Dr. John and staff believe that informed patients are better equipped to make decisions regarding their health and well being. For your personal use, we have created an extensive patient library covering an array of educational topics. Browse through these diagnoses and treatments to learn more about topics of interest to you. Or, for a more comprehensive search of our entire Web site, enter your term(s) in the search bar provided.
Also visit www.foothealthfacts.org to learn more about what conditions are treated by podiatric foot & ankle surgeons.
Many patients ask:
What is the difference between a podiatric surgeon and an orthopedic surgeon?
The short answer is that both podiatrists and orthopedists perform surgery on the foot and ankle. This is similar to neurosurgeons and orthopedists both performing back surgery or dermatologists and plastic surgeons both performing cosmetic surgery.
Yet there are some distinctions in choosing a podiatric surgeon for your foot and ankle care:
- While being the same 4 year length as osteopathic (DO) and allopathic (MD) medical school and covering the same basic and clinical sciences, the podiatric medical school curriculum provides additional intense focus on conditions of the foot, ankle and lower leg.
- Podiatric surgeons typically complete 3 years of intense residency training in complex foot and ankle surgery. General orthopedists who desire to pursue additional training in foot and ankle surgery typically complete a 1 year fellowship.
- As Fellows of the American College of Foot & Ankle Surgeons, podiatric surgeons remain among a group of the only physicians who are Board Certified in Foot Surgery and/or Reconstructive Rearfoot Surgery.
Ulcers are skin wounds that are slow to heal. In the foot, as prominent metatarsal heads on the plantar (bottom of the foot)are subjected to increased pressure, the skin begins to become callused. When subjected to shearing forces, there is a separation between the layers on this callused skin, which fills with fluid and becomes contaminated and infected. The result is a foot ulcer.
Ulcers are classified in four stages, according to how deeply they penetrate the layers of skin they have broken through.
The four stages of ulcers are:
- Stage 1—Characterized by reddening wounds over bony areas. The redness on the skin does not go away when pressure is relieved.
- Stage 2—Characterized by blisters, peeling, or cracked skin. There is a partial thickness skin loss involving the top two layers of the skin.
- Stage 3—Characterized by broken skin and sometimes bloody drainage. There is a full thickness skin loss involving subcutaneous tissue (the tissue between the skin and the muscle.)
- Stage 4—Characterized by breaks in the skin involving skin, muscle, tendon, and bone and are often associated with a bone infection (osteomyelitis).
The are also four major cause of foot ulcers:
- Neuropathic—Related to the nerves and characterized by a loss of sensation in the feet.
- Arterial—Related to poor blood circulation to the lower extremity. This type of ulcer can be very painful and is usually found on the tips of toes, lower legs, ankle, heel, and top of the foot. It can very easily become infected.
- Venous—Related to compromised veins. These ulcers are often seen around the inside of the ankle and are slow to heal.
- Decubitus—Derived from excessive and prolonged pressure on one area of the foot. The most common type of decubitus ulcer of the feet is bed sores on the backs of the heels of people confined to bed for long periods of time.
Foot ulcers are a common problem for diabetics. Contact casts are sometimes applied to the diabetic foot to relieve the bony prominent areas of pressure, allowing ulcers to heal.