FOOT DEFORMITIES

We provide surgical care for hammertoe and bunion deformities of the teenage, adult and geriatric feet. We use the most up-to-date techniques and correction of these deformities and have had tremendous success over the last 28 years of practice.

ANKLE PAIN/DEFORMITIES

Ankle pain can be extremely disabling. The cause can be from either major or minor trauma to the ankle. Besides nonsurgical treatment to the ankle to alleviate discomfort, we provide arthroscopy to the ankle and repair of unstable and arthritic ankle joints.

DIABETIC NEUROPATHY

The Institute for Peripheral Nerve Surgery, associated with the Regional Foot and Ankle Medical Center, introduces the newest form of quantitative sensory testing (QST), a neurosensory and motor testing (NMT), and a pressure-specific sensory device (PSSD™).

NMT is the latest technology in the fight against neuropathy. Neuropathy is the lack of normal sensation that often affects an extremity: it is most common in diabetics. It is the leading cause of ulceration, infection, loss of toes, and, with advanced cases, amputation.

As of December, 2002, the Regional Foot and Ankle Medical Center, in partnership with the Institute for Peripheral Nerve Surgery, is the only medical clinic in the Los Angeles area, is only one of three facilities in California, and is only one of less than 100 facilities world-wide that specializes in NMT instrumentation with pressure-specific sensory device technology.

NMT is a state-of-the-art, accurate, noninvasive tool that allows physicians to measure the degree of neuropathy starting at its very early onset. NMT allows physicians to take action before the patient has serious problems with neuropathy. The test is painless and only a gentle touch to the skin of a sensory device is required.

NMT is a preventive and restorative medicine. The NMT is a handheld sensory device connected to a computer that allows the technician to graph out your sense of touch and feeling. Information derived from the NMT provides important clues so that the physician may make an accurate diagnosis and construct a treatment plan. Older, painful, more traditional testing methods for neuropathy tell the physician only one thing – whether or not you have the disease – and usually only after it has been progressing for a long time.

NMT is the only test that actually measures the degree of neuropathy at its onset. It can predict where a patient is in the course of a disease. At three to six months, the patient can be retested to see if the condition has improved, leveled off, or deteriorated. Since neuropathy is a progressive disease, the early detection that NMT can provide is vital to patients. The American Diabetes Association recommends that a sensory evaluation, such as NMT, be done on a diabetic’s foot at least once a year. It is painless and takes less than an hour to complete. This test is covered by most insurance plans.

NMT testing with PSSD technology, utilized at the Regional Foot and Ankle Medical Center, is the only diagnostic study of its type in Los Angeles. This unit has been given approval by the FDA with a 99% competence level.

TREATMENT OPTIONS

In the past, physicians were limited on treatments for patients with diabetic neuropathy. We could only give them medication which dulled the nerve sensations to make the patient more comfortable. Neurosensory motor testing (NMT), available at the Regional Foot and Ankle Medical Center, assists physicians and surgeons to reverse and even halt the progression of diabetic neuropathy. NMT can actually pinpoint specific compressed nerves and the degree of neuropathy. This is beneficial for surgeons in determining which patients would benefit from advanced therapeutic treatment such as surgical decompression. The current statistical success rate is 69% in the lower extremities and 88% in the upper extremities.

Surgical decompression is a surgical procedure utilized to relieve pressure on a nerve, which can be done in the arm, hand, leg, and foot. Dr. LaRose, who is a Fellow of the Institute for Peripheral Nerve Surgery, will open the tight area through which the nerve passes by dividing a ligament or fibrous band that crosses the compressed nerve. This will give the nerve more room, allowing oxygen and nutrient-rich blood to flow better into the nerve and permit the nerve to move with the movement of the nearby joint.

WHO IS A CANDIDATE FOR THIS TYPE OF SURGERY

The ideal candidate for surgery to restore sensation and strength is a diabetic who is beginning to experience numbness and tingling in the feet and who may have noticed weakness, loss of sensation, and loss of control of some of the muscles in the feet.