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The information provided on this page is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for your specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition.

Surgical Correction for Plantar Fasciitis

This is a video of a minimally invasive procedure that is performed on a chronic foot condition call plantar fasciitis. It is called an endoscopic gastroc recession and topaz plantar fasciotomy. The key to the surgery is lengthening the gastroc aponeurosis and then repairing the chronic inflammation in the ligament. In my hands, this procedure works over 90% of the time with no re-occurrence of the inflammation. This procedure also allows us to keep the plantar fascial ligament intact which key for long term foot health and stabilization.

Flatfoot Reconstructive Surgery

In this video, I perform a flatfoot reconstructive surgery on a few years ago on a youth aged child. I had placed an implant in the subtalar joint to help correct the flatfoot. The implant backed out of the joint and was palpable under the skin. The patient did not lose any correction with the flatfoot, therefore, I simply removed the implant in the office

Pediatric Flatfoot

In this video I discuss the faulty mechanics of the foot that leads to flatfoot and explain why it is a progressive deformity.

Screw Removal

This is a video of a screw I had to remove in the office. The patient broke his fifth metatarsal. I performed an open reduction with internal fixation in the OR. One of the screws in the plate became loose and started backing out. It was palpable under the skin and was causing the patient pain. I was able to remove the screw in the office under local anesthesia.

Permanent Removal of Ingrown Toenail

The patient presented with a painful ingrown nail. He had tried self surgery several times with no relief and this time he tried to remove the ingrown nail himself it became infected. He came to the office and I performed an in office procedure where I removed the ingrown nail in a sterile technique in a permanent fashion so it would never return and he will never have to deal with it again.

Shoe Recommendations

Dr. Lesley Richey-Smith discusses proper shoewear if you are having issues with your feet.

Subungal Hematoma

The patient had a contusion to the nail. He dropped a concrete block on his toe. A subungal hematoma should be drained as it creates pain, can be a source of infection and the nails could be covering more significant issues like a hematoma. In this video, I avulse the nail and drain the hematoma.

Toe Amputation

Diabetes we know is a huge problem in this country. The WHO estimates that in 2010 6.4% of adults had diabetes, which is 285 million. It is estimated to increase to 7.7%, 439 million by 2030. In 2018 there were 34.2 million people in the US with diabetes. There was an estimated 7.3 million undiagnosed with diabetes. In 2015 88 million people had pre-diabetes. We know this condition is in large part due to our diet and processed foods we eat. As well as the inactivity of patients, due to mostly computer jobs that are done at a desk and lack of exercise. We know that those who have diabetes, 25% of them will develop an ulcer (open wound) in their lifetime. That is 8.55 million people using 2018. We also know that 85% of all amputations in diabetic patients started as an ulcer (open wound). That is what happened to this patient. He presented to me with a severe infection and an open wound that probed to the bone. Although an attempt was made to save the toe, ultimately this attempt failed and he ended up needing amputation of this fifth toe.

Ingrown Toenail

This is a permanent procedure performed with phenol. I am removing the border of the nail that is ingrown and causing pain and inflammation. I then apply a phenol acid to the nail edge so the edge will not return and cause any further pain.

OR Ingrown Toenail

This is a permanent procedure for an ingrown nail. It is a surgical procedure. In this procedure, I physically cut out the cells that the nail grows from then close the incision with sutures. This will allow the nail to heal and the edges will not return or cause any future pain.

Surgical Ingrown Nail

This is a permanent procedure for an ingrown nail.

Phenol Ingrown Nail #1

This is a permanent procedure for a thick painful ingrown nail performed with acid

Phenol Ingrown Nail #2

This is a permanent procedure for a thick painful ingrown nail performed with acid

Post-op care – ingrown toenail

Dr. Lesley Richey-Smith discusses post-op care for an ingrown toenail.

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