Limb salvage is a procedure that involves saving a lower extremity from amputation. In podiatry, limb amputation often occurs as a result of diabetes, peripheral vascular disease, neuropathy, cancer, and severe crush injury. 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 the bone is removed, it is then replaced with prostheses, 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.
While complications of diabetes, such as poor circulation and neuropathy, can make a wound easier to develop and harder to detect and heal, there are many preventative measures you and your podiatrist can take to reduce your risk of amputation. On your end, make foot care a priority. Wear shoes and socks that fit well and don’t rub against any part of your feet or cut off circulation. Avoid walking barefoot. Elevate your feet and wiggle your toes frequently to keep the blood flowing. Eat a balanced diet and exercise to help manage your sugar levels and maintain a healthy body weight. Don’t smoke. Inspect your feet twice a day, using a mirror if needed, to see the bottom of your feet. Get to your podiatrist right away if you spot anything unusual. Early recognition/treatment of a problem can greatly reduce your risk of amputation. Some wounds may be avoided by getting regular foot screenings and having a podiatrist trim your toenails and treat any corns or calluses. They may also prescribe diabetic shoes and create custom orthotics to prevent foot injuries. If a wound does develop, your podiatrist can dress your wound appropriately, remove dead skin and tissue (debridement), reduce pressure and friction on the wound, and help restore adequate blood flow. They can also advise you on how to properly care for your wound at home. In cases where a higher level of wound care is necessary, your podiatrist may be able to use skin or bone grafts, or perform reconstructive surgery to replace or rebuild infected or necrotic bones, tendons and tissue.
Limb salvage can be an effective way in preventing the need for limb amputation. If you have diabetes, cancer, or any other condition that could lead to foot amputation if left unchecked, consult with Dr. Harris L. Klear from Burlington County Podiatry Associates. Our doctor will assess your condition and provide you with quality foot and ankle treatment.
What Is Limb Salvage?
Limb salvage is the attempt of saving a limb, such as the foot from amputation. Podiatrists also try to make sure that there is enough function in the foot after the salvage that it is still usable. Diabetes is the number one cause of non-traumatic amputations in the United States. 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.
However, there are other causes as well, such as cancer and traumatic injury. Links between higher mortality rates and amputation have been found. 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 one of our offices located in Marlton and Delran, NJ . We offer the newest diagnostic and treatment technologies for all your foot care needs.
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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.
Middle joints in the second, third, and fourth toes can sometimes become deformed due to an imbalance in tendons, muscles, and ligaments. When this occurs, the toe is unnaturally bent with the middle joint stuck in an upward position while the rest of the toe is bent downward. This deformity causes the toe to look almost like a hammer, which is why it is known as hammertoe. Mallet toe is similar, however, the joint nearest the nail is affected. The factors that can contribute to hammertoe include wearing high heels or other footwear that crowds the toes, throwing the toes out of alignment by stubbing or injuring them, having an imbalance in the toe muscles due to age or other conditions, inheriting a second toe that is longer than the big toe, and suffering from diabetes, arthritis, or other conditions that compromise the feet. It is important to seek treatment from a podiatrist in the early stages of hammertoe, while the toe is still flexible, and the condition is more easily correctable. If your toe is always bent or it looks red or feels stiff or painful at the joint, it is a good idea to make an appointment with a podiatrist to get it examined and to discuss your treatment options.
Hammertoes can be a painful condition to live with. For more information, contact Dr. Harris L. Klear of Burlington County Podiatry Associates. 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
Risk Factors
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 one of our offices located in Marlton and Delran, NJ . We offer the newest diagnostic and treatment technologies for all your foot care needs.
Sever’s disease, also known as calcaneal apophysitis is a common bone disorder that occurs during childhood. The disease is defined as an inflammation of the growth plate in the heel. When a child has a growth spurt, his heel bone grows faster than the muscles, tendons, and ligaments in his leg. This disease is a result of overuse. The people who are most likely to be affected by this disease are children who are in a growth spurt, especially boys who are from the ages of 5 to 13 years old. 60% of children with Sever’s disease have both heels involved.
Symptoms of this disease are heel pain that intensifies during running and jumping activities. The pain is typically localized to the posterior part of the heel. Symptoms may be severe, and they can easily interfere with daily activities. Children who play soccer, baseball, and basketball are more likely to develop Sever’s disease.
Your doctor will diagnose your child based on his or her symptoms, x-rays are generally not helpful in diagnosing this disease. Your doctor may examine both heels and ask your child questions about his or her activity level in sports. Your doctor may then use the squeeze test on your child’s heel to see if there is any pain. Nevertheless, some doctors might still use x-rays to rule out any other issues such as fractures, infections, and tumors.
Sever’s disease can be prevented by maintaining good flexibility while your child is growing. Another prevention method is to wear good-quality shoes that have firm support and a shock-absorbent sole. Sever’s disease can be treated by ceasing any activity that causes heel pain. You should apply ice to the injured heel for 20 minutes 3 times a day. Additionally, orthotics should be used for children who have high arches, flat feet, or bowed legs.
If you suspect your child has Sever’s disease, you should make an appointment with your podiatrist to have his or her foot examined. Your doctor may recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen to relieve pain. In more severe cases, your child may need a cast to rest his or her heel. Fortunately, Sever’s disease does not cause long-term foot problems. After treatment, your child should start to feel better within two weeks to two months.
Active, growing children that experience pain in their heels may have a condition known as Sever’s disease. The cause of this pain stems from irritation of the growth plate in the heel bone, as it has not yet completely developed and calcified. Bones in the calf grow more rapidly than the Achilles tendon, which attaches to the heel bone where the growth plate is located. This difference in growth can cause tightness and pressure in the Achilles tendon, which is often exacerbated with physical activity—particularly sports that involve running and jumping. Icing the area and refraining from activities that make the pain worse can sometimes help ease the pain. For professional pain relief, make an appointment with a podiatrist. They can offer a variety of pain management techniques, such as custom orthotics and heel raises, personalized stretching routines, footwear recommendations, and prescription pain medications.
Sever's disease often occurs in children and teens. If your child is experiencing foot or ankle pain, see Dr. Harris L. Klear from Burlington County Podiatry Associates. Our doctor can treat your child’s foot and ankle needs.
Sever’s Disease
Sever’s disease is also known as calcaneal apophysitis, which is a medical condition that causes heel pain I none or both feet. The disease is known to affect children between the ages of 8 and 14.
Sever’s disease occurs when part of the child’s heel known as the growth plate (calcaneal epiphysis) is attached to the Achilles tendon. This area can suffer injury when the muscles and tendons of the growing foot do not keep pace with bone growth. Therefore, the constant pain which one experiences at the back of the heel will make the child unable to put any weight on the heel. The child is then forced to walk on their toes.
Symptoms
Acute pain – Pain associated with Sever’s disease is usually felt in the heel when the child engages in physical activity such as walking, jumping and or running.
Highly active – Children who are very active are among the most susceptible in experiencing Sever’s disease, because of the stress and tension placed on their feet.
If you have any questions, please feel free to contact one of our offices located in Marlton and Delran, NJ . We offer the newest diagnostic and treatment technologies for all your foot and ankle injuries.
Athlete’s foot, or tinea pedis, is a skin disease caused by a fungal infection. The infection typically occurs between the toes, and the feet are most subject to this disease because shoes best create the warm, dark, and moist environment in which fungus thrives. Other areas that create a similar environment, such as swimming pools, public showers, and locker rooms; can also promote fungi growth.
Symptoms of athlete’s foot include dry skin, itching, scaling, inflammation, and blistering. Sometimes, blisters can evolve into the cracks or breaks in the skin. The exposed tissue can then create pain, swelling, and discharge. The spread of infection can cause itching and burning as well.
While athlete’s foot commonly occurs between the toes, it may also spread to the toenails or soles of the feet. Other parts of the body, such as the groin or underarms, can also become infected if they are touched after the original area of infection is scratched. Aside from physical contact, athlete’s foot can also spread through the contamination of footwear, clothing or bedsheets.
Proper foot hygiene is essential in preventing athlete’s foot. You can prevent the fungus from spreading by frequently washing your feet using soap and water, thoroughly drying the feet between the toes, changing shoes and socks every day to reduce moisture, and ensuring that bathroom and shower floors are disinfected. Other tips include using shower shoes, avoiding walking barefoot in public environments, wearing light and airy shoes, and wearing socks that keep the feet dry.
While treatment for athlete’s foot can involve topical or oral antifungal drugs, mild cases of the infection can be treated by dusting foot powder in shoes and socks. Any treatment used can be supplemented by frequently bathing the feet and drying the toes. If proper foot hygiene and self-care do not ease your case of athlete’s foot, contact your podiatrist. He will determine if the underlying cause of your condition is truly a fungus. If that is the case, a comprehensive treatment plan may be suggested with the inclusion of prescription antifungal medications.
Anyone can get athlete’s foot, particularly if they have damp or sweaty feet, because it is a fungal infection that thrives in warm, moist conditions. The main symptoms are itchy blisters, redness, and scaling either between the toes or on the soles of the feet. Athlete’s foot, known as tinea pedis, is extremely contagious and most apt to be spread in gym locker rooms, pool showers, or anywhere infected people walk barefoot. While athlete’s foot is not particularly serious, it can become a problem because it can easily spread to other parts of the body, such as toenails and hands. The best way to prevent it is to wear foot coverings in places where it is likely to spread. Second, it’s a good idea to make sure your feet are clean and completely dry and wear absorbent socks. If it is too late, there are numerous anti-fungal sprays available over the counter that can help to reduce symptoms. If the condition lingers or your toenails or foot becomes infected, it is strongly suggested that you see a podiatrist as soon as possible for more aggressive treatment options.
Athlete’s foot is an inconvenient condition that can be easily reduced with the proper treatment. If you have any concerns about your feet and ankles, contact Dr. Harris L. Klear from Burlington County Podiatry Associates. Our doctor will treat your foot and ankle needs.
Athlete’s Foot: The Sole Story
Athlete's foot, also known as tinea pedis, can be an extremely contagious foot infection. It is commonly contracted in public changing areas and bathrooms, dormitory style living quarters, around locker rooms and public swimming pools, or anywhere your feet often come into contact with other people.
Solutions to Combat Athlete’s Foot
Athlete’s foot can cause many irritating symptoms such as dry and flaking skin, itching, and redness. Some more severe symptoms can include bleeding and cracked skin, intense itching and burning, and even pain when walking. In the worst cases, Athlete’s foot can cause blistering as well. Speak to your podiatrist for a better understanding of the different causes of Athlete’s foot, as well as help in determining which treatment options are best for you.
If you have any questions please feel free to contact one of our offices located in Marlton and Delran, NJ . We offer the newest diagnostic and treatment technologies for all your foot and ankle needs.
