How to schedule a comprehensive diabetic foot exam

Source: WJBK-TV

The American Diabetes Association (ADA) has designated Tuesday, March 26 as Alert Day.

The day is set aside as a "wake-up" call asking the public to take a Diabetes Risk Test to find out if they are at risk for developing type 2 diabetes. The Michigan Podiatric Medical Association (MPMA) joins the ADA in calling attention to the disease and the life-changing complications that can surface without proper care.  Individuals are encouraged to visit their local podiatrist to receive an important Comprehensive Diabetic Foot Exam.

A Comprehensive Diabetic Foot Exam is recommended for individuals at any risk level of developing diabetes.  Even if the test does not identify early stages of diabetes, it gives each patient necessary information that can be used as a "base-line" record for testing in later years.  Amputations and serious diabetic foot problems can be prevented with early diagnosis and proper care.  While with the Podiatrist, patients can have a meaningful conversation about their particular risk factors and preventative measures.  The exam does not take long and is painless. 

To learn more about Alert Day and the programs of the ADA, visit www.diabetes.org.  Individuals can find the Diabetes Risk Test on Facebook/American Diabetes Association, at stopdiabetes.com or by calling 1- 800 DIABETES (1800-342-2383).

In addition, the MPMA is supporting the ADA's Diabetes Alert Mini Health Expo on Saturday, April 13.  The free event features presentations by health experts;  MPMA advice; healthy eating demonstrations, book store, Kidz Zone, health screenings and more.

Register for the free Expo at diabetes.org/detroitalert or call 888- DIABETES, ext.  6697.  The event will take place at the Southfield Civic Center Pavilion.

The Foot, Ankle & Lower Leg Center office is located in the Las Vegas and the Henderson area, which we have 2 convenient locations to serve you.  To take the first step to better foot health, call today @702-878-2455.  Please visit our website @ www.FallCenter.com where all of your questions may be answered and to schedule your appointment on-line.

When pain or injury occurs, you deserve highly personalized treatment using the most advanced techniques.  At the Foot, Ankle & Lower Leg Center (FallCenter), you’ll enjoy an unsurpassed level of quality care.  Dr. Ricciardi, Dr. Shalev and Dr. McLeod are proud to provide comprehensive solutions for all types of foot and ankle problems. 

Your quality care begins the minute you arrive, as our staff greets you by name and answers your questions.  Our team of foot and ankle specialists will inspire your confidence and their genuine warmth and compassion will earn your trust.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays.  Your treatment plan is designed to resolve your condition without surgery whenever possible.  When surgery is needed, your feet are in the hands of leading foot surgeons with expertise in the latest minimally invasive techniques.  As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs,
Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following treatment programs:  Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Medicine.

Runners: How to Prevent Achilles Tendonitis

Source: Patch.com

If you're a seasoned runner, you're already familiar with the plague called Achilles tendonitis. Achilles tendonitis is a common overuse injury when the tendon becomes inflamed and painful. However, this condition can be prevented. Follow these tips to reduce your chances of getting this injury!

·         Stretch. This really should be a no-brainer, because you stretch before you run, right? One of the main reasons the Achilles tendon becomes inflamed is because it has become tight from lack of proper use. Stretch your calves before and after your workout to prevent the tendon from getting tight. 

·         Check out your technique. No one has a perfect running technique, and we often run the way that is most comfortable for us. Just because you don't have perfect technique doesn't mean you can't have correct technique, however. If you're finding your runs are painful after your run, check out how you're running. If you naturally pronate when you're walking or at rest, it's likely you're going to overpronate when you're running- and overpronation is a leading cause of Achilles tendonitis. An orthotic in your shoe will help correct this deformity. 

·         Get good running shoes. Don't be cheap about your running shoes, especially if you run frequently. You're doing yourself the biggest harm by being frugal. The sharp pain along your Achilles tendon can also be a sign that you need new running shoes. When shopping for new running shoes, find ones that fit your feet the best and especially make sure they are flexible, since rigid shoes allow the Achilles tendon to twist. 

·         Warm up. When a muscle has been jolted into sharp, rapid movement, the likelihood of it tearing it will increase. Make sure you always warm-up before your run with stretching, jogging in place, or doing cardio. 

·         Remain aware. Be aware of when you are in pain, and take care of it immediately. If you're starting a new running regime, be aware of when something doesn't feel right. By being aware, you can track your body and its aches and pains.

The Foot, Ankle & Lower Leg Center office is located in the Las Vegas and the Henderson area, which we have 2 convenient locations to serve you.  To take the first step to better foot health, call today @702-878-2455.  Please visit our website @ www.FallCenter.com where all of your questions may be answered and to schedule your appointment on-line.

 When pain or injury occurs, you deserve highly personalized treatment using the most advanced techniques.  At the Foot, Ankle & Lower Leg Center (FallCenter), you’ll enjoy an unsurpassed level of quality care.  Dr. Ricciardi, Dr. Shalev and Dr. McLeod are proud to provide comprehensive solutions for all types of foot and ankle problems. 

Your quality care begins the minute you arrive, as our staff greets you by name and answers your questions.  Our team of foot and ankle specialists will inspire your confidence and their genuine warmth and compassion will earn your trust.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays.  Your treatment plan is designed to resolve your condition without surgery whenever possible.  When surgery is needed, your feet are in the hands of leading foot surgeons with expertise in the latest minimally invasive techniques.  As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs, Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following treatment programs:  Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Medicine.

Why Your Feet Hurt

It’s probably due to one of these ailments. Here’s how to treat them. For serious pain, see a podiatrist or a podiatric surgeon.

1. Plantar Fasciitis

Feels like:  A sharp pain in your heel (or heels) that’s at its worst when you get out of bed.
What causes it:  Inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of your foot from the heel to the toes. People with all arch types―high, medium, or low―can be prone to this type of irritation, says Carly Robbins, a podiatric surgeon in Columbus, Ohio. Wearing shoes with very flat or very high heels can worsen the problem. “If a shoe doesn’t support the arch, the fascia will be stretched, and that can cause inflammation,” says Robbins. And if your Achilles tendon often feels tight, it can exacerbate the issue.

 Treatment strategies
 

·         Wear structured shoes. Look for pairs that support the arches and enclose the heels. Avoid going barefoot or wearing ballet flats or flip-flops.

·         Stretch your Achilles tendons in the morning. “The plantar fascia is in a relaxed position when you’re sleeping,” says Jacqueline Sutera, a podiatric surgeon in New York City. “Then it gets a jolt of tension when you put weight on it.” Before hopping out of bed, wrap a towel or a T-shirt around your feet and pull the toes back to stretch the tendons.

·         Reduce swelling. Fill a plastic bottle with water, freeze it, and roll it under your foot for a few minutes to soothe the pain.

·         Consider custom orthotics. A podiatrist can make inserts that are molded specifically for your feet, which will control their motion and decrease strain on the plantar fasciae when worn inside shoes.

 

2. Ingrown Toenail

Feels like:  A throbbing sensation, usually on the side of a big toe. It might look red and swollen.
 What causes it: This often occurs when the nail edge grows sideways into the skin of the toe. The pressure on the nail jabs into the surrounding skin, causing discomfort. Wearing shoes that are too tight or too narrow can exacerbate the problem. Cutting toenails incorrectly can also be a culprit.

 Treatment strategies
 

·         Wear pointy-toed shoes infrequently. And if you’ll be walking a lot, carry them and wear shoes with roomy toe boxes until you reach your destination.

·         Keep feet well moisturized. When the skin on your toes gets inflamed, a callus can develop, causing more pressure on the ingrown nail. Keeping skin soft helps alleviate this problem.

·         Cut toenails straight across. And don’t file the corners down. If you get pedicures, be sure the technician follows these rules.

·         See a podiatrist if you suspect infection. Signs include significant swelling and redness. “Don’t try any bathroom surgery,” says Robbins. “Digging around the nail and trying to cut out the ingrown part can lead to more irritation.”

 

3. Bursitis

Feels like:  A bump, usually on the back of a heel.
 What causes it: “This condition can occur when you have a genetically enlarged heel bone,” says Marlene Reid, a podiatric surgeon in Naperville, Illinois. “It’s often called ‘pump bump’ because the bone can become irritated from wearing a shoe like a pump with a stiff back.” When the unforgiving shoe rubs against the bone, you can inflame the bursa, the protective sac of fluid in the tissue.

 Treatment strategies
 

·         Switch to shoes with open backs (or at least with more give) until the irritation subsides.

·         Use a donut pad. Try Dr. Scholl’s Foam Ease Callus Cushions ($4.50 at drugstores). Place one over the bursa to alleviate pressure. At the end of the day, ice the area to soothe the inflammation.

·         Consider seeing a doctor. If the problem causes chronic pain, a podiatric surgeon can remove the bursa and the enlarged part of the heel bone.

4. Stress fracture

Feels like: A tender area, often on the front part of the foot, at the second or third metatarsal (the metatarsals are the long bones in the midfoot).
 What causes it: Repetitive stress on a bone, like walking or running on hard surfaces, especially in shoes that aren’t designed to absorb shocks. “Every summer, I see fractures in women who walk the city sidewalks all day in flip-flops,” says Sutera. High heels can also make you more susceptible to stress fractures, because the heel’s tilt distributes your weight over your foot unevenly.

 Treatment strategies
 

·         See a doctor no matter what. A podiatrist will give you a surgical shoe to wear as you heal (it has a hard bottom that doesn’t allow the affected bones to bend) or advise you to wear some other kind of rigid shoes.

·         Slow down. Stress fractures take four to eight weeks to heal. During that time, you’ll need to stop running and limit your walking to what’s absolutely necessary.

·         Prevent recurrences. Maintain a healthy weight and wear supportive, well-cushioned shoes.

 

5. Bunions

Feel like: Sensitive, protruding bumps, typically at the heads of the big-toe joints.
 What causes them: Bunions are thought to be hereditary, and you can develop them if you have low arches or if you overpronate (your feet roll inward). “As the bump gets bigger, it’s actually your bone moving,” says Robbins. Wearing certain shoes―such as those with narrow, pointy toes and high heels―won’t cause bunions to form, but they can speed their progression.

 Treatment strategies
 

·         Choose the right shoes. Specifically, pick pairs with a wide toe box and a low heel.

·         Try gel pads. Place them over the bunions to help cushion the areas and reduce pain.

·         Consider surgery. If your bunions continue to get worse, become very painful, or begin to affect your feet’s mobility, a podiatric surgeon can realign the joints and shave off the protruding bones.

 

6. Neuroma

Feels like: A shooting pain in the ball of the foot.
 What causes it: Pressure on the nerve tissue in the underside of the foot, usually between two adjacent metatarsals. This pressure irritates the nerves, and the area swells. “Narrow, pointy shoes can put added pressure on an already irritated nerve,” says Robbins.

 Treatment strategies
 

·         Wear shoes with a wide toe box. And stick to those with low heels.

·         Employ anti-inflammatories. Take ibuprofen, or if that’s not enough, see a podiatrist and ask about a cortisone injection, which should bring down the swelling of the nerve immediately.

·         Consider surgery. For a stubborn neuroma that won’t go away with less invasive treatments, a doctor can use cryotreatment, a surgical technique in which a probe is inserted to eradicate the problem nerve.

Source: RealSimple by Sally Wadyka

The Foot, Ankle & Lower Leg Center office is located in the Las Vegas and the Henderson area, which we have 2 convenient locations to serve you.  To take the first step to better foot health, call today @702-878-2455.  Please visit our website @ www.FallCenter.com where all of your questions may be answered and to schedule your appointment on-line.

When pain or injury occurs, you deserve highly personalized treatment using the most advanced techniques.  At the Foot, Ankle & Lower Leg Center (FallCenter), you’ll enjoy an unsurpassed level of quality care.  Dr. Ricciardi, Dr. Shalev and Dr. McLeod are proud to provide comprehensive solutions for all types of foot and ankle problems. 

Your quality care begins the minute you arrive, as our staff greets you by name and answers your questions.  Our team of foot and ankle specialists will inspire your confidence and their genuine warmth and compassion will earn your trust.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays.  Your treatment plan is designed to resolve your condition without surgery whenever possible.  When surgery is needed, your feet are in the hands of leading foot surgeons with expertise in the latest minimally invasive techniques.  As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs,

Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following treatment programs:  Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Medicine.

Get a Leg Up On the Best Surfaces to Run On

Knowing the pros and cons of different running surfaces can help you stay on your feet.

Source: Muscle & Fitness

If you want to get the most from your workouts, variety is not just the spice of life; it's one of the basic food groups. Certainly you know that's true for your weightlifting routine. And if running is your main source of cardio work, then that axiom is equally applicable - especially when it comes to the types of surfaces upon which you pound those peds.

According to Edward A. Schwartz, DPM, a podiatrist who works with many runners at Coordinated Health Systems, the Bethlehem, Pennsylvania-based orthopedic medicine clinic, using many types of running surfaces "helps you vary the different types of stresses that your lower extremities have to accommodate. And that's better overall for your muscle groups and joints." Adds Bob Howard, MS, ATC, head athletic trainer at the University of Connecticut, "Every surface offers a different type of training. You want to be able to switch things up." This will help keep your body challenged but also injury-free. So get out there and mix it up, but before you lace up, know what you are in for. M&F's guide to running surfaces will give you the "dirt" on all levels.

Grounded Advice

Mixing up the surface you run on ensures the best overall fitness results. But each surface comes with its own set of pros and cons. For direction in your selection, we asked Edward A. Schwartz, DPM, and Bob Howard, MS, ATC, lead athletic trainer at the University of Connecticut (Storrs), for their advice. Here are their evaluations:

CONCRETE

Pros: Gives more spring, and typically is a more level surface. Often the only choice for urban runners.

Cons: Concrete has less give and there's more shock that the body has to absorb. There can also be many breaks and shifts in cold weather, which can create safety problems. Most coaches try to keep their runners off concrete as much as possible.

ASPHALT

Pros: Has a little more give than concrete and requires less energy expenditure than softer surfaces. Generally, a pretty level surface with few irregularities. In the summer it may have even more give than in winter, when it can be rock hard. Often the most convenient choice for many runners.

Cons: There's still a lot of force on impact. And there's also more of a slope - you'll want to change which side of the road you run on because one foot has to continually pronate (turn inward) and the other supinate (turn outward) to accommodate the road surfaces. This can create serious foot problems, which can cascade into knee, hip or back problems.

ALL-WEATHER TRACKS

Pros: Polyurethane tracks are level and have even surfaces with some give. The newly designed Tartan tracks are made with materials that offer good traction and a hard but giving surface.

Cons: Depending on the materials used, they can often be either too hard, in which case they don't cushion well, or too soft, in which case they slow you down.

CINDER/CRUSHED LIMESTONE TRACKS

Pros: There's not a lot of force on impact. Overall, cinder is an easy surface for your joints.

Cons: There can be more energy expenditure depending upon how loose the cinders are, which means footing may not always be really solid. They're hard tracks to find.

CLAY TRACKS

Pros: They have a little more give than concrete and asphalt.

Cons: Can be weather dependent, and can be almost as hard as concrete in hot, dry weather. Clay tracks are somewhat hard to find.

DIRT TRAILS
Pros: Cushion well. Try to get half or more of your runs on a typical back road or dirt trail.

Cons: You might have to work a little harder. And you need to watch out for rocks or any other irregularities - they can result in an ankle injury.

WATER

Pros: Very little mechanical stress. You can burn a lot of calories with very little stress on the muscles and joints.

Cons: You won't develop much force in your legs if you do it a lot. There's a learning curve before you can sustain an adequate workout. It doesn't typically put you in the most anatomical position to be running. You have to find a comfortable cadence.

GRASS

Pros: Lots of give, minimal shock. If you go on a hard surface for a few days, try a grassy surface to recover.

Cons: Beware of roots, rocks and holes, which can result in an injury. Watch out for slippery dew if you run shortly after sunrise.

SAND

Pros: Not a lot of force on impact with sand.

Cons: Running on sand requires muscles and tendons of the foot to really work overtime to stabilize the foot, so there's a lot of energy expenditure. Don't be fooled into thinking you can run barefoot, or you may end up with a stress fracture. If running at the beach, run closer to the water's edge, where the sand is more compact and less irregular.

TREADMILLS

Pros: Treadmills are convenient. They're generally in a weather- and light-controlled environment, they give you direct feedback on running speed and elevation, and the surface gives, to some degree.

Cons: It's a somewhat unnatural form of running. You're basically standing still while the surface is moving. You don't typically run on a treadmill, you "hop" because you have to project yourself into the air to let the belt roll under your feet. Try to do most running off the treadmill and save it just for an occasional run.

Putting Your Best Foot Forward

Individual foot structure plays a key role in what kinds of surfaces a runner should select, says Schwartz. "A high arch is not the best shock absorber, so you may not want to do a lot of training on hard-impact surfaces," he explained. "I'm not saying you can't, but you should minimize it." The opposite would be true for someone with a very flexible foot, the kind that over-pronates (rolls inward) upon striking the ground. "You probably don't want to spend a lot of time training on soft surfaces," Schwartz offers. "It would create more stress on muscles and tendons."

The Foot, Ankle & Lower Leg Center office is located in the Las Vegas and the Henderson area, which we have 2 convenient locations to serve you.  To take the first step to better foot health, call today @702-878-2455.  Please visit our website @ www.FallCenter.com where all of your questions may be answered and to schedule your appointment on-line.

 When pain or injury occurs, you deserve highly personalized treatment using the most advanced techniques.  At the Foot, Ankle & Lower Leg Center (FallCenter), you’ll enjoy an unsurpassed level of quality care.  Dr. Ricciardi, Dr. Shalev and Dr. McLeod are proud to provide comprehensive solutions for all types of foot and ankle problems. 

Your quality care begins the minute you arrive, as our staff greets you by name and answers your questions.  Our team of foot and ankle specialists will inspire your confidence and their genuine warmth and compassion will earn your trust.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays.  Your treatment plan is designed to resolve your condition without surgery whenever possible.  When surgery is needed, your feet are in the hands of leading foot surgeons with expertise in the latest minimally invasive techniques.  As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs, Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following treatment programs:  Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Medicine.

Check your feet, save your life

Source: Observer-Reporter.com

People with diabetes who develop foot ulcers are more at risk of dying prematurely than those without this complication.

Dr. James A. Marks, medical director of Washington Health System Wound & Skin Healing Center and Hyperbaric Medicine in Washington, said the devastating complication of early death usually begins with neuropathy and subsequent foot ulcers, which may lead to infection and lower extremity amputation even in the absence of vascular disease.

Although not all diabetic foot complications can be prevented, it is possible to reduce the incidence of amputations and early death through early detection, treatment and prevention. Educating patients along with their family members or care takers to the warning signs of diabetic foot disease and the importance of daily foot examinations and the proper foot care is paramount.

One study has found that 25 percent of 600 people surveyed who had suffered an amputation from diabetes said they should have seen a specialist – such as a podiatrist – sooner. Thirty percent of amputees said that paying closer attention to the warning signs would have encouraged them to visit their doctor before signs worsened.

Marks notes that three conditions make people with diabetes vulnerable to what is called Diabetic Foot Disease. These are neuropathy (damage to the nerves which supply the feet), vascular disease (narrowing of the blood vessels which supply oxygen and nourishment to the feet), and foot deformities. When one or more of these conditions is present, then either infection or minor trauma can trigger a more serious problem.

NEUROPATHY: Those suffering from neuropathy do not have normal feeling in their feet, and this can make them unaware of pain or discomfort, for example, shoes that are too tight and rubbing the skin, or, in extreme cases, scalding bath water. Marks said it is vital to have feet checked for neuropathy at least once a year. Neuropathy can also damage the feet in other ways. It can cause muscle weakness leading to a deformity of the bone structure. It can also cause the skin to be dry, resulting in cracks in the skin. Once a crack develops, it becomes an entry point for infection. The risk of neuropathy developing can be reduced by keeping sugar levels as near normal as possible.

VASCULAR DISEASE: It is known that individuals with diabetes are at a higher risk of developing narrowed blood vessels. That risk is increased by smoking, high blood pressure and by abnormalities in cholesterol. To reduce the risk of vascular disease, Marks said to avoid smoking and work with your doctor to keep blood pressure, cholesterol and blood sugar levels as near normal as possible.

FOOT DEFORMITY: Any deformity of the foot can alter the normal pressure distribution so that some areas are subject to abnormally high pressure points resulting in a foot ulcer. Sometimes the skin’s response to high pressure is to become thicker, resulting in a callus or corn. It is important to have corns and calluses evaluated and treated by a podiatrist who is familiar with diabetic foot problems, before they ulcerate.

As of today, Diabetic Foot Disease has no recognizable color or ribbon. According to Marks, the majority of the general population does not have an understanding of the magnitude of this disease. Approximately 85 percent of lower extremity diabetic amputations are preceded by a diabetic foot ulcer and 15 percent lead to an amputation. It is estimated that the five-year mortality rate among those who have had a diabetic foot ulcer or amputation is about 45 to 65 percent.

In comparison to breast cancer, it is estimated that the five-year mortality rate is approximately 14 to 18 percent. The good news is that the pink ribbon has created an awareness that has resulted in a proactive approach and attitude among the general population, especially in regard to prevention and early detection.

Diabetic Foot Disease is a major problem. While the development of a diabetic ulcer cannot always be prevented, ulceration can be stopped from progressing to a major amputation. Given the challenge of treating this high-risk population, public awareness and comprehensive foot care programs can reduce amputation rates by 45 to 85 percent.

The first step in identifying the patient’s risk factors and preventing lower extremity amputations starts with the newly diagnosed or established diabetic patient, and the family-support group. A patient’s medical team should always include a podiatrist who is trained to offer a preventive foot care plan to prevent ulcers, infections, and amputation in the patient with diabetes.

If you believe you have a diabetic foot ulcer, or you know of someone who does, you can receive a professional consultation with a wound care specialist by calling 702-878-2455.

The Foot, Ankle & Lower Leg Center office is located in the Las Vegas and the Henderson area, which we have 2 convenient locations to serve you.  To take the first step to better foot health, call today @702-878-2455.  Please visit our website @ www.FallCenter.com where all of your questions may be answered and to schedule your appointment on-line.

When pain or injury occurs, you deserve highly personalized treatment using the most advanced techniques.  At the Foot, Ankle & Lower Leg Center (FallCenter), you’ll enjoy an unsurpassed level of quality care.  Dr. Ricciardi, Dr. Shalev and Dr. McLeod are proud to provide comprehensive solutions for all types of foot and ankle problems. 

Your quality care begins the minute you arrive, as our staff greets you by name and answers your questions.  Our team of foot and ankle specialists will inspire your confidence and their genuine warmth and compassion will earn your trust.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays.  Your treatment plan is designed to resolve your condition without surgery whenever possible.  When surgery is needed, your feet are in the hands of leading foot surgeons with expertise in the latest minimally invasive techniques.  As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs,

Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following treatment programs:  Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Medicine.

Smoking and Bone Healing – A Risky Surgical Combination

Imagine being on crutches for weeks following foot or ankle surgery. Imagine the inconvenience and potential loss of income. Then, imagine learning that the bone is not mending. In a study comparing the bone healing rates of smokers and non-smokers, the findings revealed that smokers took nearly 50 percent longer to heal after surgery than non-smokers and the bones of some failed to heal. Foot and ankle surgeons are assessing ways to decrease the dangers posed to smokers during and after surgery and improve their bone health.

Smokers are a high-risk group under any circumstances, but particularly so during and after surgery.  According to foot and ankle surgeons, there are ways to reduce the risks to appropriately treat these patients for the best outcomes possible.

In addition to longer healing times, blood clots, wounds that break open and greater risk of infection are other dangers facing smokers. Perhaps the most serious threat to smokers who have foot and ankle surgery, however, is non-union or failure of the bone to mend. Smokers are four times more likely to experience non-union than non-smokers.

The implications for non-union are serious; they can be costly and time-consuming. In some cases, bones that fail to mend can be treated with a non-surgical bone stimulating device, while some patients require additional surgery. Options include internal fixation using screws or plates to stabilize the bone, external fixation or bone grafts. Bone grafts involve harvesting small sections of bone from the patient or a cadaver and implanting them in the non-healing bone.

What do foot and ankle surgeons recommend for smokers facing surgery? It goes without saying that they’d prefer patients to quit smoking. There hasn’t been a great deal of research on the topic, but some preliminary findings indicate quitting smoking for even a few weeks has a significant impact on bone healing. Surgeons who request that patients stop smoking before surgery sometimes conduct pre-operative tests to look for nicotine in the patient’s system. If nicotine is present, surgery is delayed. 

Several studies cited in The Journal of Foot & Ankle Surgery, published by the ACFAS, reveal the high incidence of bone healing complications in patients who smoke; the Journal articles stress the importance of smoking cessation prior to surgery and the critical role of foot and ankle surgeons play in pre-operative patient education. Surgeons are urged to inform their patients of the dangers posed by smoking and warn them that a choice to continue smoking can result in delayed bone healing, bone non-union and possibly more surgery. With wide access to smoking cessation counseling and assistive methods, educated and motivated patients are able to better position themselves for optimal bone healing.

While education is appropriate and possible in the case of scheduled surgeries, many foot and ankle surgeries result from accidents or injuries that require an immediate response. In those cases, surgeons recommend quitting smoking at least during the recovery period. While no definitive studies currently exist that suggest the best time to quit smoking before surgery, growing interest in the topic will likely lead to more answers. In the meantime, foot and ankle surgeons will continue to strategize on how to help their patients who smoke obtain the best surgical outcomes.

Published by: American College of Foot and Ankle Surgeons

The Foot, Ankle & Lower Leg Center office is located in the Las Vegas and the Henderson area, which we have 2 convenient locations to serve you.  To take the first step to better foot health, call today @702-878-2455, Monday thru Friday, between 9am to 5pm and closed for lunch between 1pm to 2pm.  Please visit our website @ www.FallCenter.com where all of your questions may be answered and to schedule your appointment on-line.

When pain or injury occurs, you deserve highly personalized treatment using the most advanced techniques.  At the Foot, Ankle & Lower Leg Center (FallCenter), you’ll enjoy an unsurpassed level of quality care.  Dr. Ricciardi, Dr. Shalev and Dr. McLeod are proud to provide comprehensive solutions for all types of foot and ankle problems. 

Your quality care begins the minute you arrive, as our staff greets you by name and answers your questions.  Our team of foot and ankle specialists will inspire your confidence and their genuine warmth and compassion will earn your trust.

You’ll receive a prompt and thorough assessment, including on-site diagnostic ultrasound and digital x-rays.  Your treatment plan is designed to resolve your condition without surgery whenever possible.  When surgery is needed, your feet are in the hands of leading foot surgeons with expertise in the latest minimally invasive techniques.  As a result, you’ll be back on your feet and back to your active life as quickly as possible.

Without proper treatment, an injury or chronic condition can keep you from performing even the simplest everyday tasks. To meet patients’ most critical health needs,
Dr. Ricciardi, Dr. Shalev and Dr. McLeod have developed the following treatment programs:  Bunion Solutions, Heel Pain, Diabetic Foot Care and Sports Medicine.