Practicing Urban Podiatry

Dr. Alvin Bannerjee
Dr. Alvin Bannerjee giving an ultrasound guided injection

It is never easy when moving to a new place. It’s even harder when the move is with a small child from one coast to another. I recently moved from Maryland to California with my wife and 2 year old son for the sake of a new opportunity and practicing podiatry at a different location. So far it has been an adventure! We don’t really have any family here and so when we tell people the story, majority state that we are brave! However, I would like to think that moving and new experiences are a natural part of life. It is something we force ourselves to do, to better our lives and cultural experience.

In addition to beautiful scenery, great food and abundance of outdoor activities, and the city of San Francisco offers many great amenities. Practicing podiatry in the city has also been a new experience. Mundane podiatry covers everything from fungal toenails to ankle fractures and everything in between. That means pediatric to geriatric patients with skin conditions or foot infections. Previously practicing at a suburban setting, I saw everything and anything but nothing really specific. At financial district foot and ankle, we see majority of sports medicine related injuries.

San Francisco is a great walkable city, even with all the hills going up and down, people love to walk or bike to work and everybody likes to be active. It’s a beautiful city with great outdoor space, so being active is healthy and fun. Being active and involved in sports also means potential for more injuries, whether it be chronic or acute. Treating patients in this urban environment brings a refreshing new experience in treating conditions which are very rewarding because patients are very involved in their care. Everybody wants to heal accurately and fast and so they will rest, boot, exercise and use therapy aggressively so they can start running again. Since FDFAC specializes in sports medicine and has been doing so for many years, our methods are very active and helped many return to their daily routines after a minor setback. With adding more technology and diagnostic tools to our practice, we continue to innovate and improve our diagnostics and treatment methods. Having this specialized training and niche in a private practice is not only is a great asset to have but is very rewarding as well.

At Financial District Foot & Ankle, we see foot and ankle problems from all sorts of people. Whether you are an athlete or not, new in town or lived here forever, if you have foot and ankle problems, come see us! We know how to conservatively and surgically manage your pain and symptoms and work with you throughout your healing process.

Dr. Alvin Bannerjee
Alvin Bannerjee, DPM
Foot and Ankle Surgeon

Contact us at 415-570-7490 and we can schedule you for an appointment. We look forward to helping you overcome your foot pain!

American Academy of Foot and Ankle Osteosynthesis (AAFAO), Memphis TN. 2017

Dr. Pieter Lagaay
Dr. Pieter Lagaay lecturing at American Academy of Foot and Ankle Osteosynthesis (AAFAO), Memphis TN. 2017

Twice a year I travel to Memphis, TN as a faculty member of the American Academy of Foot and Ankle Osteosynthesis (AAFAO) to teach a 3 day course in reconstructive foot and ankle surgery. This is a world class organization whose mission is to teach residents principles and technique’s related to foot and ankle surgery. I have been lecturing for the AAFAO for 6 years now. My lectures include;

  1. Principles of screw fixation – This focuses on teaching general method of how to use screws in foot and ankle surgery. The lecture focuses both on the technique and indication.
  2. Clinical applications of plate fixation in the foot – This lecture provides insight into how and when to use plates in foot and ankle surgery.
  3. Principles and Techniques for Ankle Fracture Osteosynthesis – This more advanced lecture focuses on understanding which surgical techniques to use for various types of ankle fractures.
  4. Principles of External Fixation – This is an advanced lecture to help residents understand the indications and techniques involving the application of external fixator’s for foot and ankle surgery.
  5. Charcot Foot and Ankle – This is a lecture aimed to help residents understand on how the choice of fixation affects the stability of a Charcot foot and ankle reconstruction.

Being a faculty instructor with AAFAO requires me to be an experienced expert of the topics I am teaching. I am continuously learning about what I am lecturing on, because the topics are always evolving. My education in foot and ankle surgery continuously broadens in other areas as well, because I am able to listen to other experts teach while at AAFAO.

The benefit to patients of having an experienced surgeon who is; at the forefront of their field, involved in teaching a younger generation, and constantly remaining up to date with medical advancements, is that patients will receive care that is based on real evidence and an abundance of professional experience rather than inexperienced antidotal evidence.

My approach to medical care is one which is personal but is still based on published medical evidence. This means that the treatments rendered are substantiated by statistically proven success and not just one individuals personal experience. Here at Financial District Foot and Ankle Center we pride ourselves on always staying current with advancements in modern medicine while also providing personal care to each patient. We treat our patients with compassion and empathy like we would for our own family. If you have any questions about your foot and ankle needs, don’t hesitate to contact myself or any of the staff at Financial District Foot and Ankle Center. We are here to provide the highest quality foot and ankle care just for you.

Dr. Pieter Lagaay
Pieter Lagaay, DPM
Board Certified Foot and Ankle Surgeon

Contact us by calling 415-570-7490 and one of our staff members will be glad to help you!

Cures Act May Speed Approval of Stem Cell Therapies

STEM CELLS ARE THE NEXT FRONTIER IN MEDICINE
STEM CELLS ARE THE NEXT FRONTIER IN MEDICINE
Stem cells are thought to have great therapeutic and biotechnological potential. This will not only to replace damaged or dysfunctional cells, but also rescue them and/or deliver therapeutic proteins after they have been engineered to do so.

The 21st Century Cures Act was recently enacted into US law and will permit expedited review of stem cell treatments for musculoskeletal injuries and chronic conditions. The regenerative properties of stem cells is something that is state of the art and generating lots of excitement in the medical community.

The success with treating nagging foot and ankle injuries unresponsive to conventional methods of care with regenerative stem cell therapy is superseding older treatments such as platelet rich plasma, (PRP).

I have been treating several patients with FDA approved regenerative stem cell therapy for various conditions including foot and ankle tendonitis and plantar fasciitis with great success. The results have been very successful thus far. As a physician nothing is more gratifying then seeing tears of frustration turn into tears of joy.

Come by and speak with one of our FDFAC physicians to learn more about how we can help you break free from the harness of pain keeping you off your feet!

Dr. Pieter Lagaay
Pieter Lagaay, DPM
Board Certified Foot and Ankle Surgeon

Contact us by calling 415-570-7490 and one of our staff members will be glad to help you!

Proper Diagnosis and Treatment of Stress Fracture Leads to Speedy Recovery

X-ray of Metatarsal Fracture
METATARSAL FRACTURE

Many times, a stress fracture can progress to displaced fractures.

A woman wearing heels comes into our office and says something fell on her foot. She obviously can walk and tells us there is some pain, but wants to get it checked out to make sure there isn’t a bigger issue. Her hope is that nothing is broken and she will be able to go back to her normal activities.

In-office X-Rays have greatly helped in diagnosing fractures, dislocations, infections, and even some soft tissue inflammation. The initial X-rays for this patient did not show any fractures, but all of the signs of a fracture were there. The area was swollen and red, her skin discolored, and she clearly was in pain. Since the X-ray wasn’t conclusive in this case, we used a tuning fork.

In diagnosing fractures, a tuning fork is a useful diagnostic tool. When struck, the fork emits a high-frequency vibration. Placed against a bone, it causes sharp pain if a stress fracture exists. For this particular patient, the tuning fork test was positive, so we put her in a cam walker.

This patient returned to the clinic two weeks after the initial pain was identified. She was wearing regular shoes and did not present with the same pain from the previous in clinic visit. A follow-up set of X-Rays clearly identified a fracture of her 3rd metatarsal neck. Studies consistently show that stress fractures typically take around two weeks to show up on X-ray, although sometimes it may take longer. This case is a classic example of a stress fracture with delayed fracture visualization.

It’s not uncommon for patients to come to our clinic misdiagnosed. This can delay treatment that could complicate the healing process and in some cases may require a surgical intervention for optimal outcome. Since it can take a couple of weeks for the fracture to be visually evident via X-ray, it is best to suspect that the injury is a fracture. Pain and swelling will reduce in 6 to 8 weeks.

When misdiagnosed or not caught in time, and subjected to normal or heavy force loads, stress fractures can ultimately become serious displaced fractures that require surgery.

Dr. Alvin Bannerjee
Alvin Bannerjee, DPM
Foot and Ankle Surgeon

If you or someone you know has a suspected fracture, please call our office at 415-570-7490 and we will schedule a reserved appointment to quickly diagnose and start treatment on the first visit.

Sprains, Strains, and Ankle Pain

Ankle Pain
Just because you can walk doesn’t mean your injury isn’t serious. Dr. Jenny Sanders explains how what seems to be just a sprain or strain can be more.

Just today, I treated a torn plantar fascia, heel fracture, sesamoid fracture, and metatarsal fracture – and every single one of those patients believed they were suffering from nothing more than a simple sprain!

I am constantly amazed when patients come into our clinic with sprained ankle pain, and assume nothing is broken or seriously injured simply because they can walk. The problem with this mentality is there are many injuries that can allow you to walk, but which need to be properly addressed. In the event of any injury, please do not make the assumption “it’s not a big deal.” Remember, pain is your body’s way of letting your brain know there’s a problem!

Part of the problem is that sprains and fractures share several symptoms. In both cases, you experience pain, swelling, and tenderness in the area. Some of the treatments for sprains and fractures also overlap. Depending on severity, we may include medication, rest, ice, compression, and immobilization to care for your injury.

Whereas there are similarities, there are also stark differences. Of course, you may not be aware of these differences and believe your injury is not a fracture. When you think about the fact that you cannot normally see if your bone is fractured, perhaps you will recognize the importance of having diagnostic imaging performed by our office. (In the event you can actually see broken bone that has pierced the skin, you need to seek emergency medical care!)

As a thought, always keep in mind that running or training through an injury can be dangerous. Abandon the “just walk it off” mentality and make sure you receive proper care for the problem. This might seem like, pardon the pun, a pain, but you will actually be able to resume your favorite activities more quickly and safely by doing so.

I talk about this further in my YouTube video here and hope that—after watching—you will make an appointment with us for the care you need, no matter if you twist your ankle, stub your toe, or even just plant your foot the wrong way and it continues to hurt or swell.

Regardless as to which injury you sustain, come in and see us. Don’t wait, because this can lead to additional damage you could otherwise prevent.

Dr. Jenny Sanders
Dr. Jenny Sanders
Board Certified DPM

Phone our office at 415-570-7490 and we can schedule a reserved appointment to help you overcome your foot and ankle pain! You can also register as a New Patient and our staff will call you within 30 minutes to schedule a reserved appointment.

Stem Cell Therapy for plantar fasciitis, achilles tendonitis and posterior tibial tendonitis

Stem Cell Therapy
CELLULAR ALLOGRAFT THERAPY
State-of-the-art Injectible Therapy that is Minimally Invasive and An Alternative to Surgery

The most common cause of heel pain is plantar fasciitis. I’ve had it myself, and know how frustrating it can be to know that something so simple is causing so much pain. Most of our patients often express the same sentiment, especially when they find out how long it can take to get better with traditional care. Fortunately, we have a new treatment option—regenerative healing—that works exceptionally well and can provide the results you hope to see.

Recently, I have been using a new technology of injecting cellular allograft (naturally-occurring human biomaterial extracted from fetal umbilical cords) to treat plantar fasciitis. This is done for cases that do not respond to the usual treatments of cortisone injections, orthotics, and physical therapy. The cellular allograft contains various proteins and stem cells that are essential for the healing of human tissue.

As we age, the concentration of reparative cells and proteins decrease, which, in part, slows down and decreases our natural healing potential. Regenerative healing, however, helps to overcome the decrease of these biomaterials.

Whereas surgery recovery can leave you sidelined for months, the recovery from cellular allograft injections only takes a matter of weeks. You can return to your favorite, normal activities in only four weeks following the injection.

Regenerative healing works equally well for soft tissue injuries like achilles tendonitis, posterior tibial tendonitis, and, of course, plantar fasciitis. Even better, we can also use this treatment for arthritic, stiff joints, like those found in the great toe and ankle.

If you have any questions regarding this revolutionary treatment, simply give us a call today and schedule an appointment. At your visit, we will evaluate your condition and determine whether or not regenerative injections are right for you and your circumstances.

Dr. Pieter Lagaay
Pieter Lagaay, DPM
Board Certified Foot and Ankle Surgeon

Contact us by calling 415-570-7490 and one of our staff members will be glad to help or register on our website to become a New Patient.

NOT ALL TOENAIL FUNGUS IS CREATED EQUAL

White Superficial Onychomycosis (WSO)
White Superficial Onychomycosis (WSO)

A patient came into the clinic a few days ago with a bad case of toenail fungus. She had seen three other physicians in New York for treatment recommendations prior to making an appointment at FDFAC. These recommendations included expensive medications, expensive creams and expensive laser treatments. In spite of the high costs, these treatments are sometimes worth it, depending upon the cause. In her case, though, the particular type of fungus was caused by the continuous use of toenail polish.

Fungus due to frequently polished toenails is called White Superficial Onychomycosis (WSO), and is easily cured with a simple, inexpensive emery board file. Similar to the mold that grows on the surface of cheese, this fungus is easily filed off, leaving the healthy nail below.

Dr. Jenny Sanders
Dr. Jenny Sanders
Board Certified DPM

Contact us by calling 415-570-7490 and we will determine your best treatment options or Register on our website to become a New Patient.

 

Ultrasound is an Affordable Diagnostic Tool

Ultrasound
IN-OFFICE ULTRASOUND
In-office Ultrasound allows us to diagnose and start treatment on the same day.

Medicine has come a long way with in-office diagnostics. X-Ray machines are a helpful tool to have in the office, but many foot and ankle disorders are soft tissue-related problems. To properly diagnose soft-tissue injuries we utilize Ultrasound or MRI (magnetic resonance imaging). Since ultrasound is both fast and affordable, it’s a helpful tool to have when seeing patients who suffer from a variety of foot and ankle disorders.

Of the many possible foot disorders, plantar fasciitis is one of the most common conditions we treat. Ultrasound allows quick visualization to identify and diagnose many soft tissue ailements. FDFAC will also utilize ultrasound to track progression of healing.

We measure the thickness of inflamed tissue and assess how the treatment is working and then determine when a patient may benefit from a cortisone injection. This technology is useful for diagnosing and visualizing connective tissue (ligaments, tendons) injuries and conditions, such as tendinitis and tendon tears. Additionally, disorders in the Achilles tendon, ankle ligaments and other tendons, including peroneal tendons, are more easily diagnosed and tracked by using ultrasound.

FDFAC Doctors will utilize ultrasound for ultrasound-guided injections. Why is this important? Each patient is limited to no more than three cortisone injections in a specific area per year. More than three injections can damage tissue and therefore no practitioner no will exceed this limit. Ultrasound guided injections allow our Doctors to visualize the affected area and then precisely place the injectable in the exact area for optimal results.

Diagnostic ultrasound clearly has many applications in clinical settings, which makes it a great tool to properly diagnose and treat our patients on the same day. Ultrasound is fast, convenient and affordable.

FDFAC’s goal is to provide the highest quality care that minimizes your downtime. We understand your need to recover quickly so that you can get back to the activities that you love. Having advanced diagnostic tools on-site allows us to do just that. From X-Ray to MRI, we have you covered for any foot and ankle injury with same day diagnosis and treatment to get you back in the game.

Dr. Alvin Bannerjee
Alvin Bannerjee, DPM
Foot and Ankle Surgeon

Contact us by calling 415-570-7490 and one of our staff members will be glad to help you!