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2 Common Foot and Ankle Problems Dr. Kirk Woelffer, D.P.M. Raleigh Foot & Ankle Center 1418 E. Millbrook Rd. Raleigh, NC www.

3 Presentation Goal To inform you of common foot and ankle problems, so that you can help yourself be healthy and happy. Because we all want Happy Feet!

4

5 So what do we treat? Nearly every condition below the knee. From simple skin and nail problems, to complex surgical treatment of injuries and deformities. We emphasize non-surgical treatment and perform surgery only when necessary.

6 Who do we treat?

7 Shoes Good and bad choices Stiffness and laces helpful Price not always important Barefoot never wise

8 Good shoe choices

9 Poor shoe choices

10 Barefoot okay? Nope. Unless you want your dogs to bark!

11 Orthotics Any arch support is beneficial Doctor-prescribed custom fit orthotics are usually best Multiple styles to fit in different shoe types

12 Computer Laser Scan for Custom Orthotics Faith Ballard: In-office certified orthotist

13 Plantar fasciitis Heel spurs Inflamed ligament on bottom of heel Needs rest, stretching, and arch support New shockwave treatment for stubborn cases

14 In-office Shockwave treatment

15 Neuroma More common in females Inflamed nerve Most commonly located in the ball of the foot Orthotics and injections

16 Bunions More common in females Often inherited Muscular and boney imbalance Shoes, orthotics, surgery

17

18

19

20 Hammertoes Muscular imbalance Can develop painful corns Padding, orthotics, and sometimes surgery

21 Skin conditions Growths Rashes Fungus Ulcerations (open wounds)

22 Athlete s Foot Fungal infection Responds well to topical medication Often comes back

23 Ganglion Cyst Fluid filled sac From tendon or joint Benign Usually easy to aspirate

24 Corn Small hard skin lesion Caused by pressure from shoes and/or bone spurs Proper shoes, trimming, and sometimes surgery necessary

25 Fungal toenails Discoloration Often thick with crumbling Can be contagious

26 Wart Virus More prevalent in children Flat due to weight bearing pressure

27 Ingrown toenails Most common big toe, but can occur on any toe Must remove nail spicule for resolution In-office procedure

28 Injuries Contusions Sprains Fractures Tendon tears

29 Contusion Bleeding underneath nail Often accompanied fracture Drain or nail avulsion Possible future nail dystrophy

30 Sprains Lateral sprain most common - inversion injury Often ligaments only stretched RICE, PT, bracing, rarely surgery

31 Ankle Fracture Can be mistaken for sprain Alignment important for optimal outcome Surgery sometimes necessary

32 Surgical repair of ankle fracture

33 Stress Fracture Overuse injury Most common second metatarsal, but can be any Not always seen on radiograph Immobilization

34 Tendon Tears Commonly seen in achilles tendon Explosive push-off injury Weekend warrior Casting and/or surgery

35 Diabetes and Feet Can be prone to infection Skin, nail, and bone changes Decreased sensation Important to monitor foot changes

36

37 Children s Foot Disorders Flatfeet In-toeing Sports injuries Congenital deformities

38 Flatfeet Inherited - not from bad shoes Best treatment - custom foot orthotics Surgery not always necessary

39 In-toeing Inherited Symptoms include tripping and muscle pain Can lead to arthritic pain later in life

40 Children s Sports Injuries Overuse injuries most common Poor shoe gear often responsible Growth plate conditions common

41 Congenital Deformities Birth deformities Usually only cosmetic concern Family needs reassurance

42 Hallux Valgus (bunion)

43 Dr. Woelffer and Nurse Clara relaxing after another day of bad feet!

44 The End

45

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