by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

What is an Ankle Fracture?

A fracture is a partial or complete break in a bone. Fractures in the ankle can range from the less serious avulsion injuries (small pieces of bone that have been pulled off) to severe shattering-type breaks of the tibia, fibula, or both.

Ankle fractures are common injuries that are most often caused by ankle rolling inward or outward. Many people mistake an ankle fracture for an ankle sprain, but they are quiet different and therefore require an accurate an dearly diagnosis. They sometimes occur simultaneously.

by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

A ganglion is a soft tissue mass that most commonly occurs on the wrist in women between 25 and 45 years of age. They are also seen commonly on the foot. A ganglion is a firm, rubbery mass that occurs on the top of the foot. On the foot, the most common area of involvement is in front of the ankle or on the outside of the ankle. A common characteristic of a ganglion is that they will enlarge and then shrink is size. They generally occur without any apparent cause. Ganglions arise spontaneously from a weakness in the soft tissue covering of a joint or tendon sheath. Ballooning out of the tissue occurs and it fills with a thick mucoid fluid. In many instances, ganglions are not painful until they reach a size that causes irritation from shoe pressure. On occasion they will compress a nearby skin nerve and cause tingling into the top of the toes. Tapping on the ganglion will often result in this same tingling sensation into the toes. Other common masses on the foot are giant cell tumors, fibromas and lipomas.

Diagnosis

The diagnosis is made by taking a thorough history of the clinical course of the condition. Physical exam will reveal a firm, rubbery mass that appears encapsulated and will have a discreet boundary. They tend to be firmly adhered to the underlying deep tissues under the skin. A x-ray will reveal the shadow of the soft tissue swelling. On occasion there may be a small bone spur in the area of the ganglion. Spurring indicates a level of arthritis in the joint near the ganglion. A MRI or CT scan will clearly define the mass but is not necessary to make the diagnosis. If a ganglion were suspected within the deep structures of the foot a MRI would be useful to identify the size and extent of the mass.

Treatment

Small ganglions that are not symptomatic or painful usually require no treatment. A non-surgical form of treatment is termed "needling". This involves numbing the area with a local anesthesia. Once the area is numb a large gauge needle is placed into the ganglion. Aspiration of ganglion fluid is attempted, however, because of the thickness of the fluid it is often difficult to draw the fluid out. The ganglion is then punctured with the needle several times. A steroid medication may then be placed into the mass and a snug bandage applied. This treatment has a 70% recurrence rate. The definitive treatment for a ganglion is surgical excision. (See surgical excision of a ganglion)

by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

Chronic ankle instability is a condition characterized by a recurring “giving way” of the outer (lateral) side of the ankle. This condition often develops after repeated ankle sprains. Usually the “giving way” occurs while walking or doing other activities, but it can also happen when you’re just standing. Many athletes, as well as others, suffer from chronic instability.

by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

Dr. Brandon Nelson of the Issaquah Foot and Ankle Specialists explains ankle sprains and what causes them.

by Brandon Nelson, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. Also called the "heel cord," the Achilles tendon facilitates walking by helping to raise the heel off the ground.

An Achilles tendon rupture is a complete or partial tear that occurs when the tendon is stretched beyond its capacity. Forceful jumping or pivoting, or sudden accelerations of running, can overstretch the tendon and cause a tear. An injury to the tendon can also result from falling or tripping.

by Timothy W. H. Young, DPM This email address is being protected from spambots. You need JavaScript enabled to view it.

This video discusses in more detail one of the most common disorders of the Achilles Tendon. This disorder, or injury, is caused by overuse. Dr. Young discusses in detail the various treatment options for this condition.

For patients experiencing a pain or tenderness behind or just above the heel this video will offer some insight about the condition and treatment options. The Achilles tendon can suffer from degeneration, inflammation, spurring and calcification. These can be seen with ultrasound imaging (included in the video).

Dr. Young uses ultrasound imaging to view a patients Achilles tendon and discusses treatment options.

The best course of action with any injury that due to overuse or misuse (possibly from an abnormal gait/stride) is to correct any issues that are causing this type of injury. Prevention is key.

Proper stretching and footwear will help prevent injury/re-injury, custom orthotics may be necessary.