Diabetic Foot and Prevention
Diabetic Foot is a term that commonly encompasses a number of foot problems related to diabetes mellitus. The reason stems from the fact that their could be abnormalities in the artery leading to its rupture and the neurons could also be affected due to it.
The delay caused in the healing of the wound causes infection and can lead to gangrene. Around ten to fifteen percent of patients suffering from diabetes at some point in their time suffer from some problem related to their foot. Fifty percent of problems related with diabetes are related with foot andthey account for many hospital admissions.
Prevention is better than cure and methods to prevent include frequent check ups to a chiropodist, maintaining healthy life style, usage of diabetic socks and shoes and the most important of all avoiding injury. Some studies suggest that there is very little effect in the usage of custom made shoes.
Injuries to neurons seem to be one reason why shoes custom made for diabetic patients are recommended as this could result in reduction in injuries to the foot.
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Diabetic Foot and Treatment
Treatment for Diabetic Foot requires the expertise of many specialists including diabetes specialists and surgeons. Treatment consists of antibiotics against staphylococcus, streptococcus and anaerobe strains. Removal of skin debris and also arterial revascularisation to increase the flow of blood.It is believed that nitric oxide is highly effective in the healing of wounds due to diabetes. The reason is that that nitric oxide is powerful vasodilator helping in bring oxygen to tissues speeding up healing. Light therapy such as LLLT are also used to treat diabetic ulcers. Hyperbaric Oxygen Therapy is found to be effective and the need to amputate is greatly decreased as this improves healing. The problem with this treatment facility is that it is expensive.
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Podiatric Specialities
Surgical and non surgical practices are employed by podiatrists to treat problems of the foot and the ankle. Podiatrists further in their career sub specialize in a variety of disciplines to provide effective care and treatment. These include
1. Reconstruction of Rear foot and Ankle Surgery: Podiatrists in this sub discipline specializes in the reconstruction of rear foot and ankle damage by accidents.
2. Sports Medicine: Podiatrists sub specializing in this field attend to the general well being of the foot and lower limb of the athletes. Athletes are prone to high injury and requires the service of podiatrists for the general well being of their foot and ankles.
3. Diabetic limb salvage and wound care .
4. Podopaediatrics: This involves the study of the foot and ankle conditions of children.
5. Forensic Podiatry: This involves the study of footprints, footwear, shoe prints and feet associated with crime scene investigations. Careers are with the investigating agencies.
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Diabetic Foot Neuropathy
Diabetic foot neuropathy is a common feature of people suffering from diabetes mellitus. The most common feeling is numbness and other signs include tingling and burning sensations. The problem if left untreated can culminate in foot deformities and foot ulcers. The way to proper well being is wearing the right kind of shoes, proper diet , monitoring of sugar levels and avoiding smoking and drinking. Keeping the foot clean and washing them daily with warm water also provides a level of comfort to the patients. Maintenance should be supplemented with regular visits to the doctors. Usage of lotion and other creams, wearing of specially made shoes for diabetic patients etc are advised for patients undergoing such disease.
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Diabetes Foot Cream
People suffering from foot problems due to diabetes need to keep their foot in good in good hygiene and soft as it is very important in preventing infections. One of the symptoms of diabetes related complications is dry foot and to avoid that lotions are advised as it keeps them soft. Additionally one can use socks specially made for such people along with cream and lotion. The foot should be kept clean and should be washed with warm water and toweled well. Foot cream like Neurelief can provide relaxation from numbness and keep the foot free from infections. The basic use of a foot cream is that it can prevent infections and also provide other protection but it is always advisable to consult a podiatrist.
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Diabetic Foot Wear
Diabetic Shoes are custom made therapeutic shoes and are made so as not to cause any breakage of skin in patients suffering from diabetes. The major use of using such footwear is to decrease the risk of ulcer, callus and gangrenes. Shoes are also provided with orthotics such as arch supports, wedges and heels. These provide support for legs and prevent the happening of injury and improves mobility.
Types of shoes:
Custom molded shoes are shoes that are constructed over a positive model of the wearer’s foot these are made from leather or other material of equal quality and have removable inserts which can be altered / placed as the wearer’s condition demands and also have some form of shoe closure, such as lace or velcro.
Depth shoes are shoes that have a full length heel to toe liner which when removed, provides a minimum of 3 inch of extra depth which can be used to accommodate custom molded or customized inserts which are made from leather or other material and have some form of shoe closure made of lace or Velcro are these are available in full and half sizes with a minimum of three widths.
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Symptoms of Haglund’s Deformation
Haglund’s deformation is a type of deformation occuring in the heels which causes an enlargement of the bone. An inflammation of the bursa called bursitis can develop which can be quite painful.
The symptoms of Haglund’s Deformation include:
1. A noticeable bump on the back of heel.
2. Pain in the area where the Achilles tendon attaches to the heel.
3. Swelling in the back of the heel.
4. Redness near the inflamed tissue.
The symptoms persist if no proper care is taken.
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Causes of Haglund’s Deformation
Haglund’s Deformation also called pump bump and is often seen in women who wear pump style shoes. Achilles tendon if tight can also cause Haglund’s deformation wheras a soft tendon causes less discomfort. High arches also leads to Haglund’s deformity. A highly arched causes the heel bone to be tilted into the achilles tendon which causes this deformity.
Heridity also plays a role in causing Haglund’s deformity . People inherit certain types of foot structure which leads to high arches. Sometimes walking styles can also cause this deformation. Walking on the outside heels causes the sole to bend inwards pressurizing the tendon. Inflammation of the bursa occurs resulting in pain and discomfort.
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Haglunds Deformation
Haglunds deformation is a bonny enlargement at the back of the foot. Pressure due to ill fitting shoes is one of the major reasons cited for this deformation. The major symptom of this deformity is the knot or the bump forming above the heel at the place where it meets the Achilles tendon
. The bursa is inf lammed leading to bursitis. The deformation can be diagnosed by the naked eye but an x-ray report will provide details about the size and other aspects of the disease providing better insight onto the patients profile of the disease.
Swelling may be present and the treatment includes wearing shoes with out any backs or sandals. This decreases the pressure induced thereby decreasing the swelling . other option is surgery if the pin becomes unbearable or if the deformity persists for a longer duration. Surgery involves the removal of a section of the bone leading to a change in the deformation. Rest is advised until the surgery is healed.
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Plantar fasciitis
Plantar fasciitis is an extremely painful inflammatory condition in which the plantar fascia which supports the arches of the foot degenerate due to excess wear and tear. It is formed as a result of excess weight bearing and stress related work. Plantar fasciitis can lead to flat feet. It was formerly called dogs heel and also flip flop disease by podiatrists. Treatment for this disease vary . Usage of anti inflammatory drugs can lessen pain. Quick remedial measures include rolling packets of ice over the affected area and lessening of stress related jobs .
Surgical porcedures can be ineffective as sometimes pain may not subsidice and also while surgery there are chances of the nerve getting damaged. Extracorporeal shockwave therapy is found to be successful in this procedure the area is enflamed leading to increase in blood floew to the affected area. Coblation surgery (aka Topaz procedure) has been used successfully to treat plantar fasciitis which is recalcitrant. This procedure makes use of radiofrequency ablation and the procedure is minimally invasive.
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