Is it really ingrown toenail?

By |2023-10-10T08:57:50+11:00October 10th, 2023|Foot pain, Ingrown Toenails|

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 to me due to her complex medical history; however, she had no history of diabetes, yet had been a long-time smoker. On assessment, there was indeed an [...]

Posterior “ankle pain” (intra-operative images)

By |2023-08-29T09:25:07+10:00August 29th, 2023|Ankle pain, Foot pain|

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 are. The os trigonum had been particularly painful as it was large and had fractured during the initial trauma, plus it was pushing against the flexor [...]

Posterior “ankle pain”

By |2023-08-18T20:06:36+10:00August 7th, 2023|Ankle pain, Foot 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 has had a corticosteroid injection into the ankle joint with no success. There are 3 very specific regions of pain: the anterior lateral ankle the posterior [...]

Second MTPJ arthrosis and capsular interpositional arthroplasty

By |2023-07-10T08:45:59+10:00July 10th, 2023|Foot pain, MTPJ|

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. Please see the left image for decreased joint space, subchondral sclerosis and bony spurring. Range of motion was limited with dorsal jamming and marked crepitus. My [...]

Severed tendon

By |2023-06-25T14:53:13+10:00June 26th, 2023|Diagnosis, Foot pain, MTPJ|

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 ground. She has had previous surgery on this 2nd MTPJ when in her 20s. She can no longer walk barefoot, and it is now leading to [...]

Paediatric rigid flat foot

By |2023-06-14T10:44:39+10:00June 1st, 2023|Bunions, Flat feet, Foot pain, Post operative|

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, his main symptoms were being experienced on the medial longitudinal arch. The non-weight-bearing image was taken on the day of his surgery, but, when he first [...]

Nerve entrapment from early bunion formation

By |2023-06-14T10:45:33+10:00May 18th, 2023|Bunions, Foot pain|

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 anti-inflammatory medication (both orally and topically), orthotics, deflective pads and corticosteroid injection. On examination, the pain was reproducible specifically over the dorsal medial bony prominence of [...]

Bipartite Os Peroneum

By |2023-06-14T10:46:24+10:00April 26th, 2023|Foot pain, Tendonosis|

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 delves into the plantar foot. Most of these are asymptomatic, but, in certain situations, they can lead to symptoms. Symptoms may occur when the fibrous attachments [...]

Subungual exostoses

By |2023-04-26T10:00:43+10:00April 26th, 2023|Diagnosis, Foot pain, Ingrown Toenails|

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 toenail for some time. I find they have a very particular appearance (a firm fibrous/callus on top) and sit just under the nail. Sometimes they can [...]

Minimally-invasive surgery (bunion and lateral hallux IPJ)

By |2023-03-30T21:29:41+11:00March 29th, 2023|Bunions, Corns, Foot pain, Hallux limitus, Keyhole surgery|

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 the lateral hallux and medial 2nd toe, involving pain and a corn formation. The conservative care had failed to provide enough relief. Note the signs of [...]

Fractured bone spur

By |2023-03-30T21:31:45+11:00March 29th, 2023|Foot pain, Hallux limitus, MTPJ|

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 joint became swollen and stiff after the run, and symptoms have slightly settled. The patient has had a generalised ache in the joint for a few [...]

Deep vein thrombosis / venous thromboembolism

By |2023-03-17T09:11:50+11:00March 13th, 2023|Foot pain|

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 aware of when doing any surgery. A risk profile is done for every patient who has surgery carried out by my team. If there are known [...]

Gout or degenerative osteoarthrosis/hallux limitus?

By |2023-02-17T10:10:02+11:00February 15th, 2023|Diagnosis, Foot pain, Gout, Hallux limitus, MTPJ|

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 not seem like your typical gout presentation. He has marked symptoms; however, the 1st MTPJ is never red, hot and swollen. He had blood tests many [...]

1st MTPJ cartilage damage

By |2023-02-11T19:03:45+11:00February 1st, 2023|Bunions, Diagnosis, Foot pain, MTPJ|

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, medication and various splints. No pain relief was achieved, and she noted that the joint was becoming slightly stiff and more symptomatic. X-ray assessment showed a [...]

Posterior heel pain

By |2023-02-01T08:10:28+11:00January 27th, 2023|Ankle pain, Diagnosis, Foot 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 with any enclosed shoes. The area rubs become red and enlarged and can blister. She feels she has exhausted conservative care. She is young and is [...]

Ultrasound in the operating theatre

By |2023-02-01T08:12:23+11:00January 20th, 2023|Diagnosis, Foot pain|

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 skin. It is vitally important to keep plantar skin incisions to a minimum to reduce the risk of creating a plantar scar. Due to weight-bearing forces, [...]

Hallux Limitus / Rigidus

By |2023-03-22T10:39:44+11:00November 30th, 2022|Foot pain, Hallux limitus, MTPJ|

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 crepitus present. The radiograph was reported to have only mild degenerative disease in the joint; however, there are some subtle changes in the position of the [...]

Heloma Molle (interdigital corn)

By |2022-11-25T15:14:36+11:00November 23rd, 2022|Corns, Foot pain, 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 simple to do and produce great results with minimal recovery time. These corns are caused by the skin in the webbing being compressed by the underlying [...]

Tarsal coalition

By |2022-11-25T15:30:14+11:00November 9th, 2022|Foot pain|

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 in the imaging below has had marked foot pain for many years and has consulted various health professionals over the years. One intervention, approximately ten years [...]

Interdigital ulcer success

By |2022-11-25T15:17:05+11:00November 4th, 2022|Corns, Foot pain|

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 on the medial 5th toe that would not resolve. The referring podiatrist arranged an X-ray, and an obvious cause was identified. Past trauma to the PIPJ [...]

Minimally invasive forefoot reconstruction

By |2022-11-06T10:40:28+11:00October 18th, 2022|Foot pain, Keyhole surgery|

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 after images are from a patient I recently performed surgery on. The left image is before, and the right is one-week post-operative. The patient is still [...]

Gout deposits (not bunions)

By |2023-02-28T21:10:11+11:00September 1st, 2022|Bunions, Foot pain, Gout, MTPJ|

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 prophylactic medications. On the clinical images on the left, he does look as though he has bunions, plus he has painful 1st MTPJs that could be [...]

Adult-acquired flat foot (PTTD)

By |2022-11-06T10:41:27+11:00August 4th, 2022|Flat feet, Foot pain, Heel pain|

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 and disability markedly increased. He can no longer carry out weight-bearing exercises, work at his usual job or play with his kids as desired. Conservative care [...]

Calcaneonavicular coalition

By |2022-08-16T13:49:39+10:00July 26th, 2022|Foot pain, Heel pain|

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 chronic markedly painful feet. This patient had a painful lateral rearfoot with no success from conservative care. X-rays were negative, and the patient's biomechanics were not [...]

Freiberg’s Disease/Infraction

By |2023-02-01T08:09:40+11:00June 9th, 2022|Foot pain|

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 a 'neuroma' or 'bursitis'. The treatment interventions have been unsuccessful, and she was referred to me. On examination, her pain was solely focused around a slightly [...]

Minimally invasive fracture fixation

By |2022-11-04T04:25:57+11:00May 23rd, 2022|Foot pain|

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 presented with a painful non-union of the base of the 5th metatarsal. Commonly called Jones fracture, however, this actual fracture is at the margins of a [...]

Post-operative wounds

By |2023-02-11T19:10:03+11:00April 29th, 2022|Foot pain, Hallux limitus, MTPJ, Post operative|

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 was shown she had hallux limitus with an abducted hallux and chronic overload to the 2nd MTPJ. The image on the left is intra-operative and shows [...]

The problems with keyhole bunion surgery

By |2023-02-28T21:10:27+11:00March 24th, 2022|Bunions, Foot pain|

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 good results are achieved. Keyhole surgery, better known as minimally invasive surgery, is very much the "flavour of the month". It does have a place, but [...]

Improvements in bunion surgery

By |2023-02-28T21:10:53+11:00August 3rd, 2021|Bunions, Foot pain|

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. This has all changed now; however, sadly, there still exist many surgeons who have not progressed. This case is a perfect example. This was brought to [...]

Bunion surgery: Modern procedures for quick recuperation and long-term results

By |2023-02-28T21:11:05+11:00May 15th, 2020|Bunions, Foot pain|

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 for small incision, quick recuperation, and research confirms long-term results are achievable. Typically the surgery is day surgery, incisions are much smaller now and recuperation is [...]

Rigid flat feet

By |2022-09-08T15:02:44+10:00May 1st, 2020|Flat feet, Foot pain|

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 may be present and further in-depth investigation should be carried out. In recent months I have had a few children present with markedly painful flat feet [...]

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