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What Is a Nail Avulsion?

What Is a Nail Avulsion?

A nail avulsion is a surgical procedure that is used to treat severe ingrown toenails. During the surgery, the doctor removes the ingrown part of your nail from the surrounding skin. There are two types of nail avulsions. A partial nail avulsion involves removal of part of the nail bed. During this procedure, the nail is numbed with anesthetic and the ingrown edge is removed. Any pus is also drained. A total nail avulsion involves the complete removal of the nail. It can take a year or longer for a new nail to grow back. This operation is usually reserved for chronic cases that have not responded to any other treatments. If you have ingrown toenails, please seek the care of a podiatrist, who will find the right treatment for you. 

Ingrown toenails may initially present themselves as a minor discomfort, but they may progress into an infection in the skin without proper treatment. For more information about ingrown toenails, contact one of our podiatrists of Lewis Wolstein, DPM, P.C. & Associates. Our doctors can provide the care you need to keep you pain-free and on your feet.

Ingrown Toenails

Ingrown toenails are caused when the corner or side of a toenail grows into the soft flesh surrounding it. They often result in redness, swelling, pain, and in some cases, infection. This condition typically affects the big toe and may recur if it is not treated properly.

Causes

  • Improper toenail trimming
  • Genetics
  • Improper shoe fitting
  • Injury from pedicures or nail picking
  • Abnormal gait
  • Poor hygiene

You are more likely to develop an ingrown toenail if you are obese, have diabetes, arthritis, or have any fungal infection in your nails. Additionally, people who have foot or toe deformities are at a higher risk of developing an ingrown toenail.

Symptoms

Some symptoms of ingrown toenails are redness, swelling, and pain. In rare cases, there may be a yellowish drainage coming from the nail.

Treatment

Ignoring an ingrown toenail can have serious complications. Infections of the nail border can progress to a deeper soft-tissue infection, which can then turn into a bone infection. You should always speak with your podiatrist if you suspect you have an ingrown toenail, especially if you have diabetes or poor circulation.

If you have any questions, please feel free to contact our office located in Co-Op City, NY . We offer the newest diagnostic and treatment technologies for all your foot care needs.

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Wound Care

Wound Care

Diabetics must be wary of all wounds, regardless of depth or size. Diabetes, a chronic disease in which the body cannot properly use glucose the way it normally would, causes various complications that make wounds difficult to heal. Nerve damage or neuropathy will cause diabetics to have trouble feeling the pain of a blister or cut until the condition has significantly worsened or become infected. A diabetic’s weakened immune system can make even the most minor of wounds easily susceptible to infection. Diabetics are also more prone to developing narrow, clogged arteries, and are therefore more likely to develop wounds.

Wounds should be taken care of immediately after discovery, as even the smallest of wounds can become infected if enough bacteria build up within the wound.  To remove dirt, wounds should be first rinsed under running water only. Soap, hydrogen peroxide, or iodine can irritate the injury and should be avoided. To prevent infection, apply antibiotic ointment to the wound and cover it with a bandage. The bandage should be changed daily. The skin around the wound may be cleaned with soap.

To prevent further exacerbation, see a doctor—especially if you have diabetes. Minor skin conditions can become larger problems if not properly inspected. As the wound heals, make sure to avoid applying pressure to the affected area.

Six Ways to Treat Diabetic Foot Ulcers

Six Ways to Treat Diabetic Foot Ulcers

Diabetic foot ulcers (DFUs) are wounds that occur on the feet of diabetic patients. These wounds may heal poorly, slowly, and have an increased risk of becoming infected. Because of this, prompt and proper wound care is necessary. Your podiatrist may treat your DFU by keeping pressure off of the wound using casts, boots, specialty shoes, or off-loading devices. The wound may also need to be debrided, which involves removing dead or damaged tissue and any foreign objects from the wound. You will then need to keep the foot clean and dry and moisturize the area with a prescribed cream to promote healing. Your doctor might also suggest ways to improve your circulation or prescribe additional therapies to encourage the wound to heal. For more information about caring for DFUs, please consult with a podiatrist. 

Wound care is an important part in dealing with diabetes. If you have diabetes and a foot wound or would like more information about wound care for diabetics, consult with one of our podiatrists from Lewis Wolstein, DPM, P.C. & Associates. Our doctors will assess your condition and provide you with quality foot and ankle treatment.

What Is Wound Care?

Wound care is the practice of taking proper care of a wound. This can range from the smallest to the largest of wounds. While everyone can benefit from proper wound care, it is much more important for diabetics. Diabetics often suffer from poor blood circulation which causes wounds to heal much slower than they would in a non-diabetic. 

What Is the Importance of Wound Care?

While it may not seem apparent with small ulcers on the foot, for diabetics, any size ulcer can become infected. Diabetics often also suffer from neuropathy, or nerve loss. This means they might not even feel when they have an ulcer on their foot. If the wound becomes severely infected, amputation may be necessary. Therefore, it is of the upmost importance to properly care for any and all foot wounds.

How to Care for Wounds

The best way to care for foot wounds is to prevent them. For diabetics, this means daily inspections of the feet for any signs of abnormalities or ulcers. It is also recommended to see a podiatrist several times a year for a foot inspection. If you do have an ulcer, run the wound under water to clear dirt from the wound; then apply antibiotic ointment to the wound and cover with a bandage. Bandages should be changed daily and keeping pressure off the wound is smart. It is advised to see a podiatrist, who can keep an eye on it.

If you have any questions, please feel free to contact our office located in Co-Op City, NY . We offer the newest diagnostic and treatment technologies for all your foot care needs.

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Sports Related Foot and Ankle Injuries

Sports Related Foot and Ankle Injuries

Foot and ankle injuries are common among athletes and those who exercise frequently. Most of these injuries are non-life-threatening and can heal in weeks with proper treatment and care. Serious injuries, however, require urgent medical treatment.

Common minor injuries include ankle sprains, ankle strains, Achilles tendonitis, plantar fasciitis, stress fractures, and turf toe. An ankle sprain is when the ligaments in the ankle have either become stretched or torn. When the muscle or tendon is stretched or torn, it is an ankle strain. When the big toe is sprained, it is known as turf toe. Achilles tendonitis is the overuse and inflammation of the Achilles tendon. Plantar fasciitis is the inflammation of the plantar fascia and generally occurs from overuse in athletics. Stress fractures are also caused from overuse and are small cracks in the bone.

Achilles tendon ruptures are common, but more serious. This injury occurs when the Achilles tendon, the largest tendon in the body, ruptures. In most cases, this causes severe pain and difficulty walking; some who have experienced this injury have reported, however, no signs or symptoms. A laceration is a deep cut that can occur anywhere on the body. Lacerations on the foot are rarer, but can occur from things like metal cleats landing on the foot.   

Treatment options cover a wide range of methods based upon the injury and its severity. Conditions like plantar fasciitis, stress fractures, Achilles tendonitis, turf toe and ankle sprains/ strains can heal on their own without immediate medical care, but seeing a podiatrist to monitor the injury is always recommended. Following the RICE (Rest, Icing, Compression, and Elevation) protocol is generally enough to treat minor injuries. This means resting the foot by either keeping pressure off the foot or not walking at all. Icing the injury will help reduce swelling and pain. Compressing the wound with a wrap will immobilize and help promote healing. Finally, keeping the wound elevated will also reduce swelling and also help the healing process.

It is important to note that even minor injuries can vary in severity, with grade one being a minor injury and grade three requiring urgent care by a podiatrist. Achilles tendon ruptures and lacerations on the foot generally require urgent medical care and treatment options that need a podiatrist. These could include imaging tests, stitches for cuts, rehabilitation, and casts or braces. Every case is different, however, so it is always recommended to see a podiatrist when pain in the foot does not disappear.

What Is Tennis Toe?

What Is Tennis Toe?

Tennis toe is a common sports injury where damage to the toe causes blood to collect beneath the toenail, giving the nail a black or red appearance. Other names for this condition include “subungual hematoma” and “runner’s toe,” as it is common among runners and other athletes who participate in activities that place immense pressure on the toes. In addition to nail discoloration, the affected toe may also throb, and the nail can thicken and become brittle. Although it can be painful, this condition is not indicative of a broken toe. Mild cases are treated by cleaning the affected nail with an antiseptic and covering it with a dressing to prevent infection, although it does take a few months for a new, healthy nail to grow out. Severe cases, characterized by significant bleeding, swelling or infection, may require a small hole to be drilled into the nail to drain the blood that has pooled beneath it. If you are suffering from tennis toe, please seek the care of a podiatrist. 

Ankle and foot injuries are common among athletes and in many sports. They can be caused by several problems and may be potentially serious. If you are feeling pain or think you were injured in a sporting event or when exercising, consult with one of our podiatrists from Lewis Wolstein, DPM, P.C. & Associates. Our doctors will assess your condition and provide you with quality foot and ankle treatment.

Common Injuries

The most common injuries that occur in sporting activities include:

  • Achilles Tendonitis
  • Achilles Tendon Rupture
  • Ankle Sprains
  • Broken Foot
  • Plantar Fasciitis
  • Stress Fractures
  • Turf Toe

Symptoms

Symptoms vary depending upon the injury and in some cases, there may be no symptoms at all. However, in most cases, some form of symptom is experienced. Pain, aching, burning, bruising, tenderness, tightness or stiffness, sensation loss, difficulty moving, and swelling are the most common symptoms.

Treatment

Just as symptoms vary depending upon the injury, so do treatment options. A common treatment method is known as the RICE method. This method involves rest, applying ice, compression and elevating the afflicted foot or ankle. If the injury appears to be more serious, surgery might be required, such as arthroscopic or reconstructive surgery. Lastly, rehabilitation or therapy might be needed to gain full functionality in the afflicted area. Any discomfort experienced by an athlete must be evaluated by a licensed, reputable medical professional.  

If you have any questions, please feel free to contact our office located in Co-Op City, NY . We offer the newest diagnostic and treatment technologies for all your foot care needs.

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Limb Salvage

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, 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.

Podiatry and Preventing Lower Limb Loss

Podiatry and Preventing Lower Limb Loss

Lower limb amputations, and specifically amputations associated with diabetes, have been on the rise in the United States for several years. These include both minor and major amputations. The rates of amputation have particularly increased among people ages 18-44 and 45-64, and are more common in men than in women. Many risks are associated with amputation, including permanent disability and death. When it comes to lower limb care, focus should be on preserving the limbs. Patients who regularly see a podiatrist, even if they have severe lower limb complications, have a decreased chance of amputation. Podiatrists can provide preventive care and treatments to manage various lower extremity problems, with the goal of preserving the limb and your quality of life. If you are diabetic or experience any foot or ankle problems, schedule an appointment with a podiatrist near you.

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 one of our podiatrists from Lewis Wolstein, DPM, P.C. & Associates. Our doctors 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 our office located in Co-Op City, NY . We offer the newest diagnostic and treatment technologies for all your foot care needs.

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Let the Expert Treat Your Ingrown Toenails

Let the Expert Treat Your Ingrown Toenails

Ingrown toenails can be painful and can make wearing shoes or walking uncomfortable. Seek professional help if you believe you've developed an ingrown toenail and be treated safely. 

Morton's Neuroma

Morton's Neuroma

Morton's Neuroma, also called Intermetatarsal Neuroma or Plantar Neuroma, is a condition that affects the nerves of the feet, usually the area between the third and fourth toe. Neuroma refers to a benign growth that can occur in different parts of the body. Morton's Neuroma strictly affects the feet. This condition causes the tissue around the nerves that lead to the toes becoming thick, causing pain in the ball of the foot.

This condition can be caused by injury, pressure or irritation. Normally no lump will be felt, but instead burning pain in the ball of the foot will be experienced. Numbness and tingling may also occur. With the onset of this condition, a person may feel pain when tight or narrow shoes are worn. As the condition worsens, the pain may persist for days, or even weeks.

Persistent foot pain should always be a concern. The foot should be examined by a podiatrist if pain persists longer than a few days with no relief from changing shoes. The earlier the foot is examined and treated, the less chance there will be for surgical treatment.

There are some factors that can play a role in the development of Morton's Neuroma. These include wearing ill-fitting shoes that cause pressure to the toes, such as high heels. Also, high impact exercise may contribute to the cause of this condition. Morton’s Neuroma may also develop if the foot sustains an injury. Another cause includes walking abnormally due to bunions or flat feet. This causes excessive pressure and irritates the tissue. At times, people are affected for no determinable reason.

Podiatrists can alleviate the effects of this condition using a treatment plan to help decrease the pain and heal the foot tissue. Depending upon the severity of the Morton's Neuroma, the treatment plan can vary. For cases that are mild to moderate, treatments may include applying padding to the arch to relieve pressure from the nerve and reduce compression while walking. Ice packs can also help reduce swelling. The podiatrist may also create a custom orthotic device to support the foot and reduce compression and pressure on the affected nerve. The doctor will probably advise against partaking in activities that cause constant pressure on the affected area. They may provide wider shoes to ease the pressure from the toes. If these treatments do not relieve the symptoms of this condition, the doctor may use injection therapy.

Surgical treatment may be recommended by the podiatrist if all other treatments fail to provide relief. Normally, the podiatric surgeon will decide on either a surgical procedure that involves removal of the affected nerve or will choose surgery to release the nerve. After examination, the surgeon will decide on the best approach to treat the problem.

Recovery varies according to the type of surgical procedure. The patient will also be instructed on the best shoe wear to prevent the return of this condition, along with changes to workout routines, if this was a cause. Preventative measures are important in ensuring the condition does not return.

Do You Feel Like You Are Walking on a Pebble?

Do You Feel Like You Are Walking on a Pebble?

When the nerve located between the third and fourth toes becomes compressed or otherwise irritated, the tissue surrounding it can thicken and become inflamed. This condition is known as Morton’s neuroma, or intermetatarsal neuroma. It can produce symptoms of pain, burning, tingling, or numbness in the ball of the foot that develops over time, and some people might have the sensation of a bunched-up sock or pebble in their shoe. It may be brought on by shoes that are too tight or narrow or by engaging in athletics that are played on a court. Additionally, hammertoes, flat feet, bunions and other foot conditions may increase the risk of developing Morton’s neuroma. If you have any symptoms of Morton’s neuroma, it is important to get properly diagnosed and treated by a podiatrist as soon as possible in order to avoid it advancing and possibly leading to permanent nerve damage.

Morton’s neuroma is a very uncomfortable condition to live with. If you think you have Morton’s neuroma, contact one of our podiatrists of Lewis Wolstein, DPM, P.C. & Associates. Our doctors will attend to all of your foot care needs and answer any of your related questions.  

Morton’s Neuroma

Morton's neuroma is a painful foot condition that commonly affects the areas between the second and third or third and fourth toe, although other areas of the foot are also susceptible. Morton’s neuroma is caused by an inflamed nerve in the foot that is being squeezed and aggravated by surrounding bones.

What Increases the Chances of Having Morton’s Neuroma?

  • Ill-fitting high heels or shoes that add pressure to the toe or foot
  • Jogging, running or any sport that involves constant impact to the foot
  • Flat feet, bunions, and any other foot deformities

Morton’s neuroma is a very treatable condition. Orthotics and shoe inserts can often be used to alleviate the pain on the forefront of the feet. In more severe cases, corticosteroids can also be prescribed. In order to figure out the best treatment for your neuroma, it’s recommended to seek the care of a podiatrist who can diagnose your condition and provide different treatment options.

If you have any questions, please feel free to contact our office located in Co-Op City, NY . We offer the newest diagnostic and treatment technologies for all your foot care needs.

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