COMMON FOOT DISORDERS&

SEVEN TIPS FOR BETTER FOOT HEALTH

Dr. David T. SavageBoard Certified Foot Surgery

Anatomy of the Foot

Segments of the Foot

Spectrum of ForefootConditions

• Local (soft corn, callus)• Traumatic (fracture, ulcers)• Biomechanical (bunion, hammer toe,

neuroma)• Infection (infected ingrown nail)• Oncologic (melanoma, bone tumors)• Systemic (arthritis)

Soft Corn:Signs and Symptoms

• Hyperkeratotic lesions on toe(s)• Pain on direct pressure• Pain while wearing shoes• Erythema, swelling• Maceration

Soft Corn:Differential Diagnosis

• Tinea pedis• Verruca

Soft Corn

Interdigital Tinea

Verruca

Ulcerated Soft Corn

Soft Corn:Etiology

• Women's dress shoes• Other tight-fitting footwear• Deformed toes • Bone spur in toes

Soft Corn:Treatment

• Conservative therapy• Patient education• Surgical intervention as indicated

Digital Case

Toe Deformity

Toe Deformity:Symptoms

• Pain• Erythema (Redness)• Edema (Swelling)

Hammertoe

Hammertoe

Hammertoe:Treatment

• Conservative treatment• Surgical treatment

Digital Case

Abnormality of Nail

Melanoma in Nail Bed

Nail Streak of Trauma

Fungal Infection

Granuloma

Hallux (Big Toe) Joint Abnormalities

Swollen Great Toe

Swollen Hallux:Differential Diagnosis

• Bunion• Gout• Fracture: Joint or Sesamoid• Rheumatoid arthritis

Hallux Valgus

Gout

Sesamoid Fracture

Rheumatoid Arthritis

Hallux Limitus

Hallux Limitus:

Conservative Therapy

• Special shoes, padding, inserts• Rigid rockerbottom shoes• Physical therapy• NSAIDs• Patient education

Pain in Ball of the Foot

Pain in Ball of Foot:Differential Diagnosis

• Stress fracture• Callus• Frieberg's infraction• Capsulitis• Bone tumor• Local manifestation of systemic disease• Neuroma• Torn plantar plate

Stress Fracture

Callus

Frieberg's Infraction

Capsulitis

Bone Tumor

Rheumatoid Arthritis

Neuroma

Lesion on Sole:Differential Diagnosis

• Porokeratosis• Callus• Plantar wart• Foreign body reaction

Porokeratosis

Callus

Plantar Verruca

Lesion on Sole:Treatment – Callus

• Debridement• Footwear Consultation• Shoe Padding or Inserts• Surgery

Hot, Swollen Foot

Hot, Swollen Foot:Differential Diagnosis

• Osteomyelitis• Metatarsal stress fracture• Gout and rheumatoid arthritis• Cellulitis• Acute Charcot arthropathy

Osteomyelitis

Metatarsal Stress Fracture

Charcot Foot

Podiatric Foot and AnkleSurgeon: Training

• 4-year program to DPM degree• Residency in surgical specialty

The Podiatric Surgeon

Thank You!!

Tips For Better Foot Health

Question: Often when I buy a new pair of shoes they feel comfortable in the store, but after wearing them only a few hours, they feel unbearably tight. Why does this happen?

Tip#1 – Buy shoes in the afternoon or evening.

• Question: My toenails are thick and discolored, what can I do to make them look better before going barefoot at the beach this summer?

Tip #2 – Consider therapy directed to eliminating the fungus with prescribed oral and/or topical medications.

Tips For Better Foot Health

Tips For Better Foot Health

• Question: I absolutely hate my feet because I can never get them to fit into stylish high heels. I have at least three friends getting married this year and want to be able to wear sexy high heels to all of their weddings. I am contemplating getting that new cosmetic foot surgery that everyone is talking about so that I can slip my feet in to some great new shoes. This surgery is easy, right?

Tip #3: If it is not broke, don’t fix it. It is unwise to have surgery if your feet don’t hurt to begin with and you have no problems walking.

Tips For Better Foot Health

• Question: I am scared to take of my shoes when I am at other people’s homes because my feet often smell badly after they have been in my shoes for an extended period of time. I don’t want anyone to think I smell, so is there anything I can do to eliminate this odor?

Tip #4 There is over 250,000 sweat glands in the foot. Bromhidrosis is the term to describe smelly feet. Closed toed shoes aggravate sweaty feet and set up the perfect environment for bacteria to grow, leading to more odor and more sweat. “Before slipping on shoes, try rubbing cornstarch or spraying antiperspirant directly on the soles of your feet to stop the sweating”

Tips For Better Foot Health

• Question: A few days after I get a pedicure at the nail salon, the area around my big toenail becomes inflamed and really hurts. Why does this happen and is there anything I can do to stop the pain?

Tip#5 It is important to remember to cut all toenails straight across when trimming so that they grow straight and not into the skin around the toes.

Tips For Better Foot Health

• Question:I just bought a new pair of sneakers and I have noticed that after I workout my toes hurt and both of my big toenails are starting to look a little discolored. Why is this happening and how can I fix it?

Tip #6 Make sure that you get your feet measured in a shoe store while standing. Shoe models vary. Don’t rely on the size of the last pair of shoes. You should have a thumbs width of room at the end of the toe when standing. Replace sneakers every 300-500 miles.

Tips For Better Foot Health

• Question: When buying a new pair of sandals this season, what should I look for in a shoe to make sure that they will also be comfortable?

Tip#7 – Material like terry cloth, soft leather and mesh fabrics are great for letting your feet breathe during the hot days and nights of summer. Good mobility. Don’t cause blisters. Ensure that they fit properly and look for ultra-cushioned soles.