of the soft tissues in the foot or ankle
- Inflammatory Arthritis not only affects the joints but also the ligaments leading to a fallen arch and painful Flatfoot.
- Injury to the foot ligament, fracture/dislocation of the midfoot bone
- Change in alignment of the foot/flattened arch
- Pain while walking, running or standing for long duration
- Most of the toes are visible from the back of the foot
- Limp walk
- Swelling and tenderness over the inner ankle
- Longstanding history of pain in the inner or outer ankle
- Improper alignment of heel and leg
- Deformity of the forefoot
The orthopedic doctor will be able to assess the problem by looking at the feet when the patient stands. People with AAFD have feet that appear splayed out wherein most of the toes are visible from the back of the foot and the arch is noticeably flattened. Diagnostic tests may include:
Single leg-heel rise test- This test requires the patient to stand on one leg and raise the heel above the ground a couple of times. Ability to do so indicates that the posterior tibial is still intact.
X-ray of the foot while bearing the complete body weight helps to establish the extent of deformity.
Acquired Adult Flatfoot Deformity can generally be treated through non-surgical methods by supporting and strengthening the tendons or ligament. Surgical intervention is required only when these non-operative measures fail to restore the foot arch and balance. Depending on the degree and functional requirement of the patient, a specific or combination of procedures can be used for treatment. These may include:
- Rest and avoidance of strenuous activities
- Immobilization of the foot with a cast for a specific time period
- Orthotic inserts can be prescribed to support the hind foot
- Wearing an ankle brace
- Weight loss to prevent pressure on the soft tissues and ligaments
- Surgical intervention to lengthen the ligament or muscle
- Surgical replacement of the affected tendon with another tendon
- Surgical realignment of bones
For diagnosis and treatment of Acquired Adult Flatfoot, visit OrthoTexas. To schedule an appointment with the orthopedic doctors in Flower Mound, TX, call at (972) 899-4679 or visit 4951 Long Prairie Rd, Suite 100, Flower Mound, TX 75028.