“Dr. Bowman, My referring doctor told me I had a Paronychia.  What is it?”  I get this question at least once a week.

A Paronychia is a skin infection that occurs around the nails and is often occur with an Ingrown Nail.  This condition is usually caused by an injury to the surrounding tissue of the nail from picking at the nail, improper trimming of the nail and trauma. 

The main symptom of a Paronychia is a painful, red area with swelling to the nail fold.  More often than not pus or drainage is present.  There may be pus filled blisters with a bacterial infection.  Acute Paronychia is typically caused by bacteria called Staphylococcus Aureus.

Treatment is often to perform a minor procedure in the office where the area is drained and a culture will be taken to determine the bacteria.  A small portion of the nail may need to be removed as well.  The patient will be given oral antibiotics and soaks with a topical antibiotic.

A chronic Paronychia is one that “comes and goes” or one that clears up on its own but then reoccurs. Chronic conditions can cause permanent damage to the shape of the nail and spread of infection to other areas, including tendons, bone, or blood stream.

If you see pus or drainage from a toenail, contact your local podiatrist right away before the condition spreads.

Dr. Bowman is a Foot and Ankle surgeon with Houston Foot Specialists and can be contacted at www.houstonfootspecialists.com  or by calling 713-467-8886.

You may have recently seen television ads regarding “Minimally Invasive Bunion Surgery” or “Mini Bunionectomy.”  This is a procedure available at Houston Foot Specialists performed by Dr. Jeffrey Bowman.

The first step in evaluating whether the Mini Bunionectomy is right for you is to understand what causes the bunion or “Hallux Abducto Valgus” deformity. The space between the first and second metatarsal bones (the long bones in your foot) is called the Inter-metatarsal angle or “IM angle”.  As the angle increases, so does the growth at the base of the big toe (Hallux) from shoe pressure.  The big toe usually drifts toward the second toe, sometimes overlapping or underlapping the second toe.  Some of the factors causing this include weak ligaments, trauma, improper fitting shoes, tight high heels, flat feet, and hereditary factors.  When bunion pain first starts, it should be treated conservatively.  If this fails, then surgery is usually indicated.

There are numerous bunion procedures, and your podiatrist will take X-rays and perform a biomechanical exam to determine which procedure is the one that is correct for you.  The bone enlargement is removed in all procedures and the big toe is placed in a straighter position.  

Most bunion procedures are named after the surgeon who developed them.  One procedure that isn’t named after a doctor is the minimally invasive procedure called the “Mini-Tight Rope” procedure.  It is extremely important that a patient realize this procedure is not meant for everyone.  As with any surgical procedure, complications could develop.  Your podiatrist will determine whether you are a candidate for surgery and whether the “Mini-Tight Rope” procedure is right for you.  What does the “Mini-Tight Rope” procedure involve?  Two small incisions are made: one to remove the enlarged bone at the base of the big toe, and the second incision is placed over the second metatarsal.  Next, a very strong type of suture is placed into the first metatarsal then passed through the second metatarsal to pull the first metatarsal over toward the second, in essence narrowing the foot.  This is secured in place by two small “buttons” on either side of both bones.  A shift is needed in all procedures to help minimize any return of the foot deformity and again, your podiatrist will determine if this procedure or another is better to correct your bunion.

If you suffer from pain at the base of the big toe or Bunion Deformity, please see your podiatrist.  At Houston Foot Specialists, we perform and are experienced in all types of bunion procedures.  Contact us at www.houstonfootspecialists.com for details and ask a question on our “Contact Us” page.  Or, you may call Dr. Bowman at 713-467-8886, and one of our caring and friendly staff members will be glad to help.  Our goal is to stop your foot pain and get you back into all the shoes you want to wear with comfort!

One of the most painful and frequent foot ailments is an ingrown nail.  There are three major causes of ingrown nails.  The most common cause of getting an ingrown nail is improper trimming of the nails.  If you round the nails or cut into the corners, your chances of getting an ingrown nail are much greater.  Trauma is another cause of an Ingrown Nail, with improper fitting shoes as the third most common cause.

We often see ingrown nails with red skin growing over the nail itself with pus or drainage.  If an infection is present, we will usually take a culture to determine the type of bacteria present, and we will typically prescribe an antibiotic and foot soaks.  In some cases, we may provide temporary relief by trimming out a part of the nail.  However, until the infection is gone, we usually leave the nail as is to prevent further infection.

Once the infection is gone, a simple, quick in-office procedure can be performed to prevent the ingrown nail from returning.  The procedure is done under local anesthesia where a portion of the nail is removed; then, the nail growth center for that part of the nail is either surgically removed or chemically destroyed.  Normally, no pain medication is needed.  The old saying in Podiatry is, “Once you have an ingrown nail, you will always get another.”  However, we have found that after this procedure, the chance of your ingrown nail returning is very low.  Normal skin will fill in where the sliver of nail was removed.  

If you have nail pain, don’t wait because it usually won’t go away on its own.  Contact our office at www.houstonfootspecialists.com or call, 713-467-8886 and Dr. Jeffrey  Bowman will be glad to get you the help you need.