INTRODUCING ARCTIC GRIP FROM VIBRAM.
Patient's who suffer from Achilles tendinitis and/or partial tendon ruptures may benefit from this minimally invasive procedure (PRP) and avoid surgery and its possible complications.
I treated a patient yesterday, who lives in West Babylon, NY 11704 and is suffering from this condition.
Please click on the link below to watch a short YouTube video on this procedure:
If you have this condition or have other foot problems call
Dr. Landy's office to discuss treatment options:
631-669-5440 or 516-938-6000
Os Trigonum Syndrome
What is the Os Trigonum?
The os trigonum is an extra (accessory) bone that sometimes develops behind the ankle bone (talus). It is connected to the talus by a fibrous band. The presence of an os trigonum in one or both feet is congenital (present at birth). It becomes evident during adolescence when one area of the talus does not fuse with the rest of the bone, creating a small extra bone. Only a small number of people have this extra bone.
What is Os Trigonum Syndrome?
Often, people don’t know they have an os trigonum if it hasn’t caused any problems. However, some people with this extra bone develop a painful condition known as os trigonum syndrome.
Os trigonum syndrome is usually triggered by an injury, such as an ankle sprain. The syndrome is also frequently caused by repeated downward pointing of the toes, which is common among ballet dancers, soccer players and other athletes.
For the person who has an os trigonum, pointing the toes downward can result in a “nutcracker injury.” Like an almond in a nutcracker, the os trigonum is crunched between the ankle and heel bones. As the os trigonum pulls loose, the tissue connecting it to the talus is stretched or torn and the area becomes inflamed.
Signs and Symptoms of Os Trigonum Syndrome
The signs and symptoms of os trigonum syndrome may include:
- Deep, aching pain in the back of the ankle, occurring mostly when pushing off on the big toe (as in walking) or when pointing the toes downward
- Tenderness in the area when touched
- Swelling in the back of the ankle
Os trigonum syndrome can mimic other conditions such as an Achilles tendon injury, ankle sprain, or talus fracture. Diagnosis of os trigonum syndrome begins with questions from the doctor about the development of the symptoms. After the foot and ankle are examined, x-rays or other imaging tests are often ordered to assist in making the diagnosis.
Treatment: Non-surgical Approaches
Relief of the symptoms is often achieved through treatments that can include a combination of the following:
- Rest. It is important to stay off the injured foot to let the inflammation subside.
- Immobilization. Often a walking boot is used to restrict ankle motion and allow the injured tissue to heal.
- Ice. Swelling is decreased by applying a bag of ice covered with a thin towel to the affected area. Do not put ice directly against the skin.
- Oral medication. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
- Injections. Sometimes cortisone is injected into the area to reduce the inflammation and pain.
When is Surgery Needed?
Most patients’ symptoms improve with non-surgical treatment. However, in some patients, surgery may be required to relieve the symptoms. Surgery typically involves removal of the os trigonum, as this extra bone is not necessary for normal foot function.
What Is Frostbite?
Frostbite is damage to the skin and other tissue after exposure to very cold conditions, usually below 0.55C or 31F.
Very cold weather makes blood vessels get smaller, affecting blood flow and the supply of oxygen.
Frostbite usually affects areas like the hands, feet, ears, nose and lips, but can affect any part of the body.
Symptoms of frostbite often start with pain from the cold, pins and needles and numbness.
Who is at risk of frostbite?
Those at a greater risk of getting frostbite include:
- Those who take part in winter sports and high altitude sports, such mountaineers and skiers
- People stranded in extreme cold weather conditions
- People with jobs that mean they are outdoors in harsh conditions for a long period of time, such as soldiers, sailors and rescue workers
- Homeless people
- The very young and very old whose bodies are less able to regulate their body temperature
- People with blood vessel damage or circulation problems, such as diabetes and Raynaud’s phenomenon
- People taking medicines that constrict the blood vessels, including beta-blockers, and smokers.
Diagnosis of frostbite
A doctor will examine the affected areas and ask questions about how the parts of the body came to become frostbitten, and how long the exposure lasted.
The damage from frostbite may not be apparent soon after thawing and further checks dome days later may be needed.
Imaging scans, such as X-rays, bone scans or an MRI may be recommended to check for damage beneath the skin.
Long-term effects of frostbite
A person who's had frostbite may recover completely. However, some people may be left with increased sensitivity to cold, numbness, loss of touch and lastingpain in the frostbitten areas,
- First, call for help.
- Keep the affected part elevated in order to reduce swelling.
- Move to a warm area to prevent further heat loss.
- Note that many people with frostbite may also be experiencing hypothermia. Saving their lives is more important than preserving a finger or foot.
- Remove all constrictive jewellery and clothes because they may further block blood flow.
- Give the person warm, non- alcoholic, non-caffeinated fluids to drink.
- Never warm up an affected area if there is any chance that it may freeze again. This thaw-refreeze cycle is very harmful and leads to disastrous results.
- Do not rub the frozen area with snow (or anything else, for that matter). The friction created by this technique will only cause further tissue damage.
- Above all, keep in mind that the final amount of tissue destruction is proportional to the time it remains frozen, not to the absolute temperature to which it was exposed. Therefore, rapid transport to a hospital is very important.
Medical treatment for frostbite
- After immediate threats to the patient's life are addressed, warming up is the highest priority.
- The affected area should be re-warmed by immersing it in warm water.
- Once the affected area has been thawed apply a dry, sterile bandage, placing cotton between any involved fingers or toes (to prevent rubbing).
- Narcotic pain medications may be given because this process is very painful.
- Because dehydration is very common, intravenous fluids may also be given.
- After warming, post-thaw care is undertaken in order to prevent infection and a continuing lack of oxygen to the area.
- Any clear blisters are removed, and the bloody ones are left intact so as not to disturb the underlying blood vessels.
- A tetanus booster is given if needed.
- People with frostbite are admitted to hospital for as long as is necessary to determine the extent of injury and to receive appropriate treatment.
How can I prevent frostbite?
Frostbite can result in serious consequences and prevention is extremely important. If you are planning outdoor activities, check weather forecasts frequently and heed warnings about cold temperatures and possible storms that might strand you in dangerous conditions. Avoid risky situations -- such as hikes or camping trips in cold weather -- that may be beyond your experience level. It is also wise to consult local park staff or other authorities about the weather, terrain, avalanche danger, and other conditions that may interfere with your ability to obtain shelter or emergency help.
To prevent or reduce your risk of frostbite, dress properly in cold temperatures. This includes protecting your hands, feet, nose, and ears. Bundle in warm, layered, and loose-fitting clothes, a hat and scarf or ski mask, warm socks, and mittens (not gloves), and make sure children are properly bundled. Go indoors periodically to warm up. Wet clothing or damp skin can increase your risk of frostbite.
- If you've just arrived in a cold climate from a warmer one, give your body time to adjust before spending extended periods outside.
- Avoid drinking alcohol before or during exposure to cold weather since alcohol may keep you from realising that your body is becoming too cold.
- Avoid smoking cigarettes, which can decrease your circulation and increase your risk of frostbite.
- At the first sign of redness, blueness or whiteness, or pain in your skin, which may indicate that you are becoming too cold or that frostbite is a potential risk, get out of the cold, warm up and protect the exposed skin.
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