Services
Orthotics
The human foot is made up of 26 bones, 33 joints, and more than 100 muscles and ligaments, all working together to allow us to walk. In a perfect world, the front of the foot (the forefoot), the middle of the foot (the midfoot), and the back of the foot (the rearfoot), all work in synchronicity with one another resulting in a perfectly balanced and aligned foot with no digital deformities, arch abnormalities or joint derangements.
Unfortunately, this is not usually the case. In almost all humans, different parts of the foot are negatively influenced by muscles and the tendons attached to them. This causes the foot to function in an abnormal fashion and can lead to foot pain, deformity, impaired ambulation, and arthritis.
Orthotics are custom molded inserts for the shoes that are made to neutralize abnormal foot mechanics and allow the parts of the foot to function in an appropriate manner, thereby reducing or eliminating pain, slowing or arresting deformity progression, and producing a more normal and, hopefully, pain-free gait. While they cannot correct a specific structural deformity already present in the foot, they can help to prevent its progression.
If you would like more information about our Footmaxx® custom-molded orthotics, or if you currently wear custom orthotics and need a new set, make an appointment with Anchorage Foot & Ankle Clinic.
For an informative video about Footmaxx® orthotics, including metascan technology, please click the following hyperlink:
Diabetes
Diabetes is a disease caused by the inability of the body to either make insulin at all (Type I) or to use the insulin that it makes (Type II). Type II diabetes accounts for approximately 95% of all cases of diabetes and diabetes, with cases in children becoming more common.
Insulin allows skeletal muscles and fat tissues to absorb glucose (sugar) from the blood for use as energy. When insulin is either absent or is not utilized, blood glucose levels rise as this uptake of glucose does not occur. The result is hyperglycemia. Poorly controlled diabetes can affect multiple organ systems. It can lead to nerve damage, kidney disease, vascular disease, blindness, ulcerations, infections, amputations, and, ultimately, death.
The nerve damage associated with diabetes, called diabetic neuropathy, can especially affect the feet. With damaged nerves in the legs or feet, a patient might not feel cold, heat, pain, or any cuts and sores. Without intact touch sensation, wounds can develop, progress and become infected. Because diabetes also can decrease blood flow to the foot, open wounds and infections may become difficult to resolve.
Nerve damage can also prevent leg and foot muscles from working properly, which can create problems with foot alignment. At Anchorage Foot & Ankle Clinic, we can help you manage a wide range of diabetes-related foot conditions. Our Anodyne Diabetic Shoe® collection offers shoes designed and constructed to not only protect your feet, but to do so in style. Our Sole Soothers Store offers a wide variety of products for diabetes-related ailments.
While diabetes can be a serious and potentially life-threatening illness, it is manageable. Studies have found that diabetic patients who maintain a healthy lifestyle and keep their blood sugars under tight control have a lifespan that is virtually the same as a healthy non-diabetic patient.
Bunion Deformity
A bunion is a foot deformity that occurs when the long bone behind the big toe (called a metatarsal bone) starts to shift abnormally, moving away from the other metatarsal bones. It visibly appears as a large bump at the base of the big toe and, unfortunately, it can worsen and get bigger over time.
There are many factors that can cause a bunion to develop, and genetics definitely plays a role. (Yes, you can blame your parents and grandparents for this one!) There are a variety of ways that a bunion can be managed without surgery. However, bunions are generally only correctible through outpatient surgery. If you or someone you know has a bunion, please call and schedule an appointment with Dr. Kaufman to discuss which treatment options may be recommended.
If you would like to watch a video on bunion surgery, please click a hyperlink below.
(These videos contain live surgical footage. Viewer discretion is advised.)
Austin Bunionectomy with Screw Fixation
https://www.youtube.com/watch?v=Dt_4R7QWGxQ&t=250s
Lapidus Bunionectomy with Screw Fixation
Neuroma
A neuroma (also sometimes called Morton’s Neuroma) is an inflamed, enlarged, painful nerve in the front of the foot that is usually felt in the ball of the foot. It is oftentimes described as a sharp pain but may also be described as feeling like a pebble or a stone under the foot, or a wadded-up or wrinkled sock under the forefoot. It tends to get worse with activity, and get better with rest and removal of shoes.
There are many factors that can cause a neuroma to develop. They can often be treated without the need for surgery. However, if they do not respond to non-surgical care, surgical removal may be recommended. If you or someone you know may have a neuroma, please call and schedule an appointment with Dr. Kaufman to discuss which treatment options may be recommended.
If you would like to watch a video on neuroma removal surgery, please click the hyperlink below.
(This video contains live surgical footage. Viewer discretion is advised.)
Surgery for Morton’s Neuroma
Plantar Fasciitis (a.k.a. Heel Spur Syndrome)
Plantar Fasciitis is one of the most common problems seen in a podiatrist’s office. The plantar fascia is a very thick, strong band of tissue at the bottom of the foot. It helps to lend support to the arch of the foot when weight bearing. Over time, and for many reasons, the fascia can start to become inflamed where it inserts into the heel bone. This creates heel pain that is usually worse in the morning or after periods of rest, and often improves after a few minutes of walking. However, the pain may return after extended periods of walking or standing. X-rays taken of the affected heel often will reveal a spur extending off the heel bone. (Thus the term “heel spur syndrome”.)
Plantar fasciitis can often be treated without surgery. However, in cases where non-surgical management does not resolve the problem, surgery to release the fascia may be recommended. If you or someone you know may have plantar fasciitis, please call and schedule an appointment with Dr. Kaufman to discuss which treatment options may be recommended.
If you would like to watch a video on surgical plantar fascia release, please click on the hyperlink below.
(This video contains live surgical footage. Viewer discretion is advised.)
Endoscopic Plantar Fasciotomy Surgery
https://www.youtube.com/watch?v=oTLBoxeZoRs
Ingrown Toenails
An ingrown toenail develops when one or both sides of the nail plate starts to curve down into the adjacent edge of skin. This can occur for many reasons, including improper nail cutting techniques, aggressive pedicures, nail deformity or trauma, and even genetic predisposition. An ingrown toenail can be very painful, redness and swelling may develop at the skin edge, and infection can even result requiring antibiotic management.
Ingrown toenails can occur in any age group. They also tend to be three times more common in men compared to women. While there are ways to try and manage an ingrown toenail, it is generally recommended to remove the ingrown nail border, either permanently or non-permanently. It is a minor procedure that can be done in the doctor’s office under local anesthetic.
If you or someone you know may have an ingrown toenail, please call and schedule an appointment with Dr. Kaufman to discuss which treatment options may be recommended.
If you would like to watch a video on removal of an ingrown toenail, please click the hyperlink below.
(This video contains live surgical footage. Viewer discretion is advised.)
Ingrown Toenail Removal with Acid
https://www.youtube.com/watch?v=_X_nFmKmVCI&t=532s
Hammertoe Deformity
A hammertoe is a deformity where one or more of the joints of the toe start to contract, causing the toe to become bent and painful. Patients will often complain of the toes rubbing or becoming irritated inside their shoes. Callouses may also develop over the joints of the toe, or under the metatarsal that sits behind the toe.
Hammertoes can develop for a number of reasons including genetics, shoes, poor foot functioning and arthritis. They can be managed conservatively but are correctible through outpatient surgery.
If you or someone you know may have a painful hammertoe, please call and schedule an appointment with Dr. Kaufman to discuss what treatment options may be recommended.
If you would like to watch a video on hammertoe correction surgery, please click one of the hyperlinks below.
(This video contains live surgical footage. Viewer discretion is advised.)
Hammer toe deformity correction PIP resection Arthroplasty
https://www.youtube.com/watch?v=32sppJsADWM
2nd PIPJ Arthrodesis with Smart Toe Implant
Posterior Heel Spur
A posterior heel spur is a bone prominence that develops in the back of the heel bone. It is caused from a tight Achilles tendon (the big tendon you can see in the back of the ankle that elevates your heel when you walk). As the Achilles pulls on the bone, it can stimulate a reaction in the bone that forms the spur. The spur itself lives inside of the tendon, which can irritate and even damage the tendon over time. It also can cause pain when wearing shoes that have a closed in back. Sometimes redness and swelling may develop, further increasing the pain from wearing shoes.
Posterior heel spurs can often be managed without surgery, but sometimes outpatient surgery is needed to remove the spur and repair any damage to the Achilles tendon, and to relax the tendon so that a new spur does not form later.
If you or someone you know may have a posterior heel spur, please call and schedule an appointment with Dr. Kaufman to discuss which treatment options may be recommended.
If you would like to watch a video on posterior heel spur removal surgery, please click the hyperlink below.
(This video contains live surgical footage. Viewer discretion is advised.)
Achilles Tendon Debridement and Removal of Bone Spur
Flat Foot Deformity
A flat foot is when the arch of the foot is lower than normal or, in severe cases, completely flattened. Flat feet can be congenital (occurring at birth) or they can develop over time (acquired). This occurs when one or more tendons or soft tissue structures supporting the arch of the foot start to dysfunction.
Depending upon the severity of the deformity or the activities in which the patient wishes to participate, the flat foot deformity may cause little or no disability or pain. Often, simple conservative management such as supportive shoes and custom insoles may be all the patient needs. Sometimes physical therapy is ordered as well.
In more severe cases, particularly those that are progressive, painful or debilitating, more aggressive/surgical intervention is required. These are generally reconstructive surgeries that may include both bone and soft tissue procedures.
If you or someone you know may have a flat foot deformity, please call and schedule an appointment with Dr. Kaufman to discuss which treatment options may be recommended.
If you would like to watch a video on common flatfoot reconstructive procedures, please click the hyperlinks below.
(This video contains live surgical footage. Viewer discretion is advised.)
Posterior Tibial Tendon Repair with Flexor Digitorum Longus Tendon Transfer for Flat Foot Correction
https://www.youtube.com/watch?v=1kQsaOfysQk
Medial Sliding Calcaneal (Heel Bone) Osteotomy for Flat Foot Correction
https://www.youtube.com/watch?v=lX-mR6Tf678
Evans Calcaneal Osteotomy
https://www.youtube.com/watch?v=seQWLR6NeYk&t=30s
Ankle Sprains
Ankle sprains are one of the most common sports-related injuries and occur with slightly greater frequency in men compared to women.
An ankle sprain happens when one or more of the ligaments surrounding and supporting the ankle joint become injured or torn. Following such an injury, the ankle may swell or look bruised and, depending upon the severity of the injury, the patient may or may not be able to bear weight on the injured ankle.
Following an ankle sprain injury, the ankle may become structurally unstable (mechanical instability) or it may simply feel unstable without actual structural fault (functional instability). Either of these scenarios can result in long-term problems for the patient, placing the patient at-risk for recurrent ankle sprains, joint stiffness, muscle or tendon weakness, and even post-traumatic arthritis or fracture.
It is important that proper intervention and treatment of an ankle sprain be initiated as early as possible following the injury to reduce the risk for long-term negative outcomes. Often, conservative treatment (non-surgical) is all that is needed to return the patient to full activity. However, in some cases—particularly in competitive athletes or patients with significant injury—surgical management may be necessary to stabilize the ankle, repair or tighten the ligaments and soft tissue structures around the ankle joint, and quickly get the patient back to action.
If you or someone you know has suffered an ankle sprain, please call and schedule an appointment with Dr. Kaufman to discuss which treatment options may be recommended.
If you would like to watch a video on lateral ankle stabilization, please click the hyperlink below. (Please note that the suggested post-operative course discussed in the video may not be the same as that recommended by Dr. Kaufman.)
(This video contains live surgical footage. Viewer discretion is advised.)
Lateral Ankle Stabilization with Internal Brace Reinforcement
https://www.youtube.com/watch?v=_Hsg2ziDSRI&t=547s
Tendonitis
This is a condition where a tendon, which connects a muscle to a bone, becomes inflamed and painful. This can happen from repetitive overuse, specific injury, biomechanical abnormalities, arthritis, or even certain medications.
Treatment for tendonitis varies according to its severity, the tendon(s) involved, the activity level—or desired activity level—of the patient, and the patient’s age. More often than not, conservative (non-surgical) care resolves the problem. This may include various types of injections, immobilization or orthotics. Physical therapy is also common.
In severe cases of tendonitis, or if there is tearing of the tendon, surgical intervention may be needed. This may include removing damaged tendon material, fixing tears and/or cleaning out the tendon sheath.
If you or someone you know may have tendonitis, please call and schedule an appointment with Dr. Kaufman to discuss which treatment options may be recommended.
If you would like to watch a video on tendon repair, please click the hyperlink below.
(This video contains live surgical footage. Viewer discretion is advised.)
Posterior Tibial Tendon Debridement
