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Posts for: February, 2015

Cut yourself walking barefoot? It's more serious than you realize

February 26, 2015. Bare feet are universally associated with summer, but for those who enjoy walking barefoot, a local foot and ankle surgeon warns that inattention to seemingly minor puncture wounds on the soles of your feet can allow serious infections to develop and spread.

“Going barefoot heightens risk for puncture wounds, which require different treatment from cuts because the tiny holes often harbor foreign matter under the skin,” says Steven Gordon, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons. “Glass, nails, needles and seashells are common offenders. Regardless of the substance, anything that remains in the wound increases your chances for complications.”

Puncture wounds in the feet too often are superficially treated, according to Dr. Gordon, and it is best to get proper care within the first 24 hours to make sure anything that might be embedded in the wound is removed. He notes research suggests that 10 percent of puncture wounds do result in serious infection, but such complications can be prevented with prompt and appropriate medical attention.

The depth and relative cleanliness of a puncture wound are the main factors determining possible infection risk.

“Studies show 60 percent of patients who required incision and drainage of a puncture wound had something embedded,” says Dr. Gordon. “With the increasing prevalence of drug-resistant bacteria, even healthy people are getting potentially life-threatening staph infections. So if you step on something and the skin is broken, get treated right away.”

Treatment involves a thorough cleaning to decrease infection risk. Tetanus shots often are needed. Following treatment, the wound should be monitored carefully at home.

“Sometimes an infection can develop later and migrate to the bones,” says Dr. Gordon. “So if the wound stays red, swollen and sore after a few days, go back to the doctor for further treatment. In all cases, a puncture wound on your foot should never be taken lightly.”

For further information about puncture wounds and other foot conditions, contact Dr. Gordon at (703) 368-7166 or visit the ACFAS consumer Web site, FootHealthFacts.org.


February 20, 2015
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Northern Virginia foot and ankle surgeon says new procedures, techniques speeding patients' recoveries

(Reston, Manassas, Leesburg, VA – 2/20/15) Many Achilles tendon surgery patients in Northern Virginia are getting back on their feet faster, thanks to new procedures and techniques.

Shaun Hafner, DPM, FACFAS, a foot and ankle surgeon with offices in Reston, Manassas, and Leesburg, says the introduction of tissue graft products, bone anchors, radio frequency treatments and new arthroscopic procedures provide patients with less invasive treatments and speedier recovery times.

"These surgical advances will shorten recovery times for many patients, allowing them to get back to their jobs and active lifestyles in less time," says Dr. Hafner.

The Achilles tendon connects the calf muscle to the heel bone in the back of the leg and facilitates walking. The most common Achilles condition is tendonitis, an inflammation of the tendon. Hafner says most tendonitis cases can be successfully treated with non-surgical methods such as rest, ice, anti-inflammatory medications and physical therapy.

But some tendonitis patients develop scar tissue on the tendon, or their tendon fibers weaken and develop microscopic tears, a condition called Achilles tendonosis. Fixing these problems may require surgery and weeks to months of recovery.

Dr. Hafner says recently-introduced radio frequency technology can shorten recovery time for some patients by using radio waves to stimulate healing in the tendon. The procedure requires smaller incisions to insert the wand-like radio frequency device. Smaller incisions mean less damage to skin and muscle, less pain, and lower risk of surgical infections. Patients recover faster.

Overuse, especially in athletes, can cause the Achilles tendon to tighten and pull so hard on the heel bone that a bone spur, or bump, develops. Shoes can rub against the spur and cause pain. In addition, a painful fluid-filled sac called a bursa can develop between the heel bone and the tendon. Traditionally, correcting this tightness involved cutting the tendon, removing the bone spur or bursa, and then reattaching the tendon.

According to Dr. Shaun Hafner, new arthroscopic techniques can provide a minimally invasive option to removing bone spurs and bursas without significant damage to the Achilles tendon. When the tendon does have to be surgically detached, new bone anchor constructs (screws that are drilled into the heel bone to secure the tendon and tissues) can reattach the tendon, minimizing the chance of a potentially painful knot developing on the back of the heel.

Achilles tendon ruptures are the most serious Achilles injuries. Most patients require surgery to decrease the likelihood of a re-rupture. Various techniques are available, and increasingly may include tissue grafts used as a bridge to link the detached tendon lengths. The graft provides a scaffold on which new tissue grows, increases the overall strength of the repair, and is usually absorbed by the body within a year.


February 13, 2015
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Got gout? Holiday season triggers painful toes in Northern Virginia

February 13, 2015, Got gout? If so, a Northern Virginia foot and ankle surgeon has a recommendation for surviving the holidays: Watch what you eat and drink.

Changes in diet, including overindulging in certain foods and beverages, can cause gout attacks this time of year, says Steven Gordon, DPM, FACFAS. Dr. Gordon is a member of the American College of Foot and Ankle Surgeons (ACFAS) with offices in Reston, Manassas and Leesburg.

Gout attacks are extremely painful. They are caused when uric acid accumulates in the tissues or a joint and crystallizes. This most commonly occurs in the big toe joint. Dr. Gordon explains this is because the toe is the coolest part of the body and uric acid is sensitive to temperature changes.

He says foods that are high in purines contribute to uric acid build-up. He recommends that people prone to gout attacks avoid purine-rich items such as shellfish (shrimp, crab, etc.), organ meats (kidney, liver, etc.), red meat, red wine and beer.

Gout can be treated with medications, diet changes, increasing consumption of appropriate fluids, and immobilizing the foot. In some cases surgery is required to remove the uric acid crystals and repair the joint. For more information on gout, visit the ACFAS consumer Web site, FootHealthFacts.org, or contact Dr, Gordon’s office at (703) 437-6333 or www.FootVA.com


Old ankle sprains come back to haunt Baby Boomers

(Reston, Manassas, and Leesburg, VA – 2/6/15) A Northern Virginian foot and ankle surgeon has a message for Baby Boomers getting back into fitness and sports: Get your ankles checked for chronic instability caused by injuries that might not have healed properly years ago.

Steven Gordon, DPM, FACFAS, says many Boomers who have suffered ankle sprains in their younger years could be at risk for more serious damage as they age and try to stay active. It is estimated that one in four sports injuries involves the foot or ankle, and a majority of them occur from incomplete rehabilitation of earlier injuries.

“Pain isn't normal in the ankle, even if you're just getting back into shape," says Gordon.

He says swelling is another symptom these previously-injured Boomers may experience. Both amateur and professional athletes often misunderstand how serious a sprain can be, and they rush back into action without taking time to rehabilitate the injury properly.

“A sprain that happened years ago can leave residual weakness that isn’t noticed in normal daily activity, but subjecting the ankle to rigorous physical activity can further damage improperly healed ligaments, and cause persistent pain and swelling,” he said. “For anyone hoping to regain past athletic fitness, it’s recommended that you have that old ankle injury checked out before becoming active again.”

Some sprains are severe enough to strain or tear the tendons on the outside of the ankle, called the peroneal tendons. Research shows that more than 85 percent of athletes who had surgery to repair a torn peroneal tendon were able to return to full sporting activity within three months after the procedure.

“Peroneal tendon tears are an overlooked cause of lateral ankle pain,” said Dr. Gordon. “Although surgery for athletically active patients shouldn’t be taken lightly, surgical repair of the peroneal tendons is proving to be very successful in helping athletes with serious ankle problems return to full activity.”

Dr. Steven Gordon added that persistent pain and tenderness after a sprain, especially if the individual felt a ‘pop’ on the outside of the ankle and couldn’t stand tiptoe, might be a warning sign that the tendon is torn or split. The injury is best diagnosed with an MRI exam.

Anyone needing further information should contact Dr. Steven Gordon at the Reston Office by calling 703-437-6333, the Manassas Office at 703-368-7166, and the Leesburg Office at 703-777-2101. You may also reach Dr. Gordon’s offices by visiting our website at www.FootVA.com