Fissures are cracks in the skin in combination with a thick formation of skin layers (callus) commonly found on ball of the foot, heel, sides of the foot. Cracks in the heels are caused by excessive pressure combined with the thick skin, and open shoe gear. A large majority of our patients get fissures when wearing rubber or leather sandals in the summer. This is caused mostly by an inflammation and swelling in the skin because those materials have been linked with an irritation reaction from direct contact with the skin. Diabetes and other diseases like Lupus can increase the incidence of dry cracked skin, especially in the feet and hands.
These fissures can deepen on the outer surface of the skin or can go deeper causing bleeding or infection. Pain ranges from dull to sharp depending upon the level of irritation and compression of the nerves that are around these areas.
Anti-inflammatory medication (Eg. Ibuprofen, Naprosyn) aspirin products, and Acetaminophen can help with the chronic pain. Anti-fungals, and topical cortisone help with dryness, inflammation, and soreness.
Temporary arch supports or custom molded orthotics can minimize the pressure on the spur or correct the foot position causing the pressure. These devices are good solution for long term treatment with or without surgical intervention.
Reduction by either professional sharp debridement (shaving) or consistent filing will give temporary relief. Use caution with over the counter callus removal medication or pads. The medication is a type of acid that can cause an ulceration or infection if not used properly or in excess.
The bone structure causing the pressure is either remodeled and smoothed down or repositioned. Depending on the location or severity, the skin lesion or callus itself is removed during the procedure or it will naturally fall off 3 to 4 weeks after the surgery. Incisions are minimal and vary in size (average 1.5cm to 3/4 inch). Sutures are removed at 2 weeks.
The procedure is performed at an outpatient facility under sedation. Partial weight bearing is allowed after 48 to 72 hours of non weight bearing if the bone is remodeled or partial weight bearing is allowed after 1 to 3 weeks of non weight bearing with crutches if the bone is repositioned.
Quick, efficient, and effective. I’ve had two visits and been very happy with my treatments and service.
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