Amputations of the lower extremity take a huge physical, emotional and economic toll on a person...

The Podiatrists at Midtown Podiatry put great effort in preserving limbs should infections or other complications arise that put the limb at risk. Diabetic patients, especially those with neuropathy and/or vascular disease, are at greater risk than average for the types of complications that can lead to amputation. Research has shown that people with a lower leg amputation are twice as likely to sustain an amputation of the other leg within the next 2 years, and are at a greater risk of death.

The economic impact an amputation can cause can be devastating as well. Long periods of disability and the inability to return to previous jobs can cause hardship for many of these patients. The emotional toll can be significant, with depression commonly adding to the disability. It is for all these reasons that limb preservation is a focus, not only for us, but the entire profession of Podiatry.

It all starts with prevention. The new Thompson-Reuters study has demonstrated the positive role regular podiatry visits have on prevention of foot complications of diabetics. Here at Midtown Podiatry, we like to keep a close eye on our diabetic patients. Each begins with a thorough evaluation of the current foot and health status, tailoring treatment and follow up intervals based on individual needs. Should limb threatening complications arise, we have the resources to address those immediately. Our podiatrists have extensive training and experience in treating these complications.

We have access to a team of dedicated medical and surgical specialists at Beth Isreal Medical Center to assist us in managing these often multifaced complications. Our goal is to address these issues quickly and efficiently and return people to function as soon as possible. We know despite the best efforts, some limbs can not be salvaged, and for some situations, amputation is the best alternative. Advances in prosthetics and in medical and psychological management have improved outcomes in those undergoing amputation. Continued podiatry care is essential to preserve the other limb.

With the efforts of those dedicated to limb preservation, we hope to reduce and eventually end these devastating events.

If you or a loved one has diabetes or vascular disease, please make an appointment with the podiatrists at Midtown Podiatry, with locations in Midtown, Union Square, Gramercy Park, Wall Street and Glen Cove, immediately for an evaluation and personalized prevention plan. The limb and life you save could be your own.

By: Paul J. Betschart, DPM

With school sports seasons in full swing, it’s important to remember athletes should never “play through the pain” in their feet. Left untreated, heel pain can lead to difficulty in walking that may require complicated therapy or treatment.

Our Podiatrists at Midtown Podiatry have been seeing an increase in pediatric patients reporting heel pain with sports such as football, soccer and basketball. Obesity is also emerging as another prominent cause of heel pain even with students in physical education class activities. The good news is that kids generally heal very quickly and treatment may be simple if it is taken care of promptly.

Kids undergoing growth spurts are especially susceptible to heel pain starting at age 8 until around age 13 for girls and 15 for boys. The source of the pain is usually the growth plate of the heel bone, a strip of soft tissue where new bone is forming to accommodate adolescents’ lengthening feet. Overuse, repeated pounding or excessive force on the Achilles tendon can cause inflammation and pain.

For many teenagers, the growth plate has completely closed, and heel pain is caused by other conditions such as plantar fasciitis, tendonitis, bursitis, bone bruises or fractures. The only way to know for sure what your child is suffering from is to have them examined.

People have a tendency to give it time and see if the pain goes away on its own, and sometimes that can happen. But if symptoms persist, it’s best to make an appointment at Midtown Podiatry with locations in Midtown, Gramercy Park, Union Square, Wall Street  and Glen Cove to make an accurate diagnosis and to avoid complications.

By: Paul J. Betschart, DPM

NY Giants running back Amad Bradshaw doesn't think his will keep him out of the 46^thannual Superbowl this weekend, even though he did miss 4 games earlier in the season. His fracture is not completely healed and he is hoping that off season rest will heal it without resorting to surgery.

Amad has 1 of the 2 most common 5th metatarsal fractures, the Jones fracture. This fracture is on the outside of the foot, just forward of the normal boney prominence of the 5th metatarsal base. Usually it is caused by indirect trauma, i.e. a twisting injury. The circulation to the bone in this area is not great, so these fractures can be stubborn to heal. Often, they do require surgery. Because of the potential for delayed of non-healing, we recommend most active, athletic patients have this type of fracture treated surgically. The surgery can be performed as an out patient procedure. A period of crutch walking for 4-6 weeks is needed, followed by a walking boot for another 4 weeks. Athletic activity can usually resume in 3 months. Non- surgical treatment usually involves protected weight bearing in a walking boot until signs of healing are seen on x-ray, which can take 2 to 3 months to appear. After 3 months we consider the fracture a delayed union and after 6 months without healing it is considered a non-union. Electromagnetic or ultrasound bone stimulators can be used to treat delayed or non-unions.

These fractures can be quite painful. I guess that makes Amad tough as nails! I don't recommend you continue playing with this type of fracture, but I hope he can put up some good yardage this weekend!

If you or a loved one has sustained a foot injury, even one that was treated elsewhere, make an appointment at Midtown Podiatry with locations in Midtown, Gramercy, Union Square, Wall Street and Glen Cove. We will do everything we can to get you back in the game quickly.

By: Paul J. Betschart, DPM

Its time to say goodbye to 2011 and say hello to 2012! As the New Year rolls in there are many things to get excited about for this upcoming year; the year of the Dragon according to the Chinese, the 46^thSuperbowl, the Presidental Election of the United States and the return of the Olympics! With the Olympics in mind, a particular Gold medalist has been bringing light to a disorder that is frequently looked over. Peggy Flemming, who won the Gold Medal in 1968, has a passion for spreading awareness about PAD, a disorder commonly seen in our office at Midtown Podiatry.

What is PAD?

Peripheral Arterial Disease or PAD is a disorder of the blood circulation of the extremities where the blood flow is decreased. This is usually caused by narrowing of the arteries by a buildup on their interior wall called plaque. This condition resembles clogged pipes in your home. If the pipe is partially blocked, flow is decreased. If the pipe is completely blocked, flow stops. We don't want our blood flow to stop!

How do I know if I have PAD?

Some symptoms of PAD are foot and leg cramps while walking, coldness of the toes, loss of toe hair, nail irregularity and redness when the feet are down. Late signs are rest pain, non healing wounds and gangrene. PAD is easy to identify by one of the podiatrists at Midtown Podiatry. A physical examination will reveal clues and a simple, non-invasive test can give a picture of circulatory health in minutes.

What can be done about PAD?

In the early stages, exercise is the most common recommendation. Exercise increases the overall blood flow to the extremities and can cause blood vessels to form around the blocked area. Smoking cessation is a must if you are a smoker. Nicotine causes blood vessels to constrict, making them even more narrow. Medications which improve the flexibility of the red blood cells have also been shown to decrease symptoms of PAD. In later stages, intervention by a Vascular Specialist may be needed. Recently there have been many recent advances in the surgical management of PAD. Most exiting has been the endovascular removal of those plaques. Endovascular means working inside the blood vessel. It is a minimally invasive technique that can be performed with minimal or no hospital stay.

Should you or a loved one be concerned about PAD, make an appointment online today at Midtown Podiatry, with locations in Midtown, Gramercy, Union Square, Wall Street and Glen Cove immediately for a circulatory screening. We are offering it free of charge to all our patients and to anyone that you know!

*PAD can be a marker for circulatory problems in other parts of the body as well, like kidneys, heart and brain. This test could be a real life saver!

By: Paul J Betschart, DPM

Are you experiencing sharp pains between your third and fourth toes? If so you could be suffering from a condition called Morton's Neuromas.

Dr. Adam Cirlincione discusses what neuromas are and some typical treatment options that the podiatrists at Midtown Podiatry use to fix them.

To watch the video click here 

If you would like to speak with our doctors more about neuromas and discuss options that are best for you, please contact the podiatrists at Midtown Podiatry, with locations in Midtown, Gramercy Park, Union Square, Wall Street and Glen Cove.