Foot and Ankle Surgeon – Podiatry in Melville, Dix Hills, Huntington, NY – Briarwood, Flushing, Kew Gardens, Queens
Surgery on the foot, ankle, or lower leg is usually performed by podiatric surgeons and orthopedic surgeons specializing in the foot and ankle.
Foot and ankle surgeries address a wide variety of foot problems, including:
Sprains and fractures.
Arthritis and joint disease.
Benign and malignant tumors.
Birth deformities.
Bunions.
Calluses and warts.
Corns and hammertoes.
Flatfeet.
Heel or toe spurs.
Neuromas (nerve tumors).
Many foot and ankle surgeries today can be performed in the doctor’s office or a surgical center on an outpatient basis. They frequently can be performed using local anesthesia, in some cases combined with sedation. Most foot surgeries require a period of immobilization after the procedures with protective devices, such as a bandages, splints, surgical shoes, casts, or open sandals. Limited weight bearing, elevating and icing the foot, and keeping the area dry are commonly required for the first two weeks following surgery until sutures are removed. Most surgeons will encourage post-operative exercise of the foot and legs to speed recovery. In addition, many patients need additional therapy or treatments after surgery in order to aid in the healing and recovery process. These may include physiotherapy, orthotic devices, and special footwear. After sufficient healing time, which varies from procedure to procedure, most patients can resume wearing their usual footwear.
There are three important factors that impact the success of bunion surgery:
Choose a surgeon with extensive experience with bunionectomies. Because a deep understanding of the biomechanics of each patient’s foot as well as the intricacies of each surgical option is needed, surgeons with more experience at doing bunionectomies are better able to help each patient achieve the best outcome.
Be realistic in your expectation about what a bunionectomy can accomplish. No physician can guarantee that a bunion won’t recur or that a patient will be absolutely pain free. Additionally, because of the complexity of the foot structures impacted by a bunion, patients may never be able to wear normal or slender shoes. Bunion surgery can reduce or eliminate the bone deformity, improve foot alignment and function, and prevent damage to other toes, but it does have its limitations. Be sure you understand all the possibilities before opting for this surgery.
Bunion surgery is not a magic bullet. Surgery alone may not be all that is needed to achieve your best outcome. After surgery, many patients experience long healing and recovery times and often have to spend time in physical therapy. Additionally, you may need a corrective orthotic device on an ongoing basis.
What to Expect
Most bunions surgeries today are performed on an outpatient basis at a surgical center or hospital. Set aside the entire day for the surgery, although you may only be at the facility for a half day.
Prior to the surgery, patients will need to make some preparatory arrangements. These include:
Seeing your Primary Care Physician (PCP) to make sure any other health conditions are stabilized prior to surgery and to document your complete medical history, which can then be given to the foot surgeon.
Arranging your schedule to make sure you don’t need to take any long trips for at least two to three weeks following the surgery.
Lining up another person to drive you home and stay with you for the first 24 hours after the surgery.
Stopping the use of any anti-inflammatory medications, such as aspirin, ibuprofen, or acetaminophen, for five to seven days before the surgery.
The night before the surgery, you will not be able to eat or drink anything after midnight. You should also wash your foot the night before and morning of the procedure to help reduce surrounding bacteria and prevent infection.
Bunion surgery is usually performed with a local anesthetic and is administered by an anesthesiologist. This may be combined with sedation medication to put you into “twilight” so that you are fully relaxed. After the surgery, patients are often given a long-acting anesthetic and pain medication, which is why someone else must drive the patient home.
The type of procedure you have will determine the degree to which you can put weight on the foot immediately after the surgery. Some patients, particularly those having base procedures, may have to use crutches; others may be sent home wearing a surgical shoe. The foot will be covered in a dressing, which you will need to keep dry for up to two weeks or until the sutures are removed.
During the first week after surgery, you will need to keep the foot elevated as much as possible. Ice packs also should be applied for the first three to four days to reduce swelling. Limited ambulation or walking is required over the first two weeks to promote healing. Most patients also are instructed on some basic exercises that need to be performed daily.
Sutures are generally removed about two weeks after the surgery in the doctor’s office. Once the sutures are removed, you can bathe and shower normally, but will still need to wear a dressing over the wound to keep it clean and prevent infection.
By the third or fourth week post surgery, swelling generally subsides enough for the patient to begin wearing a wide athletic shoe. It is important to continue daily exercises. If recommended, physical therapy may be initiated at this time. Once the wound has completely closed, you can use lotions to soften the skin in the surgical area.
By week five after the surgery, you will be able to walk short distances and do mild fitness activities. Continue following your surgeons instructions for increasing exercise and activities until you are back to normal.
Bunions are progressive bone deformities of the foot that often cause recurring or chronic inflammation, irritation, and pain that require surgical correction. Surgical removal of a bunion is called a bunionectomy. However, there are multiple types of bunionectomies, each designed to resolve different structural changes caused by the deformity.
Bunion surgeries fall into two major categories:
Head procedures that treat the big toe joint. In a head procedure bunionectomy, the bone is cut just behind the joint, moved into its proper position, and fixed in place with a screw or pin. Head procedures are often used for patients who cannot be immobilized for long periods of time.
Base procedures concentrate on the bone near or behind the big toe joint. Different types of base procedures are conducted depending on the nature of the deformity. These range from cutting a wedge out of the bone and splitting it so that it can be moved into its proper position; making a semi-circular cut and rotating the bone into its correct position; or fusing the joint. Ligaments inside and outside the toe may also be treated during a base procedure.
There are three important factors that impact the success of bunion surgery:
Choose a surgeon with extensive experience with bunionectomies. Because a deep understanding of the biomechanics of each patient’s foot as well as the intricacies of each surgical option is needed, surgeons with more experience at doing bunionectomies are better able to help each patient achieve the best outcome.
Be realistic in your expectation about what a bunionectomy can accomplish. No physician can guarantee that a bunion won’t recur or that a patient will be absolutely pain free. Additionally, because of the complexity of the foot structures impacted by a bunion, patients may never be able to wear normal or slender shoes. Bunion surgery can reduce or eliminate the bone deformity, improve foot alignment and function, and prevent damage to other toes, but it does have its limitations. Be sure you understand all the possibilities before opting for this surgery.
Bunion surgery is not a magic bullet. Surgery alone may not be all that is needed to achieve your best outcome. After surgery, many patients experience long healing and recovery times and often have to spend time in physical therapy. Additionally, you may need a corrective orthotic device on an ongoing basis.
What To Expect
Most bunions surgeries today are performed on an outpatient basis at a surgical center or hospital. Set aside the entire day for the surgery, although you may only be at the facility for a half day.
Prior to the surgery, patients will need to make some preparatory arrangements. These include:
Seeing your Primary Care Physician (PCP) to make sure any other health conditions are stabilized prior to surgery and to document your complete medical history, which can then be given to the foot surgeon.
Arranging your schedule to make sure you don’t need to take any long trips for at least two to three weeks following the surgery.
Lining up another person to drive you home and stay with you for the first 24 hours after the surgery.
Stopping the use of any anti-inflammatory medications, such as aspirin, ibuprofen, or acetaminophen, for five to seven days before the surgery.
The night before the surgery, you will not be able to eat or drink anything after midnight. You should also wash your foot the night before and morning of the procedure to help reduce surrounding bacteria and prevent infection.
Bunion surgery is usually performed with a local anesthetic and is administered by an anesthesiologist. This may be combined with sedation medication to put you into “twilight” so that you are fully relaxed. After the surgery, patients are often given a long-acting anesthetic and pain medication, which is why someone else must drive the patient home.
The type of procedure you have will determine the degree to which you can put weight on the foot immediately after the surgery. Some patients, particularly those having base procedures, may have to use crutches; others may be sent home wearing a surgical shoe. The foot will be covered in a dressing, which you will need to keep dry for up to two weeks or until the sutures are removed.
During the first week after surgery, you will need to keep the foot elevated as much as possible. Ice packs also should be applied for the first three to four days to reduce swelling. Limited ambulation or walking is required over the first two weeks to promote healing. Most patients also are instructed on some basic exercises that need to be performed daily.
Sutures are generally removed about two weeks after the surgery in the doctor’s office. Once the sutures are removed, you can bathe and shower normally, but will still need to wear a dressing over the wound to keep it clean and prevent infection.
By the third or fourth week post surgery, swelling generally subsides enough for the patient to begin wearing a wide athletic shoe. It is important to continue daily exercises. If recommended, physical therapy may be initiated at this time. Once the wound has completely closed, you can use lotions to soften the skin in the surgical area.
By week five after the surgery, you will be able to walk short distances and do mild fitness activities. Continue following your surgeons instructions for increasing exercise and activities until you are back to normal.
There are three important factors that impact the success of bunion surgery:
Choose a surgeon with extensive experience with bunionectomies. Because a deep understanding of the biomechanics of each patient’s foot as well as the intricacies of each surgical option is needed, surgeons with more experience at doing bunionectomies are better able to help each patient achieve the best outcome.
Be realistic in your expectation about what a bunionectomy can accomplish. No physician can guarantee that a bunion won’t recur or that a patient will be absolutely pain free. Additionally, because of the complexity of the foot structures impacted by a bunion, patients may never be able to wear normal or slender shoes. Bunion surgery can reduce or eliminate the bone deformity, improve foot alignment and function, and prevent damage to other toes, but it does have its limitations. Be sure you understand all the possibilities before opting for this surgery.
Bunion surgery is not a magic bullet. Surgery alone may not be all that is needed to achieve your best outcome. After surgery, many patients experience long healing and recovery times and often have to spend time in physical therapy. Additionally, you may need a corrective orthotic device on an ongoing basis.
What to Expect
Most bunions surgeries today are performed on an outpatient basis at a surgical center or hospital. Set aside the entire day for the surgery, although you may only be at the facility for a half day.
Prior to the surgery, patients will need to make some preparatory arrangements. These include:
Seeing your Primary Care Physician (PCP) to make sure any other health conditions are stabilized prior to surgery and to document your complete medical history, which can then be given to the foot surgeon.
Arranging your schedule to make sure you don’t need to take any long trips for at least two to three weeks following the surgery.
Lining up another person to drive you home and stay with you for the first 24 hours after the surgery.
Stopping the use of any anti-inflammatory medications, such as aspirin, ibuprofen, or acetaminophen, for five to seven days before the surgery.
The night before the surgery, you will not be able to eat or drink anything after midnight. You should also wash your foot the night before and morning of the procedure to help reduce surrounding bacteria and prevent infection.
Bunion surgery is usually performed with a local anesthetic and is administered by an anesthesiologist. This may be combined with sedation medication to put you into “twilight” so that you are fully relaxed. After the surgery, patients are often given a long-acting anesthetic and pain medication, which is why someone else must drive the patient home.
The type of procedure you have will determine the degree to which you can put weight on the foot immediately after the surgery. Some patients, particularly those having base procedures, may have to use crutches; others may be sent home wearing a surgical shoe. The foot will be covered in a dressing, which you will need to keep dry for up to two weeks or until the sutures are removed.
During the first week after surgery, you will need to keep the foot elevated as much as possible. Ice packs also should be applied for the first three to four days to reduce swelling. Limited ambulation or walking is required over the first two weeks to promote healing. Most patients also are instructed on some basic exercises that need to be performed daily.
Sutures are generally removed about two weeks after the surgery in the doctor’s office. Once the sutures are removed, you can bathe and shower normally, but will still need to wear a dressing over the wound to keep it clean and prevent infection.
By the third or fourth week post surgery, swelling generally subsides enough for the patient to begin wearing a wide athletic shoe. It is important to continue daily exercises. If recommended, physical therapy may be initiated at this time. Once the wound has completely closed, you can use lotions to soften the skin in the surgical area.
By week five after the surgery, you will be able to walk short distances and do mild fitness activities. Continue following your surgeons instructions for increasing exercise and activities until you are back to normal.
Surgery on the foot, ankle, or lower leg is usually performed by podiatric surgeons and orthopedic surgeons specializing in the foot and ankle.
Foot and ankle surgeries address a wide variety of foot problems, including:
Sprains and fractures.
Arthritis and joint disease.
Benign and malignant tumors.
Birth deformities.
Bunions.
Calluses and warts.
Corns and hammertoes.
Flatfeet.
Heel or toe spurs.
Neuromas (nerve tumors).
Many foot and ankle surgeries today can be performed in the doctor’s office or a surgical center on an outpatient basis. They frequently can be performed using local anesthesia, in some cases combined with sedation. Most foot surgeries require a period of immobilization after the procedures with protective devices, such as a bandages, splints, surgical shoes, casts, or open sandals. Limited weight bearing, elevating and icing the foot, and keeping the area dry are commonly required for the first two weeks following surgery until sutures are removed. Most surgeons will encourage post-operative exercise of the foot and legs to speed recovery. In addition, many patients need additional therapy or treatments after surgery in order to aid in the healing and recovery process. These may include physiotherapy, orthotic devices, and special footwear. After sufficient healing time, which varies from procedure to procedure, most patients can resume wearing their usual footwear.
At the office of Sheldon H. Nadal D.P.M., our priority is to deliver quality care to informed patients in a comfortable and convenient setting.
Quality Care
When you have problems with bunions, heel pain, hammertoes, require shockwave therapy for plantar fasciitis or heel pain, or any issues involving your feet, you need to turn to a podiatrist who listens and responds … an experienced doctor who knows the field and can effectively diagnose and treat your needs … a friendly foot specialist who counsels you on the best ways to maintain and improve your health. Our office meets all these criteria. Plus, you benefit from a dedicated team of trained professionals who give you the individualized attention you deserve.
Informed Patients
Sheldon H. Nadal D.P.M. believes that informed patients are better prepared to make decisions
regarding their health and well being. That is why we’ve included an extensive section on this web site covering the full array of topics associated with podiatry and podiatric diagnoses and treatments. We encourage you to look through these pages whenever you have an interest or concern about your feet.
Comfortable, Convenient Setting
The best care in the world doesn’t mean anything if you can’t access it. At the clinic of Sheldon H. Nadal D.P.M., we strive to make our Toronto podiatry office as efficient and convenient as possible. Included in these web pages is information about Sheldon H. Nadal D.P.M.’s office, including our Toronto location, maps, directions, hours, insurance policies and appointment scheduling.
1) Using specially designed instruments, podiatrists are able to treat bunions, corns, hammertoes and callouses through very small openings in the skin. Consequently, there is less soft tissue work. This often results in considerably less post operative discomfort and quicker return to work and normal activities. Many people need nothing stronger than Aspirin or Tylenol post operatively.
2) The minimal incision technique can be performed under local anaesthetic in an office setting. Patients can read, listen to music or watch T.V. during the procedure. Most doctors consider local anaesthetic safer than general anaesthetic.
3) Expensive hospital beds and operating rooms are usually not necessary. This results in substantial savings for the government and medical plans.
4) Casts and crutches are usually not required with the minimal incision technique. Instead, an adhesive tape and gauze dressing is used for four to six weeks.
5) The minimal incision technique can be more cosmetically appealing because the scars are much smaller.
6) Following the minimal incision technique, people tend to get back to work and normal activities quicker. This is very important to people who run their own businesses or cannot be away from work for excessive lengths of time.
When can I return to work? Someone who sits most of the day may return to work as soon as one week following the minimal incision bunion technique. Someone who stands all day needs approximately six to eight weeks off. The more you can sit, the sooner you may go back to work.
How often do I return for checkups? Following the minimal incision bunion technique, you return to my office 3 days later for a checkup. Then I change the dressing once a week for 5 weeks. On the sixth week you may remove the dressing yourself. You then return six weeks later and every three months for a year for checkups. The number of visits can be reduced for out of town patients.
What other foot problems do you treat? In addition to bunions, I also treat corns, hammertoes and callouses with the minimal incision technique. I treat ingrown nails with the carbon dioxide laser. I also treat heel spur pain with endoscopic plantar fasciotomy. All procedures are performed under local anaesthetic in the comfort of my office.
Visit our website: http://www.footcare.net
Heel Pain Treatment – Podiatrist, foot Doctor of Podiatric Medicine, Foot Specialist, Toronto, ON
What causes heel pain?
One of the most common causes of heel pain is plantar fasciitis or heel spur syndrome.Other causes include gout, arthritis, broken heel bone, infection, foreign bodies (such as stepping on a needle). Your podiatrist can determine the exact cause of your heel pain.
What is plantar fasciitis or heel spur syndrome?
Plantar fasciitis is due to a tight tendon located under the arch and attached to the bottom of the heel. It has become strained and inflamed, often due to a lack of proper support, or due to an injury, or overuse. Over time, the tendon may begin to pull away from its attachment at the heel and a bone spur develops. Generally, the problem is not due to the heel spur, it is due to the inflamed tendon.
How do I know if I have plantar fasciitis?
Usually, you will experience pain at the bottom of the heel, particularly when getting out of bed in the morning or when starting to walk following a period of rest. It tends to feel better after a moderate amount of walking. It may not hurt during a workout but usually hurts more the next day following the workout.
What can I do at home to relieve the pain of plantar fasciitis?
Applying ice to the tender area for short periods may help. Also, try gentle calf stretches. Aspirin may relieve the inflammation. Elevating the heel by putting a soft pad in the shoe under your sore heel may help. Women may feel better in a shoe with a higher heel.
What if my heel still hurts?
It’s time to see a podiatrist.
What will the podiatrist do?
The key to relief is to reduce the inflammation and pulling of the tendon at the heel bone. The inflammation may be relieved by anti-inflammatory medicine, physiotherapy such as ultrasound, or a cortisone injection. The pulling of the tendon can be improved temporarily by supporting the arch with adhesive tapings. More long term relief may be obtained by the use of specialized shoe inlays called orthotics. They improve the mechanics of the foot and relax the plantar fascia tendon.
I’ve tried medicine, cortisone, ice, rest, orthotics etc. and I’m losing hope. What else can be done?
When conservative treatments fail, we consider surgically releasing the tight tendon at its attachment at the heel bone. The procedure can be performed under local anaesthetic using a small instrument called an endoscope. The procedure is called endoscopic plantar fasciotomy.
What is endoscopic plantar fasciotomy?
Under local anaesthetic, a small opening is made on either side of the heel. Through one opening, the endoscope or scope is inserted. The scope is attached to a small camera to allow the podiatrist to see the inflamed tendon on a television monitor. Through the other opening, small tools are used to make a tiny cut in the tendon. This allows the tendon to lengthen, relax, and relieve the tension on the heel bone or heel spur. Thus, the pain is relieved. It is usually not necessary to remove the spur.
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