Category: L

Lauge-Hansen classification system for ankle fractures

Posted on August 12, 2023 by Steve - Ankle, Classification systems, L

The Lauge-Hansen classification system is a widely used method for describing and categorizing different types of ankle fractures based on the mechanism of injury. It was developed by Danish orthopaedic surgeon Lauge-Hansen in the mid-20th century.

This classification system takes into account two main factors: the position of the foot at the time of injury (pronation or supination) and the direction of the force applied (medial or lateral).

The Lauge-Hansen classification system consists of four main fracture patterns:

Supination-Adduction (SA) injuries: These occur when the foot is in a supinated (turned inward) position and a force is applied in an adduction (inward) direction. This typically results in a fracture of the lateral malleolus (fibula) and possible rupture of the deltoid ligament on the medial side of the ankle.
Supination-External Rotation (SER) injuries: These occur when the foot is in a supinated position and a force is applied in an external rotation (outward) direction. This can result in a fracture of the fibula, followed by a rupture of the anterior talofibular ligament and the calcaneofibular ligament.
Pronation-Abduction (PA) injuries: These occur when the foot is in a pronated (turned outward) position and a force is applied in an abduction (outward) direction. This can lead to a fracture of the medial malleolus (tibia) and possible rupture of the lateral ligaments.
Pronation-External Rotation (PER) injuries: These occur when the foot is in a pronated position and a force is applied in an external rotation direction. This can result in a fracture of the medial malleolus, followed by rupture of the deltoid ligament and the syndesmosis (the ligaments that hold the tibia and fibula together).

The Lauge-Hansen classification system helps surgeons and medical professionals better understand the specific patterns of ankle fractures, which can guide treatment decisions and surgical approaches.

Lapidus procedure

Posted on March 29, 2023 by Steve - L, Midfoot, Surgical

The Lapidus procedure is a surgical procedure used to treat hallux valgus, a condition in which the big toe drifts away from the midline of the foot, causing a bunion. It involves fusing the first metatarsal bone to the medial cuneiform bone in the midfoot to correct the alignment of the bones and reduce the deformity. This procedure is typically reserved for cases of severe hallux valgus or for patients who have not responded to more conservative treatments.

During the procedure, the surgeon makes an incision on the top of the foot and removes a small piece of bone from the base of the first metatarsal. The metatarsal bone is then repositioned and fixed in place with screws or a plate to hold it in the desired alignment. Over time, the bones grow together and form a solid fusion, which helps to stabilize the midfoot and reduce the severity of the bunion.

After the surgery, the patient may need to wear a cast or brace for several weeks to protect the foot and allow the bones to fuse together. Physical therapy may also be recommended to help improve strength, flexibility, and range of motion in the affected foot. While the Lapidus procedure can be highly effective in correcting hallux valgus, it does require a period of immobilization and recovery, and may have some potential risks and complications, such as non-union, nerve injury, or infection. It is important to discuss the potential risks and benefits of the Lapidus procedure with a qualified healthcare professional before undergoing the procedure.

Lisfranc injury

Posted on March 9, 2023 by Steve - L, Midfoot, Sports

A Lisfranc injury is a type of foot injury that occurs when there is a fracture or dislocation of the bones in the midfoot, where the metatarsal bones meet the tarsal bones. This area is known as the Lisfranc joint complex, and it is responsible for the stability of the foot during walking and other activities.

Lisfranc injuries can range from mild to severe, and may include sprains, fractures, or dislocations. They are most commonly caused by a twisting or bending force applied to the foot, such as a fall or a direct blow to the foot. Athletes who participate in high-impact sports, such as football or basketball, are at increased risk of Lisfranc injuries.

Symptoms of a Lisfranc injury may include pain, swelling, bruising, and difficulty bearing weight on the affected foot. If left untreated, a Lisfranc injury can lead to chronic foot pain, instability, and arthritis.

Treatment for a Lisfranc injury depends on the severity of the injury. Mild injuries may be treated with rest, ice, compression, and elevation (RICE), as well as the use of a cast or walking boot to immobilise the foot. More severe injuries may require surgery to realign the bones and stabilise the joint.

Recovery from a Lisfranc injury can take several months, and may require physical therapy to restore range of motion and strength to the foot. It is important to follow your doctor’s recommendations for treatment and rehabilitation in order to prevent long-term complications and ensure a successful recovery.

Lichen planus

Posted on March 9, 2023 by Steve - Dermatology & nail pathology, L

Lichen planus is a chronic inflammatory condition that affects the skin, hair, nails, and mucous membranes. It can appear anywhere on the body, but is most commonly found on the wrists, ankles, and lower back. Here are some key facts about lichen planus:

Causes:

The exact cause of lichen planus is unknown, but it is believed to be an autoimmune disorder in which the body’s immune system attacks the skin and mucous membranes.
Certain medications, such as beta-blockers and non-steroidal anti-inflammatory drugs (NSAIDs), can trigger an outbreak of lichen planus in some people.

Symptoms:

Lichen planus typically appears as small, flat-topped, itchy, reddish-purple bumps or spots on the skin or mucous membranes.
In some cases, the bumps may develop into blisters or open sores.
Lichen planus can also affect the nails, causing ridges, grooves, and thinning.

Diagnosis:

A diagnosis of lichen planus is usually made based on the appearance of the skin or mucous membrane lesions.
In some cases, a skin biopsy may be necessary to confirm the diagnosis.

Treatment:

Treatment for lichen planus depends on the severity of the condition and the location of the lesions.
Mild cases may not require treatment, but topical or oral corticosteroids, retinoids, or immunosuppressive medications may be prescribed for more severe cases.
Symptomatic relief measures, such as cool compresses and oatmeal baths, can help relieve itching and discomfort.

Prognosis:

Lichen planus is a chronic condition, but it typically resolves on its own within 6-12 months.
In some cases, lichen planus can cause scarring or permanent changes in skin colour or texture.
Rarely, lichen planus can affect the oesophagus, genitals, or other internal organs, leading to more serious complications.

Lewis Durlacher

Posted on March 8, 2023 by Steve - L

Lewis Durlacher (1792-1863) was a British surgeon and inventor, best known for his work on the development of prosthetic limbs. He is credited with designing one of the earliest functional artificial hands, which was capable of gripping objects and performing tasks with a degree of dexterity.

Durlacher also made contributions to the field of podiatry, describing a type of foot ulcer that is now known as a Durlacher ulcer. He published several papers on the topic and advocated for the use of pressure-relieving footwear and orthotics in the treatment of foot ulcers.

In addition to his work in medicine, Durlacher was also an accomplished artist, producing several paintings and drawings throughout his life. He died in London in 1863 at the age of 70.

Lawnmower injuries of the foot & ankle

Posted on March 8, 2023 by Steve - L

Lawnmower accidents can cause serious foot injuries, and thousands of people end up in the emergency room every year due to these accidents. The blades of a lawnmower can cause deep cuts, severed toes, and even amputations.

To prevent these types of injuries, it’s important to follow some basic safety tips when operating a lawnmower:

Wear appropriate footwear: Always wear sturdy, closed-toe shoes with slip-resistant soles.
Keep the area clear: Before starting the mower, clear the area of any rocks, sticks, or debris that could be thrown by the blades.
Use a push mower safely: If you have a push mower, make sure to keep your hands and feet away from the blades at all times.
Turn off the mower before making any adjustments: If you need to adjust the blade height or clear a clog, turn off the mower and wait for the blade to stop rotating before making any adjustments.
Never remove the grass catcher or discharge chute while the mower is running: The blades can continue to spin even after the engine is turned off.

By following these safety tips, you can help prevent lawnmower-related foot injuries and keep yourself and others safe.

Laser for nail fungus

Posted on March 8, 2023 by Steve - Dermatology & nail pathology, L, Other

Laser treatment is a relatively new approach for treating nail fungus, also known as onychomycosis. The laser emits a focused beam of light that is absorbed by the pigment in the nail and heats up the fungal cells, causing them to be destroyed. Laser treatment for nail fungus is typically done in a podiatrist’s office and can take up to several sessions to complete.

While there have been some promising results with laser treatment for nail fungus, it is important to note that it is not a guaranteed cure and may not work for everyone. Additionally, the procedure can be quite expensive and is generally not covered by insurance. It is also important to note that laser treatment for nail fungus is not currently approved by the U.S. Food and Drug Administration (FDA), although some laser devices have been cleared for use in treating nail fungus.

If you are considering laser treatment for nail fungus, it is important to consult with a qualified podiatrist who can help determine if it is the right option for you and answer any questions you may have.

Laser for foot pain

Posted on March 8, 2023 by Steve - L, Other, Pain

Photobiomodulation therapy (PBMT), also known as low-level laser therapy or cold laser therapy, is a non-invasive treatment that uses low-level lasers or light-emitting diodes (LEDs) to stimulate cellular processes in the body. It has been shown to be effective in reducing pain and inflammation, promoting tissue healing and regeneration, and improving circulation.

PBMT has been used to treat various foot conditions, including plantar fasciitis, Achilles tendinopathy, diabetic neuropathy, and osteoarthritis. The therapy involves shining a specific wavelength of light onto the affected area, which stimulates the production of ATP (cellular energy) and other cellular processes that promote healing and pain relief.

Studies have shown that PBMT can be an effective treatment for foot pain, particularly in cases of plantar fasciitis and diabetic neuropathy. It is a non-invasive and low-risk therapy, with few side effects reported. However, it is important to note that PBMT is not suitable for everyone and should only be performed by a trained professional. It is also important to discuss the potential benefits and risks with your healthcare provider before starting any new treatment.

Lacrosse injuries of the foot & ankle

Posted on March 8, 2023 by Steve - L, Sports

Lacrosse is a popular sport that involves a lot of running, jumping, and quick changes of direction, which can put a lot of stress on the feet and ankles. Some common foot and ankle injuries in lacrosse include:

Ankle sprains: Ankle sprains occur when the ligaments in the ankle are stretched or torn. This can happen when the ankle is twisted or turned too far, which is common in lacrosse.
Achilles tendonitis: The Achilles tendon is a strong, fibrous cord that connects the calf muscles to the heel bone. Overuse or repetitive stress can cause the Achilles tendon to become inflamed and painful, which is known as Achilles tendonitis.
Plantar fasciitis: The plantar fascia is a band of tissue that runs along the bottom of the foot. Overuse or repetitive stress can cause the plantar fascia to become inflamed and painful, which is known as plantar fasciitis.
Turf toe: Turf toe is a sprain of the big toe joint that occurs when the toe is hyperextended, which is common in sports like lacrosse that involve running and jumping on artificial turf.
Stress fractures: Stress fractures are small cracks in the bone that occur when the bones are subjected to repetitive stress or overuse. They are common in the feet and ankles of lacrosse players, particularly those who play on hard or artificial surfaces.

To prevent these injuries, it’s important for lacrosse players to wear appropriate footwear and protective gear, warm up properly before playing, and stretch after playing. It’s also important to gradually increase the intensity and duration of training and to listen to your body and rest when needed.