December 2021
Diabetic Limb Salvage
Limb salvage is a procedure that involves saving a lower extremity from amputation. In podiatry, limb amputation often occurs as a result of diabetes. The fundamental goal of limb salvage is to restore and maintain stability and movement of the affected lower extremity.
The procedure typically involves removing the diseased tissue and a small portion of the surrounding healthy tissue, as well as the removal of any affected bone if necessary. If bone is removed it is then replaced with prostheses, or synthetic metal rods or plates, or grafts from either the patient’s body or a donor. Limb salvage is typically the preferred choice of procedure over amputation, as the procedure preserves both the patient’s appearance and allows for the greatest possible degree of function in the affected limb.
Upon diagnosis and determining that limb salvage is the appropriate treatment, the podiatrist may enlist the help of a physical and/or occupational therapist to prepare the patient for surgery by introducing various muscle-strengthening, walking, and range of motion exercises. Such exercises may be continued as rehabilitation post-procedure.
The Purpose of Diabetic Limb Salvage
Limb salvage surgery is a medical procedure aimed at preserving a limb that may otherwise require amputation due to severe injury, infection, or complications from conditions such as diabetes. In diabetic limb salvage, the primary goal is to prevent amputation by addressing issues like diabetic foot ulcers, infections, and poor circulation that are common among individuals with diabetes. The procedure typically involves cleaning and debriding infected tissue, improving blood flow through vascular surgery, and sometimes reconstructing damaged bone or soft tissue. In some cases, the surgeon may use skin grafts or other techniques to promote healing. By preserving the limb, limb salvage surgery allows for better functionality and quality of life. Early intervention and ongoing care are essential for a successful outcome, as untreated diabetic complications can lead to more severe consequences. If you have diabetes, it is strongly suggested that you are under the care of a podiatrist who can help you manage this condition and discuss the limb salvage procedure with you.
Diabetic Limb Salvage
Diabetic limb salvage can be an effective way in preventing the need for limb amputation. If you have a foot ulcer and diabetes, consult with Steven Spivak, DPM from Mount Holly Family Footcare. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
What Is Diabetic Limb Salvage?
Diabetic limb salvage is the attempt of saving a limb, such as the foot, that has an infected ulcer, from amputation. Podiatrists also try to make sure that there is enough function in the foot after the salvage that it is still usable. Those with diabetes experience poor blood circulation, which prevents proper healing of an ulcer. If the ulcer is left uncheck, it could become infected, which could result in the need for amputation.
Diabetes is the number one cause of non-traumatic amputations in the United States. Amputation has been found to lead to higher mortality rates. This translates into higher healthcare costs, and a reduced quality of life and mobility for amputees. Podiatrists have attempted to increase the prevalence of limb salvage in an attempt to solve these issues.
Diagnosis and Treatment
Limb salvage teams have grown in recent years that utilize a number of different treatments to save the infected limb. This includes podiatrists that specialize in wound care, rehabilitation, orthotics, and surgery. Through a combination of these methods, limb salvage has been found to be an effective treatment for infected limbs, and as an alternative to amputation. Podiatrists will first evaluate the potential for limb salvage and determine if the limb can be saved or must be amputated.
If you have any questions, please feel free to contact our office located in Lumberton, NJ . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Diabetic Foot Conditions
According to the American Diabetes Association (ADA), diabetes is a condition that affects approximately 23.6 million Americans. Around 750,000 new cases are diagnosed each year, and the disease’s most common form, Type 2 diabetes, makes up for 90 to 95 percent of these cases. Type 2 diabetes is especially prevalent among older Americans, those who are obese, and those who lead sedentary lifestyles.
Complications of the disease may lead to several foot and ankle-related conditions. The loss of nerve sensation, or neuropathy, can cause diabetics to lose feeling at the bottom of the feet and therefore leave them unaware of pain, pressure, and heat. Decreased circulation is another complication of diabetes that can slow down the healing of wounds and injuries; this can lead to the development of foot ulcers.
To prevent foot ulcers from forming, diabetics should examine their feet every day for small cuts and wear shoes that curtail pressure. Constant monitoring for the risk factors associated with ulcer formation can allow for early detection and therefore lessen the possibility of ulcers or, even worse, amputation. The removal of calluses and ingrown toenails should be left to the podiatrist to avoid improper removal and possible infection.
Diabetic patients may also experience foot deformities due to complications in their feet, such as limited joint mobility, muscle atrophy, and decreased fat padding. These complications can increase pressure in certain areas of the foot, which in turn can cause certain deformities, such as hammertoe, to form. Another deformity, Charcot foot, develops due to the collapsing of microfractures in the bones of the feet. The resulting deformity is a foot that is flattened and wider in appearance.
To help minimize pressure and prevent the development of these diabetes-related foot and ankle conditions, your podiatrist may consider using orthotics or special shoes. Charcot foot may be treated using walkers, custom orthotic insoles, or non-weight-bearing or rigid weight-bearing casts or braces. In more serious cases, surgery may be considered to treat more developed deformities. Ulcers can be further cared for with the help of proper diet, medication to control glucose, intensive wound care, and infection treatment.
How Diabetes Can Affect Foot Health
Foot problems caused by diabetes can significantly affect a patient’s health and quality of life. Two common conditions that contribute to diabetic foot complications are loss of protective sensation, or LOPS, and peripheral artery disease, or PAD. Loss of protective sensation occurs when high blood sugar levels damage the nerves in the feet, leading to reduced sensation. This can prevent a diabetic patient from feeling injuries like sores, blisters, or temperature changes, which in turn increases the risk of developing wounds that may become ulcerated or infected. Peripheral artery disease restricts blood flow to the feet resulting from a buildup of plaque. This slows the healing of sores and can lead to foot ulcers or, in severe cases, amputations. A podiatrist can monitor and address these problems by assessing nerve function, checking circulation, and providing guidance on protective footwear and foot care routines. If you have foot problems caused by diabetes, it is suggested that you schedule regular visits to a podiatrist who can help you to manage them.
Diabetic foot care is important in preventing foot ailments such as ulcers. If you are suffering from diabetes or have any other concerns about your feet, contact Steven Spivak, DPM from Mount Holly Family Footcare. Our doctor can provide the care you need to keep you pain-free and on your feet.
Diabetic Foot Care
Diabetes affects millions of people every year. The condition can damage blood vessels in many parts of the body, especially the feet. Because of this, taking care of your feet is essential if you have diabetes, and having a podiatrist help monitor your foot health is highly recommended.
The Importance of Caring for Your Feet
- Routinely inspect your feet for bruises or sores.
- Wear socks that fit your feet comfortably.
- Wear comfortable shoes that provide adequate support.
Patients with diabetes should have their doctor monitor their blood levels, as blood sugar levels play such a huge role in diabetic care. Monitoring these levels on a regular basis is highly advised.
It is always best to inform your healthcare professional of any concerns you may have regarding your feet, especially for diabetic patients. Early treatment and routine foot examinations are keys to maintaining proper health, especially because severe complications can arise if proper treatment is not applied.
If you have any questions please feel free to contact our office located in Lumberton, NJ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
Managing Leg and Ankle Edema
Leg and ankle edema, or swelling, occurs when excess fluid accumulates in the tissues of the lower limbs. This condition is often caused by poor circulation, injury, prolonged sitting or standing, or underlying medical issues like heart, kidney, or liver disease. Edema can be uncomfortable, restrict movement, and, if untreated, can lead to skin infections or sores. Seeing a podiatrist for leg and ankle edema can be beneficial. A podiatrist will assess the underlying causes, which may involve checking circulation, reviewing your medical history, and performing diagnostic tests. This type of doctor can recommend treatments such as compression therapy, elevation techniques, and exercises to reduce fluid buildup. For chronic cases, they might collaborate with other healthcare providers. If you have persistent edema in your lower limbs, it is suggested that you schedule an appointment with a podiatrist who can help you identify underlying causes and provide relief strategies.
Swollen feet can be a sign of an underlying condition. If you have any concerns, contact Steven Spivak, DPM of Mount Holly Family Footcare. Our doctor can provide the care you need to keep you pain-free and on your feet.
Swollen feet are a common ailment among pregnant women and people who stand or sit for extended periods. Aging may increase the possibility of swollen feet and patients who are obese often notice when their feet are swelling too. There may be medical reasons why swollen feet occur:
- Phlebitis - A condition that causes the veins to become inflamed and can also cause leg pain.
- Liver disease - This may lead to low blood levels of albumin which is a protein. This can cause fluid in the blood to pass into the tissues and several areas of the body can become swollen.
- Heart failure - When the heart doesn’t pump properly the blood that is normally pumped back to the heart can pool in the veins of the legs causing swollen feet.
- Kidney disease - One of the main functions of the kidneys is releasing excess fluid in the body. This type of condition can make it difficult for the kidneys to function properly, and as a result the feet may become swollen.
- Deep-vein thrombosis (DVT)- This is a serious condition where blood clots form in the veins of the legs. They can block the return of blood from the legs to the heart which may cause the feet to swell. It is important to be treated by a podiatrist if this condition is present.
Swollen feet can also be caused by bone and tendon conditions, including fractures, arthritis, and tendinitis. Additionally, there may be skin and toenail conditions and an infection may cause the feet to swell. Patients who take medicine to treat high blood pressure may be prone to getting swollen feet.
Many patients elevate their feet to help relieve the swelling and this is generally a temporary remedy. When a podiatrist is consulted the reason behind the swelling can be uncovered and subsequently treated.
If you have any questions please feel free to contact our office located in Lumberton, NJ . We offer the newest diagnostic tools and technology to treat your foot and ankle needs.
Swelling of the Feet
There are many reasons why patients experience swelling of the feet. It is rather common and may be a side effect of pregnancy or from sitting and standing for most of the day. Gravity could also play a role in the development of swollen feet. It is known that the weight of blood volume in our bodies is exerted on the veins in the legs and feet. The veins may not work as efficiently during the aging process, and this could make the blood flow backward causing swollen feet. Relief may be found when obese patients lose weight, and it may help to engage in compression therapy by wearing compression socks, stockings, or athletic sleeves. This method can release pressure on the feet and ankles which may help to reduce existing swelling. There are patients who have controlled their swollen feet by implementing healthy lifestyle changes. These can consist of reducing salt intake, incorporating a gentle exercise regime into the daily routine, and drinking plenty of fresh water. Swollen feet may be a temporary condition that affects people who travel via airplane or automobile, so it is beneficial to walk as frequently as possible even though it can be difficult. Swelling of the feet can also be indicative of other health issues so it is important to pay attention to any type of chest pain, mental confusion, dizziness, or fever. If you consistently have swollen feet, it is strongly suggested that you consult with a podiatrist who can help determine the cause and how to effectively treat it.
It's Time for Beautiful Feet
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A Look at Crooked Toes
Crooked toes, such as hammertoe, claw toe, and mallet toe, are deformities that cause the toes to bend abnormally. Hammertoe involves a middle joint that bends downward, while claw toe affects both joints, causing the toe to curl downward like a claw. Mallet toe is similar to hammertoe but affects only the joint closest to the toenail, causing it to bend down. Common symptoms include pain, difficulty walking, corns, and calluses on the tops of or between the toes. Wearing tight footwear often worsens these conditions. Relief and treatment options include wearing properly fitted shoes, using orthotics, and performing toe-stretching exercises. In more severe cases, a podiatrist may recommend splints, targeted exercises, or surgery to straighten the toes. If you have crooked toes and is causing pain or discomfort, it is suggested that you schedule an appointment with a podiatrist to receive an accurate diagnosis and explore treatment options.
Hammertoes can be a painful condition to live with. For more information, contact Steven Spivak, DPM of Mount Holly Family Footcare. Our doctor will answer any of your foot- and ankle-related questions.
Hammertoe
Hammertoe is a foot deformity that occurs due to an imbalance in the muscles, tendons, or ligaments that normally hold the toe straight. It can be caused by the type of shoes you wear, your foot structure, trauma, and certain disease processes.
Symptoms
- Painful and/or difficult toe movement
- Swelling
- Joint stiffness
- Calluses/Corns
- Physical deformity
Risk Factors
- Age – The risk of hammertoe increases with age
- Sex – Women are more likely to have hammertoe compared to men
- Toe Length – You are more likely to develop hammertoe if your second toe is longer than your big toe
- Certain Diseases – Arthritis and diabetes may make you more likely to develop hammertoe
Treatment
If you have hammertoe, you should change into a more comfortable shoe that provides enough room for your toes. Exercises such as picking up marbles may strengthen and stretch your toe muscles. Nevertheless, it is important to seek assistance from a podiatrist in order to determine the severity of your hammertoe and see which treatment option will work best for you.
If you have any questions, please feel free to contact our office located in Lumberton, NJ . We offer the newest diagnostic and treatment technologies for all your foot care needs.
What Are Hammertoes?
Hammertoes are painful deformities that frequently form on the second, third, or fourth toe. The condition is often caused by an issue in foot mechanics. This can be caused by the person’s specific gait or the manner in which they walk, or by shoes that do not comfortably fit the deformity. Hammertoes can be formed after wearing shoes that are too narrow or short for the foot or have excessively high heels. Shoes that are not properly sized will force the toes into a bent position for long periods of time. This can cause the muscles to shorten and toes to bend into the deformity of a hammertoe.
Hammertoe can also be caused by complications from rheumatoid arthritis, osteoarthritis, trauma to the foot, heredity, or a cerebral vascular accident. Pain and difficult mobility of the toes, deformities, calluses, and corns are all symptoms of a hammertoe.
Someone who suspects they have the symptoms of a hammertoe should consult with a physician—particularly a podiatrist. Podiatrists diagnose and treat complications of the foot and ankle. If the podiatrist discovers that the affected toes are still flexible, treatment for the hammertoe may simply involve exercise, physical therapy, and better-fitting shoes. Treatment for hammertoes typically involves controlling foot mechanics, such as walking, through the use of customized orthotics.
For more serious cases in which the toes have become inflexible and rigid, surgery may be suggested. During the operation, the toe would receive an incision to relieve pressure on the tendons. A re-alignment of the tendons may then be performed by removing small pieces of bone to straighten the toe. In some cases, the insertion of pins is needed to keep the bones in the proper position as the toe heals. The patient is usually allowed to return home on the same day as the surgery.
If surgery is performed to repair a hammertoe, following the postoperative directions of your doctor is essential. Directions may include several stretches, picking up marbles with your toes, or attempting to crumple a towel placed flat against your feet. Wear shoes that have low heels and a wide amount of toe space to maintain comfort. Closed-toe shoes and high heels should be avoided. Shoes with laces allow the wearer to adjust how fitted he or she may want the shoes to be and also allow for greater comfort. To provide adequate space for your toes, select shoes that have a minimum of one-half inch of space between the tip of your longest toe and the inside of the shoe. This will also relieve pressure on your toes and prevent future hammertoes from forming.
Other preventative measures that can be taken include going shopping for new shoes in the middle of the day. Your feet are its smallest in the morning and swell as the day progresses. Trying on and purchasing new shoes midday will give you the most reliable size. Be sure to check that the shoes you purchase are both the same size. If possible, ask the store to stretch out the shoes at its painful points to allow for optimum comfort.
Exploring the Anatomy of the Foot
The foot is a remarkable structure composed of numerous bones, joints, ligaments, muscles, tendons, and fascia, all working in harmony to provide stability and mobility. The foot contains twenty-six bones, including the tarsal bones, which form the hindfoot and midfoot. Key tarsal bones include the calcaneus and talus, which support body weight and facilitate movement. Joints between these bones allow for flexibility and range of motion. Ligaments connect bones and provide stability, while muscles and tendons enable movement and support the foot's arches. The plantar fascia, a thick band of connective tissue, plays a vital role in maintaining the arch and absorbing shock. Together, these components allow the foot to adapt to various surfaces, absorb impact, and enable activities such as walking, running, and jumping, highlighting its vital role in overall mobility and balance. If you have foot pain for any reason, it is suggested that you contact a podiatrist who can treat various foot and ankle conditions, and further educate you on foot anatomy.
If you have any concerns about your feet, contact Steven Spivak, DPM from Mount Holly Family Footcare. Our doctor can provide the care you need to keep you pain-free and on your feet.
Biomechanics in Podiatry
Podiatric biomechanics is a particular sector of specialty podiatry with licensed practitioners who are trained to diagnose and treat conditions affecting the foot, ankle and lower leg. Biomechanics deals with the forces that act against the body, causing an interference with the biological structures. It focuses on the movement of the ankle, the foot and the forces that interact with them.
A History of Biomechanics
- Biomechanics dates back to the BC era in Egypt where evidence of professional foot care has been recorded.
- In 1974, biomechanics gained a higher profile from the studies of Merton Root, who claimed that by changing or controlling the forces between the ankle and the foot, corrections or conditions could be implemented to gain strength and coordination in the area.
Modern technological improvements are based on past theories and therapeutic processes that provide a better understanding of podiatric concepts for biomechanics. Computers can provide accurate information about the forces and patterns of the feet and lower legs.
Understanding biomechanics of the feet can help improve and eliminate pain, stopping further stress to the foot.
If you have any questions please feel free to contact our office located in Lumberton, NJ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
