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We Understand That Pain Or injury Of The Foot And Ankle Can Severely Impact The Quality Of your Life

Our board-certified, fellowship-trained physician and his team are renowned for their treatment of all sorts of foot and ankle disorders and focus on relieving pain so you can regain mobility and function.

We treat everything from the simple and routine problems like ingrown nails, warts, orthotics, bunions, hammer toes and sprained ankles, to diabetic foot care, severe sprains and fractures of the foot and ankle, heel spurs, tendon ruptures and more. We also offer pioneering treatments such as Tenex Health TX, which is minimally invasive and helps remove damaged tissue and stimulate healing and even complex reconstruction and total replacement surgery.

Of course, whenever possible, our doctors always choose the most conservative care for patients first, such as physical therapy and pain management. Should surgery be necessary, we look at the most minimally invasive procedures first that will help with a more speedy recovery.

Ralph Napoli, DPM
Foot and Ankle
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We’ve Been Getting Northern New Jersey Back In The Game Since 1994

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See how our board certified and fellowship trained experts can help you.

Ankle Sprain

PREVENTION METHODS TO AVOID INJURY

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A sprain is caused by twisting your ankle. Your foot usually turns in or under but may turn to the outside. An ANKLE SPRAIN is an injury that causes a stretch or tear of one or more ligaments in the ankle joint. Ligaments are strong bands of tissue that connect bones at the joint. Sprains may be classified as mild, moderate, or severe. Most sprains occur on the outside part of the ankle, but they can occur on the inside as well. To diagnose a sprained ankle, the doctor will review how the injury occurred and consider your symptoms. He or she will examine your ankle carefully, possibly taking X-rays.

Symptoms

• Mild aching to sudden pain
• Swelling
• Discoloration
• Inability to move the ankle properly
• Pain in the ankle even when you are not putting any weight on it

For additional information visit:
AAOS Online Service Fact Sheet – Sprained Ankle

Achilles Tendon Injuries

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Symptoms

ACHILLES TENDONITIS causes pain and may cause swelling over the Achilles tendon. The tendon will be tender and may be swollen. You will have pain when you rise up on your toes and pain with stretching of the tendon. The range of motion of your ankle may be limited. When it tears or ruptures, you may feel a pop. If there is a complete tear, you will be unable to lift your heel off the ground or point your toes.

Achilles Tendinitis can be caused by:

• Overuse of the Achilles tendon
• Tight calf muscles
• Tight Achilles tendons
• Lots of uphill running
• Increasing the amount or intensity of training, sometimes along with switching to racing flats, racing shoes with less heel lift.
• Over-pronation, a problem where your feet roll inward and flatten out more than normal when walking or running.
• Wearing high heels at work and then switching to a lower heeled workout shoe.
• Violent stretching of the Achilles tendon can cause it to rupture.

For additional information visit:
AAOS Online Service Fact Sheet – Achilles Tendinitis

Bunions

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Bunions are painful swellings that occur at the base of the first toe on the inner side of the foot as a result of inflammation, and can lead to pain, tenderness and an altered position of the first toe. Bunions tend to run in families, suggesting that the inherited shape of the foot may lead some people to develop this condition. Flat feet, which are often unstable, can also cause bunions as the uneven pressure on the foot may cause the toe to bend and deform. Bunions can also be caused by shoes that are too small or uncomfortable, and are much more common in men than in women.

Symptoms

• Large bump on the outside of the big toe
• Swelling, redness or soreness around the big toe joint
• Thickening of the skin
• Corns or calluses
• Pain
• Restricted movement
• As time goes on, bunions often grow larger and become more painful

Treatment Options

Treatment for bunions depends on the severity of the condition, although early treatment is always considered most effective. Nonsurgical treatments such as changing shoes, applying ice, medication, orthotics and physical therapy can often help relieve symptoms of mild bunions. More severe cases may require surgical removal, which is often successful in relieving pain, inflammation, deformities and stiffness.

For additional information visit:
AAOS Online Service Fact Sheet – Bunions

Foot & Ankle Fractures

THE RIGHT ANSWERS FOR YOU

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With over 26 bones, the foot and ankle are common locations for bone fractures. A fracture is a break or crack in a bone that can cause pain and swelling in the affected area. FOOT AND ANKLE FRACTURES most commonly occur from injury, such as a fall or other event that places great force on the foot. Certain factors such as age and osteoporosis can increase a patient’s risk for fractures, and may also be a major cause, since bones begin to weaken and become brittle as we age. There are several different types of foot and ankle fractures depending on which bone is affected and the severity of the fractures. A fracture may occur in the phalanges (toes), metatarsals, talus, calcaneus, tibia or fibula.

Treatment Options

Treatment for foot and ankle fractures depends on the type, severity and location of the fracture. Your doctor will often begin treatment with conservative methods such as rest, ice, immobilization and anti-inflammatory medication to see if the fracture heals on its own. If a fracture is not out of place and the bone remains stable, most can be effectively treated without surgery. Surgery, however, may be required for some cases to set or realign the fracture and help promote healthy healing. Surgery may use a metal plate, rod or screws to realign the bone fragments and hold them in place while they heal.

For additional information visit:
AAOS Online Service Fact Sheet – Ankle Fractures
AAOS Online Service Fact Sheet – Stress Fractures of the Foot and Ankle

Ankle Replacement

Getting You Back On Your Feet

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The ankle is where the bones of the lower leg and top of the foot meet. Used every time you walk, run, or even stand, this joint can wear and tear over the years. It is also prone to injury, particularly if bones and tendons are weak or cartilage is worn. If you have ankle pain and stiffness, or suffered an ankle injury that is not responding to non-surgical treatments, you may be a candidate for ankle replacement surgery.

Procedure

The ankle joint is comprised of three bones: the tibia (shin bone), the fibula (the small bone in the lower leg), and the talus (the bone that fits in between the tibia and fibula). The talus is a hinge bone that allows your foot to move up and down. The bones are held together on both sides of the ankle joint by ligaments. Tendons cross over the ankle, helping move the ankle and toes. The Achilles tendon, which is in the back of the ankle, connects the calf muscles to the heel bone, providing the power for walking, running, and jumping. Articular cartilage covers the bones inside the joint, enabling them to move smoothly.

During ankle replacement surgery, the ankle joint is replaced with a two or three-part prosthesis. An incision is made on the front or side of the ankle, depending upon the type of implant being used. The blood vessels, nerves, and tendons are carefully moved to the side. The surgeon then makes an incision in the joint capsule that encloses the ankle joint, opens the joint, and prepares the surfaces. The ends of the tibia and fibula are shaped to fit the metal socket of the prosthesis. Then the top of the talus is shaped to insert the new talus component. All of the pieces of the prosthesis are put in place and tested.

 

Candidates

Ankle replacement may be necessary for patients whose arthritis has caused decreased function, or whose pain and dysfunction have not responded to conservative treatment. It may also be the best option when a bone is severely fractured or the joint has suffered repeated injuries. Our surgeons will evaluate your situation to determine if you are a good candidate for ankle replacement.

Recovery and Outcome

Pain after surgery is to be expected, but it can be managed with medications. Successful recovery from ankle replacement surgery requires a period of immobilization and elevation to control swelling and enhance wound healing. You will be wearing a cast or splint and will not be able to bear any weight on the foot for two weeks, so you will need to use a walker or crutches.

Your surgeon will help plan a rehabilitation program, which will be key to surgical success. Upon recovery, you should experience less pain, better function, and improved strength and motion.