Crush Fractures

This past week a women was injured by the beverage cart on a major airline. She was told that she needed to keep her foot out of the aisle, but the beverage cart still hit her. She reportedly has a cut on the top of her foot and will need to have surgery for the injury.

Crush injures can happen in many different ways. You can drop something on your foot, something can step on your foot, or a cart could roll over your foot. Regardless of the source of the injury, the outcome can be a wide range of symptoms depending upon the force of the object and what your foot was on. For instance, if a horse was to step on your foot on a dirt arena, it would have a very different impact than if it stepped on your foot in a pile of hay. Symptoms can range from bruising and swelling, to a cut like this woman or even to broken or shattered bones. Regardless of what the injury looks like, if you are in a great deal of pain, it is important for you to go and see your local podiatrist to have your foot examined. There are many anatomical structures within your foot that can be damaged and they can be fixed best if immediate medical attention is sought.

Once you arrive at the doctor’s office, they will take images of your foot to determine what kind of damage has been done. If no internal damage is found, then you may be given some pain relievers to help with the discomfort and swelling. If it is found though that a bone has been broken, then it is important to assess the type of break and proceed from there. In many instances, your foot can be immobilized with a cast and by keeping pressure off of your foot, your bones will be able to heal in no time. However, in instances such as a shattered bone, surgical intervention will be required to reconstruct your bone and get you back on your feet again.

If you live in the North Andover, Methuen, Lowell or Bradford Massachusetts area and you sustain a crush injury of your foot, our staff would be more than happy to see you and determine the best treatment plan for you.

The Snowboarder's Ankle Fracture

Snowboarding is a sport that has increased in popularity over the past several years due to popular names such as Shaun White and Kelly Clark. It is a sport that allows all of the adrenaline junkies out there to push themselves to new heights. With the ever growing variety of stunts and types of competition, it offers something for every personality. It is also a sport that has seen a wide variety of injuries. One of these is called the snowboarder’s fracture and is a break that occurs in one of the bones in your feet.

A snowboarder’s fracture occurs in the talus, which is one of the bones that help in forming your ankle. It attaches to the main bone in your leg and allows you to have the motions of flexion and extension. The part of the bone that breaks is on the outside of your foot near your ankle. When you are snowboarding, you use a rocking motion, from your heels to your toes, to help you with maintaining speed. When you turn though, you will often lean hard to the outside of your foot while leaning back onto your heels. This can cause a part of your talus to break. Depending on how much force is applied will determine if a small piece is broken off, a larger piece, or if the piece of bone shatters.

A person who has this type of injury will require imaging techniques such as X-Ray to determine how severe their injury is. Until you get to our office it is important to try and keep your ankle immobile. This can be done by using a brace or an ace bandage to hold your ankle in a stable position. In most cases, surgery will be necessary to repair the injury and reattach the fragment of bone. You will then require some time to recover where you have no weight on the foot that has been injured. This can be really difficult for people that lead such an active lifestyle, but in order for that bone to heal it is necessary to not put any stress on the bone. If you don’t follow these guidelines, you can end up with a much worse injury.

If you are a snowboarder that lives in the North Andover, Bradford, Methuen, Lowell or Lawrence Massachusetts area and you sustain an injury to your foot, please keep our office staff in mind. We would be more than happy to help you with your medical concerns and get you back out on the slopes as quickly as possible.

What if my Child has Clubfoot?

Many people have heard the term clubfoot before, but often times it is attributed to third world countries. Clubfoot is a condition that is still prevalent in the United States, but we often don’t see people with it because it is usually treated during infancy. It is a condition that can be very disconcerting for parents, but it is a condition that can be treated. Clubfoot is a condition where your foot is rolled to the outside and your toes are turned in towards the middle of your body.  

Clubfoot can be treated through a series of casting. It is important to start the treatment immediately while the child’s joints can still be corrected. When your child is born, their bones are still being formed and they are cartilage. Cartilage can be readily adjusted but as it becomes bone it is not as easily adjusted. This is why it is important to get the process started right away. The process requires a number of castings that will need to be changed anywhere from daily to once a week depending on the severity. In between the castings, your child’s foot will be manipulated into the correct position. This process will be continued until the foot is corrected or it is decided that you need to operate. X-rays will be taken of your child’s foot to verify whether or not your child’s clubfoot has been corrected.

There are instances when casting does not work to correct clubfoot and surgery needs to be performed. This can be due to the child being too old to where there foot cannot be corrected by casting or the casting just does not work to fully correct all of the components of your child’s clubfoot. In this case, surgery is recommended to give your child the best correction possible.  After casting or surgery is completed, your child will be placed in a special orthotic to maintain the position of their foot for a year.

If you live in the Newburyport, North Andover, Lowell, Methuen or Bradford Massachusetts area and you have a child with clubfoot our staff would be more than happy to help you and your child receive the care your child needs for correcting their club foot.  

Pediatric Bunions

Many children are born with bunions, but at what point is it important for you to seek help for your child? A bunion is a bump that is on the inside part of your big toe. It is a result of one bone bending in one direction and another bone bending in the other. As a result, your bones form an angle to one another and the point of this angle causes a bump. The more that the bones bend away from one another, the greater this bump will become. As this happens, the pressure on this part of the foot will increase when your child is wearing a shoe and can cause the bump to become red and painful.

 In most children, they do not have any pain or problems with their bunions, and so as a result you really don’t need to do anything about them. Unless your child is experiencing pain or discomfort, it is not necessary to correct the bunion. However, if the bunion should begin to cause your child discomfort, then it is necessary to take the proper steps to alleviate the pain. There are several different options depending on the type of bunion that your child has. Noninvasive treatment is always considered first. Some possibilities are orthoses, shoe modifications and padding. Orthoses can be either custom made for the individual or they can be made for an average foot type. The ones for the average foot type are less expensive but they do not work for everyone, whereas a custom orthoses is made for the individual person.

In some children, the bunion will be severe enough that they require surgery. This is typically necessary in children that have a bunion that is progressing rapidly or in children that their bunion is causing them a great amount of discomfort. Surgeries for pediatric bunions need to be put off for as long as possible to prevent the bunion from coming back. Bunions in children have a high recurrence due to them still growing. If you and your child live in the North Andover, Bradford, Lowell, Tewksbury, or Methuen Massachusetts area, and your child has a bunion, our office staff would be more than happy to help you and your child decide on the best treatment plan.  

What Should You Do When A Foreign Object Gets Inside Your Foot?

In a freak accident, a news anchor in Lexington Kentucky had a 3-4 inch piece of wood embedded in his foot that required surgery to remove it and all of its shards. He was rushing through his home that has old wooden floors and ended up with a large piece of wood in his foot. A podiatrist in the area had to do surgery to remove the piece of wood and he has had to have bandages over the area and wear a boot for about the past week.

It is not uncommon to get foreign objects stuck in our feet because the feet come into contact with our surrounding area every day. Most people wear shoes when they go to work or around town, but many of us will go barefoot in our home. This leaves our feet open to whatever is lying around in the house. This can result in stubbing your toe on the furniture, stepping on the children’s toys, or ending up with a nail, fork, or other foreign object either breaking through their skin or ending up lodged in their foot.

Your feet contain many bones, muscles, arteries, veins and nerves. This means that when you get something in your foot, it may be difficult to get it out. This often depends upon how deep the object has gotten into your foot, the angle and the type of material. Something like a needle will be easier than wood because there is not the fear that it may splinter. Regardless, it will be important that once the object is removed, the area will need to be thoroughly cleaned and steps need to be taken to help your foot heal. In many cases, this included some type of antibiotic ointment such as Wound Be Gone, bandaging and padding to reduce the pressure applied to the area. This will allow your wound to heal over and protect your foot from bacteria and germs entering through your foot into your body. Depending on the object and last time you had a tetanus booster; you may need a booster to help prevent the possibility of tetanus.

The most important take home message is that you should be wearing shoes around your home. If you don’t want to wear your sneakers or dress shoes that is fine, but wearing something like house slippers or Crocs is far better than nothing. A pair of shoes serves as your defense from the outside world. Although our skin protects us from many outside things such as bacteria, it is not impermeable to everything. So, it is important that we protect them. However, should you end up with something in your foot, it is important that you visit your local podiatrist who can use imaging techniques to make sure that the object has been completely removed and prevent further infection in the future. If you live in the North Andover, Lowell, Methuen, Bradford,Newburyport or Chelmsford, Massachusetts and find yourself dealing with this kind of situation, our office staff would be more than happy to schedule you immediately and help you get back on your feet.  

What's "Gout" You Down?

Gout is a condition that results from a build-up of uric acid in your blood stream. Although many people may have higher levels and never develop gout, some people will develop uric acid crystals that form gout. Gout is most common in your big toe and is often described as a red hot toe that cannot stand even the weight of the bed sheet. It is swollen, tender, red, and extremely painful. Although this is the most common location, gout has been seen in the ankle, foot, knees etc. The attacks will often times go away on their own, but they are so painful that treatment is often sought. Gout is often a reoccurring condition and so if you have had a case before, then you will most likely have gout again.

There are several medications that your physician can prescribe, both for the short term attack and for the long-term prevention. In the meantime, there are some predisposing factors to gout including excessive alcohol intake, obesity, daily meat and seafood intake and some medications. Although pain relief is very important, it is important that you do not use aspirin because it will exacerbate the condition. Using pain killers like ibuprofen and Aleve however, are fine and will provide you with some relief. It is important to try to avoid excessive amounts of any of these if you or a close family member has a history of gout because gout does have a genetic component. Typically gout can be relieved solely by medications.

It is important that if you suspect gout or you are suffering from any pain in your joints that you seek medical attention. If you are in the Newburyport, North Andover,  Chelmsford, Lowell or Billerica Massachusetts  area and you have been suffereing from any of these symptoms, our office staff would be more than happy to help you determine the cause of your pain and get you back on your feet again. Gout can lead to joint injury leaving you with long-lasting limitations. If the condition is dealt with quickly though, it will have no marked effects on your joints.

Are My Child's Flatfeet Normal?

We have all heard of the trick of walking on the beach and looking at your footprint in the sand. This is supposed to be a good indicate of whether or not your foot has a good arch or not. If you don’t, most of us don’t think anything of it unless our feet are painful. With children though, it is a completely different story, because as a parent, you are very concerned about your children’s health. You count their fingers and toes when they are born, you notice every scratch on their body and you notice when they first steps if their feet are flat. You will be happy to know though that flatfeet are common in children from 1 year of age to 3 years. So, we will typically not do anything for your child but watch them through their development to see if their feet remain flat or if they take on a proper arch. This is because your child’s bones and cartilage are all forming and have not yet reached their final form.

 If your child’s foot does not correct, it can be a result of incomplete bone maturity, those that have no symptoms and those that get worse over time. Flat foot is a result of many different causes including genetics, obesity, neurological causes or bones that are turned more than typical. Non-invasive treatment options will always be looked at first. One of these techniques is orthoses. Orthoses are devices that can either be custom made for the individual or they can be designed for an average foot type. Sometimes, the over the counter orthoses will work great for a person and will relieve all of their symptoms, but for others, they need the custom made ones that are designed for them to make the pain go away and correct their arches. For a lot of patients, this is all that they need to correct their feet and they will have no further symptoms.

In other people, the orthosis may not work and other techniques need to be considered including casting and possibly surgery. The most important thing is that if your child is over the age of 3 and you notice that they still have flat feet, you should bring them in. If you are in the Newburyport, Billerica, Wilmington, Burlington and Chelmsford Massachusetts  our staff would be more than happy to schedule you and your child to meet with Dr. Wachtel. This way, they can be evaluated and have their foot type corrected before it causes long term problems. It is important that the doctor determine which type of treatment is best so that your child can receive the treatment necessary for their condition.

The Truth About Warts

What should you know about plantar warts? Warts are a result of Human Papilloma Virus. This virus enters your body through small cuts in the skin and infects the body. The warts form on the bottom of your feet as a result of the high amounts of pressure. Plantar warts are not a medical emergency, but they can be very painful and bothersome. Plantar warts have nerve endings and blood vessels inside of them which contributes to their pain and they can bleed quite a bit when they are removed.

Most of the time our body is able to fight off the infection on its own and you will never have any visible symptoms. Sometimes though, you can end up with a plantar wart. They are typically raised and will have small dots within it that are a result of the additional blood vessels in it.

The treatment of warts is complicated because our body is not the best at dealing with viruses. Viruses are smart and they tend to evolve over time and have a tendency to outsmart our bodies. Because of this, very rarely will a plantar wart resolve on its own. To treat warts, there are typically two forms of treatment including freezing them off or using acid. Both of these treatments kill off the virus and the surrounding skin. The process is slow and takes several weeks to improve the area. The skin has to regenerate itself and sluff off the dead skin to heal over. The wart will turn black once treated, and It will take several weeks before it will eventually fall off.

Plantar warts are common among children, teenagers and young adults and are nothing to be very worried about. However, if you have recurrent warts or several warts in the same area, this may point towards other underlying systemic diseases including autoimmune deficiencies. These are conditions that your physician can determine what the underlying cause is and treat you for. If you currently have a plantar wart and live in the Newburyport and Chelmsford Massachusetts or the Salem, Windham or Pelham, New Hampshire our staff would be more than happy to help you alleviate your pain associated with your plantar wart and get you back up and going.