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18 Agos 2015 
HammertoeOverview


The Hammer toe condition is usually irreversible, but often its progression can be slowed or halted. You should visit a Podiatrist if the toe becomes painful and you have difficulty walking. A Podiatrist will be able to provide advice and treatment including padding the bony top-part of your hammertoe to relieve pain or to tape your toes as a way to change their position. Podiatrists have an important role to play in preventing and managing foot problems. Prompt action is important. Problems which are left without assessment or treatment may result in major health risks.


Causes


Hammer toe is most often caused by wearing compressive shoes. It might also be caused by the pressure from a bunion. A bunion is a corn on the top of a toe and a callus on the sole of the foot develop which makes walking painful. A high foot arch may also develop.


HammertoeSymptoms


Signs and symptoms of hammertoe and mallet toe may include a hammer-like or claw-like appearance of a toe. In mallet toe, a deformity at the end of the toe, giving the toe a mallet-like appearance. Pain and difficulty moving the toe. Corns and calluses resulting from the toe rubbing against the inside of your footwear. Both hammertoe and mallet toe can cause pain with hammertoes walking and other foot movements.


Diagnosis


The exam may reveal a toe in which the near bone of the toe (proximal phalanx) is angled upward and the middle bone of the toe points in the opposite direction (plantar flexed). Toes may appear crooked or rotated. The involved joint may be painful when moved, or stiff. There may be areas of thickened skin (corns or calluses) on top of or between the toes, a callus may also be observed at the tip of the affected toe beneath the toenail. An attempt to passively correct the deformity will help elucidate the best treatment option as the examiner determines whether the toe is still flexible or not. It is advisable to assess palpable pulses, since their presence is associated with a good prognosis for healing after surgery. X-rays will demonstrate the contractures of the involved joints, as well as possible arthritic changes and bone enlargements (exostoses, spurs). X-rays of the involved foot are usually performed in a weight-bearing position.


Non Surgical Treatment


Non-surgical methods for hammer toes (claw toes) are aimed at decreasing symptoms (i.e., pain and/or calluses) and/or limiting the progression into a larger problem. Simple treatments patients can do are wear supportive shoes. Use an arch support. Wear shoes with a wide toe box. Modify activities. Spot stretch shoes. Periodic callus care.


Surgical Treatment


Laser surgery is popular for cosmetic procedures, however, for hammer toe surgery it does not offer any advantage to traditional methods. Laser is useful for soft tissues (not bone), and because hammer toe surgery involves bone procedures, it is not effective. For cosmetic hammer toe surgery, patients should look for surgeons experienced in aesthetic foot surgery.
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19 Jun 2015 
Overview
Bunions Callous Hallux abductovalgus (HAV) or bunion, is a commonly seen deformity of the first metatarsophalangeal joint (MPJ) in which the hallux is abducted and everted, frequently overriding the second toe. Although the terms HAV and bunion are often used synonymously (as is done in this paper), it should be noted that a bunion actually refers to the callus and inflamed adventitious bursa overlying the HAV deformity. Even though bunions have been described in the medical literature for several hundred years (the word bunion is believed to be derived from the Latin, bunio, meaning turnip), there continues to be much controversy concerning its etiology. This is most likely because the development of HAV is multifactorial, stemming from a variety of structural and functional aberrancies.

Causes
It is thought that the primary cause of bunions is a mechanical instability in the big toe joint. There are a number of different reasons as to why this may happen. Bunions tend to run in families so a person with a family history of bunions has an increased risk of developing them. Factors that are known to increase the risk of bunions include wearing improperly fitting shoes (particularly narrow and/or high-heeled shoes). Certain arthritic conditions and ligament disorders. Age (the incidence of bunions increases with age). Being flatfooted with feet that roll inwards (over pronation). Past injury (trauma) to the foot. Nerve conditions affecting the foot. Bunions most commonly affect women (approximately 90% of cases) and are less common in people who do not regularly wear shoes.

Symptoms
The most common symptoms of foot bunions are toe Position, the toe points inwards towards the other toes in the foot into the hallux adbucto valgus position and may even cross over the next toe. Bony Lump, swelling on the outer side of the base of the toe which protrudes outwards. Redness, over the bony lump where it becomes inflamed. Hard Skin, over the bony lump known as a callus. Pain, it is often painful around the big toe, made worse by pressure on the toe and weight bearing activities. Change in Foot Shape, Your whole foot may gradually change shape for example getting wider. Stiffness, the big toe often becomes stiff and may develop arthritis. Foot bunions are more common with increasing age. They develop gradually overtime from repeated force through the big toe and left untreated, become more pronounced with worsening symptoms.

Diagnosis
Looking at the problem area on the foot is the best way to discover a bunion. If it has the shape characteristic of a bunion, this is the first hint of a problem. The doctor may also look at the shape of your leg, ankle, and foot while you are standing, and check the range of motion of your toe and joints by asking you to move your toes in different directions A closer examination with weight-bearing X-rays helps your doctor examine the actual bone structure at the joint and see how severe the problem is. A doctor may ask about the types of shoes you wear, sports or activities (e.g., ballet) you participate in, and whether or not you have had a recent injury. This information will help determine your treatment.

Non Surgical Treatment
A hinged flexible bunion splint, can relieve pain by providing corrective arch support and releasing tension away from the inflamed joint. Change shoes! Avoid flip flops, high-heels and shoes with pointed, narrow toe-boxes. Medicine will not prevent or cure bunions. However, the use of over the counter anti- inflammatory medications can help. Bunion splints, pads and arch supports can help redistribute weight and move pressure away from the big toe. Bunions Callous

Surgical Treatment
Bunion surgery generally involves repositioning the maligned bones with a bone cut (osteotomy) and/or bone mending procedure (fusion). As such, the time it takes for bones to set or mend in the corrected position generally takes six weeks. Smokers and those in poor medical health may take longer to mend the bone. The biology of bone healing is about six weeks, that time frame can't be made quicker. What can be changed is the disability that one experiences while the bone is mending.
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