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A newsletter from Ankle & Foot Care Centers.

August 2010 Edition:

Surgery for Drop Foot Speeds Recovery From Ulcer

Foot Ulcers, Amputations & Diabetes

Here are some interesting statistics compiled by sources reviewed by Ankle & Foot Care Centers:

· Approximately 85 percent of all amputations are preceded by a non-healing foot ulcer.
· Within five years of an amputation, up to 51 percent of diabetes amputees undergo a second leg amputation.
· 69 percent of diabetic amputees will not survive more than five years.
· An amputation may mean decreased quality of life or lead to death for a diabetic foot ulcer patient.

Sources: Diabetes Care,, Archives of Surgery

A surgery that straightened out Mary Ann Caccarozzo’s drop foot made such a dramatic improvement in the way she walks that it also sped up the healing of a large, persistent foot ulcer.

Mrs. Caccarozzo, 79, a resident of the assisted living center at Victoria House at Ashley Circle in Austintown, walks much more comfortably now.

But walking had been a struggle in the aftermath of an accident that occurred in 2008. One morning, her son found her unconscious after a severe fall that left her left leg swollen and in need of surgery.

In one of the complications of her surgery, a tendon and nerves in her foot were cut, causing the drop foot condition. The foot appeared to hang from her lower leg.

In addition to making it difficult for her to walk, the drop foot forced Mrs. Caccarozzo to put tremendous pressure on her left heel when she did walk, compounding an ulcer there.

The ulcer had persisted for a year and despite multiple treatment options, only minor improvement was achieved until Mary had surgery to correct her drop foot condition. Dr. Lawrence DiDomenico of Ankle & Foot Care Centers notes that correction of the underlying biomechanical problem is important in resolving foot ulcers – otherwise ulcers will simply reoccur.

The surgery to correct the drop foot wound up eliminating the ulcer.

Dr. DiDomenico addressed the drop foot by inserting two steel rods that straightened Mrs. Caccarozzo’s foot, making it easier for her to walk as she had before the accident.

Because she was no longer putting such pressure on her left heel, the ulcer cleared up.

“The day I had the surgery on that foot, the ulcer began to go away,” she said. “It feels good.”

Copyright © August 2010 Ankle & Foot Care Centers

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Meet the Doc: Dr. John Chiaro

Dr. John ChiaroDr. John Chiaro has been with Ankle & Foot Care Centers since 2000.

He earned a doctor of podiatric medicine degree from the Ohio College of Podiatric Medicine in Cleveland and completed residency training at Youngstown Osteopathic Hospital.

He sees patients in our Alliance, Howland and Poland offices.

When he’s away from the office and hospital, Dr. Chiaro enjoys golf, fishing, and spending time with his family.

He lives in Poland with his wife and two children.

Copyright © August 2010 Ankle & Foot Care Centers

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Ankle Replacement Brings Recovery After Accident

After severely injuring his foot in an accident at work, John Ohler of Malvern underwent nine surgeries and still could hardly walk without pain.

But an ankle replacement performed by Dr. Lawrence DiDomenico has put Ohler, 54, back on his feet, with most of his pain gone.

“I can walk and I can stand,” he said. “It’s still a work in progress. But it's much, much better than it was for many years.”

In 2000, Ohler was working as a warehouse manager at USF Logistics, a trucking company. He was putting a piece of steel in a bin when a nearby pile of the metal collapsed and rolled toward him.

“I had 100,000 pounds of steel fall on my left foot, and it was virtually severed, right at the ankle,” Ohler recalled.

He had surgery to rebuild his foot and stayed in a hospital for 19 days. Over the next seven years, he had eight other surgeries to reattach toes, graft skin and add support to the plates and rods that provided his balance and strength.

The pain was constant, he said.

In 2007, he had the rods and plates removed to facilitate the total ankle replacement. And later that year, Dr. DiDomenico installed his new ankle.

“The relief didn’t come right away,” Ohler said, “but after the therapy it made a lot of difference.”

He spent almost a year with regular walking exercises, foot massages, hot packs, ice packs and more.

“The pain subsided,” he said. “I still walk with a limp, and it’s a little rough on uneven ground, but I can walk a lot better. The pain is nothing like before.

“I would recommend Dr. DiDomenico to anybody.”

Copyright © August 2010 Ankle & Foot Care Centers

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Foot Care Myths Can Lead to Danger

Foot Care Myths Can Lead to DangerThe myths that we perpetuate about health care are often quite humorous, like jumping up and down on one foot to cure hiccups.

But some foot treatment myths can actually be harmful and dangerous. Here are a few that we want to dispel:

“Cutting a “V” in your nail will cure ingrown toenails.”

Toenails grow from the nail matrix that is located just beneath the skin at the base of the toenail. The idea that putting a small center “V” notch at the end of the nail will cause the nail edges to come away from the skin as the nail “grows together” at the “V” is just not medically possible.

Ingrown nails can be prevented permanently with a minor surgical procedure in which the nail matrix (growth plate) on the affected side(s) of the nail is destroyed (typically by a chemical agent, but other methods may be utilized).

Waiting on a “V” cut to eliminate an ingrown nail could allow the condition to get worse.

“Warts can be “suffocated” with duct tape or salve.”

While warts may be living viruses, they cannot be suffocated. Warts can appear anywhere on the skin, but technically only those on the sole of the foot are properly called plantar warts.

Your podiatrist can prescribe and supervise your use of a safe and appropriate wart-removal preparation. More likely, however, removal of warts by a simple surgical procedure, performed under local anesthesia, may be indicated.

People with diabetes or circulatory, immunological or neurological problems should be especially careful with the treatment of their warts and seek professional care at all times.

“Since my ulcer doesn’t hurt, it can’t be so bad.”

In patients with diabetes, an ulcer or open sore on the bottom of the foot can be a sign that should not be ignored, regardless of whether it hurts or not.

Diabetes can cause nerve damage in the legs and feet, which can lead to an inability to feel pain. Due to poor blood flow, small sores and cuts that go unnoticed on the feet can lead to hard-to-heal wounds called diabetic ulcers.

It is extremely important for patients with diabetes to schedule regular appointments with a podiatrist. Don’t let pain be the guide. Instead, make foot care a part of your routine of overall care.

Copyright © August 2010 American Podiatric Medical Association and Ankle & Foot Care Centers

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