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 [...]

Juvenile hallux valgus (bunion)

By |2023-02-28T21:11:26+11:00February 27th, 2023|Bunions|

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 diligent with orthotics and ID wedging from an early age. There is a strong family history of bunions, and the genetic predisposition for the first metatarsal [...]

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, [...]

Anterior Ankle Impingement Syndrome

By |2022-12-13T20:22:09+11:00December 7th, 2022|Ankle pain|

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 trying for many years to have the anterior pain resolved and regain pain-free motion. Many stretching programs have been attempted. However, the patient felt the ankle [...]

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 [...]

Is it posterior tibial tendon dysfunction?

By |2022-12-13T20:23:53+11:00May 5th, 2022|Flat feet, Tendonosis|

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 the medial navicular region radiating slightly proximal. She had been treated for PTTD for many months, including rest, orthotics and physiotherapy with no poor results by [...]

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 [...]

Plantar fasciotomy post-op

By |2022-07-08T15:15:48+10:00February 18th, 2022|Heel pain, Post operative|

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. A patient presented this week with a problem, involving DJD/OA of the left 2nd MTPJ. She is an existing patient, whom I carried out a plantar [...]

Heloma molle/soft corn

By |2022-11-25T15:20:29+11:00February 9th, 2022|Corns|

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 to conservative treatment and can even become infected and scarred. In these recalcitrant lesions, a simple and effective alternative exists. As you can see by the [...]

Post-operative pes planus/flat feet/excess pronation

By |2022-11-06T10:45:35+11:00February 4th, 2022|Flat feet|

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 and her symptoms could not be controlled with orthoses solely. Note the excellent alignment seen both anteriorly and posteriorly. On the anterior images, you can observe [...]

Pes planus

By |2022-09-08T15:04:08+10:00November 19th, 2021|Flat feet|

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 from orthoses, strengthening and stretching exercises, symptoms will resolve. The case below presented in my rooms this week. He has had marked recalcitrant symptoms in his [...]

Chronic heel pain

By |2022-07-08T15:16:09+10:00October 27th, 2021|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 years, including 4 steroid injections in each heel and was actually wearing a CAM/moon boot on his right foot. The patient presented with radiographs and ultrasounds [...]

Osteoid osteoma

By |2022-07-08T15:18:18+10:00October 14th, 2020|Bunions|

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 25-year-old, 4 years ago, with an excellent outcome. He has then presented subsequently in a CAM boot with a 6-month history of severe midfoot pain and [...]

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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