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Hammer Toe Repair

July 6th, 2015 parašė karenalatorre

HammertoeOverview
A Hammer toes can be flexible or rigid. Hammertoes often start out flexible and become rigid over time as your toe becomes accustomed to its crooked position. Flexible hammertoes are less serious than rigid hammertoes, as they can be easily diagnosed and treated in their initial stages. Flexible hammertoes are named as such because your affected toe still possesses some degree of movement.


Causes
Wearing ill-fitting shoes is probably the main cause of hammer toe. As the toe bends, tendons add to the problem by contracting in such a way that the bending is reinforced to the point of becoming permanent. In some cases, tendons that are abnormal to begin with may start the bending process.

Hammertoe

Symptoms
Hammertoe and mallet toe feature an abnormal bend in the joints of one or more of your toes. Moving the affected toe may be difficult or painful. Corns and calluses can result from the toe rubbing against the inside of your shoes. See your doctor if you have persistent foot pain that affects your ability to walk properly.


Diagnosis
Most health care professionals can diagnose hammertoe simply by examining your toes and feet. X-rays of the feet are not needed to diagnose hammertoe, but they may be useful to look for signs of some types of arthritis (such as rheumatoid arthritis) or other disorders that can cause hammertoe.


Non Surgical Treatment
Many people start by treating the problem themselves when they have a painful corn or callus. They try to remove the corn by cutting it off or by applying strong acids, and they try to cushion the toe by applying cushioned pads. Because these treatments can be difficult to perform by oneself (and should never be done by oneself when the patient is diabetic or circulation is poor), and because these treatments only treat the symptom, not the structural deformity that causes their symptom, these treatments can often provide only limited success, and often any success is for only short periods of time. Changes in shoe choices and various types of paddings and other appliances may help, too. For longer-lasting help, we must examine the cause of the deformity. The reason for knowing the cause is that the type of treatment will vary, depending upon the cause of the complaint. Orthotics help control the causes of certain types of contracted toes, (those caused by flexor stabilization, for example), but not other types.


Surgical Treatment
The technique the surgeon applies during the surgery depends on how much flexibility the person’s affected toes still retain. If some flexibility has still been preserved in their affected toes, the hammer toes might be corrected through making a small incision into the toe so the surgeon can manipulate the tendon that is forcing the person’s toes into a curved position. If, however, the person’s toes have become completely rigid, the surgeon might have to do more than re-aligning the person’s tendons. Some pieces of bone may have to be removed so the person’s toe has the ability to straighten out. If this is the case, some pins are attached onto the person’s foot afterwards to fix their bones into place while the injured tissue heals.

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July 1st, 2015 parašė karenalatorre

Overview
Bunion Pain
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
Bunions develop when the pressures of bearing and shifting your weight fall unevenly on the joints and tendons in your feet. This imbalance in pressure makes your big toe joint unstable, eventually molding the parts of the joint into a hard knob that juts out beyond the normal shape of your foot. Experts disagree on whether tight, high-heeled or too-narrow shoes cause bunions or whether footwear simply contributes to bunion development. Other causes include inherited foot type, foot injuries, deformities present at birth (congenital). Bunions may be associated with certain types of arthritis, particularly inflammatory types, such as rheumatoid arthritis. An occupation that puts extra stress on your feet or one that requires you to wear pointed shoes also can be a cause.


Symptoms
Signs and symptoms of a bunion include the base of the big toe is swollen and sticks out. The big toe is often bent towards the other toes, and sometimes the second toe is pushed to overlap the third toe. Skin around the big toe joint is red and sore. Thickened skin at the base of the big toe. Pain in the big toe or foot. Wearing shoes is painful. Pain or difficulty when walking.


Diagnosis
Your doctor can identify a bunion by examining your foot. Watching your big toe as you move it up and down will help your doctor determine if your range of motion is limited. Your doctor will also look for redness or swelling. After the physical exam, an X-ray of your foot can help your doctor identify the cause of the bunion and rate its severity.


Non Surgical Treatment
Treatment falls into two broad categories, conservative and surgical. From a conservative standpoint, efforts are directed at correcting faulty foot mechanics with custom molded insoles and relief of symptoms. These include Custom Orthosis to stabilize the abnormal motion of the hind and fore foot. Shoe gear modification: Using shoes with larger toe boxed and more supple materials. Changes in activities. Try to avoid those things which cause symptoms. Anti-inflammatory medication for periodic relief this includes cortisone injections into the joint as well as oral medication.
Bunions


Surgical Treatment
Larger bunions often require the surgeon to move the entire bone over (1st metatarsal). This is accomplished by a cut or fusion at the bottom of the bone. The former technique, is called the Lapidus bunionectomy. Additionally, the repositioned bone is held in place with one or two surgical screws.

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July 1st, 2015 parašė karenalatorre

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