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    Welcome to the Patient Information Center! Here you will find information about the most common foot and ankle ailments. Click on any of the issues below to find out more about specific problems and what treatment options are available. Here you will also find links to interesting websites pertaining to podiatry. If you have any questions, feel free to Contact Us through the website or give us a call!

    Common Ailments

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    The path to board certification by the American Board of Podiatric Surgery (ABPS) begins after graduating from an approved podiatric surgical residency program after which our doctors pass a rigorous written examination to become board qualified. Next, doctors spent up to 6 years of their initial practice time collecting various patient cases which demonstrate to the ABPS their decision-making, competency, and skills as a foot and ankle surgeon. After submission of these cases, detailed review, and acceptance to the ABPS, doctors sit for the ABPS oral examination held in Chicago, IL.

    • Dr. Paradoa has satisfied requirements by the ABPS to become board certified in Foot, Reconstructive Rearfoot/Ankle Surgery.

    Our patients can feel confident that they are being treated by a foot and ankle surgeon who has dedicated years of her education, training, and experience to achieving board certification status by the American Board of Podiatric Surgery.
    The American Board of Podiatric Surgery website has a wealth of information about podiatry and the requirements that must be met.

    A Doctor of Podiatric Medicine (DPM) is to the foot and ankle what a dentist is to the mouth, or an ophthalmologist to the eye — a doctor specializing in the prevention, diagnosis and treatment of foot disorders resulting from injury or disease. A DPM makes independent judgments, prescribes medications and performs surgery. The human foot has a complex interrelation with the rest of the body which means that it may be the first area to show signs of serious conditions such as diabetes and cardiovascular disease. Since the podiatric physician is often the first to detect symptoms of these disorders, he or she becomes a vital and sometimes lifesaving link in the health care team.

    The American College of Foot & Ankle Surgeons is a professional society of thousands of foot and ankle surgeons. Their website contains a plethora of information about advances in podiatry and connects its members to share that knowledge.

    FootHealthFacts.org is the official consumer website of the American College of Foot and Ankle Surgeons. This is a wonderful resource of information! From what foot injuries Olympians have suffered from during the 2012 London Olympics to a growing trend in lawn mower accidents, you will find interesting, informative and compelling articles in the world of Podiatry.

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    What is a Talar Dome Lesion?
    Talar DomeThe ankle joint is composed of the bottom of the tibia (shin) bone and the top of the talus (ankle) bone. The top of the talus is dome-shaped and is completely covered with cartilage—a tough, rubbery tissue that enables the ankle to move smoothly. A talar dome lesion is an injury to the cartilage and underlying bone of the talus within the ankle joint. It is also called an osteochondral defect (OCD) or osteochondral lesion of the talus (OLT). “Osteo” means bone and “chondral” refers to cartilage.

     

    Talar dome lesions are usually caused by an injury, such as an ankle sprain. If the cartilage doesn’t heal properly following the injury, it softens and begins to break off. Sometimes a broken piece of the damaged cartilage and bone will “float” in the ankle.
     
    Signs and Symptoms
    Unless the injury is extensive, it may take months, a year, or even longer for symptoms to develop. The signs and symptoms of a talar dome lesion may include:

    • Chronic pain deep in the ankle—typically worse when bearing weight on the foot (especially during sports) and less when resting
    • An occasional “clicking” or “catching” feeling in the ankle when walking
    • A sensation of the ankle “locking” or “giving out”
    • Episodes of swelling of the ankle—occurring when bearing weight and subsiding when at rest

    Diagnosis
    A talar dome lesion can be difficult to diagnose, because the precise site of the pain can be hard to pinpoint. To diagnose this injury, the foot and ankle surgeon will question the patient about recent or previous injury and will examine the foot and ankle, moving the ankle joint to help determine if there is pain, clicking, or limitation of motion within that joint.

    Sometimes the surgeon will inject the joint with an anesthetic (pain-relieving medication) to see if the pain goes away for a while, indicating that the pain is coming from inside the joint.
    X-rays are taken, and often an MRI or other advanced imaging tests are ordered to further evaluate the lesion and extent of the injury.

    Treatment: Non-Surgical Approaches
    Treatment depends on the severity of the talar dome lesion. If the lesion is stable (without loose pieces of cartilage or bone), one or more of the following non-surgical treatment options may be considered:

    • Immobilization. Depending on the type of injury, the leg may be placed in a cast or cast boot to protect the talus. During this period of immobilization, non-weightbearing range-of-motion exercises may be recommended.
    • Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
    • Physical therapy. Range-of-motion and strengthening exercises are beneficial once the lesion is adequately healed. Physical therapy may also include techniques to reduce pain and swelling.
    • Ankle brace. Wearing an ankle brace may help protect the patient from re-injury if the ankle is unstable.

    When is Surgery Needed?
    If non-surgical treatment fails to relieve the symptoms of talar dome lesions, surgery may be necessary. Surgery may involve removal of the loose bone and cartilage fragments within the joint and establishing an environment for healing. A variety of surgical techniques is available to accomplish this. The surgeon will select the best procedure based on the specific case.

    Complications of Talar Dome Lesions
    Depending on the amount of damage to the cartilage in the ankle joint, arthritis may develop in the joint, resulting in chronic pain, swelling and limited joint motion. Treatment for these complications is best directed by a foot and ankle surgeon, and may include one or more of the following

    • Non-steroidal or steroidal anti-inflammatory medications
    • Physical therapy
    • Bracing
    • Surgical intervention

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