AF&A Blog

The Texas Rangers face the San Francisco Giants in Game 5 of the World Series tonight.  Trailing the series 3 games to 1, a win at Rangers Park is the only thing to keep hope alive.  This team has won some tough games throughout the season to arrive at this point.  They have had a rough time with the Giants for several of the first 4 games, but they’re not about to let that history play on their future.  Every member of that team is going out to win tonight and bring that trophy back to Texas. Doing so will make them only the 6^th team in history to make such a comeback.

We want to use all that excitement and determination to explore a facet of foot health.  Wound care, especially combined with diabetes, can be a difficult challenge.  For our younger audience, wound care more than likely consists of a bandage and maybe a little Neosporin.  This paradigm becomes a little more complicated when age and disease, like diabetes, are added in.   Wounds that occur in the diabetic foot can require a large dose of determination to go along with the proper care.  While there are many different doctors who will help to get you well, the care of a podiatrist is of utmost importance when dealing with problems in the feet.  Some of the components that go into healing foot ulcers may be overlooked by other physicians.  One such component may be what is causing the wound. Typically, footwear and foot structure can cause unfavorable pressure points which eventually lead to ulceration.  A podiatric physician will off-load these pressure points with a special boot or shoe. Doing so, allows the wound to heal by eliminating further insult.  Along with this assessment, a podiatrist may take a swab of the wound to assess for possible infection.  Flushing, debridement, gels, grafts, or other modalities may all be used individually or together to promote healing.  What methods are utilized is all dependent on the type of wound you have.  As the patient, you need the determination to follow your doctor’s instructions for the weeks or months it may take to get you better.  Just a reminder, but anyone living with diabetes should examine their feet every night and seek treatment at the first sign of a problem.  If you have diabetes and a foot wound that won’t heal, make an appointment at AFAS today!

Until next time, keep those feet happy and healthy, Austin! Go Rangers!

We here at AFAS are hoping you had an opportunity to enjoy some live music over the weekend. If not, we’re sure that you’ve had the radio on lately to listen to some music. You may have heard some advertisement about a ‘new’ minimally invasive procedure to correct bunion deformity along with your music. Let’s talk a little bit about bunions and this particular procedure before you decide to get your bunion fixed by that means.

Bunions are a complicated problem. There are many factors that effect if you will get one and how quickly it will progress to pain or discomfort. As foot specialists, podiatrists learn that there are many different angles of motion that are affected. Your podiatrist needs to assess many facets of your deformity before discussing procedures that will correct the deformity and stop it from reoccurring. The ‘tight rope’ procedure attempts to correct one of these angles. There are bones behind each of your toes that are known as metatarsals. One of the angles that must be corrected during bunion surgery is the Inter-Metatarsal (IM) angle, or the angle between the first and second metatarsals. The IM angle between your 1^st and 2^nd metatarsals must be addressed with almost all bunion procedures, but is only one of the components of this multi-faceted problem.

Because this procedure relies on the 2^nd metatarsal to hold the 1^st in better alignment, weak bones or patients with osteoporosis may not be candidates for this type of surgery. The technique was first used to hold the smaller of your leg bones to the larger in order to heal. Unlike that procedure, a quick x-ray of the foot shows the 1^st metatarsal much larger than the 2^nd. The bone holding the deforming tensions is the smaller 2^nd. This fact should make it no surprise that a common complication with this tight rope procedure is fracture of the 2^nd metatarsal. While the tight rope procedure may allow you to walk soon after surgery, a broken 2^nd metatarsal will quickly put you in a non-weight bearing cast and may require another surgical procedure. Both these things will keep you off your feet for some time. Not every patient has this type of complication, but it is a significant one if you’re choosing this procedure because you won’t have to stay off your feet. Please discuss this procedure along with others and consider the risks, alternatives and complications of all. We feel that the better informed you are the better outcome you will have!

Until next time, keep those feet happy and healthy Austin!