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Ambulatory Foot Surgery

Bunions and Corns

Ingrown Toenails

Diabetic Foot Care

Ambulatory Foot Surgery

What it can mean to you.

Take a few minutes to read the information contained on this page and learn why Ambulatory Foot Surgery is the preferred approach to eliminating foot ailments.

Welcome

You are here because you are experiencing discomfort caused be one or several foot ailments. In some cases, surgery is required to correct the condition and relieve your pain. Surgery, as practiced in this office, does not usually mean overnight hospitalization, incapacitation, or discomfort. The objective of ambulatory foot surgery is to aid the sufferer with a minimum of inconvenience, discomfort and expense. An ambulatory patient is a walking patient. It is our slogan, "the patient who can walk into our office can walk out after surgery."

Ambulatory Foot Surgery - How Does It Differ From Other Surgery?

Many surgical procedures that are performed in a hospital require large incisions. A major factor in recovery time and discomfort is the amount of tissue that has been involved by the incision. Ambulatory foot surgery, in most instances, is performed in an office or an outpatient surgical center. A small incision is made in the patients' skin and a specially designed instrument is inserted into this opening. The entire procedure is performed through this tiny opening. At the conclusion of the surgery, a few stitches may be used to close the opening and a small bandage protects the area. The patient generally leaves the office walking, and in many instances in his own shoes! The condition has been corrected, the patient remains ambulatory and discomfort and prolonged disability have been avoided.

Is It Really An Effective Technique?

Today, ambulatory foot surgery is a developed art. Over 2,000 podiatric physicians and surgeons specializing in this technique are members of The Academy of Ambulatory Foot Surgery, and with each year the number increases. The triangular academy seal depicts its dedication to ambulation, rehabilitation, and education.

Ambulation - The patient who can walk into the surgeon's office can walk out. Rehabilitation - Restoring the patient to good foot health without loss of productivity at the lowest possible cost. Education - Continued research into techniques and instruments for minimal incision surgery.

It is now over thirty years since the original pioneers began the development of this art. They sought the means of ending discomfort and suffering for a wider cross section of the population. They reasoned that if the necessity for hospitalization and prolonged disability was eliminated, more people could afford to avail themselves of podiatric services. As their development progressed they found that it was rarely necessary to incapacitate their patients. Painful bunions, recurring corns, heel spurs, contracted toes and hammer toes were corrected by this new technique and the patients remained ambulatory. Through the years, other interested physicians and surgeons made worthwhile contribution until we have reached today's state of the art. Cost effective, minimal incision foot surgery is a reality and is being practiced in this office.

Your Future Health

We hope this approach makes sense to you and we can start working together to correct your problems. Thank you for the time you've spent learning about us. Now we can start learning about you.

Discover Comfortable, Permanent Surgical Treatment for Ingrown Nails

Millions of Americans suffer from ingrown toenails. Sometimes, the pain is so severe they find themselves missing work and canceling social activities. "Why, then, do they avoid treatment?" you might be asking. the reasons are simple: they do not know a permanent procedure is available, and they are afraid of pain. What they don't realize is that home remedies are often more painful than medical treatment.

The Dangers of "Fixing" Ingrown Toenails At Home If you have recurring ingrown toenails, you know the familiar signs of pain. When your toe is really sore, you'll grab your toenail clippers and try to cut out the corner of the nail. Quite often, the pain continues. This is because the nail might be ingrown all the way along the side, not just at the tip, as shown in the diagram below.



In addition to being painful, home treatments are often dangerous. Here are the risks involved:

Infection which might necessitate more extensive treatment Serious complications in people with circulatory problems such as infection, gangrene, and threatened loss of limb Return of the ingrown nail

The Real Causes of Ingrown Toenails Many people believe that improper trimming causes ingrown toenails, but this is usually not the real reason why ingrown nails occur. The most common causes of ingrown toenails are:

Family history of ingrown toenails Poor choice of shoes, or shoe pressure Curved nails Fungus nail infection Trauma (injury) to the nail

How To Prevent The Return of Painful Ingrown Toenails Now, there is a procedure that eliminates ingrown toenails. First, we will use a painless anesthesia. This new instrument, called the Dermajet, uses air pressure to place xylocaine (a light anesthetic) into your toe. A normal injection can then be done; you feel virtually nothing.

After Dr. Mikos removes the portion of the nail that has grown into the skin, he will use a special chemical to destroy the nail root. In most cases, after surgery, toenails grow normally without imbedding themselves into the skin.

Here's what you will experience during and after surgery, which can be performed in the comfort of our office:

No pain during surgery You will be able to walk immediately You will be able to return to work the same day

Insurance Pays For Nail Surgery At a time when insurance companies are limiting covered surgical procedures, almost all policies pay for ingrown toenail treatment. This is because professional treatment reduces the risk of infection and often eliminates repeat office visits for ingrown toenails that return.

Because you have been diagnosed with diabetes mellitus, you know that your body is impaired in its ability to use and store sugar. In addition to blood sugar impairment, diabetes also causes changes in your body's blood vessels. Sometimes these changes lead to circulation and vision problems. For some diabetic patients, circulation problems become so serious that they actually lose the use of their legs and feet.

Problems As Serious As Gangrene Threaten Diabetic Patients

"Surely," you may be thinking, "No one would let their feet become so neglected that they risk developing a very serious medical problem."

The answer for most patients is "Of course not." Most people who are afflicted with sores that won't heal or wounds that become infected seek prompt medical attention.

But diabetic patients are different. Diabetics often do not know that their limbs are in trouble. Trivial problems such as corns, calluses, toenails and blisters can quickly become serious. Diabetic patients also have a high incidence of developing ulcers, seriously dry or infected skin, and even gangrene.

There are several reasons for this:

Circulation problems: Your blood is composed of white cells, red cells and plasma which are essential for healing. When blood flow to your legs and feet is lessened (as it is in all diabetics), your ability to heal is dramatically reduced. This is how small problems like a blister can quickly become serious. Nerve damage: Diabetes frequently damages the nerves in your feet that respond to pain. Thus, you aren't as sensitive to pain as other people may be, and you often will not feel the discomfort of a beginning foot problem. Motor nerve damage may also cause your muscles to weaken or shrink, thereby promoting foot deformities such as hammertoes or clawfoot. Overly dry skin: Circulation problems and nerve damage both cause dry skin. For diabetic patients, this poses a particular problem because overly dry skin will develop tiny cracks; and you risk infection. Loss of vision: Diabetics frequently cannot see as well as they once could. Thus, it is recommended that you go to a professional for routine nail care, paring of corns, calluses, etc.

Helpful Tips For At-Home Foot Care

You are well-acquainted with the dietary changes you can make to control diabetes. In the same way, there are simple techniques that you can use to limit your risk of serious problems.

Here's what you should do:

Wear comfortable shoes: Well-fitting shoes will protect your feet from injuries and prevent corns and calluses. Avoid walking bare-foot, even at home, to reduce the risk of splinters. Change socks often: Make sure your socks are made of absorbent, nonbonding material. You should be especially aware of holes, as this leaves your foot exposed to injury. Practice daily grooming: Carefully inspect your feet once a day for redness, blisters or irritation. Use a mirror, if you need to. Also, do not try to pare corns, calluses or toenails yourself. Use a moisturizing lotion: By using foot lotion daily, you will keep your skin from becoming dangerously cracked. Follow your doctor's advice: Watch your diet and follow your physician's advice. You are normal if you feel frustrated by these restrictions; but, by getting into normal health care routines, you can keep your spirits up -- and remain healthy!

When To Consult Your Podiatrist

If you are a diabetic, you should see your podiatrist every 3 to 4 months for a routine check-up. Following are other medical problems that signal a visit to your podiatrist:

Toenail changes Bunions Corns or calluses Hammertoes A red or irritated spot Ulcer, blister or infection Dry or cracked skin Any difficulty with grooming

Many of these problems can be remedied without surgery. State-of-the-art advances permit your podiatrist to monitor circulation; treat fungus nails, callus formation, chronic dry skin and poor circulation; and to medically or surgically correct problems if necessary.

Surgery Can Be Safely Performed

If surgery is suggested, diabetics often exclaim "But I thought surgery wasn't safe for me!" The trust is, your physician can prepare you for surgery by keeping certain risk factors within a acceptable range. Also, Dr. Mikos may be able to perform Minimal Incision Surgery, a modern technique that further minimizes the risk of surgery and allows for rapid recovery.

If You Need Our Help

Dr. Ronald A. Mikos has devoted a large part of his practice to educating and treating diabetic patients. He enthusiastically endorses preventative foot care, teaching his patients how to minimize medical expenses and safeguard their health. If you need Dr. Mikos' expertise with diabetic foot problems, call (773) 794-1188, and ask for Beatrice.