Surgical Definitions
Achilles Tendon
The Achilles tendon is not only the strongest, but also the largest tendon in the human body. Due to its limited blood supply and the high tensions placed on it, the Achilles heel can be left vulnerable if harmed. Possible conditions that may arise due to injury of the Achilles tendon include tears, ruptures, tendinitis, peritendinitis, tendinosis, tendinopathy, and bursitis. Many times advanced imaging ( MRI, Ultrasound ) are needed to visualize the condition of the Achilles tendon. We suggest you meet with our podiatrist to get you on a path to healing and a return to activity.
Ankle Arthroscopy / Ankle Scope
Ankle arthroscopy or "ankle scope" is a minimally invasive surgery in which the surgeon makes two small (1 cm) incisions at the front of the ankle. In one incision a small camera in placed in the ankle joint. In the other incision small tools are used to clean up damage to the joint surface and repair and remove debris that can cause pain to the joint. This procedure offers a faster recovery and can provide long term relief to patients with persistent ankle pain.
Ankle Fusion / Ankle Arthrodesis
When a patient has chronic ankle joint pain or when the ankle joint is severely damaged (including loss of the protective cartilage) we are often left with two choices. Replace the ankle joint, or fuse the ankle joint. Ankle joint fusion or "Arthrodesis" involves fusing the leg to the ankle bone. This is usually effective at relieving the patient from long standing joint pain, however, this limits the motion available in the foot. An in depth discussion with our podiatrist is recommended for anyone considering ankle joint fusion.
Ankle Fractures
When the foot or ankle experiences trauma, a fracture may occur. Causes of foot and ankle fractures can vary. In some cases, an obvious impact to the foot or ankle from a fall can cause a fracture. Fractures can also occur because of increased stress on the bone over time. Ankle fractures typically present in predictable patterns based on the mechanism of injury (what caused the fracture). It is important to meet with a podiatrist who understands how these patterns can affect your treatment options.
Bunions
A bunion is a bony, painful swelling that is often formed on the first joint of the big toe. Bunions can be extremely painful due to the weight of all your body resting on it each time you take a step. Everyday activities, such as walking and wearing shoes, can cause you extreme discomfort if you have a bunion. Because bunions can result in other painful foot problems, such as hammertoes and bursitis, we recommend that you meet with our podiatrist for a professional diagnosis and for information regarding all your treatment options.
Charcot Foot / Charcot Reconstruction
Charcot foot or ( Charcot joint / Neuropathic Arthropathy ) refers to progressive degeneration or destruction of a weight bearing joint. This process occurs over time and is marked by bony destruction, bone resorption, and eventual deformity due to loss of sensation.This condition of the foot is one of the most serious complications diabetic patients can face, and includes a high risk for amputation. Early identification of joint changes is the best way to limit the risks of ulceration, infection, or amputation. Treatment options include both surgical and non surgical approaches, and are focused around limb salvage.
Complex Wounds
Wound care is particularly important for those with diabetes. It’s possible that what appears to be a small wound could turn into more severe foot complications down the road if left untreated. It’s common for those with diabetes to experience neuropathy. Neuropathy is a type of nerve damage that affects the body and can cause you to lose feeling in the feet. If you’re no longer experiencing feeling in your feet and a wound develops, it’s very possible it may go unnoticed if you don’t check your feet daily. For long standing and complex wounds, it is important to understand WHY a wound is not healing. Surgery may be necessary; however, we have a host of non-surgical treatment options for wounds of all kinds.
Cysts & Soft Tissue
Cysts and soft tissue masses are common in the foot and ankle. Often times these masses are painless, however, they can cause difficulty in shoe gear and when walking barefoot. Because these do not involve the bone, oftentimes, an X-ray does little to help diagnose the problem. Our Dr. uses Ultrasound in office to locate and diagnose these "soft tissue issues". We then discuss a variety of treatments appropriate to your specific diagnosis.
Deformity & Congenital Defects
Deformities and congenital defects include problems with the size, position, anatomy, and function of the foot. Some of these problems can develop over time, and some of them we are born with. Because technology and techniques in foot and ankle care continue to change and improve, it is important to see our podiatrist for a discussion on any of these conditions; especially if you have been given little or no options in the past.
External Fixation
Many times a patient may be deemed "High Risk" for surgery. This can be due to infection, diabetes, diminished blood flow, or a number of things that could effect healing. In these instances the patient may be a good candidate for less invasive surgery. External fixation is an alternative to Internal fixation ( plates, screws, etc. ). The application is unique for every patient. We recommend you discuss all surgical options with our podiatrist, who will be able to explain the benefits and risks of this surgical treatment.
Flat Foot Reconstruction
Flat feet may cause a certain level of pain due to strained muscles and connecting ligaments. Those not afflicted by flat feet are able to get support while walking by the spring that the arch provides, which in turn, helps to distribute your body weight while taking steps. When the arch is no longer present, there is a larger amount of pressure on your muscles and ligaments in the feet, which is why they become strained and may cause you to feel pain. There are many things that can contribute to flat feet and a wide age of patients who may experience pain with flat feet. X-rays and clinical exams can help us determine the type of flat foot you have and which of many treatment options are right for you. Custom Orthotics are often necessary for many patients.
Fractures
When the foot or ankle experiences trauma, a fracture may occur. Causes of foot and ankle fractures can vary. In some cases, an obvious impact to the foot or a fall can be behind a fracture. Fractures can also occur because of increased stress on the bone over time. The location of the fracture can often give your podiatrist information on how the fracture occurred. Pain, especially when bearing weight, can be a sign of a fracture. Other symptoms include inflammation, bruising, deformity, and tenderness. A deformity may occur due to a shift in bone alignment so it is important to see our podiatrist to make sure it doesn't get worse with time. While pain is a significant symptom of breakage, a patient who has nerve damage or who has diabetes may not feel this pain. In this instance, your podiatrist will look for additional signs to determine whether a fracture has occurred.
Hammer Toes
Hammertoes can be identified by an abnormal bend in the middle joint of the toe. This abnormal bending can lead to added pressure on the toe when wearing shoes. It can also cause pain or discomfort when walking or running. Because hammertoes typically worsen overtime and become increasingly more rigid, it’s recommended that you discuss treatment options with our podiatrist.
Ingrown Toenails
Ingrown toenails can form when the side of a toenail begins to grow into the flesh surrounding the nail. As a result, the affected toe—most commonly the big toe—may become red, swollen, painful, and—in severe cases—infected. If you are someone who has diabetes, it’s extremely important to remain mindful of ingrown toenail prevention, as minor cuts or simple scrapes can lead to serious complications. Treatment for an ingrown toenail will vary on a case by case basis. Removing a small portion of the ingrown nail is done in the office and typically takes less than 10 minutes.
Joint Replacement & Joint Fusion
Conditions affecting the feet due to complications with arthritis can take many forms, including osteoarthritis, rheumatoid arthritis, gout, psoriatic arthritis, and ankylosing spondylitis. Osteoarthritis typically affects the joint connecting your big toe to your foot, though it can also be found in the midfoot or ankle region as well. When joints of the foot have been damaged due to arthritis there are options for replacing joint surfaces to prolong the life of the joint, eliminate pain, and keep regular range of motion. In some circumstances it may be better to fuse the joint surfaces. This procedure often gives great pain relief to the patient. For a discussion on which treatment option is best for you and why, please see our Podiatrist.
Nerve Pain
Nerve pain is a very common problem that can seriously interfere with your daily life. There are several causes for nerve pain; injury to your lower back, disease, diabetes, nutrition, etc. A common complaint in the feet, ankles, and legs can be a loss of sensation with or without burning, numbness, tingling, or shooting pains. We are pleased to offer new and emerging treatments for nerve pain that do not involve taking medication. If you are experiencing peripheral neuropathy (nerve pain in the legs or feet), come see us for a consultation on up to date treatments for this common problem.
Neuroma ( Morton's )
Morton’s neuroma may develop when the tissue around one of the nerves leading to your foot begins to thicken. When this occurs, you may experience some discomfort as if you were standing on a pebble stuck in your shoe. Most symptoms will not appear outwardly and will be experienced in the form of a sharp, burning pain in the ball of the foot, as well as a stinging or burning feeling in the toes that may sometimes lead to numbness. Treatment for Morton’s Neuroma will often vary, depending on the severity of a patient’s condition. In some cases, injections may be helpful for alleviating pain. Another form of treatment is decompression surgery, in which a podiatrist will work to alleviate the pressure on the nerve. In more severe cases, full removal of the nerve would be required.
Pediatrics
At Family Foot and Ankle Center of San Antonio we treat patients of ALL ages. Our pediatric treatment for kids ( usually between 4-17) includes extensive physical exams so we can get to the root of your child's pain. We have surgical and non-surgical solutions for flat feet, club feet, sports injuries, heel pain, ingrown toenails, ankle sprains, tendon strains, fractures, bunions, rashes, warts, and much more! We provide comprehensive care for the whole family.
Plantar Fasciitis & Heel Pain
Plantar fasciitis affects the plantar regions of the foot, namely the heel, arch, and midfoot. When too much stress is put on the plantar fascia, or the connective tissue that stretches from the heel to the ball of your foot, inflammation, overtightening, and tearing may arise. This can cause foot pain. Because of plantar fasciitis, you may experience tearing with the first steps you take in the morning each day. If you’re feeling pain after sitting, walking, or standing for a long period of time, as well as when you first step out of bed or climb stairs, you may be showing signs of plantar fasciitis. Although plantar fasciitis is typically the most common cause for heel pain, there are many other problems that can mimic this common issue. Visit our podiatrist if your heel pain is not improving for an accurate diagnosis and get on the road to a quick recovery.
Rearfoot Reconstruction
Overtime the joints in the foot and ankle can undergo wear and tear that leads to persistent pain. Sometimes the problem is in the forefoot (toes, arch, and ball of the foot); however, sometimes the pain can be in the rearfoot (heel, ankle, subtalar joint. Choices in shoe gear, activity, bracing, anti-inflammatories, and stretching can do a lot to manage pain in the rearfoot. If these do not help, there may be damage to the bone, joints, or soft tissue that requires further attention. Rearfoot surgery often involves surgical techniques designed for long term pain relief. We always aim to find pain relief in a non-surgical way, but rest assured, if surgery is needed, our podiatrist can offer you several options in surgical solutions.
Tendon / Ligament Repair
Tendons connect the muscles in your legs and feet to the bones of the foot. Ligaments connect one bone to another bone. Both tendons and ligaments can cause pain to the patient. Overuse injuries, trauma, sports injuries, sprains and strains are very common. Most of the injuries we experience with tendons and ligaments will get better with time and rest; however, when things are not getting better over time, it is important to see our podiatrist who can determine if you will benefit from other forms of treatment.
Tendon Transfers
Tendons connect the muscles in your legs and feet to the bones of the foot. Muscle weakness, injury, disease, etc. can cause the foot to become unbalanced. Most of the time we try to support this problem with bracing, inserts (orthotics), and special shoes. However, depending on the age of the patient and the cause of the imbalance, it may be necessary to transfer tendons in the foot to different insertion points. These transfers provide a "rebalancing" of the foot and can allow for much better overall foot function.
Total Ankle Replacement
Ankle replacement, or ankle arthroplasty, is a surgical procedure to replace the damaged articular surfaces (cartilage) of the ankle joint with prosthetic components. This procedure offers an alternative for patients with moderate to severe arthritis of the ankle joint, and replaces the conventional treatment of arthrodesis, i.e. fusion of the ankle bones. Total ankle replacement allows for preservation of range of motion, which is a key feature in choosing joint replacement over ankle joint fusion. Unlike joint replacements of the knee or hip, the ankle has its own unique patient selection criteria. For more information on appropriate treatment options, and diagnosis we suggest you make an appointment to consult with our podiatrist.