No, it is not caused by hitting your foot with your golf club.  It is a congenital deformity of the foot that is usually recognized at birth or shortly thereafter. It occurs approximately 1 in every 1,000 births.  The position of the foot is turned inward toward the center of the body. If untreated and left to adulthood, the foot will resemble a club when walked on, hence the name. The cause of this condition is unknown. It may be due to abnormal intrauterine position or abnormal development of soft tissue or bone. The position can be flexible, rigid or a combination.

Fortunately, in the developed world, this condition can be successfully treated. The earlier this condition is recognized and treated, the better the outcome. It is treated with serial casting, surgery or a combination of both. Most often, serial casting is employed first. This involves manipulation of the foot in a certain way to reduce the contractures of the joints and tendons. The foot is then placed in a plaster cast to maintain the correction. This manipulation and casting is done at weekly intervals for several months to achieve correction. Following casting, if there is residual deformity, surgical correction may be performed.  Good results can be achieved with these treatments, allowing children to function fairly normally. Bracing is sometimes needed after correction to prevent recurrence. 

Neglected clubfoot seen later in life usually requires more complicated surgical approaches, usually involving the fusing of multiple foot joints. Neglected clubfoot is rarely seen in this country due to the early recognition and treatment mentioned above. Other areas of the world do not have access to the treatments we take for granted in this country. Generous doctors and nurses from our country regularly participate in medical missions throughout the world bringing advanced medical care to those in need. Several of our doctors have participated in such missions. To get involved, check with the United Way, Doctor's Without Borders, The Baja Crippled Children Project, or Google “Medical Missions”.

Should you or a loved one need advanced foot and ankle care, make an appointment  with Midtown Podiatry. We will give you the best care within our borders!

By: Paul J. Betschart

Before	After

A common disorder seen by our podiatrists is brachymetatarsal, a genetic disorder in which one of the metatarsal bones of the foot is abnormally short the appearance of a short toe.

Our physicians use a mixture of conservative and surgical treatment options to fix this deformity. Our podiatrists have been featured on Fox 5 - Good Day NY News thanks to their many successful cases of fixing Brachymetatarsia.
 

To view the video click here:

http://www.youtube.com/watch?v=2GSthr2FI7M&context=C4e8afafADvjVQa1PpcFM3hB3o9WcH0ARwybbqdhxBhmAZ3sgeiAc=

If you or someone you know is suffering from this disorder, make an appointment  with Midtown Podiatry, with locations in Midtown, Gramercy Park, Union Square, Wall Street and Glen Cove

Will a bad toe keep tennis great Lleyton Hewitt out of the olympics?

He doesn't think so. The Australian tennis star has been suffering with pain in his big toe joint for several years. This past season, the condition became so painful, he had to get local anesthetic injections into the joint for most of his matches. The condition he suffers from is Hallux Limitus.

Hallux Limitus is a degenerative joint condition of the big toe. It can start as a result of a trauma or from mechanical imbalances such as an elevated or hypermobile fist metatarsal bone. Early in this condition, limitation of motion in the upward direction is seen. Over time the jamming of the joint at the end range of upward bending causes damage to the cartilage of the joint resulting in pain. In later stages, bone spurs form around the joint, further restricting motion and causing additional symptoms.

Due to the impact the pain and restriction of motion was having on his tennis game, Lleyton opted for surgical treatment. He had a procedure called a Cheilectomy performed at the end of the competitive season. In this procedure, damaged bone and cartilage is removed from the joint and scar tissue released to improve pain free motion. Healing takes 4 to 6 weeks and the results should last 10-15 years. Protection of the joint with an orthotic device after surgery can enhance the results.

Lleyton expects to play and be a medal contender in the upcoming London Olympics this summer following this surgery. We will be keeping any eye on his foot work!

Should you or anyone you know be suffering from pain in the big toe joint, make an appointment to see us with locations in Midtown, Gramercy Park, Union Square, Wall Street and Glen Cove. There are many options available for treatment, but it all starts with an accurate diagnosis. Make sure you choose the right specialist. Choose the podiatrists at Midtown Podiatry!

By: Paul Betschart, DPM

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

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