The Family Foot and Leg Center
At the Family Foot and Leg Center, "We keep you walking."
Patients want to come and see us here because we care about our patients.
The newest advances in reconstructive surgery and technology
including ankle and foot implants which can give you the gift of walking
and eliminate pain.
This is the patient status post 9 weeks revisional forefoot reconstruction surgery,
pre-op patient had -- unfortunately had a bad result
initially presents to office for revisional surgery to stabilize her toes
her 5th toe is floppy, flailing, unable wear shoes without significant pain
and catching her fifth toe.
This is the nine weeks post up right now
patient has minimal swelling, hardly any pain, her toes are realigned and
stability of the fourth and fifth toe was achieved with syndactyly, second toe revisional arthroplasty
and third toe revisional arthrodesis was done and revisional bunion was done also
to straighten out deformity of the bunion as well as the big toe bone called the proximal phalanx
Well this is the foot as compared to the x-ray that we've had
this is at nine weeks postoperatively
as you can see the toes are nice and straight, the hallux nice and straight,
the bunion is corrected from the previous x-ray
Now from a patient perspective, was it scary undergoing a second surgery -- revisional surgery?
"Yes it was a little scary but I made sure I picked my doctor wisely this time."
"I went online, read some testimonials and turned out great."
This is before Keryflex
patient is a diabetic treated with topicals as you can see we're halfway through
but we're gonna finish it up today with the Keryflex procedure
we're going to transform all ten nails today and we'll see the results
So this is a right after the procedure
suffering from onychomycosis for how many years?
"Oh my goodness, 45,"
And you're ashamed to wear sandals, now now you're good to go.
"Yes, I can wear high heels." [Laughter]
Sixty-year-old a Caucasian female with a history of posterior tibial tendonitis
with tendon tear and collapse of the foot
notice that status post triple arthrodesis done in April, now we are September -- mid-September
patient walking in a camboot with very little pain
scars have all healed wonderfully, edema is very minimal, it is late in the afternoon
again the scar from the triple arthrodesis.
How's your experience been?
"It has been absolutely wonderful, I haven't had any pain, hardly, I mean it's so minor
and after I got through the initial surgery for the first days of the pain
then after that hardly anything
and when I went to therapy when it was time to go to therapy, I went 9 times,
and I didn't even feel like I needed it, I just feel great
and when I first came here from the first point that I was in so much pain and now this just seems like
so long ago, none at all."
Great. Would you recommend the surgery to other people will require this?
"Very much so, very much, and the neat thing was I trusted Dr. Lam, I have no qualms whatsoever
I'm just so enthusiastic about him and his staff."
Well your alignment looks awesome and beautiful.
This is status post triple arthrodesis at five months
the patient's foot is rectus and in proper alignment
the swelling is very minimal and no pain, am I correct? "Correct."
And you're walking pretty good, let's turn around, let's look at that heel.
The heel is pretty good right here, the stance, heel is pretty straight and
she is able to come up on her tippy toes which --
"I couldn't even begin to do that."
Oh look at that, a couple more raises, a couple more raises for me, good, beautiful.
Look at that your function is awesome
Okay, this is a patient two and a half months after ankle scope,
has severe pain upon presentation, these are the scar from an ankle scope
Sir, move your ankle up and around and motion please,
Has the motion improved after the ankle scope? "Oh yes."
Has the pain decreased? "Yes."
How much has it decreased by? "Oh, I'd say 80% from what I had before."
Okay, what has been the biggest change that you're able to do now
that you are not able to do before surgery?
Well, do you have any words of wisdom for someone else that
have the same kind of problem and -- "Get it done." Get it done, right?
Good.
How much pain do you have in there right now? "None."
None, okay good. Are you happy with the results? "I am"
Good, good, good, you could show off your foot to all your friends now [patient laughs]
You don't have to -be afraid. "Yeah." [patient laughs]
Okay, are you satisfied with the surgical results so far? "I am. Very satisfied."
Good, good, good, excellent.
This is the pre-op x-ray of the previous patient that we were talking to, this is the pre-op
and we're going to look at the post-op x-rays today, this is the x-ray about status post 7 weeks now
as you can see her toe is well-aligned, her staples and her screws well in place
I chose a double osteotomy for better correction as well as better long-term results.
Look at the side of her foot right here on the medial side, you'll see the skin is right here,
the skin is very straight as you can see on the foot, her foot is nice and straight
also on the actual person we're going to go back over here to pre-op x-ray
see that big lump and bump protruding out the outside, that is resolved and
the patient is doing well as you've heard, so another success story.
A 55 year old female status post 7 weeks bunionectomy today, Austin and an Akin,
no pain today, how is the post-operative course, was it better than expected, worse than expected?
"Better."
Better, and I I know you hear as well as other people hear all these horror stories
about bunion surgeries, is it true --?
"No, I've had an excellent experience and I'm really happy with my results."
"I would definitely do this again."
Okay well that's your scar right there, is that scar bigger than expected or smaller than expected?
"Smaller."
Okay well look at the x-ray, you've healed up very well, your bone is about 90% healed today
so any words of wisdom for people thinking about bunion surgery?
"Don't hesitate, come see Dr. Lam."
Well thank you for the endorsement
Status post triple arthrodesis, incision-- lateral
"Look Dr. Lam, I can do this, watch, look, look"
The ankle is doing good, the triple arthrodesis solid, how's everything going with that ankle?
Not too much problems, huh? "How do you like that?"
Very good, very good, we'll fix those toes one day.
But how was your experience with the ankle surgery? Good?
"What?" How was your experience with the ankle surgery?
"This foot is -- you're a miracle man."
Let me see you stand up on that.
"Now watch."
Good, good, good. Okay good.
Well you no longer -- "See now I have 2 good feet."
"The therapy helped." Going for therapy helps, good.
"Definitely."
Well this is the before x-ray, notice the subchondral cyst in the ankle joint on the mortise view
and this is a today's view with no pain as previously stated and patient is doing well
We're going to take a another look back over here at the AP view, note the subchondral cyst and
narrowing of the joint and we go back and compare the AP view of today
this is about six months post-op
Okay this is 79 year old female with an ankle fusion
status post two years
no pain around the ankle at this point, am I correct?
"Yes."
Okay great, this is the result of an arthroscopy gone bad so I had to fuse the ankles
due to severe pain and debility.
Patient currently is able to walk -- how long now for exercise? "Three miles."
A day? You walk more than me.
She is able to walk three miles a day now and the motion of the ankle is excellent.
Push down, pull up and around in the circle again, perfect, perfect.
The fusion involved cutting the fibula using as an onlay graft,
there's no pain or swelling about the ankle anteriorly, medially, or laterally,
the motion is excellent.
This is one of our favorite patients here with a joint implant about three years ago.
"Oh yeah?"
Yeah, that's you. "Me?" Yes. [patient laughs]
and today here she's on follow-up for a toe fracture
but we just want to take a look at the joint right here
see how she's doing and that joint looks good, great on the x-ray
and let's take a look at the patient's foot.
Okay, awesome, awesome. Range of motion is perfect, it used to be stuck before surgery
no pain, scars hardly visible.
How was the surgery?
"Surgery was falling off a log, nothing to it."
Nothing to it, so three years ago, so how was the pain afterwards?
"Minimal, don't remember very much about it."
Are you happy you had the surgery done? "Oh absolutely."
Big difference? "Big difference."
Huge difference. "Huge difference.
Were you scared before surgery?
"No I wasn't too scared, I had confidence in the doctor."
Well, thank you. [patient laughs]