Our Mobility Is Our Legs – Take Care Of Them

By Author: paul harm
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The Podiatric surgeries today have evolved in a very high percentage. Decades back, people with small discomforts on their legs, feet, warts and inner toe nail growth, never bothered much about them and continued to live with all those complaints and without much awareness about getting cured from those little things and also with not much of options. But today the entire scene has changed. There are hospitals to cater to all these needs, especially specialists in the particular fields have increased in heaps and bounds. Hospitals specialized for Podiatric surgeries like we have one in Western Australia stand as an ideal example.

In Podiatric surgeries we can include:

Warts

Call them just warts or planter warts, are nothing extraordinary or uncommon, they are general local growth on the human skin, on the foot mainly, and occurs due to infection due to dust, dampness, untidy surroundings, usage of unhygienic and wrong and worn out foot wear etc. These warts are not visible in the beginning, but are very painful and more so if they happen to be located on the weight bearing surfaces of the feet. They start ...
... as just a spot and increase in size and multiply gradually and spread to the other feet and others also.

The treatment for this is either caustics or freezing. This is a very prolonged and painful process and most of the time has proved unsuccessful. There is another simple minor procedure, called as “Curettage”. A simple and a minor operation done under local anaesthesia, on the same day of consultation itself, and it usually carried out in the OP ward or in the consultation room itself. This surgery does not require any stitching. The pain is kept under complete control and 2 to 4 days of rest will heal the wound and after 2 days dressing change is done and 2 to 4 weeks of reduced activity will give a complete heal.

In grown nail

Earlier in the olden days these conditions of ingrown toenails were very common and often very painful. Hence, naturally typically ingrown toenail surgery was very painful and required hospitalisation. But today this is not the case with contemporary podiatric surgery. Modern ingrown toenail surgery is in most cases is pain free during and after the surgery. In fact the surgery has advanced so much that a working person need not even take off from his work. And most importantly good and long time positive results are obtained.

The surgery procedure is done in the medical centre in a minor op room, although it can be carried out in the day surgery with general anaesthetic if preferred. Local anaesthetic is typically utilized and complete numbness is guaranteed. Once numb the offending side of the nail is gently removed and a chemical is applied to the nail producing region. The area is flushed and no stitching is required. The dressing is removed after 2- 4 days and a small dressing is changed daily at home for 2 - 4 weeks. Normal shoes can be worn after approximately one week. This should prevent the reoccurrence of an ingrown toenail ever again.

Hammer toe

This is a very common occurrence among people who do not take good care of their feet, foot wear and at times due to genetics. This condition of a hammertoe looks clawed and is a condition where the toes become retracted. The bent appearance of the fore foot often produces a wider and deeper look. The problem in this condition is, the feet will rub on the shoes leading to painful friction and corn formation.

This problem of Hammertoes can be mild and flexible at times and severe and rigid for others. Treatment could be commenced by a general podiatrist who could produce orthotics, toe splints or protective pads. If all these prove ineffective then surgery could be considered. The surgery can be carried out under local or general anaesthetic condition. On the severity of the problem the procedure will be chosen. These can vary from simple soft tissue release to bony realignment and tendon transfer and in severe cases internal absorbable pins may be required. But with the modern technology this method of Pins protruding out of toes are rarely adopted.

Surgery is on a day care arrangement and no cast is required. Sutures are removed after two weeks and after four weeks of lesser activity or complete rest deep wide shoes or sandals can be used. And with the time span of eight to ten weeks full activity and normal foot wear will be achievable. During and after surgery the pain is kept under complete control.

Bunion‘s treatment

What is this Bunion? Many of us will not know what type of problem is this, though we might have seen this often. A bunion is a bony prominence on the inside of the big toe joint. It is actually a change in position of a bone called the first metatarsal and one should not mistake it for solely a bone growing out of the foot.

In this condition, pain often occurs due to shoe pressure. The important information to note is the bunion increases arthritis and often the pain can become deep and aching. The other problems this Bunion can lead to are - hammertoes, stress fractures, corns and callouses; all these make one suffer from wearing shoe wear and walking very painful.
The treatment of bunions initially can be done in a conservative way, for example with the use of functional orthotics or shoe modification. Orthotics may be attained from a general podiatrist. But if this conservative method of treatment fails then surgery is the only and next solution.

Earlier in the olden daysBunion surgery had been very painful and most of the time gave poor or negative results. But with the Modern surgery and technical methods aims to control the pain and produce long term positive results are focused. But till date, there had been only a very few methods in this treatment that were proven to produce good and positive results. Depending on the size and type of Bunion, a correct procedure of treatment is chosen.

Procedures are carried out in accredited hospitals. Most cases are under general anaesthetic carried out by qualified medical specialist anaesthetist. Usually a day care basis is all that is required as pain is controllable and hospital stay is in most cases unnecessary.

A small incision is made over the joint and after soft tissue release is carried out, cuts are made in the offending bone and the bone is realigned. This correction is held in place while healing occurs by small pins or screws which sit flush in the bone and do not protrude out of the skin and do not need to be removed. Following suturing the area is dressed in a compressive bandage. There is no need for a cast with modern surgery. The patient is given a post- op shoe and a small amount of weight bearing is allowed in the first two weeks. Stitches are removed at approximately two weeks and a wide deep shoe can be worn at approximately four weeks. More and more walking is allowed over the following weeks. Full return to shoe wear and activity should follow shortly.

It is important to realise complications such as scaring, return to deformity, excess bleeding, infection and DVT are rare however may still occur. This will be discussed in full before any surgery is carried out.

Flat Feet

Not always and not for every flat foot surgery is required. Depending on the degree and type of flat foot, when the conservative treatment and modalities become unsuccessful, and if the person is still suffering from pain, then only surgery is advised. So is the case of heel pain also. The treatment starts with the conservative modalities and the surgery comes in only when the situation goes beyond control. The legs are our carriers; hence we should take extra bit of care of them.
Today we have excellentPodiatric surgeons in Australia who are highly trained specialist podiatrists and who have undergone postgraduate training in podiatric medicine and surgery and have successfully completed the requirements for treating any kind of patients coming with podiatric complaints.

Podiatric surgeons are commonwealth accredited and registered with the various state health departments. Damien Lafferty is registered with the NSW Health, Podiatrists Registration Board. All most all podiatric surgeons undertake at least 10 years training before being qualified for membership as a Fellow with the ACPS.