We provide a full range of clinical podiatry care, including the treatment of foot and ankle conditions such as ingrown toenails, nail fungus, bunions, hammertoes, sprains, strains and heel pain as well as comprehensive diabetic foot care, wound care and all types of foot and ankle surgeries.
Our Services Include:
Minimal Incision (1-stitch) Surgery
Extracorporeal Shockwave Therapy
Custom Orthotic Devices
You can be assured – we have a commitment to excellence when it comes to the level of care we provide.
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A bunion is seen as an enlargement or “bump” on the inside of the foot near the big toe. Often, the big toe will turn and begin to point toward the second toe. Actually, a bunion forms when one of the long bones of the foot, known as the first metatarsal, becomes dislocated toward the other foot. The problem is often aggravated by narrow shoes, and a callus often forms on the side and underneath the bone and on the side of the big toe. The corrective procedure most often performed at Laser Foot Surgery Center is as follows:
An incision approximately 1/8 inch in length is made over the “neck” of the first metatarsal bone, and using a tiny drill, a small cut is made across the bone enabling the doctor to reposition the top 1/3 of the bone to a straight position. Also, the area of the metatarsal bone where the bump was located is smoothed down. It is also necessary in most cases to “lengthen” one or more of the tendons (muscle attachments) to the big toe. In case of severe bunions, it may also be necessary to make a second cut in the bone of the big toe in order to further straighten that toe. It is usually necessary to wear a post-surgical shoe for 3 to 4 weeks after this procedure is performed with the bandage changed once a week.
Custom Orthotic Devices
The VFAS process is different because the fitting and manufacture is done while you stand with your full weight on the FootAligner, giving a more accurate, comfortable fit. It makes sense that to address your pain and alignment issues, your practitioner should first correct the alignment of your feet while your body is bearing the loads that occur when you are standing. This way your practitioner can be certain that the shape of the finished orthotics will be as they are intended – an exact fit for your feet.
Some indications for Custom Foot Orthotic Devices which can be make for adults and children are:
Heel and Arch Pain
Flat Feet (fallen arches)
High Arched Feet (raised arches)
Out-toeing (duck-type walking)
Pain on the Ball of The Foot
Some Callous Problems
Diabetic Ulcers and Pressure Sores
"The best part about the Orthotic Lab is the patient gets
to take home their orthotics the same day."
Question: When is a bunion not a bunion?
Answer: When it’s an arthritic big toe joint.
The normal range of motion for a big toe joint is 65 to 75 degrees of dorsiflexion (upward movement) and 30 to 35 degrees of plantarflexion (downward movement). When this movement is restricted due to deterioration of the cartilage in the big toe joint and/or the formation of arthritic bone spurs around that joint, the condition is called hallux limitus (limited big toe joint movement).
In more severe cases when the big toe joint is unable to move at all, the condition is called hallux rigidus (rigid big toe joint).
Many podiatrists and orthopedists treat these conditions by removing some of the bone(s) in the big toe joint and inserting “joint implants” which can be made out of plastic, metal, or both. Laser Foot Surgery Centers strongly recommends against the insertion of these devices in the foot.
For most cases of hallux limitus, a minimally invasive procedure called a Valenti Arthroplasty can be performed through a tiny incision to remodel the arthritic spurs and big toe joint, allow an improved range of motion. At right are illustrations of this procedure before and after treatments. For more severe cases, such as hallux rigidus, a small portion of the base of the great toe can be removed in a technique known as a Keller Procedure.
Both of these procedures can be performed on an outpatient basis at the State-of-the-Art offices of Laser Foot Surgery Center.
A Tailor’s Bunion (bunionette) is seen as an enlargement or “bump” on the outside of the foot near the little toe. Actually a tailor’s bunion forms when one of the long bones of the foot, known as the fifth metatarsal, becomes dislocated towards the outside of the foot. The problem is often aggravated by narrow shoes, and a callus often forms on the side and underneath the bone.
The corrective procedure most often performed at Laser Foot Surgery Center is as follows:
An incision approximately 1/8 inch in length is made over the “neck” of the fifth metatarsal bone. Then using a dental-type drill, a small cut is made across the bone in this area enabling the doctor to reposition the “head” of the metatarsal. Thus, the part of the bone causing the “bump” is repositioned and realigned back inside the foot in the normal anatomical position.
It is usually necessary to wear a post-surgical shoe for 2 weeks after this procedure is performed.
A callus is an area of thickened skin located on the bottom of the foot, in most cases on the ball of the foot and/or heel. The most common cause of calluses on the ball of the foot is a “declination” of one or more of the long bones of the foot called metatarsal bones of which there are normally five in each foot. Since one or more of these metatarsal bones is/are lower than the others, the bone(s) bear more weight. A callus forms under the end of the metatarsal bone in order to protect the bone from trauma. In the case of some severe calluses, a small core or “nucleus” can be found within the callus and if present, the patient usually feels as though he/she is walking on a small pebble. The procedure most often performed at Laser Foot Surgery Center is as follows:
A small incision (approximately 1/8 inch) is on the top of the foot at the neck of the affected metatarsal bone. Using our special drill, a small cut is made across the metatarsal bone and the metatarsal head is repositioned toward the top of the foot enough to redistribute the weight. If the callus has a “nucleus,” this is removed from the bottom of the foot with a laser and is sent to our pathology lab for analysis. In most cases, this “nucleus” is a “Porokeratoma” or a benign “plugged sweat gland.”
Hammer Toes occur when the tendons and ligaments around the toes become contracted and the toes take on a “claw-like” appearance. The problem is aggravated when the toes come in contact with the top of a shoe causing “corns” to form on the tops of the toes. In severe cases, a callus can also form at the end of one or more toes. The most common method of correction at Laser Foot Surgery Center is as follows:
The tendon (muscle attachments) on the top and bottom of the toe are “lengthened.” Then, using a special drill, a small cut is made across one of the joints and/or the bones in the toe, allowing the joint to be realigned, and thus the toe straightened. After these procedures are performed, it is usually necessary for the patient to wear a post-surgical shoe for one week.
A soft corn forms between the toes when the bony prominence known to doctors as the “condyle” of a toe rubs against the condyle of the adjacent toe while walking. In an attempt to protect the body, nature builds up a layer of thickened skin (a soft corn) to cushion the bony prominences. The moisture between the toes keeps the thickened skin somewhat soft, thus the name “soft corn.” If left untreated, the corns become quite painful. Although soft corns can form between any two toes, they are most often found between the fourth and fifth toes. The most common procedure used to correct soft corns at Laser Foot Surgery Center is as follows:
A small incision is made on the top of the affected toe and, using a small drill, the condyles are smoothed down so that these prominences will not rub against one another. It is usually necessary to wear a post-surgical shoe one week after the procedure is performed.
The most common cause of thick toenails is a fungus infection similar or identical to the fungus that causes “athlete’s foot.” The nail usually takes on a yellowish cast and may be difficult to cut. The problem usually becomes painful when closed shoes are worn since the thick nail is pressed down into the skin underneath. Although the big toe (hallux) is most commonly affected, the nails of the other toes are also often involved.
In some cases, this problem may be best treated with oral and/ or topical antifungal medicine. In other cases, Laser surgery may be the best option. There are two corrective methods commonly used at Laser Foot Surgery Center. The more common one involves aiming the Laser at the nail plate and nail root in an effort to kill the fungus germs so the nail plate will grow out normally.
In more severe cases, the affected thick toenail is removed and a chemical and Laser beam are used to dissolve the entire nail root so that the thickened nail will not grow back. No skin incisions are made using either technique.
Ingrown toenails are one of the most common conditions we see in our offices. The problem is just what its name implies. The nail plate is too large for the under covering or bed and one or both sides are pressing into the skin. Ingrown nails can result from several possible causes such as improper cutting, abnormal nail structure and localized injury to the plate. The appearance of the toe involved may range from a sensitive redness and slight inflammation to a full-blown infection of the toe with pus and bleeding usually evident. The object of course, is to prevent the infectious stage from taking place and to remedy the problem earlier in its development.
How do you treat them?
Adequate prevention of ingrown nails can be accomplished in most cases by proper trimming and judicious self-care. The nail plate should be carefully trimmed so as to follow the fleshy curve at the end of the toe. Under no circumstance, should a sharp instrument be used or inserted to cut diagonally back into the corners of the nail. Leaving a jagged nail edge, a loose piece, or inadvertently cutting the skin can predictably lead to problems. In those cases where injury has occurred with a subsequent ingrown nail, professional assistance by a foot specialist is suggested. The doctor is well trained and equipped to treat such a problem and with little to no discomfort to the patient.
Ingrown nails may seem simple enough but in actuality have sidelined many a person from his or her daily activities. These annoying and painful nail conditions are frequently encountered in various athletic activities. Soccer, jogging, racquet sports, football, basketball, and baseball all involve running and often lead to digital problems such as ingrown nails. Antibiotic medication, disinfectant soaks, and inactivity are not the total solution. It is essential to reduce and/or remove the offending spicule or nail edge that is causing the problem. Sometimes this can be done to give temporary relief or attempt to permanently correct the condition.
Morton’s Neuroma occurs when one of the nerves on the bottom of the foot becomes “pinched” between two adjacent metatarsal bones or the base of the bones of two adjacent toes. Fibrous tissue builds up around the nerve and the condition generally worsens. Patients generally experience sharp pain on the bottom of the end of their feet radiating into two adjacent toes, most frequently the third and fourth toes. Conservative treatment includes ethyl alcohol injections, cold-water soaks, and sometimes orthotic arch supports to control motion of the foot. Surgical treatment is indicated if these fail and involves removing the inflamed section of nerve via Laser. This procedure can usually be performed on an outpatient basis at Laser Foot Surgery Center.
EPAT “Shock Wave” Treatment for Heel Pain
Extracorporeal Pulse Activation Treatment (EPAT) is a remedy that uses “pressure waves” to increase blood flow to the soft tissue that is being treated. This accelerates the natural healing process considerably. The blood brings the essential nutrients needed for your cells to repair themselves and eliminate the damage. As your feet heal, they experience less pain and you are able to return to your normal activities. Studies show this is highly effective for treating persistent tendon pain, like in plantar fasciitis or Achilles’ tendinitis, though other soft tissues in the foot have also benefited from it. Some literature even suggests it could be useful for stimulating better recovery in fractures or slow-healing joint fusions.
The EPAT is suggested after the doctor at Laser Foot Surgery Centers has had a chance to examine your feet and your pain thoroughly. If your discomfort is severe and persistent, this remedy may be a good fit for you. At your appointment, gel similar to that used for ultrasounds will be applied to the affected area of your foot. A wand or applicator is moved gently in circles over the area experiencing pain. The device pulses waves of energy into the tissues, stimulating their natural healing processes. The whole procedure is relatively quick—most last about fifteen minutes. Generally, the pain is taken care of after three treatments, though more may be necessary depending on your condition. Studies have documented up to 80-90% success rates for relieving soft tissue pain in the feet and ankles using this technology.
Heel pain is usually caused by acute or chronic inflammation of the plantar fascia, a ligament-like structure located on the bottom of the foot. Inflammation of the plantar fascia (plantar fascitis) can be caused by a heel spur (pointed to by arrow in picture below) or by gout, arthritis, obesity, and other local and systemic diseases. Heel pain can frequently be treated by such conservative methods as orthotic foot supports, cortisone injections, oral anti-inflammatory medications, and weight loss, if indicated. A new conservative treatment called EPAT (shock wave therapy) may also alleviate the pain without surgery. When conservative treatment fails, surgical intervention may be necessary. In most cases, the surgical treatment can be performed minimal invasive in the modern facilities of Laser Foot Surgery Centers.