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Posts for category: foot surgery

By Dr Aarti Kumar
October 22, 2020
Category: foot surgery
                              
Soft tissue masses of the feet and ankles are very common. Though most masses tend to be benign; some soft tissue masses of the foot and ankle can be malignant and need further work up. It is important and recommended to come in to the office for an evaluation if you feel any "lumps or bumps" on your feet. 
 
One of the most common soft tissue masses seen amongst patients are ganglion cysts which most likely develop from friction and pressure. These cysts can usually be aspirated or removed in the office without any large incisions and sent out to the lab for further analysis. Other times, excisional biopsies are necessary to evaluate and remove the soft tissue masses in totality in the operating room under sterile conditions.
 
Our offices are fully equipped with advanced imaging such as ultrasounds which our experienced foot and ankle physicians utilize to determine what the soft tissue mass is comprised of. Sometimes, an MRI may be ordered to evaluate the extent of the soft tissue mass and to see whether it is benign or malignant. 
 
If you feel any growth on your foot or ankle, do not hesitate to come into one of our offices and get evaluated. No mass is small enough to be ignored! 
By Dr Aarti Kumar
June 27, 2019
Category: foot surgery
Tags: Hammertoe Surgery  
                         
 
A hammertoe is a common foot deformity in which the lesser toes buckle at one of the toe joints called the proximal interphalangeal joint. Hammertoes can develop from various conditions whether it be flat feet, high arched feet or some neurological conditions. A hammertoe can either be a flexible, semi-rigid or rigid deformity. 
 
Depending on the extent of the deformity, hammertoe surgery can range from removal of a portion of the bone called the proximal phalangeal head to fusing the joint with either a pin or an implant so that the deformity does not recur. This type of surgery is typically performed at an outpatient ambulatory surgery center and patients ambulate with a walking boot. 
 
The typical healing period is about 4-6 weeks but patients are completely mobile through the recovery period and patients usually go back in sneakers after the one month mark. Surgical sutures are removed in the office in 2 weeks if normal healing is noted. As with any surgery, postoperative swelling is very common. We typically advise patients to allow at least 6 months for swelling to completely subside. 
 
At Advanced Podiatry, our doctors use advanced and minimally invasive techniques to ensure patient satisfaction along with quick recovery. We realize how important it is for patients to be able to continue with their daily activities and life and that the thought of surgery may be holding you back but do not hesitate to make an appointment with one of our podiatrists so that we can explain what options are available! 
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.



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Advanced Podiatry of Manhasset at the Americana

(631) 427-3678 Huntington NY
(516) 869-3300 Manhasset NY
(718) 639-0499 Maspeth NY
(516) 681-8866 Plainview NY

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Advanced Podiatry
2110 Northern Blvd.
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Manhasset, NY 11030
(516) 869-3300

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Advanced Podiatry
181 Main St.
Suite-207
Huntington, NY 11743
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70-01 Grand Ave
Maspeth, NY 11378
(718) 639-0499

Plainview, NY Office
Advanced Podiatry
875 Old Country Rd
Plainview, NY 11803
(516) 681-8866