surgery Archives - DOC

#826 How can I tell if I should have surgery to remove a big toe fracture fragment?

If you get a fracture in your big toe joint it can be easy to get talked into surgery. Especially if you see fragments on an X-ray.

Your doctor may call old broken bone pieces by a number of terms:

“Osteophytes”

“Fracture fragments”

“Loose bodies”

“Surgical targets”

If your doctor points them out and starts talking about surgery, the chances are good that you’re going to want to have them removed. But there are times when surgery is totally unnecessary.

How can I tell if I really need to have surgery to remove a fracture fragment in my big toe joint?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#823 Last chance option to avoid non-union surgery in a runner

Today’s episode applies to any injured running pondering surgery.

I just spoke to a runner who was told she might need surgery to fix a non-union of a metatarsal fracture.

I said, “Look, you have two choices. You can have surgery or not have surgery.”

We talked about what it meant if she did have surgery in terms of her recovery. And we also talked about how she could potentially get it to heal without having all the risk associated with surgery.

What is the very last option you can do as a runner to avoid surgery?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#810 Can EPFR get me back to running?

Every runner who has heel pain wants it fixed.

A lot of us think about this in the way that we fix automobiles. The alternator goes out in your car, you go get a new one put in. Your battery dies, you go get a new battery. But your foot doesn’t work this way. So unfortunately, when you have surgery, you’re trading one problem for another.

I have done endoscopic plantar fascia release surgeries, but not on any runners for more than a decade. Why do you think that is?

Can an endoscopic plantar fascia release surgery get me back to running faster?

Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run Podcast.

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#720 3 reasons for Cheilectomy failure after Hallux Rigidus surgery

If you have a condition called “hallux rigidus” or “hallux limitus,” the name tells you what’s wrong.

“Hallux” means big toe.

“Rigidus” means the big toe joint doesn’t move at all.

“Limitus” just means the big toe joint movement is limited and stiff.

There are three problems with hallux rigidus, which are: 1) damage to the cartilage, 2) bone spurs around the joint and 3) restriction of the soft tissues such that the toe doesn’t move up and down the way it should.

Those three reasons that cause the condition are the same reasons that can fail if you have a cheilectomy surgery.

Today on the Doc On The Run Podcast we’re talking about three reasons for cheilectomy failure after hallux rigidus surgery.

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#719 What is a tendon synovectomy surgery?

Let’s say you have a nagging tendon injury that’s really been painful. It’s been bugging you a lot when you run.

You have had persistent pain either on the side of the ankle that just won’t seem to go away, even if you run less.

You see the doctor and she says, “Look, we tried everything. We should do surgery. Your tendon is not really torn, but we should do this surgical procedure called a “synovectomy” to get it to calm down so it will finally stop hurting.”

What is a tendon synovectomy surgery?

Well, that’s what we’re talking about today on the Doc On The Run Podcast.

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#714 Foot pain that is truly a pain in the butt

What would be worse than not being able to run because you had foot pain that didn’t get better for a year or two?

I know one thing that would be worse… Having foot surgery to treat a problem that was not actually even located in the foot.

Think about that. You had pain in your foot for two years. Then some doctor convinces you to have surgery, only to find out there was no problem with the tendon.

You stop running. You have surgery. You wait for your stitches to heal. You have to stay off your feet until the incision is all healed.

And your foot pain does not change at all.

Sounds crazy, but this can happen. And it’s most likely to occur when you have something called referred pain. The pain in your foot might be actually caused by nerve compression deep to your glues maximus…that’ right…in your butt.

Today on the Doc On the Run Podcast we are talking about foot pain that is truly a pain in the butt!

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#513 Should a runner have surgery for a plantar plate tear?

If you are a runner with a plantar plate injury, it is pretty easy for a doctor to make a convincing sales pitch on surgery. There are a couple of reasons that you should consider surgery for a plantar plate sprain. The first reason surgery makes sense is you tried everything else and nothing non-surgical will work. But you have to be honest about your non-surgical attempts. Here are some examples I often hear from injured runners.” I used the fracture boot a little bit, but had to take it off to drive. “I “sort of taped the toe.” I used some pads, “but I’m not sure if they are in the right spot. “You have to be honest with yourself about those treatments before you can say that you failed those treatments. that. But when you have clearly failed all of the non-surgical treatments and you cannot get better, then and only then does surgery makes sense. Should a runner have surgery for a plantar plate injury? That’s a great question and that’s what we’re talking about today on the Doc On The Run podcast.

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#492 Should a runner have surgery to remove bone fragments?

Today’s question comes from a telemedicine visit second opinion for a runner. She was asking if she should have surgery to remove bone fragments. I said, “Well, let’s talk about what’s going on with you first.” Anytime we see something abnormal on an x-ray or an MRI, we often think that it’s pathologic. We presume something is wrong, just because it doesn’t look right. We think if something’s wrong, we should go cut your foot open and fix it. Should a runner have surgery to remove bone fragments? Well, that’s a great question and that’s what we’re talking about today on the Doc On The Run podcast.

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#471 Rehab after tibial sesamoid non-union removal surgery in both feet

Today I got a question from a doctor who wanted to know what I would do with a runner after surgery to remove non-healing sesamoid fractures in both feet.

You have two sesamoid bones under the big toe joint in each foot. When one of them develops a stress fracture, it can break.

If it breaks into two pieces, it can be very difficult to get the broken sesamoid to heal completely.

If it doesn’t heal, becomes arthritic and turns into what we as doctors call a “sesamoid fracture non-union” your doctor may recommend surgery to take it out.

Today on the Doc on the Run Podcast, we’re talking about what to think about when a doctor is trying to rehabilitate a runner after tibial sesamoid non-union removal surgery in both feet.

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#320 Can I run after broken ankle surgery?

A runner broke her ankle and foot in five places and had surgery. She wrote in and wanted to know if she might run again:

“I’m 34 years old. I had a bike accident 4 days ago. I broke my tibia bone at the medial malleolus, distal fibula bone, and metatarsal bones 2, 3, and 4. The surgery went well. I was a runner. I used to run  4 times a week. Is there any chance I can run again?”

Today on the Doc On The Run Podcast we’re talking about what whether or not there is any chance you can run again after breaking five bones in your foot and ankle, and recovering from ankle fracture surgery.

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