Advanced techniques in foot and ankle surgery.

Bone lengthenings, ankle and rearfoot fusions along with advanced trauma techniques.

Efforts to advise all options in foot and ankle care are taken to meet the needs of the patient and strive for the most appropriate surgical plans and operations for the best outcome with the easiest recovery.

Since you stand and walk and run on your feet, these surgeries are different from most in the orthopedic world. Sometimes the more aggressive procedures are the more long lasting but a longer recovery is needed. Sometimes a less aggressive, with very little recovery time procedure fits the patients desires and will achieve a satisfactory outcome.

Techniques in surgery involve knowledge, skill and use of hardware. Hardware used in orthopedic surgery includes, plates, screws (absorbable or non), fixation devices like frames, pins, staples, special cements and implants.

Our feet are very complex structures, comprised of 26 bones, 30 joints, 19 muscles, and 107 ligaments in each foot.  Ailments related to the foot are very common and can be very debilitating. Although some can be traced to heredity, many stem from the cumulative impact of a lifetime of abuse and neglect.  There are a number of systemic diseases that are sometimes first detected in the feet, such as diabetes, circulatory disorders, anemia, and kidney problems. Arthritis, including gout, often attacks foot joints first. As specialists in foot and ankle pathology, our purpose is determining a cause and finding a solution to your pain and discomfort. Your feet, like other specialized structures, require specialized care. A doctor of podiatric medicine can make an important contribution to your total health, whether it is regular preventive care or surgery to correct a deformity. 

In order to keep your feet healthy, you should be familiar with the most common ills that affect them. Remember, though, that self-treatment can often turn a minor problem into a major one and is generally not advisable. You should see a podiatric physician when any of the following conditions occur or persist. Some of these ailments are:



Athlete’s foot is a skin disease, usually starting between the toes or on the bottom of the feet, which can spread to other parts of the body. It is caused by a fungus that commonly attacks the feet. Signs of athlete’s foot are dry scaly skin, itching, inflammation, and blisters. You can help prevent infection by washing your feet daily with soap and warm water; drying carefully, especially between the toes; and changing shoes and hose regularly to decrease moisture.



Warts are caused by a virus, which enters the skin through small cuts and infects the skin. Children, especially teenagers, tend to be more susceptible to warts than adults. Most warts are harmless and benign, even though painful and unsightly. There are several simple procedures which your podiatric physician might use to remove warts.



Bunions are usually described as a painful bump on the foot. The deformity occurs when the first metatarsal is misaligned with the great toe. The metatarsal begins to slant outward, and the great toe angles toward the other toes. Bunions tend to run in families, but the tendency can be aggravated by shoes that are too narrow in the forefoot and toe. There are conservative (nonsurgical) measures  that can minimize the discomfort of a bunion, but surgery is frequently recommended to correct the problem.



These are thickenings that form on the bottom of the foot as a result of increased pressure. Increased pressure may be related to prominent bones, and/or foot structure.  As the friction in area of insult increases, the corns/calluses also increases in size, in turn causing significant pain in shoes and when walking. Oftentimes, patients will self by removing the hardened skin with a razor and this is not advised as it can cause harm. The podiatrist can treat these by decreasing the amount of hardened skin and providing you with treatments to soften the corn/callus. 



Hammertoes are commonly seen in the 2nd- 5th toes. It is a contracture (bend) in one of the two joints that comprise each toe. This contracture is caused by an imbalance between the tendons on the top and bottom of the toe.  Hammertoes often start out as a flexible deformity. However, as time progresses it becomes more rigid.  These contractures cause the bone in the toe to become prominent, in turn causing rubbing and irritation in shoes. The affected toe can form a callus, and become red and inflamed.  In severe cases, open sores can form. Treatment includes wider shoes, callus removal, and padding of prominent areas. For more rigid deformities correction of the deformity with surgery may be indicated.



Heel pain can have many causes including faulty biomechanics, stress fractures, trauma, inflammatory diseases, gout, arthritis, and circulatory problems are some examples. Seeing a podiatrist can help one determine the cause for the heel pain and administer appropriate treatments.

In addition, heel spurs are common pathologies of the heel. They are growths of bone on the underside of the heel bone. They can occur without pain; pain may result when inflammation develops at the point where the spur forms. Both heel pain and heel spurs are often associated with plantar fasciitis, an inflammation of the long band of connective tissue running from the heel to the ball of the foot. Treatments may range from exercise and custom-made orthotics to anti-inflammatory medication or cortisone injections.



Ingrown nails often occur when the borders of the nail become imbedded into the neighboring skin causing pain and/or infection. This is frequently caused by improper nail trimming but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure. Toenails should be trimmed straight across, slightly longer than the end of the toe, with toenail clippers. If the ingrown portion of the nail is painful or infected, your podiatric physician may remove the affected portion; if the condition reoccurs frequently, your podiatrist may permanently remove the nail or the offending border of the nail.



Neuromas are enlarged, benign growths of nerves, most commonly between the third and fourth metatarsals. They are caused by bones and other tissue rubbing against and irritating the nerves. Abnormal bone structure or pressure from ill-fitting shoes also can create the condition, which can result in pain, burning, tingling, or numbness between the toes and in the ball of the foot. Conservative treatment can include padding, taping, orthotic devices, and cortisone injections, but surgical removal of the growth is sometimes necessary 



Many sports require miles of running -- with quick stops and starts -- per game. Competition is usually on grass fields, which "give" so players may change direction quickly. It also provides a soft landing surface on which to crash.

Injuries are inevitable in contact sports. The lower extremities -- an athlete's steering, accelerator, and braking systems-- are particularly susceptible. But with proper conditioning, equipment, and technique, competitors in contact sports have successful, healthy playing seasons.

Podiatric physicians, specialists in care of the lower extremity, are able to treat these sports injuries and get the athlete back into competition as soon as safely possible.  


Preventing "Overuse" Injuries:

The time a football, soccer, or lacrosse player spends in an actual game represents only a tiny fraction of time spent in practice, conditioning for competition. Practice involves hours of running, repetitive drills, and scrimmages every day.

While conditioning exercises in practice will strengthen and improve flexibility in the lower extremity, the repeated stress of practice may bring on chronic, or "overuse" injuries. These injuries can nag at a player and hamper, if not end, a season of competition.

Overuse injuries also come from faulty biomechanics of the feet -- how the lower extremity physically adjusts to the ground. If an athlete has "flat" feet, which tend to pronate (out-toe) or excessively high arches, which often supinate (in-toe), extensive running and cutting can produce chronically strained ankles.

Before taking the practice field, it's wise to be examined by a podiatric physician specializing in sports medicine, who will identify any biomechanical abnormalities that increase the chance of injury. The podiatrist may recommend specific exercises to strengthen and improve flexibility of the foot and ankle, or recommend taping or padding of the foot or ankle before practice and competition. A podiatrist may also prescribe orthoses, customized shoe inserts that correct biomechanical problems by redistributing the body's weight.

Podiatric physicians say proper stretching and warm-up before and after home workouts, practice, and before games go far to prevent overuse injuries to the supporting structures of the lower extremity. Warm-up and cool-down exercises should take 5-10 minutes and should be conducted in a stretch/hold/relax pattern, without any bouncing or pulling. When muscles are properly warmed up, the strain on muscles, tendons, and joints is reduced. 


This is just to mention a few of the very common pathologies Podiatric physicians encounter and manage on a daily basis. Details of each and every ailment is too much to mention in this small brochure. Below is a list of other conditions treated:


Conditions treated include:

    • Achilles Tendon Rupture (Tear)
    • Ankle Fractures (Broken Ankle)
    • Calcaneus (Heel Bone), toe, forefoot Fractures
    • Lisfranc (Midfoot) Injury
    • Sprained Ankle
    • Stress Fractures of the Foot and Ankle
    • Turf Toe
    • Achilles Tendinitis
    • Flatfoot in Adults & children
    • Arthritis of the Foot and Ankle
    • Talotarsal Displacement
    • Diabetic (Charcot) Foot
    • Intoeing Posterior Tibial Tendon Dysfunction
    • Sesamoiditis