Foot disorder

“And many foot problems, including hammertoes, blisters, bunions, corns and calluses, claw and mallet toes, ingrown toenails, toenail fungus, and athlete’s foot, can develop from neglect, ill-fitting shoes, and simple wear and tear. Pain in your feet may even be the first sign of a systemic problem.

Hallux Vagus

Hallux Valgus is a common condition of the foot. It causes deformity of the bones and soft tissue imbalance at the same time, leading to a functional and cosmetic deformity.

The big toe leans towards the 2nd toe, rather than pointing straight ahead. This produces a bump (bunion) which over a period of time becomes increasingly prominent.

The exact etiology is still unclear. Many different factors including footwear, genetic predisposition and biomechanical factors have been commonly associated with this condition.

Non-surgical treatment options include; changes in footwear, padding, activity modification, NSAIDs, Icepacks.

When non-surgical options fail, surgical options i.e. Wilson’s Osteotomy – (paper has been published by me in the Journal of Foot & Ankle Surgery) is one such procedure that corrects the bony deformity and soft-tissue imbalance at the same time, giving good functional and cosmetic results.

Ingrown Toe Nail​

In-grown toe nail is one of the most common problems encountered by young adults provoking pain, inflammation and functional limitations. Most commonly occurs in the Great Toe rarely other toe nails are involved. Of the various causes that have been proposed, the two main causes are tight shoes and incorrect nail trimming technique.

Patients complain of pain, later drainage and infection develop. Leading to loss of labour, difficulty in wearing shoes, cosmetic problems, and consequently extreme difficulty in daily activities.
The most important aspect of this treatment is to prevent recurrence.

Surgical treatment options include the Winograd technique (paper published by me in Journal of Foot and Ankle Surgery – Asia/Pacific: Agarwala S et al. Neutralized Chemical Matricectomy with the Winograd Method in the Management of Ingrowing Toenail. JFASAP. 2014;1:55–9.) when combined with neutralized Phenol Matricectomy, is associated with a very low recurrence and infection rate allowing early post-operative recovery and good cosmetic recovery with a high level of patient satisfaction.

Addition on TA repairs under Foot disorders.

There exists a controversy regarding the ideal treatment method for Tendo Achilles rupture.
Available options include conservative treatment, open surgery and minimal invasive repair. Review of literature recommends surgical treatment as the optimal strategy with particular attention to re-rupture and complications. Various complications have led researchers to devise minimally invasive and percutaneous repair methods.

At present, with the percutaneous suture technique, functional recovery is almost identical to that of open surgery, with a considerable decrease in post-operative complications. However, with these methods problems like re-rupture and nerve damage persist. Therefore we have developed and published (Ref. The Journal of Foot and Ankle Surgery (Asia Pacific), Jan-June 2015; 2(1):22-26) a Novel semi-invasive technique which helps in eliminating re-rupturing and nerve damage and combines the advantages of both the percutaneous suture and direct suture technique. It complies with the anatomy and physiology of the Achilles tendon and also provides an optimal environment for healing.

P. D. HINDUJA NATIONAL HOSPITAL, Veer Savarkar Marg, Mahim, Mumbai - 400 016.

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