Extra skin on big toe: The request could not be satisfied
Skin and Toenail Conditions | Boston Medical Center
Skin and toenail conditions include any unusual discoloration, irritation or unusual appearance.
Ingrown nails are nails whose corners or sides dig painfully into the soft tissue of nail grooves, often leading to irritation, redness, and swelling. Usually, toenails grow straight out. Sometimes, however, one or both corners or sides curve and grow into the flesh. The big toe is the most common location for this condition, but it can also occur on other toes. Ingrown toenails may be caused by improperly trimmed nails, they run in your family, shoe pressure that crowds the toes, or repeated trauma to the feet from normal activities.
You should see a podiatrist immediately if any drainage or excessive redness is present around the toenail. Home treatments may help treat ingrown toenails. If there is no improvement after three days, see your podiatrist. If you have diabetes or poor circulation, you should seek immediate treatment at the first signs of an ingrown toenail, as it can lead to more severe complications.
Toenail fungus, or onychomycosis, is an infection underneath the surface of the nail caused by fungi. Symptoms include a progressive change in a toenail’s quality and color, which is often ugly and embarrassing.
You should visit a podiatrist when you notice any discoloration, thickening, or deformity of your toenails. The earlier you seek professional treatment, the greater your chance at getting your fungal infection to clear. Treatments vary, but may include an oral antifungal, a topical prescription, or surgery to remove the infected nail.
Warts are caused by a virus and can appear anywhere on the skin. Those that appear on the sole of the foot are called plantar warts. Your podiatrist can remove warts by a simple surgical procedure or laser treatment, performed under local anesthetic.
Corns and Calluses
Corns and calluses are areas of thickened skin that develop to protect that area from irritation. They occur when something rubs against the foot repeatedly or causes excess pressure against part of the foot. If the thickening of skin occurs on the bottom of the foot, it’s called a callus. If it occurs on the top of the foot (or toe), it’s called a corn. Corns and calluses are not contagious but may become painful if they get too thick. In people with diabetes or decreased circulation, they can lead to more serious foot problems.
Corns and calluses are diagnosed based on appearance and history. If you have mild corns or calluses, your podiatrist may suggest changing your shoes and/or adding padding to your shoes. Larger corns and calluses are most effectively reduced (made smaller) with a surgical blade. A podiatrist can use the blade to carefully shave away the thickened, dead skin—right in the office. The procedure is painless because the skin is already dead. Additional treatments may be needed if the corn or callus recurs.
Skin cancers of the feet have several features in common. Most are painless, and often there is a history of recurrent cracking, bleeding, or ulceration. Frequently, individuals discover their skin cancer after unrelated ailments near the affected site.
Podiatrists are uniquely trained as lower extremity specialists to recognize and treat abnormal conditions on the skin of the lower legs and feet. Skin cancers affecting the feet may have a very different appearance from those arising on the rest of the body. For this reason, a podiatrist’s knowledge and clinical training is of extreme importance for patients for the early detection of both benign and malignant skin tumors.
Learn the ABCDs of melanoma. If you notice a mole, bump, or patch on the skin that meets any of the following criteria, see a podiatrist immediately:
- Asymmetry – If the lesion is divided in half, the sides don’t match.
- Borders – Borders look scalloped, uneven, or ragged.
- Color – There may be more than one color. These colors may have an uneven distribution.
- Diameter – The lesion is wider than a pencil eraser (greater than 6 mm).
- To detect other types of skin cancer, look for spontaneous ulcers and non-healing sores, bumps that crack or bleed, nodules with rolled or “donut-shaped” edges, or scaly areas.
Dry Skin (Cracked Heels)
There are many potential causes of “cracked heels.” Dry skin (xerosis) is common and can get worse if you wear open-back shoes, gain weight, or have increased friction from the back of shoes. Dry cracking skin can also be a subtle sign of more significant problems, such as diabetes or loss of nerve function (autonomic neuropathy). Heels should be kept well moisturized with a cream to help reduce the cracking. If an open sore is noted, make an appointment with a podiatrist.
Sweaty feet are a common disorder in which the sweat glands of the feet produce excessive sweat. People with this condition usually have a genetic predisposition or are under stress, which activates the brain to produce more sweat to keep the body cool. Athlete’s foot or smelly feet may accompany sweaty feet. The foot and ankle surgeon can recommend one of a variety of treatments for this condition.
Psoriasis is a skin condition characterized by dry, whitish patches on the skin. Normally, new skin cells rise to the surface of the skin once a month; the old surface skin cells die and fall off while the new cells are moving to the surface. In people who have psoriasis, the new cells move to the surface so rapidly that the dead cells build up on the surface. Some people have mild cases of psoriasis. Others have extensive cases that affect multiple parts of the body.
Weird Things That Can Happen To Your Toenails And Feet
Your feet don’t exactly have a reputation as being the cleanest part of your body. Every time you walk around barefoot, you subject them to the germs of the great outdoors. You stick them into sweaty sneakers on the reg, and honestly, you probably forget to wash them in the shower (along with your legs). So it only makes sense that some seriously gross stuff can happen to your paws.
Don’t fret—most of the issues that crop up on your toes and feet are (a.) totally normal and (b.) treatable, says Brian Fullem, D.P.M., a podiatrist and author of The Runner’s Guide to Healthy Feet and Ankles. (Whew!) Here, he outlines some of footsie problems he sees most frequently and how to get your feet back to fresh pedicure, strappy-sandal status, stat.
Skin Growing Around Your Nails
When your skin starts to grow around the corner of your toenail, causing redness and discomfort, you’ve got an ingrown nail. There are two main types of ingrown nails, according to Fullem: those caused by improper cutting and those that just naturally occur.
To avoid creating an ingrown nail yourself, always cut the nail slightly rounded (the nail should be the same shape as the end of your toe). And don’t cut down into the corners. “Often times, a sharp edge is left that will grow into the skin in weeks or a month or two and that can create a bad infection,” says Fullem.
If it’s just one ingrown that pops up out of the blue, soak it in warm water and epsom salts for 10 minutes and apply antibiotic ointment such as Neosporin twice a day, he suggests. If you get recurrent ingrowns, a podiatrist can clip your nails professionally, too.
Seem to simply be predisposed to them even if you’re trimming properly? A podiatrist can perform a procedure called a partial matrixectomy, which partially removes the side of the nail permanently. (A chemical kills the nail matrix cells, which stops it from growing.) “The area will drain and be slightly sore for a few weeks after the procedure, but the end result, if successful, is the elimination of future ingrown nails,” Fullem notes.
Related: Ingrown Toenail-Removal Videos Are The New Pimple-Popping Videos
Thickened, Discolored Nails
If your toenails are looking super thick, gross, and are causing you pain, odds are you’ve got a nail fungus. “Fungus in the nail is known as onychomycosis,” says Fullem. “It typically develops from micro-trauma from being in the shoes, as fungus normally resides in everyone’s shoes.”
Yes, this sounds gross, but the good news is that fungus is not a threat to your health and won’t spread to other parts of your body, Fullem says. While there are no lifetime cures for fungus, Fullem notes that every six to nine months, the nail is replaced completely by a new one. However, it’s worth noting—that new nail can also get infected. “Spraying some anti-fungal spray in your shoes and on your feet may help prevent a recurrence,” he says.
The good news: “There are two newer topical agents which work fairly well, Jublia and Kerydin,” says Fullem. The bad news: “You have to apply the medicine every day to the nail for up to a year and most insurances do not cover the medications.” (An eight-milliliter bottle of Jublia, for example, costs about $173, he says.)
Another option is the oral medication Lamisil, which is less expensive than the above-mentioned medicines. But Fullem notes that while it has a high success rate (up to 70 percent), your body clears it through the liver, so there are some concerns about toxicity. A final treatment option is laser treatment, but it’s not covered by most insurance plans and can cost anywhere from $150 to $1,500, depending on where you live.
Watch a hot doctor explain why your feet are peeling:
These lovelies are a common occurrence among runners, dancers, and those who find themselves jumping, stopping, and starting more than the average human. “The nails may jam into the end of the shoes, creating a blood blister under the nail which will give it the black appearance,” says Fullem.
If you can see some of the skin bubbling at the tip of the nail, sterilize a needle and puncture the blob to release some of the fluid, he says. This should relieve pain, he notes. Can’t do it yourself? Your podiatrist can. Fullem says he almost always drains blood blisters because of the relief it brings, but says doing so isn’t 100 percent necessary.
Just remember: Don’t take the nail off, he says. Since it’s already likely separated from the tissue underneath, it’s “dead” and will fall off or get pushed out by the nail starting behind it.
When the nail does fall off, Fullem says, apply antibiotic ointment to prevent bacteria from growing. You can also soak your feet in warm water and epsom salts. “Ideally, the nail will grow back in normally,” he says. “But expect the entire nail to take six to nine months to grow in fully.” Make an appointment with a podiatrist if you notice any redness streaking up your toe or find yourself in more and more pain. Says Fullem: “These are signs of a bacterial infection that may require oral antibiotics.”
Related: 5 Reasons Why Your Toenails Are Black—And When You Should See A Doctor
A Weird, Fleshy Growth
Noticing some fleshy bumps on your feet? You most likely have plantar warts. These aren’t really that different than warts anywhere else on your body—it’s just that the medical term for the bottom of the foot is the “plantar side,” says Fullem.
“Warts are caused by the verrca vulgaris virus and can multiply and spread to other parts of the body—this is known as the Koebner phenomenon,” says Fullem. Like with a cold, you get infected by someone who already has the virus, he says. FWIW, he’s had patients with 50 to 60 warts on one foot! As you can imagine, this can be painful and debilitating.
Unfortunately, most warts don’t respond well to OTC treatment. “In the U.S., all wart medicine is over-the-counter and no more than a weak concentration of salicylic acid, which does not work well on the bottom of the foot due to the thickness of the skin,” Fullem says.
Podiatrists, though, can perform excisions and can also prescribe topical, injectable, and oral treatments, he notes. Fullem uses a medicine called Canthacur-PS. He also suggests taking 15 milligrams of zinc and 10,000 IUs of vitamin A twice a day. Vitamin A helps the skin turn over faster and may have an affect on the virus, he says, while zinc helps the body with immunity.
Related: Make Sure You’re Not Eating While You Watch This Epically Gross Ear-Pimple Extraction Video
Cracked, Bleeding Feet
This isn’t necessarily a sign that you need to use more moisturizer—rather, it’s a hallmark characteristic of tinea pedis, a.k.a. athlete’s foot. It’s a fungal infection that can lead to red, peeling, bleeding soles . “Fungus requires three elements to develop in the skin: darkness, warmth, and moisture,” says Fullem. Think: the locker room of your gym, showers, and tile around the pool.
Fortunately, athlete’s foot responds well to topical creams and lotions. If you’re suffering, try an anti-fungal cream once or twice a day for a month.
Don’t notice any progress? Attack the cause of the fungus.“Eliminating the moisture is the easiest to accomplish,” Fullem says. He suggests spraying an antiperspirant on your feet, always drying well before putting on your socks and shoes, and using socks make of Coolmax-type fabrics, which wick moisture away from your feet.
Cassie Shortsleeve is a skilled freelance writer and editor with almost a decade of experience reporting on all things health, fitness, and travel.
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Calluses – Podiatrist in Green Bay, WI
A callus, also known as hyperkeratosis, is an area of hard, thickened skin that can occur across the ball of the foot, on the heel, or on the outer side of the big toe. Although many consider them a skin problem, they are indicative of a problem with the bone.
Calluses form from repeated friction and pressure, as the shoe (or ground) rubs against a bony prominence (bone spur) on the toe or foot. The skin thickens in response to this pressure. Small amounts of friction or pressure over long periods of time cause a corn or callus. A great deal of friction or pressure over shorter periods of time can cause blisters or open sores. Calluses typically develop under a metatarsal head (the long bone that forms the ball of the foot). Calluses have painful nerves and bursal sacs (fluid-filled balloons that act as shock absorbers) beneath them, causing symptoms ranging from sharp, shooting pain to dull, aching soreness.
Calluses can be treated with over-the-counter callus removers, which use strong acids to peel this excess skin away after repeated application. Be careful using these products as they can cause chemical burns when misapplied or used in excess. Alternatively, treat calluses as follows: Begin by soaking the foot or feet in warm soapy water and gently rubbing away any dead skin that loosens. Next, use a pumice stone or emery board to file away the thickened skin. Apply a good moisturizer to the hardened areas to keep them softer and relieve pain. Nonmedicated corn pads or moleskin (a thin fuzzy sheet of fabric with an adhesive back) are available in stores and can relieve pain caused by calluses. However, use caution removing pads or moleskins to avoid tearing the skin.
If you need assistance relieving calluses, please contact our office. We can trim and apply comfortable padding to the painful areas. In more severe cases, we may prescribe medication to relieve inflammation, or inject cortisone into the underlying bursal sac to rapidly reduce pain and swelling.
A plantar callus forms on the bottom of the heel over time where one metatarsal bone is longer or lower than the others. This structure causes the one metatarsal to hit the ground first and with more force than it is equipped to handle. As a result, the skin under this bone thickens. In most cases, plantar calluses can be treated without surgery. In some recurring cases, however, a surgical procedure, called an osteotomy, is performed to relieve the pressure on the bone.
A condition called Intractable Plantar Keratosis (IPK) is a deep callus directly under the ball of the foot. IPK is caused by a “dropped metatarsal,” which happens when the metatarsal head drops to a lower level than the surrounding metatarsals and protrudes from the bottom of the foot. This results in more pressure being applied in this area and causes a thick callus to form. A dropped metatarsal can either be a congenital abnormality, a result of a metatarsal fracture, or a structural change that may have occurred over time.
You can prevent calluses by:
- Switching to better-fitting shoes or using an orthotic device to correct an underlying cause.
- Buying socks with double-thick toes and heels or nylon hose with woven cotton soles on the bottom of the foot.
Ingrown Toenails Specialist in NYC
Updated on Jul 29, 2021 by Dr. Mohammad Rimawi (Podiatrist) of Manhattan Foot Specialists
Ingrown toenails are the result of the corners or edges of your toenails growing into the skin of your toe. Ingrown toenails most commonly occur on your big toe. This problem affects people of all ages and should be examined by a foot doctor in New York to prevent any complications.
Ingrown nails can be very painful and may become infected when they are sticking deep into the skin. If you try to dig the nail out, you may cut your skin and potentially get an infection that could affect the bone. All symptoms should always be evaluated with a thorough consultation and examination by your podiatrist for an accurate diagnosis and treatment plan to exclude any underlying serious condition.
What Causes Ingrown Toenails?
Ingrown nails can be caused by other toenail problems, such as fungal nails. Your foot doctor in New York sees many patients with this issue, especially in those with sweaty feet. Toenails can thicken due to a variety of factors, and this makes them more likely to become ingrown.
Common causes of an ingrown toenail that good podiatrists see regularly include:
- Curved or abnormally shaped toenails;
- Poor cutting techniques — avoid rounding off your toenails; cut straight across, which makes it more difficult for the toenail to curve and grow into your toe skin;
- Injury to your toes;
- Tight-fitting footwear;
- Poor foot hygiene — keep your feet dry and clean;
- Genetic predisposition, such as if your parents have had ingrown toenails;
- Poor posture places undue pressure on your toes.
Certain athletic activities may make you prone to developing ingrown toenails. These strenuous activities include sports like soccer or kickball, where you’re repeatedly kicking a ball. Additional sports at high risk for ingrown toenails common to your foot doctor in New York are football, ballet, kickboxing, and basketball. Sudden stops put a strain on your toes if you’re not wearing loose footwear.
Symptoms of Ingrown Toenails
Ingrown toenails can be painful, and the pain typically worsens in stages. Visit a best-in-class podiatrist in NYC as soon as these symptoms appear so you can avoid further complications. The early symptoms of ingrown toenails include:
- Fluid build-up on your toe
- Tender, hard or swollen skin next to the affected toenail
- Pain when putting pressure on the toe
If your toe becomes infected, you should schedule an appointment with a good podiatrist as soon as possible. Infected symptoms may include:
- Overgrown skin on the affected toe
- Swollen, throbbing, red toe
- Pus oozing from the affected toe
A visit to your foot doctor in New York can help you find effective treatments for these symptoms. Don’t delay if you’re experiencing these advanced pains and swelling symptoms. Get relief.
Diagnosing Ingrown Toenails
A good podiatrist can diagnose your ingrown toenail with a physical examination. It is especially important to see a good New York podiatrist of Manhattan podiatry center if you have diabetes because of an increased risk for infection. If you have poor circulation, also a consequence of diabetes, you’re at a higher risk of developing ingrown toenails. Diabetic foot examinations should be performed at least once a year with a foot doctor in New York. In some cases, X-rays may be required if the following conditions are present:
- Severe pain;
- Ingrown toenail caused by an injury;
- A history of chronic infections;
- Recurrent ingrown nails.
Your foot doctor in New York may also ask about your general health to determine if you fall into a high-risk category, such as having diabetes or poor circulation. A good podiatrist also asks about your family history and a possible genetic predisposition.
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How to Prevent Ingrown Toenails?
A mild ingrown nail can often be prevented by trimming your nail straight across rather than angled at the edges. Wearing shoes with a larger toe box can also prevent ingrown nails. If the ingrown nail shows no sign of infection (redness, swelling, pain, pus), you can trim the nail without digging into the skin until you can make it to a foot doctor in New York. If your toenail has pierced the skin or shows signs of infection, please schedule an appointment with a foot doctor in New York. Typical signs of infection include pus, toe warmth, swelling, or redness.
Seeing a good podiatrist is important in the early stages of having an ingrown nail. Preventative care is what medicine has focused on in recent years, and we would like to ensure your nail issue does not worsen to the point that you may need antibiotics or total nail removal.
How to Fix Ingrown Toenail?
If conventional treatments fail to solve your ingrown toenail issues, you may need a surgical procedure from a good podiatrist. Your foot doctor in New York may have to surgically remove part of your toenail or even your complete toenail. Your procedure is determined by how bad your ingrown toenail is and how many times it has needed treatment.
After a local injection for the pain, the surgical procedure can proceed. Your foot doctor in New York then removes part or all of your toenails. The surgical procedure is known as a nail avulsion. A matrixectomy can be performed to prevent part of the nail from growing back. A good podiatrist of Podiatry in New York will explain the type of procedure that’s right for you.
Complications from Ingrown Toenails
Untreated ingrown toenails can cause infections in your bone. This leads to open sores, foot ulcers, and a decrease in blood flow to the infected part of your foot. Additional consequences include tissue decay and death of the tissue in the area of the infection.
Diabetes issues can make foot infections even more serious. If you have diabetes, even a tiny cut on your toe from an ingrown toenail can quickly become infected. Diabetes also affects nerve sensitivity and the amount of blood flow to your infected toe. If you have diabetes, see a foot doctor in New York.
Do you have any questions about Ingrown Toenails treatment in NYC? Would you like to schedule an appointment with an internationally recognized, top NYC Podiatrist and foot doctor at Manhattan Foot Specialists? Please contact our state-of-the-art facility for a consultation.
Dr. Mohammad Rimawi has either authored or reviewed and approved this content.
New York City Locations
Manhattan Foot Specialists (Upper East Side)
983 Park Ave, Ste 1D14, New York, NY 10028
Manhattan Foot Specialists (Midtown)
51 East 25th Street, Ste 451, NY 10010
Manhattan Foot Specialists (Union Square)
55 W 17th St Ste 106, NY 10011
Neuhaus Foot & Ankle: Podiatry
If your big toe is throbbing and hurts when you put on shoes or walk, you may have an ingrown toenail, which is a common condition that occurs when a piece of your toenail cuts into the corner of your toe skin.
Causes of ingrown toenails
There are many factors that contribute to an ingrown toenail, which usually affects your big toe:
- You bumped your toe
- Your shoes are too tight
- You’re genetically predisposed
- You cut your toenails too short
- You cut your toenails at an angle instead of straight across
- You dance, play sports, or have a job that requires you to put a lot of pressure on your toes
- You’re overweight
- You don’t clean and dry your feet properly
Home remedies for ingrown toenails
Fortunately, ingrown toenails aren’t usually serious, but they can be painful. You can treat them at home with some of the following remedies:
- Applying antibiotic ointment
- Taking pain medications like Advil® or Aleve®
- Soaking in Epsom salt
- Wearing a toe protector in your shoes
- Wearing loose shoes
When to seek a podiatrist for an ingrown toenail
There are times, however, when an ingrown toenail causes significant problems and requires some professional help. At Neuhaus Foot and Ankle, with multiple locations in Murfreesboro, Brentwood, Hermitage, Nashville, Waverly, Smyrna, and Lebanon, TN, our team of expert podiatrists offers some suggestions for when you should seek help at one of the clinics.
If your toe is warm to the touch, has red streaks, or oozes pus, you should seek immediate care to prevent the infection from spreading to your soft tissues or bones.
The pain is persistent
While an ingrown toenail is painful, it shouldn’t stop you from enjoying your day-to-day activities. If the pain is slowing you down or keeping you up at night, see our team to get some much-needed relief.
You have diabetes
If you have diabetes, you already know you need to take extra precautions to care for your feet. Diabetics often suffer from reduced blood flow and nerve damage. Foot problems that stem from sores, calluses, ingrown toenails, and corns are primary reasons that diabetics seek care at a hospital. We can save you the trip.
You have vascular disease
A relatively small problem like an ingrown toenail can become a big deal if you have blood flow problems due to vascular disease. Nerve damage means that you often don’t discern the extent of a problem until the situation is advanced.
Treating an ingrown toenail
To treat your ingrown toenail and alleviate your pain or infection, one of our skilled podiatrists gently lifts and removes the piece of your nail that’s causing the problem. We know your toe is sore and you’re in a lot of pain, so we use a local anesthetic to make sure you’re comfortable during the quick procedure.
In some cases, we may suggest lifting and splinting the nail instead of removing it. This helps train it to grow away from the skin and prevent future problems.
For fast relief from your ingrown toenail, call Neuhaus Foot and Ankle at 615-239-6207 or use the convenient online scheduling option.
North Star Foot & Ankle Associates: Podiatry
An ingrown toenail is annoying and often painful. Constant walking rubs the toes against socks and shoes, causing further irritation to the ingrown toenail. If left untreated, an ingrown toenail can become infected and cause even more discomfort.
Medically known as Onychocryptosis, an ingrown toenail can occur to anyone, at any age, although it seems to be slightly more common in males than in females. It’s one of the most common problems a person can experience with their toes.
If an ingrown toenail is causing you grievances, it’s time to learn the best way to remove it and be comfortable again.
Natural Ingrown Toenail Treatment Remedies
There are several natural remedies to treat an ingrown toenail.
Many people prefer to try these options before purchasing OTC medications or scheduling an appointment with the doctor.
If you’d like to try a natural, at-home ingrown toenail solution, the following are among the top solutions used:
Soak the affected foot in warm, soapy water to keep bacteria at bay. Add Epsom salt to the water to soften the skin. Soak the foot three or four times daily.
Rubbing essential oils on the ingrown toenail is an effective way to soften and soothe the skin, minimize the pain, and hopefully draw the toenail out of the skin.
Use dental floss under an ingrown toenail to help shift the nail into the correct growth direction. Ingrown toenails occur when the nail grows downward into the skin. Simply lift the edge of the nail containing the ingrown toenail and place the dental floss between it.
Castile Soap Wash
If you’re unable to soak your foot three or four times per day, use castile soap once per day instead. Use the soap with water to cleanse the nail bed using a soft washcloth.
Cutting an Ingrown Toenail
If you prefer to cut the ingrown toenail, it is best that you have someone help you or schedule an appointment with your doctor.
Cutting the ingrown toenail incorrectly could make the issue worse and increase pain.
If you choose to remove the toenail yourself, follow these steps for accuracy:
- Soak your foot in Epsom salt or Castile soap for 30 minutes to soften the toenail. This will reduce the pain and swelling after removal.
- Wash your hands. It is imperative that your hands are clean before you start removing an ingrown toenail.
- Push the skin back from the nail border. This can be painful! Do not try to force the skin back further than it will go.
- Cut the toenail straight across, starting at the toenail edges. Do not cut the toenail from the middle.
- Place a piece of cotton between the nail and the skin to prevent it from growing back into the skin. Slightly raise the edge of the problematic toenail to make the insertion.
- Apply a medicated ingrown toenail ointment to the affected area. Numerous ingrown toenail ointments are sold at pharmacies and online.
- Apply a bandage to the infected toenail. Do not touch the area. The toenail area will likely be painful and swollen.
- Change the cotton in the toenail twice per day to keep it clean and free of bacteria and germs.
Treating Your Ingrown Toenail
Carefully follow the instructions above if there is an ingrown toenail causing you grief. In a matter of a few short weeks, the issue should be resolved! If your ingrown toenail is advanced, removing it yourself may not be impossible. Instead, it is a good idea to schedule an appointment with your doctor who may recommend a surgical treatment to remove the ingrown toenail.
There are a few surgical options, including the Matrixectomy, Wedge Resection, and the Vandenbos Procedure. The doctor will determine which option is most suitable for your ingrown toenail after evaluating the specific circumstances of your case.
Is My Ingrown Toenail Causing My Toe To Feel Numb? – Auckland Ingrown Toenail Clinic
While the most common descriptors of ingrown toenails from our patients include painful, frustrating, uncomfortable, annoying, excruciating, can’t-wear-shoes-anymore and can’t-sleep-at-night, we recently had a patient call in to book an appointment because he’d had an ingrown toenail for a couple of weeks now, and alongside some pain and discomfort, it was feeling quite numb.
Meeting him at the clinic, we discussed that he’d tried looking up online whether numbness, particularly around one side of his big toe, was normal or if it could be a sign of something more sinister – with no luck at all from Dr. Google. So today, our podiatrists at the Auckland Ingrown Toenail Clinic thought we’d answer this question for anyone else stuck in the same boat: Is numbness normal in ingrown toenails?
No, we don’t usually expect your toe to feel numb
First thing’s first: in our experience, numbness is not on the ‘typical’ or ‘expected’ list for common symptoms associated with ingrown toenails. We expect feelings of pain, swelling, redness, bleeding, and even clear/yellow discharge if an infection is present, because given that a piece of nail is currently piercing into your skin, these are all fairly normal responses from your body.
Your body wants to stimulate quick healing and direct your immune cells to the site to fight off infection or prevent it – and hence your toe swells and becomes red with the increased blood flow. The action of the nail piercing the skin is painful, and any additional pressure to the area from shoes or bed sheets will exacerbate the pain. This is all expected.
Numbness, on the other hand, is a ‘neural symptom’, meaning that it starts from a problem or interruption in one of the nerves in your foot, leg or back that then, instead of delivering clear messages of sensation or pain to your brain, provides a numb feeling. Is the cause of the nerve interruption having your nail pierce the skin? It’s unlikely – especially given that the problem is at the tip of the toe, and if your whole toe is numb, we’d expect the nerve interruption/damage to occur further up the toe or foot.
But, it’s definitely possible
With that said, it could be that your toe is so intensely swollen – and you’ll know if this is happening to you – that all the extra fluid and pressure in your toe is pressing on a nerve and creating those neural symptoms, which can include numbness, pins and needles, burning, tingling and more. So we’re not ruling it out completely or saying that it doesn’t happen, it’s just not the ‘norm’. If this is the case, the numbness would be very localised to the tip of that toe – and wouldn’t extend far down the toe, the foot, or to the other toes. That’s just due to the way our nerves work and give sensation to different areas of the feet.
It could be the symptoms of two problems, simultaneously
It may well be that the numbness you’re feeling is a symptom of another problem, that just so happens to be affecting your problematic ingrown toe, as well as potentially other parts of your feet or legs. There are a number of causes of numbness in the toes and feet, including:
- Diabetes – this is the most common cause, and arises because, over time, diabetes causes damage to our nerves, which leads to a problem called peripheral neuropathy – which causes numbness and other neural symptoms in our feet. It can also ultimately lead to the complete absence of sensation, so you’ve got to be very careful
- Arthritis – whether it’s rheumatoid arthritis, osteoarthritis or gout, if you’ve got arthritis in the joints of your feet, particularly at your big toe, and particularly if you’ve got some notable swelling happening, then this may be compressing the nerves in your feet and resulting in numbness in the big toe
- A new injury – following similar principles to arthritis, if you’ve recently injured your foot, whether it’s a muscle, tissue or bone, and you’ve still got some new or lingering swelling, it may be compressing a nerve and causing your numbness. Or the injury itself may have damaged a nerve, resulting in the same symptoms
- It’s winter, and the blood vessels in your feet have constricted – a less common but possible cause is vasoconstriction, meaning the narrowing of the blood vessels, in your feet. Cold is a big cause of this, as our body wants to minimise heat loss and so our blood vessels constrict. The result is decreased blood flow, especially at the tips of the toes, which leads to problems like Raynaud’s, frostbite and more. If this is the case, you’ll also likely notice your feet feel quite cold, and may be white and patchy
- Circulation problems – following on from the above, you may just have circulation problems, and the same process is happening, except that the weather isn’t the cause, but it’s the changes or damage to the blood vessels creating the problem
- It’s your bunion (if you have one) – finally, it could be related to the joint changes you’re experiencing in the big toe joint at the ball of the foot directly related to your bunion
It’s a clear indicator that you need to treat your ingrown toenail – as your risks increase
Whatever the reason, one thing that’s definitely for sure is that you need to have your ingrown toenail treated ASAP. We rely on our body’s ability to feel to inform us of so much – including when things are going wrong, which we feel as pain. If the numbness is taking over to the point where instead of pain, we feel numb, then our body isn’t alerted to the problems we may be experiencing – including ingrown toenails. This puts you at risk of your nail significantly worsening, developing an infection, or even a secondary infection (which is when it gets pretty bad!), and you being unable to detect it due to the numbness. When you don’t detect it, you don’t know that you need to treat it – and so the problem worsens.
It’s a vicious and dangerous cycle, and the long story short is that if you have an ingrown toenail and you’re getting any numbness, reduce your risks and have your ingrown toenail treated ASAP. Most ingrown toenails do not get better on their own, so for most people, they are just delaying the inevitable.
Uncertain as to what’s happening with your toe?
We’re here to help. We’re Auckland’s leading ingrown toenail experts, and offer a number of solutions for painful, frustrating and numb ingrown toenails, including options to fix the problem permanently using a minor surgical procedure.
For any questions, or to book an appointment with our team, give us a call on 09 523 2333 or book online. We’re located within the One Health Clinic in Remuera, inside Perform Podiatry.
90,000 What you need to know about hardened feet
The skin of the legs may not be as delicate as the skin of the face, but only rough skin every day can withstand the pressure of our body weight.
The process of skin thickening (formation of keratinous skin) is a natural defense that helps maintain healthy legs.
However, excessive pressure for a long time, as well as friction, causes the skin to thicken too much, which is also known as hyperkeratosis.
2. Rough skin forms on specific areas of the foot
Although dry calluses can also be found on the hands, they most often appear on the heels and on the joints of the toes.
The toes carry the most pressure when walking, and the heels are usually the victim of uncomfortable shoes.
3. Remove rough skin regularly
Each of us has coarse skin on our feet, however, some have this layer thicker, while others – thinner.
To prevent hardened skin from causing discomfort, pain and discomfort, it is necessary to remove it promptly. Remove excess skin layers every week with, for example, the Scholl electric file with an abrasive surface.
4. Moisturize the skin of the feet
If your feet are getting too dry, use moisturizers or balms, such as Scholl Intensive Moisture Cream. For maximum effect, apply the cream after showering when the skin absorbs moisture better.
5. Wet corn or corns?
When talking about corns, it is important to note that they are different from wet corns. Perhaps they are similar, but the corns are usually oval in shape, and they also turn yellow over time. They also provide a burning sensation in the feet.
Wet calluses, on the other hand, cause severe pain, since its apex is adjacent to the nerve endings.
Is there a solution?
As for the prevention of calluses and rough skin, the best solution would be to opt for comfortable shoes.
When choosing another pair, make sure there is space between the top of your toe and the toe of the shoe. Also try to choose shoes in the evening – it is known that legs can increase slightly in the evening.
To get rid of rough skin quickly and with minimal effort, you can use a Scholl electric file with an abrasive coating.
This file with a rotating roller nozzle allows you to remove calluses and rough skin. The file has three attachments, each suitable for varying skin thicknesses to tackle even the most severe dry calluses.
The bone on the big toe “grows”. Operate or get along? (27.04.2017.)
Surgery of the protruding big toe bone is one of the rarest manipulations in traumatology and orthopedics, which people choose not only because of pain or severe discomfort, but also for aesthetic reasons. If the main motive in considering surgery is a desire to wear tight, graceful shoes, then it might be worth considering it again.
“At the initial stage of hallux valgus, it can be assumed that it can be easily corrected – the” extra “bone just needs to be eliminated”, – Andrey Peredistiy, traumatologist-orthopedist of the ORTO clinic, tells about the ideas of people, – “In reality, everything is much more complicated, because , firstly, this is not just an extra formation, constantly increasing in size, but the first so-called metatarsal bone (its head), which has shifted and protrudes outward. ”
Why is this happening?
The traditional cause of foot deformity is narrow high-heeled shoes.This contributes to an uneven distribution of the load on the foot, especially the toe part is overloaded. The body’s response is a gradual deformation of the bones. In addition, the bulging of the inner bone of the foot is also characteristic of people with flat feet, as a result of which the load on the feet is also unevenly distributed. In addition, the cause of deformity can be endocrine diseases, osteoporosis, as well as a genetic predisposition.
With the progression of the deformity, the ratio of the adjacent bones changes accordingly, as a result of which the second and even the third toe of the foot may be located not next to the rest, but above the big toe.
Myths and truth
Deformity of the bones of the foot is very common. The process of bone displacement is slow and mostly painless, so the problem makes itself felt most often in middle age. About 80% of people who experience hallux valgus simply get along with it. About 20% decide on the operation. “The answer to the question“ when will the operation be done? ”Is simple,” says Andrey Peredisty, “You should think about the operation if you suffer from constant severe pain and it becomes difficult to buy shoes because of deformation.”
Anything else the medical industry offers – liners, insoles, retainers, and ointments – can help reduce symptoms caused by deformity. “You should not blindly believe an advertisement promising to suspend or correct bone deformity,” warns Andrei Peredistyt. “These aids will reduce the discomfort caused by the deformity. The only way to correct the displacement of the metatarsal bone is through surgery, which will restore the correct position of the bones,” the doctor emphasizes.
What will the operation give?
During the operation (corrective osteotomy), the shape of the deformed bones changes by sawing them in a certain place, plane and at a certain angle and further displacement to the anatomically correct position, as a result of which the foot restores its natural structure. Depending on the features of the foot deformity, there are several solutions for corrective osteotomy. After surgery, the foot does not always restore its perfectly narrow and beautiful shape.However, there is no more “extra bone” and all fingers are positioned correctly.
“Often, in order for the foot to regain its ideal shape, it is necessary to carry out several operations,” says Andrey Peredistiy, emphasizing, “that if a person wants to carry out an operation for aesthetic reasons, this does not mean that he is absolutely protected from postoperative risks and complications, that each of us may face.There is a whole chain of diseases, such as diabetes mellitus, vascular diseases, rheumatoid arthritis, gout, which can lead to complications and slow down the healing process.There are also concomitant diseases, for example, neurological, which affect the condition of the tendons and muscles and contribute to the development of new deformities in the foot. This is one of the reasons why the operated bone of the foot begins to grow again after some time.
Reflect on goals
“Compared to other operations, people rarely complain of pain after an osteotomy,” says traumatologist-orthopedist Andrey Peredistyi, emphasizing that it should be borne in mind that the healing process will take six months.In the early weeks, you may need to walk on crutches and wear special shoes or a splint. Swelling may develop on the leg for several months after surgery. In addition, when the foot is completely healed, not everyone will be able to return to their usual sports activities or resume wearing tight high-heeled shoes. “Therefore, I always draw the attention of my patients to the fact that the purpose of the operation should be to eliminate life-burdening deformity and pain.
The bone is growing. What should I do?
● If you see the first signs of flat feet or bone displacement, consult your podiatrist.
● If there are no expressed complaints, then the best way of prevention will be wearing comfortable and high-quality shoes.
● If, as a result of foot deformity, pain and difficulty in walking appear, an orthopedic traumatologist will help you choose the appropriate instep supports or orthopedic shoes and prescribe a course of physiotherapy.
● If the deformity of the foot causes serious problems for movement, there is constant pain, it is impossible to put on any shoes, then it may be worth considering the possibility of an operation
Cones or bones on the legs – Official website of the Federal State Budgetary Healthcare Institution KB No. 85 FMBA of Russia
“Bumps” or “bones” on the toes is a common concept among patients suffering from static deformities of the forefoot, such as transverse flat feet and hallux valgus.
As a rule, patients consider their main problem to be the presence of gradually increasing bone formations in the area of the first metatarsophalangeal joint – “cones” or “bones”, but this is far from the case. Valgus deviation of the first toe can be a reason for limiting the patient’s physical activity and, in some cases, cause psychological problems.
The presence of hallux valgus is not the only disorder found during examination in such patients.As a rule, it is combined with deviation of the first metatarsal bone to the medial side, subluxation of the base of the main phalanx of the first toe, hammer-like deformity of other toes, subluxation of the sesamoid bones, etc.
Reasons for the development of bumps on the legs
Among the most common external causes of bumps or bumps on the feet, the use of narrow high-heeled shoes is considered to be . Scientists have noted a high connection between the presence of Hallux valgus in American women in the 4th – 6th decades of their lives using a certain type of shoe.According to other researchers, the prevalence of hallux valgus Hallux valgus in Japanese women also increased dramatically after the introduction of high-heeled footwear after World War II.
The main internal causes of the formation of bumps on the legs:
- pronation of the hindfoot,
- flat feet,
- increase in the angle between the first and second metatarsal bones ( metatarsus primus varus ),
- contracture of the Achilles tendon,
- laxity and hypermobility of the 1st metatarsal-wedge joint,
- heredity can also be a factor in the development of Hallux valgus ( studies have shown that in 63% of patients with Hallux valgus, parents also suffered from this pathology, valgus deviation of the first toe in children in 94% of cases was detected in their mothers )
- Damage to the nervous system (paralytic deformities, etc.)etc.).
Treatment of bones on the legs
Treatment for hallux valgus, as a rule, begins with conservative methods, especially in the initial stages. Various corrective devices are used, in combination with physiotherapy, physiotherapy exercises, anti-inflammatory therapy. Changing the way of life – limiting static loads on the feet, reducing excess weight, etc., is becoming important in the treatment of bones on goggles.
Preparation for operation
with bones on the legs
bump on the big toe
View of the foot immediately
In advanced stages, as well as with the ineffectiveness of conservative methods of treating bones on the legs, surgical treatment is used.Surgical treatment can include various options for affecting the soft tissue structures of the foot, affecting the bones of the foot, as well as their combination.
Thus, during the surgical treatment of the bones on the legs, the surgeon must determine the pathological elements that need correction ( increased angle of hallux valgus, intermetatarsal angle, pronation of the first toe, increased medial exophyte and subluxation of the sesamoid bones ) and must be eliminated. Despite the large number of methods for treating hallux valgus of the first toe, none of them is universal and in a particular situation in the treatment of a certain deformity of the foot should be determined by the surgeon based on the clinical situation and the data of an objective examination of the patient.
Video reviews of the treatment of bones on the legs in our center
Patient Saurin E.L. – surgery for Hallux Valgus
Patient E. D. Burkova – surgery for Hallux Valgus
Patient S. Shestakova – surgery for bones on the legs
Zdorina T.V. 45 years old – removal of bones on the legs
Video on the treatment of bones on the legs
Pavel Zhadan on Hallux Valgus treatment on TVC
On April 18, 2013, the TVC channel aired the Doctor I program in which the orthopedic traumatologist P.L. Zhadan. The program touched upon the topic of the treatment of flat feet and one of the most common orthopedic pathologies of the anterior part of the feet – hallux valgus. The program highlighted the causes of static foot deformities, prevention and modern methods of treating patients with this orthopedic pathology. We recommend that you watch the full version of the program on our website.
90,000 Why does the skin on our fingers wrinkle when we take a bath
- Jason Goldman
- BBC Future
Photo Credit, Getty Images
Have you ever wondered why our does the skin wrinkle only on the fingers? BBC Future columnist is exploring possible answers to this question.
Areas of the skin that are deprived of hair react in a special way to water. Unlike other parts of the body, the skin on the fingers, toes, palms and feet becomes wrinkled after being in water. This usually takes five minutes.
But why does this phenomenon affect only these areas of the skin?
It is believed that this is the result of a biochemical reaction, an osmotic process in which certain substances are “washed out” of the skin, and it is deformed.
However, scientists knew a hundred years ago that this curious reaction was not a simple reflex or the result of osmosis.
Surgeons have noticed that if certain nerves are damaged in the fingers, then the skin on them does not wrinkle.
Thus, bumps on the fingers are a sign that the nervous system is intact.
Scientists have even proposed using this reaction to test how well the sympathetic nervous system functions in patients if they do not respond to other stimuli.
Photo author, Getty Images
Usually, the skin begins to wrinkle after about five minutes in the water
The scientific community has already reached a consensus on all these issues. Nevertheless, the debate about the origin of this reaction and whether it is the result of adaptation is still ongoing.
Neuroscientist Mark Changizi of 2AI Labs believes this is the result of adaptation. Take a tire tread as an example.
Smooth tires provide better grip on dry roads. This is why racing cars tend to use non-grooved tires. However, when it rains, tread tires are irreplaceable.
Thus, fingers with wrinkles and bumps are best at gripping both dry and wet objects.
However, it is very difficult to prove that a particular biological feature is the result of adaptation, and it can be even more difficult to determine the causes of its occurrence.Scientists can only look for clues and make assumptions about what is the result of adaptation and what is not.
In 2011, Changizi and his colleagues found evidence that wrinkles on the fingers act as a kind of protector.
With excess moisture, they channel water away from the fingers and toes, allowing primates – more precisely, humans and macaques – to better grip objects.
In other words, these wrinkles resulting from exposure to water can be compared to a river basin, where many small streams merge into larger channels that flow into a river channel, or to a tree, where small branches grow on large branches that, in turn originate in the trunk.
At the same time, land areas between canals and streams are not interconnected.
To test whether the wrinkled toes of primates have a structure similar to a river basin, Changizi and his colleagues analyzed photographs of 28 fingers belonging to different people.
They did find the similarity of these diverging and non-intersecting grooves to the river network.
Scientists have also come to the conclusion that the location of the folds obeys a certain logic.The river collects water, while the grooves in the wrinkled finger are designed to divert it.
“When you press the pad of your finger on a wet surface, the water flows through the channels, ensuring optimal contact of the finger with the surface,” the scientists write.
One more fact should be taken into account: wrinkles appear only after five minutes of continuous contact with water.
Author of the photo, Thinkstock
Caption to the photo,
Why do we need these bumps and wrinkles?
This means that to start this process, accidental contact with water is not enough, and this feature of the body becomes useful only in rainy or wet weather.
In addition, the reaction proceeds much faster in fresh water than in salt water. This may indicate the conditions in which we evolved into primates.
It is possible that the irregularities on the fingers are not directly related to the evolutionary processes associated with the improvement of grip, but fingers with wrinkles are still better at this task.
For example, a study by British neuroscientists in 2013 showed that bumps on the pads of the fingers help to hold wet objects more tightly.
During the experiment, 20 people moved 45 objects of various sizes – glass balls and fishing weights – from one container to another.
In some cases, objects were dry and participants’ fingers were smooth or wrinkled. In others, objects were submerged in water.
Scientists have found that participants with wrinkled fingers move objects faster under water, and dry objects at the same speed as the rest.
However, a similar study by German scientists in 2014 showed the opposite.
Researchers asked 40 people to move 52 glass marbles and dice of various sizes and weights from one container to another.
All participants – with both smooth and wrinkled fingers – moved dry and wet objects and showed approximately the same results.
A group of Taiwanese researchers conducted a series of their own experiments with a 24-year-old man.
They measured the friction of the skin of his fingers in contact with a flat surface in a smooth and wrinkled state, as well as the strength of his hands when sliding on a bar.They also evaluated the subject’s ability to compress the spring.
Oddly enough, they found that all exercises were worse when the skin on the fingers was wrinkled.
Photo author, Getty Images
The appearance of bumps on the skin under the influence of water is a natural process
What follows from this? Regardless of whether the uneven skin of the hands is a product of evolution or not, laboratory conditions are unlikely to be suitable for such tests.
Changizi believes that bumps on the skin are needed to keep the body in balance, and not for manipulating small objects.
“To do a truly demonstrative experiment, ask participants to grab onto trees or heavier objects, not small balls,” he says.
The expert notes that when moving balls between containers there is no risk of slipping through the water.
At the same time, it is important to assess the effect of unevenness in the skin on a person’s physical activity, and not on his sleight of hand.
Which experiment does he think is ideal? For example, you can involve in the study parkourists – urban acrobats who could show their tricks with different skin conditions and in different weather conditions.
“Of course you have to take care of their safety,” he adds.
In general, we continue to sit in the water, admiring our wrinkled fingers and not understanding why we need it.
Plastic surgery for polydactyly | Booking Health
Currently, due to the difficulties associated with the organization of treatment in Turkey, Switzerland, South Korea and India, we have suspended the processing of applications in these areas.
If you are interested in organizing treatment in Germany, please leave a request and our specialists will contact you as soon as possible.
Polydactyly is the medical term for the presence of extra fingers or toes. This is a congenital pathology associated with a violation of the formation of limbs under the influence of genetic or external factors. The impacts in the early stages of pregnancy are of the greatest importance, since fingers are visible on ultrasound already from the 41-43rd day of pregnancy, and on the 53rd day they are already fully formed.
This structural defect can be corrected with plastic surgery. The type of intervention and its timing are determined depending on the form of polydactyly. When performed before the age of 2 years, the operation allows you to maintain normal limb function and avoid psychological trauma. Such surgical interventions are possible only in the world’s leading clinics.
- How do I know if my child has polydactyly?
- What types of polydactyly are there?
- Is polydactyly dangerous?
- How can you get rid of polydactyly?
- What happens after the surgery?
- Treatment of polydactyly in the world’s leading clinics
- How to get treatment abroad?
How do I know if my child has polydactyly?
A preliminary diagnosis of polydactyly does not require a special examination; for this, an examination by a neonatologist is sufficient.The visual presence of extra fingers or toes is an indication for further X-ray diagnostics.
X-ray allows you to see the internal structure of the extra finger. It can be made of only skin, or it can look like a regular finger (with bones, ligaments and tendons). Sometimes polydactyly is diagnosed in utero, during the mandatory screening ultrasound.
The disease can be hereditary (most often it is a doubling of the little finger or middle finger) or it can develop for no apparent reason (for example, with a doubling of the thumb).The term “hereditary” means that the mother or father of the child had the same pathology of genetic origin. Also, the disease can occur with genetic syndromes:
- Bardet-Biedl syndrome.
- Greig’s cephalopolysindactyly syndrome.
- Polydactyly of the triphalangeal thumb. 90 130
- And others.
In other cases, there are no genetic disorders, and the developmental malformation is formed in a random way. It is impossible to predict or prevent this.
What types of polydactyly are there?
Three types of polydactyly are distinguished, depending on the location of the extra finger:
- Preaxial polydactyly (or doubling of the thumb).
- Postaxial polydactyly (or doubling of the little finger).
- Central polydactyly (doubling of the middle fingers, extremely rare).
Preaxial polydactyly is the most common type of pathology and is diagnosed in 1 in 1000-10,000 children.Usually these are isolated cases not related to heredity. To differentiate between different types of preaxial polydactyly, doctors use the Wessel classification:
- Type I – splitting of the distal phalanx of the thumb.
- Type II – doubling of the distal phalanx of the thumb.
- Type III – Splitting of the proximal phalanx of the thumb.
- Type IV – doubling of the proximal phalanx of the thumb.
- Type V – splitting of the metacarpal bone.
- Type VI – duplication of the metacarpal bone.
- Type VII – triphalangia.
It is important to establish the exact type of polydactyly, since the choice of the most effective surgical intervention depends on it.
Is polydactyly dangerous?
Having an extra finger does not hurt or bother the child. Until a certain age, the child does not understand that something is wrong with him. Later, when he begins to compare himself with other children, pathology can cause discomfort and lead to problems with adaptation in society.Thus, the first of the negative consequences of polydactyly is psychological trauma .
The second is functional disturbances . This is especially true for the doubling of the thumb and the formation of additional phalanges. The child can squeeze the hand with sufficient force, but fine motor skills suffer. Difficulties appear with writing, interacting with small objects (for example, coins), tying shoelaces, etc.
In rare cases, severe anatomical changes lead to circulatory disorders , functions of sensory and motor nerve endings .This, in turn, can lead to numbness and other sensory disturbances, lack of movement in the affected finger, and even tissue necrosis.
How can you get rid of polydactyly?
Surgical correction is the most effective treatment for polydactyly. The operation improves the child’s appearance and hand function. Surgical treatment includes not only the removal of the extra finger, but also the reconstruction of soft tissues, joints, blood vessels and nerves, tendons and ligaments.When planning plastic surgery, the cosmetic result must be taken into account.
The main goal of surgery is to remove the least functional accessory (finger or phalanx) and restore normal:
- If the accessory finger is connected to the hand only by soft tissues, it can be removed with a “minor” surgery or ligation.
- If the extra finger is formed correctly, the operation includes the correction of bone structures, joints and ligaments.
- In central polydactyly, surgeons actually reshape the entire arm.
It is also important to choose the most suitable age for the intervention:
- Small extra fingers (especially those associated with the hand only by soft tissues) can be removed immediately after birth, at the age of 3-6 weeks.
- Removal of well-formed extra little fingers is usually performed between 6-12 months of age.
- Removal of other well-formed accessory toes is performed later, at 12-18 months of age.
- If surgery to remove extra fingers could not be performed at an early age, then in adults it is performed at any time.
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What happens after the surgery?
Removal of small extra toes without bones does not require subsequent rehabilitation or analgesics. For the prevention of infectious complications, antibacterial drugs are prescribed.
More extensive operations are carried out in the clinic, in an inpatient setting.Such interventions require general anesthesia, which is adapted to the age and weight of the child. Your child will wear a cast or splint for a period of time after surgery. During follow-up visits, the doctor assesses the functional state of the hand. If necessary, the patient is assigned a set of physical exercises.
It is also worth undergoing a more thorough examination, since polydactyly often accompanies heart defects, craniofacial anomalies, and blood diseases.
Treatment of polydactyly in the world’s leading clinics
Since plastic surgery of polydactyly is mainly performed on young children, such interventions require high-tech medical equipment and excellent medical skills. German clinics are among the leading medical institutions in this area. Doctors in Germany develop individual treatment programs, carry out two-stage medical interventions for children with complex pathologies, and pay due attention to quality rehabilitation.
Leading clinics in this field:
- University Hospital Ludwig-Maximilian University of Munich, Department of Hand, Plastic and Aesthetic Surgery
- University Hospital Halle (Saale), Department of Pediatric Traumatology and Surgery
- University Hospital Marburg, Department of Pediatric Surgery
- University Hospital Hamburg-Eppendorf, Department of Pediatric Surgery
- University Hospital Erlangen, Department of Plastic Surgery, Adult and Pediatric Surgery of the Hand
The cost of surgical treatment of polydactyly – from 3,966 euros.
How to get treatment abroad?
Since polydactyly plastic surgery is mainly performed on young children, such interventions require high-tech medical equipment and excellent medical skills. German clinics are among the leading medical institutions in this area. Doctors in Germany develop individual treatment programs, carry out two-stage medical interventions for children with complex pathologies, and pay due attention to quality rehabilitation.
If you are applying for foreign medical care for the first time, it will be more convenient for you to use the full package of services of the Booking Health company. Booking Health is the world’s only certified medical tourism operator with an international quality control certificate ISO 9001: 2015. Booking Health specialists offer assistance with:
- Choosing a suitable university clinic or academic hospital.
- Make an appointment for the desired date.
- Remote communication with the attending physician before and after the operation.
- Preliminary preparation of the treatment program, consultation on the best surgical techniques.
- Providing a favorable cost of treatment, without additional surcharges (savings up to 50%).
- Monitoring the medical program at all stages.
- Account control and return of unspent funds.
- Organization of rehabilitation (if necessary).
- Additional services of the highest level: booking accommodation and air tickets, organizing a transfer, accompanying an interpreter.
Leave a request with contact details and medical information on the Booking Health website, and our consultant doctor will contact you within 24 hours. After discussing all aspects of the medical program, we will support you at all stages of the surgical treatment abroad.
Choose treatment abroad and you will undoubtedly get an excellent result!
Authors: Dr. Valeria Kruzhilina, Alexandra Solovey
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Down Syndrome is a genetic disorder that causes mental retardation, physical retardation, and congenital heart defects.In addition, it is often accompanied by dysfunction of the thyroid gland, hearing and vision impairment.
Down syndrome is the most common disease caused by chromosome abnormalities. As the mother ages, the risk of having a baby with Down syndrome increases.
The disease cannot be cured, its severity may vary.
Treatment depends on the manifestations of the disease. Although it is impossible to get rid of the syndrome itself, working with a defectologist from an early age contributes to the development of the child’s mental functions.
Trisomy on the 21st chromosome, Trisomy G.
Down Syndrome, Down’s syndrome, Trisomy 21.
Children with Down syndrome may have specific facial and head features:
- small head,
- wide face,
- short neck, excess skin on the back of the neck,
- short and wide nose
- underdeveloped upper jaw,
- light gray spots on the iris of the eyes up to the 12th month of life,
- epicanthus – a lunate skin fold in the inner corner of the upper eyelid – “third eyelid” – and, as a consequence, a narrow, Mongoloid eye section,
- small, asymmetrical, low-set ears,
- large tongue without central sulcus, often open mouth,
- Incorrectly positioned teeth.
Also, for patients with Down syndrome, the following symptoms are characteristic:
- low muscle tone,
- disproportionate physique,
- underdevelopment of sexual characteristics,
- wide short palms with one fold instead of two, the thumb is low in relation to the other fingers,
- sandal gap between the first and second toes,
- Relatively short, overly flexible fingers.
Children with Down syndrome usually develop more slowly than normal. They begin to sit, crawl and walk about twice as late as normal children.
Also, patients have a moderate degree of mental retardation.
General information about the disease
Down syndrome is a genetic disorder caused by an abnormality of chromosome 21, which manifests itself in the form of mental retardation, heart defects and developmental disorders.
It is often accompanied by impaired thyroid function, hearing impairment, and vision impairment.
There are 23 pairs of chromosomes in the human chromosome set. In this case, one chromosome from a pair comes from the mother, one from the father. There are 46 chromosomes in the body.
The cause of Down’s disease is an abnormality of the 21st chromosome, which is characterized by the presence of additional copies of the genetic material on the 21st chromosome in the form of trisomy or translocation. Chromosome 21 affects almost all organ systems and is responsible for the traits and developmental features impaired in Down’s disease.
- Trisomy on chromosome 21 suggests a copy of that chromosome. That is, instead of two chromosomes, the 21st pair is represented by three. Thus, in all cells of the body there are three chromosomes of the 21st pair instead of two.
Trisomy accounts for 95% of chromosome 21 abnormalities. It occurs when cell division is disturbed during the formation of reproductive cells (sperm and eggs) of the parents. The extra chromosome is almost always passed on to a child with Down syndrome from the mother.With increasing age of the mother, the risk of having a baby with Down syndrome increases. The older the egg, the greater the likelihood of improper cell division.
- Mosaic variant of the syndrome occurs when only some cells of the body have an abnormal copy of the 21st chromosome. The “mosaic” of abnormal and normal cells is caused by a violation of cell division after fertilization in the embryo.
- Translocation of the 21st chromosome to other chromosomes (more often to the 15th or 14th).Children have two chromosomes 21 pairs and extra material chromosome 21. In this case, part of the 21st chromosome moves to another when chromosome division is disturbed during the formation of sperm and eggs of the parents (about 25% of cases of translocation) or at the time of conception (about 75% of cases).
Thus, Down syndrome is caused by an abnormal cell division during the development of the egg, sperm or embryo.
Down syndrome is not a hereditary disease, although there is a predisposition to its development.Women with Down syndrome have a 50% chance of having a sick child, and spontaneous abortion often occurs. Men with Down syndrome are infertile, with the exception of the mosaic variant of the syndrome.
Carriers of genetic chromosome translocation are also more likely to have a baby with Down syndrome. If the carrier is the mother, the child with Down syndrome is born in 10-30%, if the carrier is the father – in 5%.
Women who have a child with Down syndrome have a 1% chance of having a second sick child.
Children with Down syndrome may experience the following complications.
- Heart defects. About half of babies with Down syndrome are born with heart defects that may require surgery in early childhood.
- Leukemia (malignant disease of the hematopoietic system). Children with Down syndrome, especially at an early age, are more likely to develop leukemia than other children.
- Infectious diseases. Due to disorders of the body’s immune system, children with Down syndrome are more susceptible to infectious diseases.
- Dementia. After 40 years, patients with Down syndrome have an increased risk of developing dementia.
- Sleep apnea. Children with Down syndrome are prone to sleep apnea, a condition in which ventilation of the lungs stops for 20-30 seconds during sleep. In severe cases, sleep apnea can take up up to 60% of the total nighttime sleep. Regular sleep apnea leads to daytime sleepiness, memory impairment, decreased intelligence, decreased performance, and constant fatigue.
Life expectancy of people with Down syndrome depends on the severity of manifestations and is on average 50 years or more.
Who is at risk?
- Women with Down syndrome (men with Down syndrome are usually infertile).
- Mothers after 30 years. With age, the risk of giving birth to a child with Down syndrome increases: by the age of 35 it is 1 in 400, by 45 – 1 in 35. However, approximately 80% of children with Down syndrome are born to mothers before 35 years of age.
- Fathers over 42 years old.
- Carriers of genetic translocation of chromosomes. If the carrier is the mother, the risk of having a baby with Down syndrome is about 10-30%, if the father is about 5%.
- Parents who already have a child with Down syndrome. The risk of having another child with this condition is approximately 1%.
The diagnosis is made on the basis of a characteristic clinical picture. Newborns are tested for Down syndrome.Pregnant women are also assigned studies aimed at identifying Down syndrome in the fetus.
Down syndrome is suspected based on the presence of physical features characteristic of the disease. The diagnosis is confirmed by karyotyping – a study of the child’s chromosomes for abnormalities.
In addition, functions that can be impaired in Down’s syndrome are being investigated – the function of the thyroid gland, visual, auditory analyzers. Possible heart defects and leukemia are identified.
- Thyroid stimulating hormone (TSH) is a hormone produced in the pituitary gland, a small gland located in the brain. It regulates the functioning of the thyroid gland. If its function is disturbed, its level, as a rule, changes.
- Thyroxine is a hormone produced by the thyroid gland and affecting many types of metabolism in the body. In Down’s syndrome, its level may be reduced.
- Bone marrow biopsy. Examining a sample of bone marrow under a microscope can detect leukemia.
In a fetus, Down syndrome may be suspected on screening and ultrasound. An alpha-fetaprotein test is recommended for all pregnant women. In addition, the examination of pregnant women involves the following tests.
First trimester of pregnancy
- Human chorionic gonadotropin (hCG) is a hormone that is produced by the membrane of the embryo and is involved in maintaining pregnancy.
- Pregnancy-associated plasma protein A (PAPP A).Abnormal levels of hCG and PAPP-A may indicate fetal developmental disorders.
Second trimester of pregnancy
- Ultrasound examination – allows you to identify violations of the development of the fetus.
- Alpha-fetoprotein (alpha-AF) – Low levels may indicate Down syndrome.
- The beta subunit of human chorionic gonadotropin (beta-hCG). An increase in the concentration of hCG in some cases is associated with a child’s illness.
- Free estriol.Low estriol levels are also a sign of Down syndrome.
Ultrasound, PAPP-A, alpha-FP, hCG and estriol, combined with maternal age and heredity, can be used to calculate the risk of having a baby with Down syndrome.
These studies are especially important for women at risk of having children with this disease.
If the risk is found to be very high, the following tests can be performed.
- Amniocentesis – taking a sample of amniotic fluid and then examining the fetal chromosomes.
- Chorionic biopsy – Obtaining a sample of chorionic tissue (the outer germ membrane that surrounds the embryo). Allows you to identify chromosomal abnormalities.
- Umbilical blood draw – allows you to identify chromosomal abnormalities. The test is performed if previous studies have been ineffective.
For women with a predisposition to the disease, genetic counseling is recommended during pregnancy planning.
Down syndrome cannot be cured, so therapy is directed at specific manifestations of the disease.
If necessary, surgical operations are performed to treat heart defects, abnormalities of the gastrointestinal tract, examination by a neurologist, cardiologist, ophthalmologist, defectologist, speech therapist, pediatrician, etc.
Early treatment will maximize the capacity of children with Down syndrome and improve their quality of life. Immediately after birth, it is extremely important to develop the child’s motor, cognitive sphere, and his mental functions. There are special preschool and school institutions where a program has been developed for children with an appropriate level of intelligence.
Prevention of the birth of children with Down syndrome has not been developed. People who are at risk of having a child with this disease are advised to undergo genetic testing during pregnancy planning.
- Free beta-subunit of human chorionic gonadotropin (beta-hCG free)
- Pregnancy-associated plasma protein A (PAPP A)
- Alpha-fetoprotein (alpha-FP)
- Free estriol
- Thyroid stimulating hormone (TSH)
- Free thyroxine (T4 free)
- Total thyroxine (T4)
- Dan L.Longo, Dennis L. Kasper, J. Larry Jameson, Anthony S. Fauci, Harrison’s principles of internal medicine (18th ed.). New York: McGraw-Hill Medical Publishing Division, 2011.
About footwear for children – not the Russian point of view of orthopedists.
This is a translation of the book by the American orthopedist Dr. Simon J. Wikler “Take Off Your Shoes and Walk”.
This paragraph can convey the main idea: “Typical is the example of Suzy R. When she started to walk, the arch of her foot was physiologically low, and when she walked, she had slight flat feet, like all small children.Her legs were shod in heavy “orthopedic” boots.
After wearing stiff, supportive shoes for several months, her feet became weak. When she wanted to walk barefoot, it turned out that her legs were so tender, and her muscles were so undeveloped that this walking hurt her. However, she was still able to walk in supportive shoes, since the walk was performed without any flexion of the foot. Her mother was sure that the reason was, first of all, Susie’s problem feet, so now the girl buys the same expensive shoes from the same seller.Her feet are crippled for life. A child’s foot can never grow properly if its complex mechanisms are mercilessly altered. “
According to Dr. Lee Beavings, a pediatrician in Atlanta, 99% of newborns’ feet are completely normal – but, according to his clinic, more than 60% of these same children, after being shod, develop foot dysfunctions by the age of six. The ideal physiological boot, which is equivalent to wearing barefoot, would keep children’s feet normal even by the age of six!
In an article published in the Journal of Military Medicine in August 1959., dr. Thomas Hale Jr. cited the opinions of fifty leading authorities in the field of foot disease, whose views on the causes and prevention of foot diseases were very different and sometimes diametrically opposed. Experts admit that the reasons have not been established, but therapists, pediatricians and orthopedists have to reckon with these specialists. Even if doctors are perplexed by diseases of the legs, then how much more difficult it is for a non-professional to understand them! However, one thing is clear: all common foot diseases are preventable.We will tell you about reasonable, practical and conservative ways to avoid them, which will definitely be approved by your doctor.
Prevention of foot problems in nondriving babies.
You have probably noticed that from the first weeks of his life your child is constantly spreading, bending and unbending toes and fingers. But it never crossed your mind to prevent him from moving the arms. You won’t swaddle his palms, will you? So why swaddle the legs? Swaddling tightly to fix the feet and toes weakens their muscles.It’s better to just cover the baby’s legs with a blanket. You can place the edge of the blanket on the support at the foot of the crib to leave more room for the feet to move. If in infancy the child does not have enough ability to move the toes, they will not develop correctly, and no further treatment will be able to fully restore their function. Unfortunately, most parents in America harm their child’s feet and toes by making it impossible for them to move their feet freely.If you gave up the tight swaddling of the baby’s feet, thereby you have already opened the way for him to health.
No shoes before the first steps!
Do not buy shoes for your child until they start to walk. These shoes seem so cute and soft, but they can seriously interfere with normal foot movement. If you see beautiful baby booties, you should know that this is a symbol of harm done to the legs of some baby. In warm weather, the baby can play barefoot in the playpen.When he starts to crawl on the carpeted floor, you should let him do it barefoot.
Crawling as an exercise.
Crawling is an exercise that is essential for your child’s development. Encourage him in every way. (Infants are often held in different seating positions for too long to get tangled up in their busy mothers. This puts pressure on the hips, which can strain muscles and even interrupt blood supply.)At every opportunity, give the child to crawl in the playpen, instead of holding him still. Don’t try to speed up your baby’s first steps. He will start walking when his feet and legs are ready for it.
In the first year of life, the best footwear for a baby is woolen booties. But they must be large enough so as not to constrain the feet and toes in any way. When the child begins to hobble on the cool floor, such booties or soft slippers, which easily yield under the pressure of children’s feet, will suit him perfectly.Baby feet don’t need as much protection from the cold as some adults think. When crawling on a cold floor, the feet require no more such protection than the palms. Usually, adults are afraid to leave a child barefoot because they are used to having their own feet protected by shoes and do not like to leave them open. But children are usually delighted with this.
When a child starts to wear socks, they should be sized as carefully as shoes.The toe does not follow the shape of the foot. Rather, it has the shape of a tube tapering towards the toe. Therefore, elastic socks are especially harmful as they constantly put pressure on the toes. If you tightly fit the child’s leg with a sock, the toes will tend to take the shape of the sock, which is narrowed towards the end. Your socks should be at least an inch longer than your feet. Wear them so that the “stock” is in front of your toes – this way the excess fabric will be in the gap between the feet and the toe of the shoe.
The first shoe.
When a child begins to walk around the house on his own, it means that he will soon walk on the sidewalk, and his soles must be protected. You are now ready to purchase your first pair of shoes for your little one. The best shoes are flexible, spacious, and simple. Remember, your child’s feet and toes should be able to grow freely without any restrictions.
Why shoes need to be flexible.
Some shoes are beautiful, made of good leather and look sturdy, but often they are so hard that they make it difficult for a child to move their feet freely.
To test flexibility, take a heel in one hand and a toe in the other and bend the boot inward. If the sole flexes just behind the toe and not in the center, it means the shoe is monstrously stiff. A child in such boots will have difficulty waddling about, because they will not allow him to bend his foot normally. In no case should you buy such shoes.
Shoe stores selling children’s footwear that support the arch of the foot often do not have flexible boots on sale.A salesperson can make a very compelling case for a supportive shoe. Be firm and find a store that has shoes for your child that bend in the arch of the foot. And when you find it, make sure the outsole itself is not too thick, otherwise the boot will still bend badly. The toddler will grow out of the shoe before it wears it off, so there is no point in having a sole that is too thick and should be avoided. Do not put new soles on children’s shoes as this will reduce the size of the shoe.
The next thing to notice is the shape of the sock. In the past ten years, the shape of the socks of children’s shoes has improved dramatically. Sometimes there are still old-fashioned “cowboy” pointed shoes. Do not buy them in any way.
To learn how to distinguish children’s sharp-toed shoes, compare the usually slightly tapered toes of adult shoes and wide-toed children’s shoes. After spending just a few minutes, you will remember this difference forever.Keep buying blunt toe shoes for kids until they get older and their choice of shoes expands and you give them a few extra years of normal growth until you get to the inevitable pointed toe adult shoes.
Avoid supportive footwear.
Look inside the shoe. Just because the seller says it’s a “supportive” shoe, or even if it’s written on the label, doesn’t mean it really is. Some manufacturers declare their products “supportive” just to sell more.Run your fingers over the insole. If the sole has bulges, be on the lookout. There are usually other supportive devices in these shoes, all of which deform the foot. We will talk about this in more detail below. For now, let’s just say that arch support shoes should be avoided.
How to choose the right length.
Once you have chosen the best type of shoe for your little one, you can move on to choosing the right length. Usually, shop assistants measure the approximate size with a measuring device and then bring several pairs of shoes to try them on.Check if the seller is correct that the length of the shoe is suitable for the child. Have the child stand with an even support on both legs. Feel with your hand where the child’s fingers are. Don’t be afraid to ruin your shoes by pressing hard on a hard toe to find the tip of your toe. Keep in mind that the fit is not a good fit for kids’ shoes. If the shoes are “just right” for the child, they will be too small for him very soon after the purchase. Between the edge of the shoe and the child’s toes, there should be at least an adult’s thumb (i.e.i.e. the distance in ¾ inch1). (Some experts talk about a distance of 1 cm between the toes and the edge of the boot – ed.)
How to choose the right width.
When buying shoes for a child, choose the widest pair of all. To check the width, slide your toes between the edges of the foot and the rim of the shoe and make sure there is some space there. Be sure to insert your toes on both sides at the same time so that the boot does not slide to one side when checking.One sign that the shoe is wide enough is if there is enough space between the rows of holes to tighten the laces. The mother should be prepared for the fact that the shop assistants will protest their demands for the width of the shoes. Most people just don’t know that normal, tight kids shoes can deform the foot. The most severe deformities due to shoe pressure occur before the age of four, when the bones of children are at their softest.
Small children should walk barefoot.
It is not enough to protect children from foot-disfiguring shoes. Foot health also depends on whether children walk barefoot to develop flexibility and strength in their feet. Toddlers should wear shoes outdoors only in cold weather, and at home only on rare special occasions. Fortunately, children often run barefoot in the first five years of life, until they go to school. These years are the most important for the development of the legs. Children under the age of five can safely walk barefoot under the supervision of their parents, who will make sure that they do not cut their feet or get hurt.Moreover, if they often go barefoot, then soon their soles will become coarse. Their skin will remain soft and free of calluses, but protects the leg well. You’ve probably read in the newspapers about athletics stars who win barefoot races on a concrete track. This is a normal property of human feet, although it is difficult for people who are pampered with shoes to understand.
Experience the difference.
If you adhere to the above recommendations until the child turns five, you will see that his legs are perfectly developed and practically not disfigured.(The tips of the first, fourth, and fifth toes may curl slightly inward no matter how hard you try, because there are currently no completely safe children’s shoes on the market.) Compare your child’s feet to those of friends whose parents did not take these precautions. Your child’s toes will be stronger and straighter, and the muscles in the foot will be firmer. You will be surprised to see other children have weak, thin, and even crooked toes. By looking at how easily your baby moves, you will be rewarded for taking care of his legs.
Footwear for children from five to twelve years old.
Shoes for older children are not designed for the height of the foot. It tapers more strongly to the toe and in this respect is worse than an infant. Often, your child will grow out of a new pair within a month after the purchase. So make it a habit to check his legs at least once a week. If the headroom in front of the thumb is reduced to an inch or less, then the shoes are too short. Throw them away, no matter how worn out.To understand why these shoes should be thrown away, take a look at the toe of the shoe. See how much it tapers in the last inch. Sometimes the width of the boot narrows in half one inch from the edge. Further, the fingers of children are deformed painlessly. This means that parents may not be aware that their child’s feet are being deformed every day. Do not assume that if your child does not complain about tight shoes, then they are not small for him.
Are your loose shoes too big?
If you buy loose shoes, as you should, older people will inevitably tell you that it is bad for your feet.Don’t trust them. They feel that the foot needs support because their own feet are so weak that without well-supported shoes they would not be able to walk at all. Children with healthy legs do not need support; they only need shoes for protection.
How long should a shoe last?
How often should you buy new shoes? Once every one to nine months, although the shoes can get small after 12 weeks. It is a constant race between growing feet and the margin of safety in the shoe before the tapering toe of the shoe begins to clench the toes.
Outdoor shoes for children.
Buying weekend shoes in addition to casual shoes is a bad habit. Many parents believe that when a pair “for every day” is worn out, it will be possible to wear ceremonial shoes. The temptation to squeeze the best out of both pairs is too great, even if the shoes are already too short. If you buy one pair at a time, but more often, this may solve the problem for the boy. Girls are more difficult because they usually want to have weekend shoes – for example, leather pumps.If a girl wears such shoes, the parents can take comfort in the fact that the “Sunday” pair of shoes can only be worn twelve times before the child grows out of it. The so-called ballet flats are also popular among little girls. They should fit very tightly to the toe so as not to fall off your feet. But this is not as dangerous as it seems, because the socks of such shoes are flexible, and the toes stretch them to some extent. Ballet flats with stiff toes, however, deform the foot quite a bit.
Should older children go barefoot?
Not so long ago, village children almost always walked barefoot in warm weather, like most adults.Only since the production of shoes became cheaper, we began to wear them all the time.
Fortunately, customs are changing again. In the big cities of California and Florida, it has become fashionable for children to walk barefoot. This custom has always been popular in Hawaii. Children in the suburbs in the East also go barefoot in the summer.
Are you afraid that your child will hurt his foot if he plays without shoes? In Hawaii, children and adults play barefoot soccer. There is even a whole “Barefoot League” of such teams.
Are you afraid that he will catch a cold if he walks down the street with unprotected legs? In the orphanage in the Austrian village of Eggenberg, the director once could not pay for winter shoes for the children, and they walked barefoot all winter, including through deep snow. This did not harm them in the least, and they became much more resistant to colds than children from the same village who wore shoes.
Do you live in a city where children usually cannot walk barefoot? Then get into the custom of asking them to take off their shoes when they come from the street.Let them walk in socks with soles, slates, or no shoes at all.
If you had seen as many feet as I have seen, you would have learned to instantly recognize people who had the opportunity to walk barefoot in childhood. They can be immediately recognized by the flexibility and strength of the feet. “As a child, you often walked barefoot!”, Sometimes I say to people whom I see for the first time in my life. They look at me in surprise, but invariably answer: “Yes.” I ask: “You probably don’t get tired very quickly?” And I almost always hear the answer: “Never!”
1 Inch equals 2.54 cm (approx.ed.)
2 Orthopedic footwear (ed.)
3 Published in 1961 (ed.