Tailor’s Bunion

A Tailor's Bunion (Bunionette) is a type of bunion that occurs on the outside of the foot at the base of the little toe. It is a prominence that may be caused by irritation of bone or soft tissue about the lateral aspect of the fifth metatarsal head. Symptoms result from shoe pressure over the bony prominence, local nerve irritation, capsulitis, or a bursa.

Tailor's Bunion is named from clothing tailors sitting with crossed legs.

There is a three to one female to male predominance. They are common in adolescents and adults. Two thirds of patients have significant pes planus (flat feet).

As far as anatomical pathology is concerned, constricting footwear over the lateral 5th metatarsal head yields pain and a bursa. There may be incomplete insertion or development of the transverse metatarsal ligament.

Hyperactive Abductor digiti minimi and Opponens digiti minimi muscles may be present. One may encounter insufficient insertion of the Adductor Hallucis muscle. One may posess a congenital wide 5th metatarsal head.

On clinical presentation, there is pain and irritation at the lateral 5th metatarsal head and prominence. An inflamed bursa may be present. Hyperkeratosis and erythema may be present over the 5th metatarsal head. The 5th toe assumes a varus attitude.

Radiological findings include rotation of the lateral plantar tubercle into a lateral position, increased intermetatarsal angle (IM)(normal 6.47degrees)-People with a tailor's bunion have an IM of 8.71 or greater, increased lateral deviation angle (normal 2.64) people with a tailor's bunion have a lateral deviation of 8.05 degrees, a large dumbbell-shaped 5th metatarsal head, arthritic changes resulting in exostosis (spur) formation at the 5th metatarsophalangeal joint, and any combination of the above conditions.

Type 1 Tailor's Bunion has enlargement of the lateral portion of the 5th metatarsal head. It approximately occurs in 27% of the cases.

Type 2 Tailor's Bunion results in lateral bowing of the diaphysis (shaft) of the 5th metatarsal. This occurs in approximately in 23% of the cases.

Type 3 Tailor's Bunion results in an increase in the 4th-5th intermetarsal angle. This occurs in 50% of the cases. Patients are most symptomatic with this type. Type 4 results from a combination of two or more of the above deformities and is frequently seen in rheumatoid arthritis patients.

Conservative treatments include wearing wide toe box shoes, debridement of lesions. Orthotics may be utilized to control pressure areas and mechanics of the foot. Non Steroidal Anti-Inflammatory Drugs may be taken. Injections may be given.

Surgical Treatment is indicated when conservative treatment fails. It is primarily indicated in special demands like sports. The goal is to decrease the width of the foot and decrease the pain and prominence of the Bunionette.

References

  • Banks, Alan S. et al. McGlamry's Comprehensive Textbook of Foot and Ankle Surgery. Philadelphia: Lippincott Williams and Wilkins, 2001.
  • Fallat LM, Buckholz J. Analysis of the tailor's bunions by radiographic and anatomical display. J AM Podiatry Assoc 1980;70:597-603.

Oven Roasted Vegetable Soup

Ingredients

  • 4 carrots, washed
  • 2 zucchini, washed
  • 3 ribs celery, cut in half
  • 2 tomatoes, quartered
  • 1 eggplant, quartered
  • 2 potatoes, quartered
  • 2 turnips, cleaned, trimmed and quartered
  • 2 large onions, peeled and quartered
  • 1 leek, trimmed and quartered
  • 3 garlic cloves, peeled
  • 2 teaspoon dried thyme
  • 1/4 cup olive oil
  • 8 cups vegetable stock

Directions

  1. Preheat oven to 400 degrees.
  2. Spread all the vegetables out on a baking sheet.
  3. Sprinkle with the thyme and drizzle with oil.
  4. Roast for 1 hour or until well browned.
  5. Transfer vegetables to a large pot, cover with stock.
  6. Bring to a simmer and cook for 45 minutes.
  7. Cool and strain

Bon Appetit!

Ragu No boiling Lasagna

Ingredients

  • 2 containers (15 oz. each) Precious Ricotta Cheese
  • 2 cups Precious Mozarella Cheese, shredded (about 8oz.)
  • 1/2 cup grated Parmesan cheese
  • 2 eggs
  • 2 jars (26 oz.each) Ragu Old World Style Pasta Sauce
  • 12 uncooked lasagna noodles

Directions

  1. Preheat oven to 375*. In bowl, combine ricotta cheese, 1 cup mozarella cheese, 1/4 cup Parmesan cheese and eggs.
  2. In 13x19-inch baking dish, spread 1 cup Sauce. Layer 4 uncooked noodles, then 1 cup Sauce.
  3. Cover tightly with aluminum foil and bake 1 hour. Remove foil and sprinkle with remaining mozarella and Parmesan cheeses.
  4. Bake uncovered 10 minutes.
  5. Let stand 10 minutes before serving.
  6. Serve with remaining sauce heated.

  • Prep Time: 10 minutes
  • Cook Time: 70 minutes
  • Makes about 12 servings.

Athlete’s Foot

Overview

Athlete's foot is a skin disease caused by a fungus, usually
occurring between the toes.

The fungus most commonly attacks the feet because shoes create a
warm, dark, and humid environment which encourages fungus growth.

Athlete's foot (tinea pedis) is a common, persistent infection of
the foot caused by a dermatophyte, a microscopic fungus that
lives on dead tissue of the hair, toenails, and outer skin
layers. These fungi thrive in warm, moist environments such as
shoes, stockings, and the floors of public showers, locker rooms,
and swimming pools. Athlete's foot is transmitted through contact
with a cut or abrasion on the plantar surface (bottom) of the
foot. In rare cases, the fungus is transmitted from infected
animals to humans.

Dermatophyte (skin) infections cause raised, circular pimples or
blisters that resemble the lesions caused by ringworm. The
infections are named after the part of the body they infect.
Tinea pedis, therefore, refers to an infection of the feet.

Incidence and Prevalence

Athlete's foot is most common in men from the teenage years to the
early 50s. Prevalence is affected by personal hygiene and daily
activity. People with compromised immune systems are at greater
risk.

Causes

There are at least four dermatophytes that can cause tineas pedis.
The most common is trichophyton rubrum.

Signs and Symptoms

There are four common forms of athlete's foot:

  1. The most common is an annoying, persistent itching of the skin on
    the sole of the foot or between the toes (often the fourth and
    fifth toes). As the infection progresses, the skin grows soft.
    The center of the infection is inflamed and sensitive to the
    touch. Gradually, the edges of the infected area become milky
    white and the skin begins to peel. There may also be a slight
    watery discharge.
  2. In the ulcerative type, the peeling skin becomes worse. Large
    cracks develop in the skin, making the patient susceptible to
    secondary bacterial infections. The infection can be transmitted
    to other parts of the body by scratching, or contamination of
    clothing or bedding.
  3. The third type of tinea infection is often called "moccasin
    foot." In this type, a red rash spreads across the lower portion
    of the foot in the pattern of a moccasin. The skin in this region
    gradually becomes dense, white, and scaly.
  4. The fourth form of tinea pedis is inflammatory or vesicular, in
    which a series of raised bumps or ridges develops under the skin
    on the bottom of the foot, typically in the region of the
    metatarsal heads. Itching is intense and there is less peeling of
    the skin.

People with acute tinea infections may develop similar outbreaks
on their hands, typically on the palms. This trichophyde
reaction, also known as tineas manuum, is an immune system
response to fungal antigens (antibodies that fight the fungal
infection).

Diagnosis

Diagnosis is made by visual observation of the symptoms. The
podiatrist eliminates the possibility of a bacterial infection by
performing a microscopic examination of skin scrapings to
determine the type of fungus causing the infection. Other tests
include growing a fungal culture from skin scrapings and
examining the patient's foot under an ultraviolet light.

Treatment

Tinea infections may disappear spontaneously or persist for
years. They are difficult to eliminate and often recur. Best
results usually are obtained with early treatment before the
fungal infection establishes itself firmly. Antifungal drugs may
be used to fight the infection.

If the infection is bacterial, a course of oral antibiotics may
be prescribed.

If you are experiencing any of the symptoms addressed, we
strongly recommend that you seek the advice of your podiatrist
for proper diagnosis.

Nail Fungus

Fungal infection of the toenails is also known as onychomycosis. It is a common health problem that many of its sufferers do not know they have because the infection can be present for many years without causing any pain.

Onychomycosis is an infection of the plate and soft nail bed under the toenail, and is caused by dirt, debris, and different types of fungi.

Fungus attacks the nail and thrives on the nail's protein matter, keratin. Once this occurs, the nail will thicken, become discolored, foul smelling, and may even detach from the nail bed or deteriorate.

If ignored, the infection can spread to other toenails, the fingernails, and the skin. Its spread could also impair your ability to walk.

Proper foot hygiene and regular inspection of the feet and toes are the best ways to prevent this condition.

You should also:

  • Keep your bath or shower area clean
  • Wear shower shoes whenever possible, in public
    showering facilities
  • Wash your feet with soap and water every day
  • Dry your feet well, particularly between the toes
  • Always wear clean socks
  • Change shoes after two days to give them time to dry out
  • Use a foot powder daily
  • Properly disinfect pedicure tools and do not apply polish
    to any nails suspected of infection
  • Nails should be trimmed short and straight across
  • Visit your podiatrist annually

Treatment may vary depending on the nature of your infection. Your podiatrist may devise a treatment plan that includes one or all of the following:

  • Debridement (removal of diseased nail matter)
  • Prescription of an oral or topical medication
  • In severe cases, removal of the diseased nail

For more information on this subject, or to schedule an appointment with a footDrHorsley Podiatrist, please call (877) 372-6048

If you are experiencing any of the symptoms addressed, we strongly recommend that you seek the advice of your podiatrist for proper diagnosis.

Garlic Seseame Cauliflower

Ingredients

  • 1 small cauliflower (about 1-1/2 pounds)
  • 1 tablespoon virgin olive oil
  • 2 large garlic cloves, minced
  • 1 tablespoon toasted sesame seeds
  • Dash paprika
  • Pepper to taste

Directions

  1. In a large kettle, bring 2 quarts of water to a boil.
  2. Trim cauliflower and break into flowerets.
  3. Drop into boiling water and cook 2 minutes. Drain in a colander.
  4. In a large, non-stick skillet, heat oil and brown garlic.
  5. Add cauliflower and sesame seeds and stir-fry 1 minute.
  6. Dust with paprika and pepper before serving.

Your Physician’s Role

Because diabetes is a systemic disease affecting many different parts of the body, ideal case management requires a team approach. The podiatric physician, as an integral part of the treatment team, has documented success in the prevention of amputations. The key to amputation prevention in diabetic patients is early recognition and regular foot screenings, at least annually, from a podiatric physician.

In addition to these check ups, there are warning signs that you should be aware of so that they may be identified and called to the attention of the family physician or podiatrist.

They include:

  • Skin color changes
  • Elevation in skin temperature
  • Swelling of the foot or ankle
  • Pain in the legs
  • Open sores on the feet that are slow to heal
  • Ingrown and fungal calluses
  • Bleeding corns and calluses
  • Dry cracks in the skin, especially around the heel.

Grilled Lasagna

Ingredients

  • 2 slices of bread
  • 4 cooked slices of veggie bacon
  • 1 slice mozzarella cheese
  • 1 tablespoon pizza sauce
  • 1 tablespoon sour cream mix (recipe below)
  • Butter for grilling

Directions

  1. Spread sour cream mix on one slice of bread and the other slice with the pizza sauce.
  2. Layer cheese and veggie bacon on first slice and cover with the second slice of bread.
  3. Butter the outside of the sandwich and grill till golden brown on both sides.

This goes great with a warm vegetable soup!

Sour Cream Mix

  • 1/2 cup sour cream
  • 1 tablespoon minced fresh onion
  • 1 tsp. minced fresh garlic
  • 1 tsp. Italian seasoning
  • 1/2 tsp. each salt and pepper

Combine all ingredients, mixing well and let set for 1/2 hour in the refrigerator to blend the flavors.

7 Classics

Fresh Tomato Sauce Pasta Receipe

Ingredients

  • Your choice of pasta - 1 lb
  • Tomatoes - 4 (diced)
  • Cucumber - 1/2 cup (diced)
  • Garlic - 2 cloves (minced)
  • Dried basil - 2 tbsps
  • Dried mint - 2 tbsps
  • Salt - 1 to 2 tsps
  • Pepper - 1/2 tsp

Directions

  1. Mix tomatoes, cucumber, garlic, basil, mint, salt, and pepper.
  2. Let it sit at room temperature for 2 hours.
  3. Cook your pasta according to package directions. Then drain, and toss with the sauce.

Breakfast Burritos

Ingredients

  • Eggs - 8**
  • Jalapeno peppers - 2 (chopped and seeded)
  • Green bell pepper - 1/3 cup (chopped)
  • Tomatoes - 2 (seeded and chopped)
  • Low fat cheddar cheese - 6 slices
  • Large flour tortillas - 6
  • Salt and pepper - add to taste
  • Hot pepper sauce - a dash
  • Low fat butter - 1 tbsp
  • Cilantro

You may also substitute the eggs with TOFU

Directions

  1. Beat the eggs well, and add hot pepper sauce, jalapenos salt, and pepper.
  2. Melt butter in a pan on medium-high heat.
  3. Then pour in egg mixture, and cook until the eggs solidify.
  4. Place a slice of cheese on each tortilla.
  5. Top with egg mixture, tomatoes, and cilantro.
  6. Roll the tortilla and tuck the ends under.
  7. Bake for 10 minutes at 350.

Delicious Summer Greek Salad Sandwiches

Ingredients

  • Pita bread
  • Tomatoes - 3 (coarsely chopped)
  • Cucumber - 1/2 (diced)
  • Onion - 1/2 (diced)
  • Roasted peppers - 100g (drained)
  • Feta cheese - 100g
  • Olive oil - 2 tbsp
  • Vinegar - 2 tbsp
  • Dried oregano - 1 tsp
  • Salt and pepper - add to taste

Directions

  1. Mix the tomatoes, cucumber, onion, roasted peppers, feta cheese, olive oil, vinegar, oregano, salt and pepper.
  2. Pack in to warm pita breads and serve.

Cauliflower and Lemon Salad

Ingredients

  • Cauliflower florets - 2 cups
  • Cherry tomatoes - 2 cups (cut in half)
  • Lemon - 1 (thinly slice)
  • Olives - 1/2 to 1 cup
  • Extra virgin olive oil - 1/4 to 1/2 cup
  • White vinegar - 1/4 cup
  • Parsley - 6 to 8 strands (chopped)
  • Oregano - 1 teaspoon
  • Minced garlic - 1 teaspoon
  • Salt and pepper

Directions

  1. Pour boiling water over cauliflower and lemon slices. Let it soak for 8 to 10 minutes.
  2. Drain, and mix with tomatoes and olives.
  3. Mix olive oil, vinegar, parsley, lemon juice, oregano, garlic, salt and pepper in a bowl. Mix well.
  4. Pour the salad dressing over the vegetables and mix well. Let it sit in the fridge for 2 hours. Serve.

Fresh Tomato Sauce Pasta Receipe

Ingredients

  • Your choice of pasta - 1 lb
  • Tomatoes - 4 (diced)
  • Cucumber - 1/2 cup (diced)
  • Garlic - 2 cloves (minced)
  • Dried basil - 2 tbsps
  • Dried mint - 2 tbsps
  • Salt - 1 to 2 tsps
  • Pepper - 1/2 tsp

Directions

  1. Mix tomatoes, cucumber, garlic, basil, mint, salt, and pepper.
  2. Let it sit at room temperature for 2 hours.
  3. Cook your pasta according to package directions.
  4. Then drain, and toss with the sauce.

Vegetarian Black Bean Chili

Ingredients

  • Black beans - 2 cans (19oz each drained and rinsed)
  • Onion - 1 (chopped)
  • Carrot - 1 (chopped)
  • Tomatoes - 3 (chopped)
  • Green bell pepper - 1 (chopped)
  • Jalapeno pepper - 1 (minded)
  • Chili powder - 1 tbsp
  • Ground cumin - 1 tsp
  • Crumbled dry rosemary - 1 tsp
  • Salt - 1 tsp
  • Garlic - 2 cloves (minced)
  • Vegetable oil - 1 tbsp

Directions

  1. Heat oil to medium-high.
  2. Add in garlic, onion, jalapeno, carrot, and green pepper
  3. Cook until the veggies are soft
  4. Add in tomatoes, beans, chili powder, salt, rosemary, and cumin
  5. Bring to a boil then reduce heat.
  6. Simmer for 20 minutes.
  7. Serve.

Tofu Stuffed Mushrooms

Ingredients

  • Large mushrooms - 6 to 8 (hollowed out)
  • Tofu - 1 block (375 grams) (cut into 1/2cm square)
  • Green onions - 2 (chopped)
  • Crushed garlic - 2 cloves
  • Light soy sauce - 1 tablespoon
  • Frozen corn - 200 grams
  • Sesame oil - 2 teaspoons
  • Salt and black pepper

Directions

  1. Chop up the mushroom stalks and mix with the green onions and oyster sauce.
  2. Mix with the tofu and corn.
  3. Add in salt and pepper. Mix well.
  4. Stuff the mushrooms with this tofu mix, and brush the edge of the mushrooms with sesame oil.
  5. Bake in the oven for 12 to 15 minutes, and serve.

Runners Feet

Black toe is a black discoloration beneath one or more toenails. It is usually caused by trauma resulting in bleeding under the nail plate. Swelling usually occurs and the nail could fall off.

There are numerous causes for a bruised toe, or black toenail. The main reasons for this are: their feet are unstable in their shoes and they are pronating and elongating (when weight is placed on the feet they stretch longer). The second reason would be that the shoe is improperly sized and fitted and the foot is sliding forward in the shoe. The third reason is a toe box that does not match the shape of the toe region on the foot. If the toe box is too narrow in height and it actually puts a downward pressure on top of the toenails, then eventually, over a long period of time, this can bruise the toenail and also make it turn black.

It is very common with runners to see black toenails. Their feet slide forward to the front of the shoe and the ends of the toes hit the front of the toe box of the boot. This can push the toenail backwards and bruise the root area from which the nail grows (the matrix).

The toenail will progressively turn black until it falls off, and a new toenail will start to grow underneath the old bruised toenail. This can take up to three to six months. If bleeding and pressure continues to build beneath the nail it is recommended that you seek the help of your podiatrist.

For more information on this subject, or to schedule an appointment with a footDrHorsley Podiatrist, please call (877) 372-6048 (Toll Free)

If you are experiencing any of the symptoms addressed, we strongly recommend that you seek the advice of your podiatrist for proper diagnosis.