Keeping Deadly Blood Clots at Bay After Foot Surgery

Each year in the United States, pulmonary embolisms (PE) kill more people than AIDS, breast cancer and motor vehicle crashes combined. According to the American College of Foot and Ankle Surgeons, this little-known condition occurs when a blood clot in the leg travels to the lungs, blocking one or more arteries. Most recently, news that tennis star Serena Williams suffered a PE after undergoing surgery is raising awareness about the condition, its risk factors and how to prevent the potentially deadly condition from occurring.

The blood clots that cause PE often originate in the deep veins of the leg, a condition called deep vein thrombosis or DVT. Women are at the highest risk for blood clots and pulmonary embolism, as well as men and women who are overweight, smokers and those taking oral contraceptives. Surgery is also one of the leading causes of blood clots in patients, which means those at highest risk need to be diligent in speaking to their surgeon about their elevated risks so preventive measures can be taken. Patients facing surgery should take note that blood clots in the leg are relatively rare after foot and ankle surgery. In addition, the clots can be prevented with medication and exercise. Depending on a patient’s risk factors, the surgeon may decide to prescribe an anti-clotting medication to prevent DVT. The most common medications are low-molecular weight heparins, which patients inject into their arm, leg or stomach for about two to three weeks after surgery. Patients also would be advised to get up and move around after surgery — even if they are wearing a cast or using crutches.

Symptoms of pulmonary embolisms vary and can mimic those of other conditions such as a heart attack. The most common signs include sudden, unexplained shortness of breath, chest pain and a cough that produces blood-tinged mucus. Other symptoms may include wheezing, leg swelling, excessive sweating, rapid heartbeat and fainting. Pulmonary embolisms can occur quickly, and prompt medical attention is vital for recovery, so patients need to seek care if they are suffering from any of the symptoms associated with the condition.

If you would like more information please visit our website at http://www.drrobertrosenstein.com/ or contact our office, 440-946-5858.

Running in Flip Flops......Deleterious Effects

Running in flip flops....not a good idea. Running in flip flops through an airport trying to catch a flight.....even worse of an idea. This lesson learned, unfortunately came with consequences.....a fracture to the cuboid.

A cuboid bone fracture or broken cuboid bone is an uncommon foot injury. It can occur due to road accidents or any event causing a forcible twisting of the ankle or foot in an outward direction, in my case trying to pivot around fellow airline patrons in non-supportive shoes. The common mechanism for a cuboid fracture is entrapment of the calcaneus (heel bone) and the 4th and 5th metatarsals. This phenomenon resembles the cracking of a nut between the two prongs of a nutcracker, therefore a cuboid bone fracture is also called a "nutcracker’s fracture."

Once the diagnosis of a cuboid fracture is established, the course of treatment consists of immobilization of the foot and the ankle. This is achieved with a pneumatic walking boot (which I am currently using) or plaster of Paris or fiberglass cast for 4-6 weeks. This is followed by progressive physical therapy exercises, which help in regaining the foot and ankle movements and muscle strength.

If you or someone you know have suffered the same fate, please give my office a call, 440-946-5858, for a consultation.

Going Barefoot. Beware!

Parents and families can prevent cuts, puncture wounds and other injuries from going barefoot by following some simple recommendations:

--See a foot and ankle surgeon within 24 hours for a puncture wound.

Why: These injuries can embed un-sterile foreign objects deep inside the foot. A puncture wound must be cleaned properly and monitored throughout the healing process. This will help to avoid complications, such as tissue and bone infections or damage to tendons and muscles in the foot.

--Make sure you've been vaccinated against tetanus. Experts recommend teens and adults get a booster shot every 10 years.

Why: Cuts and puncture wounds from sharp objects can lead to infections and illnesses such as tetanus.

--Apply sunscreen to the tops and bottoms of your feet.

Why: Feet get sunburn too. Deadly skin cancers can develop on the feet.

--Inspect your feet and your children's feet on a routine basis for skin problems such as warts, calluses, ingrown toenails and suspicious moles, spots or freckles.

Why: The earlier a skin condition is detected, the easier it is for your foot and ankle surgeon to treat it.

--Wear flip-flops or sandals around swimming pools, locker rooms and beaches.

Why: To avoid cuts and abrasions from rough anti-slip surfaces and sharp objects hidden beneath sandy beaches, and to prevent contact with bacteria and viruses that can cause athlete's foot, plantar warts, and other problems.

--Use common sense.

Why: Every year, people lose toes while mowing the lawn barefoot. Others suffer serious burns from accidentally stepping on stray campfire coals or fireworks. Murky rivers, lakes and ponds can conceal sharp objects underwater. People with diabetes should never go barefoot, even indoors, because their nervous system may not "feel" an injury and their circulatory system will struggle to heal breaks in the skin.

If you or someone you know have any further questions regarding the topics above or need treatment for one of the conditions listed above, please feel free to contact our office, 440-946-5858, for an appointment.