Robert Craig Maccabee, DPM Powered by ZocDoc

767 Lexington Avenue New York, NY 11021 Tel.212.223.2277

Sports Medicine

Fractures of the Foot and Ankle

A fracture is a break in a bone. It may be a crack in the bone (a stress fracture) or a complete break; the bones may shift out of place or break the skin. Fractures in the bones of the foot and ankle cause a variety of symptoms and require different treatments depending on the location and severity of the break as well as the patient's overall health.

Fractures of the foot and ankle may occur within the:

Like fractures within other areas of the body, these injuries usually occur as a result of a fall, automobile accident, fight, sports injury or other types of injury, and often cause pain, swelling and bruising. Symptoms tend to get worse while walking.

Fracture Care

We offer specialized knowledge and care for the treatment of fractures. Dr. Maccabee treats your injury every step of the way until it is completely healed. Bone fractures can be diagnosed by physical examination and an X-ray or CT scan. Immobilizing the area is often helpful in relieving pain before proper treatment begins. Treatment for bone fractures depends on the location and type of fracture, as well as the patient's medical history. We take all of these factors into account when developing a treatment plan.

Mild fractures, including stress and greenstick fractures, usually only require the conservative treatment methods of ice, rest and anti-inflammatory medication. Moderate fractures may require splints or braces along with pain medication. The immobilization helps relieve pain and speed up recovery. More severe fractures may require surgical treatment, especially open fractures with wounds that need to be closed.

After the proper treatment is performed, the rehabilitation process begins. It is important to care for your fracture while it heals. Full healing can take several weeks to several months. Dr. Maccabee will advise you on how to care for your fracture and helpful measures you can take to ensure a speedy and healthy recovery.

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Neuroma

A neuroma is a painful swelling of a nerve, usually in the ball or heel of the foot. Symptoms include sporadic pain; burning, tingling or numbness of one or more toes; and a popping sensation when walking. Pain is often soothed by taking weight off the foot or by massaging the area.

In the foot, there are the long bones (metatarsals) and thin nerves running between them. The nerves split in a Y-shape when they reach the toes. If the metatarsals move abnormally, they can pinch the nerve between them, causing inflammation and, eventually, permanent nerve damage. Morton’s Neuroma is the most common of this type and affects the nerve between the third and fourth toes. Neuromas may also occur after a nerve has been injured, either from a traumatic wound or from damage suffered during surgery.

A physical examination and one or more imaging tests will determine whether the pain is caused by a neuroma or by a condition with similar symptoms such as arthritis, stress fractures, tendon inflammation, tarsal tunnel syndrome and nerve compressions in the ankle or leg. Treatment begins with a combination of cortisone injections to reduce swelling and orthotic inserts to correct problematic metatarsal movement. If the nerve is permanently damaged, the patient may decide to undergo chemical destruction of the nerve, have the nerve surgically removed, or endure the pain.

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Surgical Treatment of Arthritic Deformities, Including Joint Replacement Surgeries

Like any other joint in the body, the ankle can be affected by arthritis, a chronic condition that can cause pain, swelling and stiffness and an eventual loss of motion in the affected area. The ankle is the joint that connects the shinbone (tibia) to the upper bone of the foot (talus). Although the ankle is not affected by arthritis as commonly as other joints like the hand and hip, it is still a serious condition that can cause severe pain for those affected.

Although there are many treatment options available to relieve arthritis pain, some people are so severely affected by this condition that their pain is unresponsive to conservative methods. Long-term, disabling arthritis pain may benefit from joint surgery to reduce pain and restore normal functioning. Joint surgery is typically used as a last resort treatment for arthritis.

Total joint replacement involves removing the damaged bones and tissues and replacing them with synthetic materials to stimulate the natural behavior of the joint. While this is the most complex and advanced procedure, it is very successful and can last for several years. Less complex procedures include arthrodesis, arthroplasty, osteotomy, resection and synovectomy, which relieve pain by removing or repairing damaged joint materials.

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