FOOT SURGERY

INGROWN TOENAIL

This is one of the most common problems that we face and we best deal with podiatrists, whose results are enormous and quickly thankful to the patient. The incarnate or incarnate nail consists of the penetration of the lateral edges of the nail plate or nail into the soft tissues or flesh of the dorsum of the fingers.

The cause of this pathology responds to hereditary and morphological factors of the nail or by bad care, traumatisms or inappropriate cutting of the same. When the blade of the nail grows nailing on the sides of the fingers ends up generating a wound and infection with great pain. Especially dangerous is when the patient is diabetic or presents some type of general pathology, pacemaker or prosthesis that can cause a bacterial spread.

The approach of this pathology comprises from the careful removal of the spicule that generates the lesion trying to “recanalize” the nail, to the surgery through simple but precise techniques chosen by the podiatrist to remove only the lateral or ribbon that generates the injury and prevent Return to nailing leaving a good aesthetic of the nail. All this with a small anesthetic injection and a quick and non-painful recovery without substantially changing the life of the patient.

CLAY FINGERS

This is the result of an imbalance between the forces acting on the dorsum and the sole of the fingers, aided by biomechanical factors or footwear.
Sometimes the deformity stagnates with the change to a footwear more correct and less injurious to the foot or the placement of small silicone orthoses that maintain the joint range and the alignment of the fingers.
It is sometimes necessary to use custom templates to compensate for biomechanical alterations.

The final treatment of claw toes is through an intervention to align the fingers and correct the effects of length and muscle imbalances of the same. It is performed ambulatorily and under local anesthesia and has a recovery period of about two to six weeks according to case and technique used with postsurgical footwear referring the patient generally a minimal or nonexistent and perfectly tolerable pain..

JUANETE DE SASTRE

This is a pathology similar to that of the bunion of the first finger but whose location is in the fifth and its own finger and whose solution is very similar to the previous one as well as its recovery times and patterns. It receives this name because of the cross-legged position on the ground that the tailors used to work in the past and which forced the joint to generate the deformity.

MORTON NEUROMA

The neuroma is the thickening of the nerve sheath that passes between the heads of the metatarsals 3º and 4º and / or 3º and 2º of the foot opening Y-shaped and going towards the sides of the fingers.
The origin of this thickening is traumatic and responds to compression factors to the passage of the nerve between the heads of the metatarsals as well as to abnormal biomechanics but mainly to the use of narrow and high-heeled shoes.

The symptoms of the Morton’s Neuroma are tingling, urgent pain and numbness of the fingers, which in some cases are described as having a small stone in the plant that causes great discomfort and even a discharge or cramp and that compels the patient to Take off and massage the area for relief.

The conservative solution of this pathology can be found with the change of footwear to a less harmful one avoiding heels and narrow toes, use of functional templates that discharge the area and infiltrations that help to destroy that overgrowth of the nerve. Unfortunately in many cases the conservative treatments are not enough and it is necessary to go to the surgery. This is done with a small incision and the elimination of that nervous overgrowth.

The recovery is very good, relieving the pain area and greatly improving the patient’s quality of life. In some cases there is still a slight numbness of the involved fingers, which in many cases, over time, the body recovers.

HALLUX VALGUS

This well-known pathology is the overgrowth of the inner side of the first metatarsal and the deviation of the finger in the opposite direction to be placed above or below the 2nd finger.

The important pain that this deformation generates is due to the irritation of the nerve that passes close to the joint by the inside of the foot along with the osseous overgrowth and the dislocation of the joint and the surrounding tissues and that of the adjacent metatarsophalangeal joints, Mainly the second, reason in many cases of the surgical option.

The causes are multifactorial: genetic factors, hypermobility, biomechanical alterations, use of narrow and high-heeled shoes, etc.
Conservative treatment in a first phase involves the use of footwear that does not compress the foot and if there is any biomechanical alteration its compensation with insoles or in some cases silicone orthoses to avoid the progression of the deformity.

Surgical treatment will be the last route when the deformity is large and is justified by preventing a normal life of the patient. It will seek to realign the joint between the metatarsal and the first finger and the adjacent joints and the removal of the bone overgrowth generated by the excess pressure.

Currently, these interventions are performed under local anesthesia (without admission) and their recovery usually takes between three and six weeks with post-surgical footwear on which the patient can in most cases support from the first day. The pain is usually poor and well tolerated by the patient if the intervention is careful and the medication appropriate.