This content is intended for healthcare professionals only
Is it really ingrown toenail?
Blog's main page The image is of a patient who presented at my rooms recently with a markedly painful left hallux "ingrown toenail" unresponsive to treatment. The patient was referred [...]
Posterior “ankle pain” (intra-operative images)
Blog's main page These are intra-operative images taken during the surgery to remove the painful ossicles discussed in my previous article, Posterior "ankle pain" Note how large the removed bones [...]
Posterior “ankle pain”
Blog's main page This active 25-year-old has presented with marked "ankle pain" following all activities. He remembers a severe inversion sprain when he was a child and informs me he [...]
Revisional bunion surgery: subtle points
Blog's main page The images may appear relatively straightforward on initial inspection. However, some crucial points can allow revisional, or any, bunion surgery to have a greater chance of long-term [...]
Second MTPJ arthrosis and capsular interpositional arthroplasty
Blog's main page This was a very symptomatic 2nd MTPJ that had progressed for many years. Conservative care has been exhausted, and the patient was referred for a surgical consultation. [...]
Severed tendon
Blog's main page This patient presented with a painful enlarged 2nd MTPJ, but her main concern was the fact that the associated 2nd toe is "floppy" and catches on the [...]
Advances in neuroma surgery
Blog's main page Neuromas are one of the most common conditions seen by a podiatric surgeon. The image is of a recent case, showing how small the incision can be [...]
Paediatric rigid flat foot
Blog's main page This 16-year-old had been struggling since he commenced walking – marked and multiple symptoms on the foot, including lateral midfoot and rearfoot pain, and bunion formation. However, [...]
Minimally invasive metatarsal osteotomy (keyhole surgery)
Blog's main page This is a patient who is approximately eight months postoperative from an Austin/chevron bunionectomy and correction of plantar plate pathology with medial drift of the 2nd, 3rd [...]
Nerve entrapment from early bunion formation
Blog's main page This lady presented with marked shooting pain in the right dorsal medial 1st MTPJ. She has endured this pain for approximately 12 months, with little relief from [...]
Ankylosed DIPJ and interdigital corn
Blog's main page This patient, who was referred to me for an opinion, had a markedly painful corn on the medial 5th toe that was becoming more symptomatic. On the [...]
Bipartite Os Peroneum
Blog's main page Approximately 10% of the population have Os Peroneum, an accessory bone in the peroneus longus tendon. It is typically located adjacent to the cuboid as the tendon [...]
Subungual exostoses
Blog's main page This is one of a few subungual exostoses I see regularly throughout the year. Often when I see these cases, they have been treated as an ingrown [...]
Minimally-invasive surgery (bunion and lateral hallux IPJ)
Blog's main page The images are from a case that underwent surgery a few weeks ago. The patient had a painful 1st MTPJ, but the main symptoms were felt on [...]
Fractured bone spur
Blog's main page This patient presented in early March with a history of a sudden severely inflamed and painful right 1st MTPJ after a run completed the previous month. The [...]
Deep vein thrombosis / venous thromboembolism
Blog's main page Complications can occur with all surgery, some more serious than others. Deep vein thrombosis (DVT) / venous thromboembolism (VTE) is something that all podiatric surgeons must be [...]
Juvenile hallux valgus (bunion)
Blog's main page This case shows just how strong genetics can play in the development of bunions. This is the foot of a 16-year-old. The parents and podiatrist have been [...]
Gout or degenerative osteoarthrosis/hallux limitus?
Blog's main page This patient presented approximately two weeks ago with a history of long-term gout. He is only in his thirties, and his history of supposed gout flare-ups does [...]
1st MTPJ cartilage damage
Blog's main page I operated on this patient last week. She had suffered from marked left 1st MTPJ pain. She had been treated for her bunion via rest, orthotics, mobilisation, [...]
Posterior heel pain
Blog's main page This patient presented with a history of markedly painful posterior heel "bumps". She has noted them for approximately two years. The patient is now having major problems [...]
Ultrasound in the operating theatre
Blog's main page In the last few months, I have had two patients with symptomatic foreign objects located deep to skin. These objects cannot be seen or palpated through the [...]
Anterior Ankle Impingement Syndrome
Blog's main page This case was referred to me as the patient has had a long history of anterior ankle pain with chronic 'tight' right ankle. The patient has been [...]
Hallux Limitus / Rigidus
Blog's main page This patient had marked 1st MTPJ pain that had been recalcitrant to conservative care, including various orthotics. Her range of motion was mildly reduced; however, she had [...]
Heloma Molle (interdigital corn)
Blog's main page These things can be so painful! One of my favourite procedures to carry out is the excision of the interdigital corn. As surgery goes, they are quite [...]
Tarsal coalition
Blog's main page Tarsal coalitions are rare in the general population. I suspect this may be the reason why many of these are missed or wrongly diagnosed. The patient seen [...]
Interdigital ulcer success
Blog's main page The images depict a recent case involving a patient who was referred to me for a markedly painful long-standing interdigital corn. This had recently developed an ulcer [...]
Minimally invasive forefoot reconstruction
Blog's main page There have been many advances in foot surgery over the years, with minimally invasive surgery (MIS) or keyhole surgery being one such modality. The below before and [...]
Gout deposits (not bunions)
Blog's main page This patient has presented with concerns about painful bunions. He also suffers from gout. On questioning, he has been less than conscientious with his taking of gout [...]
Adult-acquired flat foot (PTTD)
Blog's main page This is a patient who presented with a severely debilitating right flat foot. This has been progressing for approximately two years; however, three months ago, the pain [...]
Calcaneonavicular coalition
Blog's main page This is an image from one of my cases last week. The patient is another example of the need to continue your investigations into those long-standing and [...]
Freiberg’s Disease/Infraction
Blog's main page A patient has presented this week with pain in the forefoot. The pain was marked and typical for generalised forefoot pain. Her recent treatment has focused on [...]
Minimally invasive fracture fixation
Blog's main page Surgical intervention is continuously evolving. Minimally invasive surgery, or keyhole as it is commonly known, has progressed markedly over recent years as this case depicts. This patient [...]
Is it posterior tibial tendon dysfunction?
Blog's main page An astute podiatrist referred this patient to me recently with a history of treatment for supposed posterior tibial tendon dysfunction (PTTD). The patient has been symptomatic on [...]
Post-operative wounds
Blog's main page The images show how a foot can look at six weeks post-op. This patient had chronic painful 1st and 2nd MTPJs. On clinical and radiographic imaging, it [...]
The problems with keyhole bunion surgery
Blog's main page There have been marked improvements in bunion surgery over the years to the point where, typically, the procedure is day surgery, the pain is controlled and long-term [...]
Biomechanics of a pathology (bunions and pes planus)
Blog's main page This is a great example of how poor biomechanics impacts foot pathology. This is a case of juvenile bunions with flat feet that has recently been presented [...]
Plantar fasciotomy post-op
Blog's main page Following on from a post (Chronic Heel Pain, October 2021) I shared a few weeks ago about the minimally invasive plantar fasciotomy for chronic recalcitrant plantar fasciosis/fasciitis. [...]
Heloma molle/soft corn
Blog's main page Interdigital soft corns are a common occurrence and in most situations, regular debridement and ID pads can control the problem. Some of these corns can be resistant [...]
Post-operative pes planus/flat feet/excess pronation
Blog's main page The images are of a recent patient who is 4 weeks post-op, following Hyprocure insertion. This patient had the typical signs and symptoms seen with pes planus [...]
Pes planus
Blog's main page Flat feet and the plethora of symptoms associated must be one of the most commonly seen conditions in the office of a podiatrist. Typically with the help [...]
Chronic heel pain
Blog's main page This 24-year-old male presented at my rooms with an 8-year history of bilateral "plantar fasciitis". He had been treated with various modalities and health practitioners over the [...]
Accessory navicular with pes planus
Blog's main page Approximately 2.5% of the population are born with an accessory navicular. There are three types of this condition with type 2 being the most commonly symptomatic. The [...]
Gout
Blog's main page I have carried out surgery on three patients recently who have had moderate bunions on X-ray, however, clinically they appear to be much worse. On X-ray, you [...]
Dislocated 2nd MTPJ
Blog's main page This patient presented recently with a long-standing markedly painful left 2nd metatarsophalangeal joint (MTPJ). Conservative care has been unsuccessful and hence she was referred for a surgical [...]
Motion following hallux limitus surgery
Blog's main page Hallux limitus / rigidus or degenerative osteoarthrosis of the 1st metatarsophalangeal joint (MTPJ) is a very common condition in our practices. Once the condition deteriorates to the [...]
Interdigital corn
Blog's main page This would present at a podiatry practice on a regular occurrence. This case was in a 27-year-old, who had been suffering from a lateral 5th toe corn [...]
Subungual exostosis
Blog's main page I see a regular amount of subungual exostosis throughout the year. Typically they have been treated as ingrown toenails (IGTN) first. The GP and the podiatrist may [...]
Hyperpronation cure
Blog's main page Many of you may have heard of HyProCure (hyperpronation cure) and wondered what it is. The HyProCure website does a very good job of explaining in detail, [...]
Improvements in bunion surgery
Blog's main page Bunion surgery has advanced markedly in recent years. Traditionally the surgery has had a bad name. Procedures involved long recovery, large incisions, marked pain and poor outcome. [...]
Hypergranulation tissue
Blog's main page Just a reminder of the importance of removing hypergranulation tissue during a partial nail avulsion with penalisation (PNA). This young boy had this recalcitrant ingrown toenail for [...]
Platelet Rich Plasma (PRP)
Blog's main page Surgery is often described as an art and science. This case from last week depicts exactly how science can help surgical outcomes. This patient had chronic, marked [...]
Remember functional anatomy and to x-ray
Blog's main page This is an interesting case I have dealt with recently. The patient was sent to me with long-standing, markedly painful and stiff 1st metatarsophalangeal joints (MTPJ). Clinical [...]
Osteoid osteoma
Blog's main page This case will hopefully outline the importance of utilising all your knowledge and not solely relying on other professionals' reporting. I carried out bunion correction on this [...]
Bunion surgery: Modern procedures for quick recuperation and long-term results
Blog's main page A recent review of a very happy bunion patient. This just shows you how foot surgery has advanced over the years, particularly bunion surgery. Modern procedures allow [...]
Rigid flat feet
Blog's main page This post is about assessing patients with flat feet, particularly the paediatric foot. If the foot, particularly the rear foot, is fixed or rigid, something more complex [...]