Controversial Bone Graft to Save Kevin Durant’s Foot

Kevin Durant suffered a Jones fracture back in October 2014, the same injury that ended former NBA center Yao Ming’s career. A Jones fracture is a break in the bone of the 5th metatarsal, a long bone on the outside of the foot. Durant had undergone surgery and a screw was inserted into the bone. Unfortunately, Durant complained of discomfort and his doctor discovered the screw head was rubbing against the cuboid bone, a bone that sits behind the base of the 5th metatarsal, and was causing discomfort and irritation. The original screw was taken out and replaced, however the revisional surgery fell short of the desired outcomes. With little success of healing his broken bone, Durant agreed to a third surgical procedure where a non-FDA approved bone graft would be used. Durant’s surgeon used Medtronic INFUSE Bone-Graft, a graft that is FDA approved for use in the cervical area of the spine, but not in the foot. INFUSE bone graft is a synthetic protein that helps grow new bone, however it is associated with many side effects such as: infection, bone and nerve injury, male sterility, increased cancer risk and more.

Durant’s radical surgery has so far been worth the risk as he has been cleared to play. Durant’s bone will continue to remodel for a year and all of us at Foot & Ankle Doctors, Inc. wish him a full recovery.

Dr. Dardashti

 

 

Allen Reisner Out For Season with Broken Ankle

It was recently announced that Baltimore Ravens tight end, Allen Reisner is suffering from a “ broken ankle,” also referred to as an ankle fracture. Our staff at Foot & Ankle Doctors, Inc. are saddened to see an NFL player injured so early in the season and hope Reisner makes a full recovery.

The ankle joint is composed of three bones: the tibia, the fibula and the talus. Regardless of which bone(s) are broken, ankle injuries can take up to 6 weeks to heal. A twisting or rotation motion of the ankle, rolling the ankle, tripping or falling and high impact accidents are causes of ankle fractures. Reisner most likely experienced swelling and immediate pain after his injury. It is unlikely he was able to place any weight on his injured ankle. Doctors caring for the athlete more likely than not x-rayed his ankle and performed various stress tests to determine which ligaments were injured. CT and MRI images may have been ordered for further work up of his ankle.

We are unsure of the details of Reisner’s injury, however reports state that he has undergone surgery. We assume his fracture was severe enough to require an operation for stabilization of his ankle. It will take several months of rehab before Reisner can make a full recovery.

Dr. Nejad

 

Giants Tight End Fells Tackled by Small Bug

New York Giants tight end, Daniel Fells may loose his foot after suffering from a serious MRSA infection. MRSA is a type of staphylococcus infection that is resistant to methiciliin antibiotics. It is a common superbug and is contagious spreading from one person to another. The Giants have taken precaution to prevent the spread of the bug to other players by complying with infection-control protocols. MRSA can enter through a break in the skin barrier causing infection that may enter the bloodstream and affect major organs or bones.

Fells reportedly received a cortisone injection for a toe injury that may have inoculated the bacteria into his body. Anytime a foreign object such as a needle is placed into the body, there is a risk of infection. The risk is low, but there is always a risk. Fell has undergone multiple surgeries to stop the infection and save his foot. If the infection has spread to the blood, Fells will need a course of IV antibiotics.

MRSA often presents as a skin infection and can be mistaken for a pimple or spider bite. The skin will become red, swollen, painful to the touch, and filled with pus. It may be accompanied by a fever, and has the potential to become a life-threatening infection if left untreated.

All of us at Foot & Ankle Doctors, Inc. wish Fells a full recovery.

Dr. Nejad

Avoid Overuse Injuries This Spring

Spring is around the corner and many of us are ready to get back into shape and hit the pavement with the first spring thaw.  Many of us haven’t hit the gym for months and it’s important to get back into the routine of working out slowly to prevent overuse injuries.


Overuse injuries occur over time with repetitive microtrauma to tendons, bones and joints. Common overuse injuries in the lower extremities include runner’s knee, jumper’s knee, Achilles tendinitis and shin splints.


Causes of overuse injuries include

  • Training errors – over training or increasing acceleration, intensity, duration or frequency too quickly instead of gradually over time

  • Form error – improper technique or shoe gear can lead to injury overtime

  • Returning to a sport or activity too soon after injury

  • Biomechanical and individual factors – body alignment and foot structure can predispose individuals to overuse injuries


Treatment of overuse injuries can be remembered by the mnemonic RICE-AR

  • Rest – complete rest from the activity may be necessary or cross training with a different sport/activity

  • Ice – apply ice to injured area for 15 minutes a day

  • Compression – apply an ACE bandage or elastic wrap after icing to prevent further swelling

  • Elevation – elevate the injured extremity above the level of the heart when resting

  • Anti-inflammatory medication – ibuprofen or Tylenol can be taken to reduce inflammation

  • Re-condition – stretching and strength training are important steps in rehabilitation and preventing future injury


If you suspect you have an overuse injury, consult one of our doctors at Foot& Ankle Doctors, Inc.


Dr. Nejad

Toe Injuries Are Not Just For High Athlete Performers

Athletes involved with high impact sports will often suffer from toe injuries. Sports fans will remember when Pierre Garcon and Taylor Martinez both suffered from a plantar plate tear. Although a lot of us are not professional athletes we too can suffer from plantar plate tears.

The plantar plate is a ligament located on the bottom of the toes. It is responsible for cushioning the ball of the foot when walking and running and prevents hyperextension of the toes. With repeated overuse the ligament can stretch and tear and lead to a predislocation syndrome also known as a crossover toe deformity or a floating toe syndrome. Plantar plate tears most commonly affect the second toe.

Symptoms of a plantar plate tear:

  • Persistent pain at the ball of the foot

  • A toe that is changing position – lifting up or crossing over

  • Swelling

Plantar plate tears can be difficult to diagnose. Common misdiagnoses include a neuroma, tuff toe or a stress fracture. If you were given one of these diagnoses and you are unresponsive to treatment, ask your doctor about the possibility of a plantar plate tear.

At Foot& Ankle Doctors, Inc we will first offer conservative treatment options:

  • Rest

  • Ice

  • Anti-inflammatory medication

  • Accommodative padding to alleviate pressure from the ball of the foot

  • Plantarflexion strapping of the digit to hold it in place

  • Orthotics and stiff soled shoe or rocker-bottom shoes may be recommended

If conservative treatments fail, surgery may be required to repair the ligament.

 

Dr. Dardashti

Turf Toe.. More Serious Than You Think

Turf toe sounds like a minor injury that only involves a single toe, however it can be a career ending injury like it was for Deion Sanders. It commonly occurs in athletes who play sports on artificial turf, hence the name “turf” toe. This injury occurs when athletes bend their big toe beyond its normal flexibility. Cleats often get stuck in divots in artificial turf leading to hyper extension of the toe. Hyper extension of the big toe can take place every time the athlete pushes off with their toes to start running. This motion occurs multiple times during every game and practice eventually over time the big toe becomes sprained.

The severity of the injury is graded from 1 to 3

Grade

Injury

Treatment

1

Mild sprain

  • RICE – rest, ice, compress, elevate

  • Taping the toe to restrict movement

  • Non-steroid anti-inflammatory medication

2

Partial tear of the capsule and ligaments

  • Same as Grade 1 + walking boot to immobilize the big toe joint

3

Complete tear of the capsule and ligaments

  • Same as Grade 1 + walking boot or cast for immobilization

 

Physical therapy should also be implemented to prevent stiffness in the joint and gain adequate range of motion. Surgery is often not needed, but is an option for some cases.

Foot& Ankle Doctors, Inc recommend athletes who return to sports should have their shoes modified with a steel shank or stiff insoles to restrict hyper extension of the toe.

Dr. Nejad

Kevin Durant suffers from a Jones fracture

We are sad to hear that Kevin Durant is suffering from a Jones fracture. A Jones fracture is a common fracture of the 5th metatarsal (a long bone on the outside of the foot that connects to the little toe) commonly caused by an inward twisting injury of the foot.

Durant most likely experienced pain, swelling and tenderness along the outside of his foot, had difficulty walking and may have had some bruising. It was crucial that Durant was diagnosed and treated immediately because the 5th metatarsal has a poor blood supply that impedes the healing process.

Nonsurgical treatments for Durant includes resting and icing, immobilizing his foot with a cast and avoiding placing any weight on his foot. Jones fractures can take 6 weeks to heal and another 2-3 weeks of rehabilitation to build up muscle strength and range of motion.

Most professional athletes opt to treat a Jones fracture operatively with a screw or plate placed across the fracture site to avoid the possibility of delayed healing or non-unions, which are frequent with Jones fractures. It could be 8-12 weeks before Durant returns to the court if he decides to have surgery.

All of us at Foot & Ankle Doctors, Inc. are wishing Durant a speedy recovery.

 

Dr. Dardashti