Foot and Ankle Center Blog

Posts for: October, 2017

By: The Foot and Ankle Center of Illinois

The Podiatry Institute is a nationally and internationally recognized  non-profit educational foundation that offers a variety of programs conferences, workshops and postgraduate courses for advancing podiatric medicine and surgery.

The faculty members are all volunteers who are committed to ongoing education in the area of foot and ankle surgery.

Last month, Grant Gonzalez. D.P.M., from the Foot & Ankle Center of Illinois, Springfield, IL, taught a Forefoot Cadaver Surgical Course at the Podiatry Institute of DeKalb Medical Center in Decatur, Georgia, with Casey Burchill, D.P.M.

The three-and-a-half day course was aimed at increasing the attendees comfort with performing common podiatric forefoot and basic rearfoot surgical procedures through live surgical observation and hands-on participation. The course included lectures and detailed instruction in surgical procedures for the foot and principles of internal screw compression fixation.

Participants were orthopedic and podiatric surgeons from ten different states across the country.

“We went through the forefoot and explained the details of different cases, normally starting with a lecture followed by a demonstration of the procedure, and then each participant would perform the procedure on their own individual cadaver limb,” said Dr. Gonzalez.

This process was repeated for several deformities including bunions, hammertoes, great toe joint fusion, midfoot fusion, and tailor’s bunion correction.

Additional time was provided to allow for exploratory dissection, and practice of previous procedures.

Dr. Gonzalez has taken time to answer some questions and speak more about his work and the lifelong process of learning.

Why it is important to continue education?

Dr. Gonzalez: Medicine and surgery are constantly evolving and the “standard of care” can change from one decade to another. Some procedures that were commonplace in my grandfather’s days have been completely abandoned today, whereas others have simply been improved.

How are you involved with the Podiatry Institute?

Dr. Gonzalez: All members of the DeKalb Podiatric Surgical Residency program work with the Podiatry Institute during residency, and are trained in medical education and lecturing. After graduating, we become faculty members and are able to lecture at Podiatry Institute Seminars across the country, along with moderating cadaver courses at the Institute. Residents applying for the program certainly understand the additional benefit of graduating from DeKalb and it is quite competitive.

What does it mean for patients to have such highly trained foot and ankle surgeons here at the Foot and Ankle Center of Illinois? 

Dr. Gonzalez:. A surgeon with a greater knowledge base and skillset can offer their patients the greatest variety of treatment options and choose a procedure or treatment plan that is most appropriate for each individual patient, instead of practicing as a technician who uses the same cookie cutter approach for everyone.

Why do you use cadaveric limb?

Dr. Gonzalez: Cadaver limbs create a very realistic training environment mimicking the operating room experience as much as possible. This creates familiarity with the procedure and can hone surgical skills more effectively than alternative methods. As residents at DeKalb, we were able to perform every new procedure on a cadaver before ever doing one in the operating room, which gives additional practice, identifies difficult parts of the procedure and allow optimal planning for the surgery on an actual living patient. We don’t experiment in the operating room; generally every procedure has been fine tuned in the cadaver lab beforehand.      

What is your favorite part about performing surgery?

Dr. Gonzalez: Diminishing pain and improving patient function through reconstructive procedures, whether they be minor or major, is the part that still leaves me in awe during and after every case.

You are a fourth generation podiatrist. How has surgery changed throughout your family timeline?

Dr. Gonzalez: There has been a bigger focus on scar minimization and reducing perioperative pain and swelling control than in years’ past. If I would have told my grandfather (Dr. Frank Siebert, also a Podiatrist) 30 years ago that we would one day have a laser that could reduce perioperative pain and swelling and decrease recovery times, he would have had a good laugh. Keeping people as ambulatory as possible postoperatively has also been a huge focus as it leads to less debility afterwards and reduces the overall recovery time.

The Foot & Ankle Center of Illinois is located at 2921 Montvale Drive, Springfield, and has outreach clinics in Decatur, Taylorville, Carlinville, Shelbyville, and Sullivan, IL.

Click HERE to learn more about Dr. Gonzalez. Contact the center at 217-787-2700.

 


By FOOT & ANKLE CENTER OF ILLINOIS
October 04, 2017
Tags: Foot Pain   Ankle Pain   Joint Pain  

With more than 30 joints in your foot, joint pain may seem like it can come from anywhere and everywhere. Swelling, tenderness, stiffness, redness, bruising or increased warmth--these all can come along with the pain and can be caused by trauma, infection, arthritis, bursitis, gout or structural foot problems. With such an unpleasant litany of symptoms and causes, it's helpful to know a few simple tips to ease your pain before you visit your podiatrist for a full diagnosis.

Joint Pain Treatment

When you first notice any joint pain in your foot and ankle, your podiatrist may initially treat your pain with RICE, which stands for:

  • Rest
  • Ice
  • Compression
  • Elevation

Your podiatrist will also recommend limiting walking and bearing weight on the painful foot. Steroidal anti-inflammatory drugs, such as ibuprofen, can also help to reduce local inflammation and pain. Custom orthotics may also be prescribed to support the foot, particularly if the issue lies in foot mechanics. If your pain is caused by a condition such as gout, lifestyle changes and alterations in your diet may also help reduce or even eliminate your pain.

If you're experiencing immobilizing joint pain in your feet or ankles, your podiatrist is best equipped to determine the cause and recommend the appropriate treatment. What may seem like joint pain could also be something else entirely, such as a stress fracture, or could be caused by an undiagnosed autoimmune disorder, such as Rheumatoid arthritis. Schedule an appointment today to ensure accurate treatment and a speedy recovery!


By John M. Sigle, DPM, FACFAS
Content origianlly featured in the October 2017 edition of Healthy Cells Magazine

As a licensed Nurse Practitioner in Acute Care, Susan has been working 12-hour-shifts in the ER for 25 years. The amount of time on her feet has resulted in a severe bunion.

“I had my bunion for quite a while and seemed to get by with conservative treatments like shoe inserts and custom orthotics,” Susan said.

As the bunion grew, so did her pain.

“I knew it was time to find a surgeon and chose Dr. Sigle because I knew he was an advanced foot and ankle surgeon. During my initial consult we talked about the options. He told me that I was a candidate for a new surgical technique that would speed up my recovery and there would be minimal scarring,” Susan said.

“I didn’t have to use crutches or a cane. I walked out of surgery in a surgical walking shoe and was back to work within two weeks,” Susan said.

The pain, she said, was minimal, but did slightly increase as the work day progressed. She modified her demanding work hours from 12 to 8-hour shifts at first, but within a couple of weeks she had worked her way back up to the 12-hour average.

“I was pain free within a couple of months and able to resume my normal activities like walking on a treadmill and doing jumping exercises. I am totally happy that I did this. My foot looks beautiful and the scarring is on the side of my foot so it’s not really visible. I can’t even tell that I had surgery! Now I am thinking about doing the bunion on my other foot!” Susan said.

Susan is just one of the many patients electing to have Dr. Sigle perform this new bunion surgery.

There are probably over a hundred bunion surgery techniques. They are pretty straight forward: to relieve pain, to remove the bunion and keep it from returning, and to correct the alignment and mechanics of the foot. If done correctly, the appearance of the foot will most likely improve. Unfortunately, traditional practices often result in substantial pain, a long recovery time, and visible scarring. Many people are reluctant to have surgery and modify their normal routines and lifestyles to avoid surgery.

The more traditional surgical methods usually consist of an incision on the top of the big toe joint that extends toward the mid foot. Some techniques include an additional incision between the first and second toe on top of the foot extending to the mid foot. Wires, screws, pins and plates are typically used to stabilize the bones during healing. In the majority of cases, casting or boot immobilization is required along with non-load bearing crutches for 6-8 weeks. Consequently, patients are inactive and not able to return to work during that time at full capacity.

Here is the good news: Other more advanced surgical techniques that are minimally invasive are being used more often than traditional techniques. They are more effective at correcting the bunion condition, minimizing pain, enhance healing and recovery, and minimize scarring. Now, advanced foot and ankle surgeons are combining surgical techniques to achieve both functional and aesthetic results with a high degree of success.

A cosmetic approach with a smaller medial incision is made on the side of the foot that is hidden from the eye. It looks as though there’s never been any surgical work done, even while wearing sandals or being barefoot. Sutures are located under the skin to eliminate scarring and detection. Sutures are dissolvable.

Precise surgical bone cuts are engineered to withstand weight bearing, to realign toes, and to maintain proper foot structure and balance. Using the Swiss Compression Technique, tiny screws are used to fixate surgical bone cuts and to stabilize the realignment. Patients are not required to be put in a cast or on crutches. The Swiss Compression Technique allows patients to become weight bearing immediately after surgery in a surgical shoe. Patients can typically drive the day after surgery.

Most bunion surgery is done under light sedation and a local anesthesia so there is no tube and no hangover from the anesthesia. Surgery is done as an outpatient basis and patients go home the same day. Patients can drive the day after surgery, even if surgery was done to their right foot.

Minimally invasive procedures also minimize edema and pain. There is less internal scarring and damage to the tissue allowing for faster recovery time. Patients are not required to be put in a cast and or on crutches. They can begin walking immediately and, in most cases, wear comfortable athletic shoes within two weeks. Most women are back in their high heels in 12 weeks.

Patients are able to return to work faster and to their normal activities within a much shorter time than traditional bunion surgeries. Now patients can have their surgery done on a Thursday or Friday and return to work within 4-5 days. Although they are not able to make lengthy and demanding walks, they are able to get in and out of a car and walk to their office. They are extremely happy with the way their feet look and feel.

Patients of the Foot and Ankle Center of Illinois are also given an option to undergo MLS Laser Therapy to reduce edema and pain after surgery. Patients who elect to do this generally have faster recovery times.

If you are considering bunion surgery, select the right foot and ankle surgeon who is knowledgeable and experienced to customize a surgical plan that will result in the best outcome for you. Choose a surgeon with experience and one you can trust.

The Foot & Ankle Center of Illinois is located at 2921 Montvale Drive, Springfield, and has outreach clinics in Decatur, Taylorville, Carlinville, Shelbyville, and Sullivan, IL.

Visit www.myfootandanklecenter.com to view literature on the treatment of bunions or to view a short video clip on the new MLS Laser Therapy that is available following surgery. Contact the center at 217-787-2700.