Posts for category: foot surgery

By Dr Aarti Kumar
May 09, 2019
Category: foot surgery
 
                                     metatarsal-fracture
 
Metatarsals are the five long bones of the foot. Metatarsal fractures are amongst the most common injuries in the foot. These long bones help maintain the alignment and anatomy of the arches in our feet. Metatarsals are held in place with various ligaments and tendons. For anatomical purposes, the metatarsals are divided into three sections- the head (near the toes), shaft and base. Two mechanisms of injury to the metatarsals are either direct or indirect forces. Direct forces are usually from a crush injury which may also involve soft tissue compromise. Indirect forces are  when the forefoot is in a fixed position with the leg or rearfoot rotating which may also cause ligamentous and tendon damage. It is important to categorize fractures based on displacement and angulation since those characteristics dictates conservative vs surgical treatment. The most common metatarsal to become injured is the fifth metatarsal bone. A specific area on the fifth metatarsal which has decreased blood flow is most famously known as a Jones fracture and needs to be treated with extra care.  Stress fractures of the metatarsals are also fairly common which can occur from repeated trauma, fragile bone from metabolic deficiency or an associated foot deformity. Stress fractures are the most common in the second metatarsal head. 
 
Clinically, metatarsal fractures will appear as pain and swelling mostly to the top of the foot. There are several ways to aid in the diagnosis of metatarsal fractures. Plain film radiographs are usually the first line imaging used in the office. It is always important to obtain three views as one view alone may present as a false negative result. Another helpful diagnostic imaging device is a C-arm or fluoroscopy which is key when examining joints under dynamic range of motion under X-ray technology. Ultrasounds can also be utilized to rule out fractures and are fairly convenient as they can be done at the bedside. Though ultrasounds are more often used to evaluate for soft tissue abnormalities, fractures can be diagnosed using this modality with no radiation. At Advanced Podiatry, we are fully equipped with X-rays, C arm and ultrasound to help with accurate diagnosis and get our patients back on their feet as soon as possible. CT scans can also be ordered to check for displacement of multiple joints when a serious injury is suspected. MRI is helpful in diagnosing stress fractures as they do not initially appear on X-rays. 
 
Treatment for metatarsal fractures is driven by the type of fracture (i.e. displacement, angulation, joint involvement). Nonoperative treatment usually consists of a walking or CAM boot which has a stiff sole and prevents the propulsive cycle of gait. Such treatment is only effective when a fracture is non displaced or minimally displaced in isolation. Stress fractures are also treated with walking boots to inhibit the fracture from worsening. Bone typically takes about 6-8 weeks to heal so a patient can expect to be in a walking for about that time. Surgical treatment becomes necessary when displacement/angulation is involved or when multiple metatarsal fractures are involved. In surgery, the fracture part of the bone is realigned into normal position and can be fixated with a pin/wire, screws or a combination of plates and screws depending on the nature of the fracture. 
By Dr. Joseph DiStefano
November 01, 2018
Category: foot surgery
Tags: foot surgery  

                             

To cut or not to cut, that is the question. Not that it was a question. Maybe it was rhetorical.

Unlike other parts of the body, the foot is subjected to stress well in excess of normal pressures from the loading weight of the patient. It is estimated that the additive force of gravity, the body habitus of the patient, the type of foot the patient has and the ground reactive forces all play a role in amplifying the pressure subjected to the structures of the foot. Don’t forget loyal reader, the bones of the foot are some of the smallest in the body, so it is no wonder that if a condition arises that further amplifies the force on the foot, a patient shows up looking for answers.

When a patient presents to the office for a consultation, the first thing we do is examine the foot when weightbearing and non-weightbearing. I mentioned above the type of foot the patient has helps determine the additional forces that the bones and supporting structures of the foot are subjected to, and this is where we start to gather information that helps determine where the problem came from.

Usually, conservative measures are all that are needed to help the issue calm down. When I say conservative measures, I am referring to all non-surgical treatment. These treatments can range from some simple rest and ice to cortisone injections and advanced therapies like extracorporeal shockwave therapy and physical therapy. A custom orthotic device is the best way we can support the foot and ankle. This is my favorite way to rehabilitate a patient.

We do everything that we can to keep patients out of the operating room, but the truth of the matter is that sometimes surgery is the only option. We always provide a detailed plan and counsel our patients on the etiology of the problem and all the ways it can be fixed including the downtime associated with each procedure and what the patient can expect during recovery. We are a team from the start to the finish, so we can tailor a plan that works best for your situation.

The best way to know is to come in so our friendly staff and extraordinarily good looking doctors can let you know your options. We look forward to seeing you!

By Dr. Joseph DiStefano
September 10, 2018
Category: foot surgery

We live in a world of ever changing and improving technology. As soon as one piece of equipment is released, six months later an updated and improved version is released. The same is true in the world of medicine and surgery. Pharmaceutical companies are always inventing and improving medicines, and new digital and computer-based procedures for surgical correction are coming into favor by surgeons. 

The most recent development in surgical management is a minimally invasive approach to surgical procedures. Utilizing state-of-the-art instruments, doctors trained in this type of surgery are able to perform orthopedic corrective procedures without creating large incision sites. Less trauma to the surgical site not only offers a smaller scar with better aesthetic properties, but it allows for faster recovery and far less pain. 

The doctors and staff at our practice are ever vigilant in keeping up with the newest and most beneficial technologies to offer our patients. All of our doctors engage in continuing education and have been exhaustively training with the companies that offer the minimally invasive technique to be able to provide this service to our patients. 

I am very pleased to say that our patients that have undergone these procedures have been blown away with their results! At Advanced Podiatry, we pride ourselves in offering cutting-edge (no pun intended) technology to best serve our patients. Not every patient will be a candidate for this type of surgery, but please give us a call or come in for a consultation if you would like to know more.

By Dr. Evan A. Vieira
April 18, 2018
Category: foot surgery

About 75% of the patents that present to our office with the chief complaint of a painful bunion will undergo surgical intervention. Bunion surgery is an elective procedure, meaning that it is a not mandatory that it be performed.  The age range of patients presenting with bunions is very wide.  Generally, around 8-80 years of age. However, the general candidate for surgery is more in the 20-65 year-old-range.  This is not set in stone and there are exceptions to every rule.
We perform hundreds of these procedures per year between all the doctors in our group.  We are experts on the latest techniques, instrumentation and modalities.  We constantly stay abreast of advancements and are always looking to improve. We have a 99.9% success rate.
We have  minimal complications due to constant attention to detail, diligent follow up and always making sure we are available to our patients after surgery.
Bunions are very very common, some figures as high as 45-50% of the population may have some form of them.  We pride ourselves on our top notch care, our low complication rate and our desire to help our patients get better. 

Call us today for your consultation.

By Dr. Evan A. Vieira
March 28, 2018
Category: foot surgery
Tags: Untagged

Minimally invasive surgery or MIS techniques have made great advances lately.  These allow for decreased healing time and less scaring while still achieving great results.  The most important factor when deciding on having and MIS procedure is to make sure that you are the right candidate for this type of intervention. This is a decision your doctor will make and explain to you.  For example,  some bunions are to sever or advanced to be successfully corrected with MIS.  However, if caught early on they might be.  

Bunions, hammertoes, tailors bunions, neuromas and spurs can all be corrected with limited or no down time and almost no scar!  Make sure you have a provider who is well trained, experienced and knowledge on all types of procedures.  Never be afraid to ask questions and read reviews before making your final decision.  

MIS is changing the landscape in foot surgery and here at Advanced Podiatry we are on the cutting edge of it!  Feel free to reach out and set up your consultation today.



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Advanced Podiatry of Manhasset at the Americana

(516) 844-0039 - Manhasset, NY
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Manhasset, NY Podiatrist
Advanced Podiatry
2110 Northern Blvd.
Suite 208
Manhasset, NY 11030
(516) 844-0039

Huntington, NY Podiatrist
Advanced Podiatry
181 Main St.
Suite 207
Huntington, NY 11743
(631) 400-3085

Maspeth, NY  Podiatrist
Advanced Podiatry
70-01 Grand Ave
Maspeth, NY 11378
(718) 747-9250

Great Neck, NY Podiatrist
Advanced Podiatry
488 Great Neck Rd.
Great Neck, NY 11021
(516) 544-1731
*moved to Manhasset  

Plainview Office
Advanced Podiatry
875 Old Country Rd
Suite 100
Plainview, NY 11803
(516) 544 -1732

Roslyn, NY
1514 Old Northern Blvd
Roslyn, NY 11576
(516) 484-1420
*Moved to Manhasset