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Suggest Treatment For Chronic Osteomyelitis
Question: Hello,
` My name is Chad Weiss I’m 53 and I’m hoping you can answer a question for me regarding my left foot?
My left foot is currently under treatment because I broke the fifth metatarsal years ago and my left foot is cleft. As time progressed the fifth metatarsal became a boney prominence on the bottom of the foot ad since the left is cleft became a problem with it ulcerating. Since then I’ve had two surgeries on my left foot. The first time a graph patch was put on and the surgery didn't work.
Since then I went through the Alexian Bros. (Elk Grove) wound care center and I’m under his care right now with a doctor I met at he wound are center. January of 2016 having plained the fifth metatarsal and put a graph patch on the ulcerated sore. Four weeks later was able to go back to work. Then in the middle of May, 2017 the foot opened up again.
I’m under the impression that one of two things causes the foot to open up and I need to be careful of the pressure points of the foot and only the left foot is affected. Either the foot reshapes causing the problem or the insoles cause the problem. The first time because of the prominence on the bottom of the foot it reopened. The next two times the foot opened up because of the insoles. I’m at a point where hopefully this week I can get into shoes with the new insoles that’ll compensate for the cleft foot and prominence in the left foot, but I’m concerned that this will open up again.
Is they're an alternative to resolve the problem, either doing a procedure either plaining the 5th metatarsal again, doing a procedure to fix the cleft foot or a special shoe? Do you have any suggestions?
Do you know of a good podiatrist that'll treat this?
` My name is Chad Weiss I’m 53 and I’m hoping you can answer a question for me regarding my left foot?
My left foot is currently under treatment because I broke the fifth metatarsal years ago and my left foot is cleft. As time progressed the fifth metatarsal became a boney prominence on the bottom of the foot ad since the left is cleft became a problem with it ulcerating. Since then I’ve had two surgeries on my left foot. The first time a graph patch was put on and the surgery didn't work.
Since then I went through the Alexian Bros. (Elk Grove) wound care center and I’m under his care right now with a doctor I met at he wound are center. January of 2016 having plained the fifth metatarsal and put a graph patch on the ulcerated sore. Four weeks later was able to go back to work. Then in the middle of May, 2017 the foot opened up again.
I’m under the impression that one of two things causes the foot to open up and I need to be careful of the pressure points of the foot and only the left foot is affected. Either the foot reshapes causing the problem or the insoles cause the problem. The first time because of the prominence on the bottom of the foot it reopened. The next two times the foot opened up because of the insoles. I’m at a point where hopefully this week I can get into shoes with the new insoles that’ll compensate for the cleft foot and prominence in the left foot, but I’m concerned that this will open up again.
Is they're an alternative to resolve the problem, either doing a procedure either plaining the 5th metatarsal again, doing a procedure to fix the cleft foot or a special shoe? Do you have any suggestions?
Do you know of a good podiatrist that'll treat this?
Brief Answer:
Special shoe is the best option
Detailed Answer:
Hi,
Thank you for posting the question.
I have gone through your medical history in detail.
In your case there seem to be two possibilities.Either there is something wrong in the insoles / footwear that you have been wearing or there might be a remnant chronic infection inside the bone that is preventing the wound from completely healing,leading to recurrent ulcers.
Though,the first possibility seems to be more likely,you should consult a orthopedist and get a MRI/CT scan of the foot done to rule out dormant infection (chronic osteomyelitis).
If this scan comes out normal,then only the footwears and the insoles have to be blamed.In this case, just by modifying your shoes and insoles as per your foot's shape and prominences will solve the problem.
Take precautions to make 1 size larger shoe than your regular fit with extra soft cushion and silicon insoles.
Getting a surgery done to treat the cleft or plaining the 5th metattarsal would be unnecessary at this stage and will do more harm than benefit and should preferably be avoided.
You can find out from your family physician about a good podiatrist / orthopedist in your area.
I hope the answer was useful.
Feel free to ask me any follow up queries that you may have.
Thank you.
Kind regards.
Special shoe is the best option
Detailed Answer:
Hi,
Thank you for posting the question.
I have gone through your medical history in detail.
In your case there seem to be two possibilities.Either there is something wrong in the insoles / footwear that you have been wearing or there might be a remnant chronic infection inside the bone that is preventing the wound from completely healing,leading to recurrent ulcers.
Though,the first possibility seems to be more likely,you should consult a orthopedist and get a MRI/CT scan of the foot done to rule out dormant infection (chronic osteomyelitis).
If this scan comes out normal,then only the footwears and the insoles have to be blamed.In this case, just by modifying your shoes and insoles as per your foot's shape and prominences will solve the problem.
Take precautions to make 1 size larger shoe than your regular fit with extra soft cushion and silicon insoles.
Getting a surgery done to treat the cleft or plaining the 5th metattarsal would be unnecessary at this stage and will do more harm than benefit and should preferably be avoided.
You can find out from your family physician about a good podiatrist / orthopedist in your area.
I hope the answer was useful.
Feel free to ask me any follow up queries that you may have.
Thank you.
Kind regards.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Kampana
Answered by
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