Louisville | Leitchfield       502-893-1844

Services

Services

Conditions We Treat

Ankle Sprains and Fractures – These are common injuries that occur with a twisting fall.  Soft tissue ligaments, tendons and or bones can be affected.  Injuries are best assessed with an exam and x-rays to guide treatment.  Sometimes surgery is necessary to prevent continued pain, deformity and post-traumatic arthritis.

Arthritis – Painful joint condition that occurs as cartilage across a joint’s surface wears down.  This can occur following trauma or due to normal wear-and-tear degeneration in older patients.

Bunion – A gradual dislocation of the big toe joint causing pain.  The big toe pushes toward the second toe and a bump develops at the big toe joint. This “bunion” can press against the nerve causing pain.  Padding and wide shoes can accommodate the deformity.  Sometimes, surgery is indicated to fix a bunion.  Juvenile bunions, seen in children, are generally worse and painful.  Most patients develop bunions during their 20’s-40’s.

Charcot – A serious condition in which a patient who has neuropathy experiences break-down of the bones and joints through the foot and/or ankle.  The bone composition changes and allows the bone to become weak.  Continued weightbearing on the foot cause the bones and the shape of the foot to change.  A rockerbottom foot, with a prominence on the bottom, causes high areas of pressure and subsequently, wounds and infection can develop if not offloaded and managed.  There is a relatively high chance of infection which can lead to an amputation if not treated correctly.  Early presentation, diagnosis and management is crucial.  Our practice specializes in wound prevention, wound care, and limb salvage.

Clubfoot – A congenital condition seen in 1:100,000 children born in the United States.  Prevalence is more common in other areas throughout the world.  Nowadays, clubfoot is often times even diagnosed before birth.  “Serial casting” is performed every other week for several months to slowly correct the position of the foot.  A minor surgical procedure is often required to lengthen the achilles tendon.  Bracing is then important to maintain position of the soft tissues and bones.  Neglected clubfoot in adults is disabling and is rare in our country.  Dr. Kihm has been doing mission trips over the past 6 years in Nepal and Guatemala to help clubfoot patients; clubfoot is six times more prevalent in these locations.

Calluses and Corns – A lot of pressure goes on the bottom of our feet when standing and walking.  There are also shear friction forces on the prominent bone surfaces.  The body responds by forming a build-up of skin layers in these areas (corns or calluses).  Offloading, padding and accommodative shoes are initial recommendations.  Sometimes surgery is performed to address the underlying bone structure, decreasing pressure on the area, and  relieving the pain.

Diabetic Foot Care – Patients with diabetes have increased chance of amputation by 15%.  We focus on prevention of these issues.  Patients who cannot feel their feet may develop a problem that is only recognized if they are looking at their feet (since they cannot feel the problem).  Daily foot exams are important (especially the bottom surface of the foot).  Diabetes affects healing potential of problems when they do arise.  Sometimes, these patients are overweight and this means increased pressures on the bottom of the feet which make problems here even more difficult to heal.  Prevention focuses on daily patient self-exams, routine nail care and assessments, diabetic shoes and insoles and diabetes management.

Flat Feet – Collapsed arches cause pain across the strained ligaments and tendons.  The feet can feel easily fatigued and tired to the point that it hurts to stand or walk even short distances.  This condition, when painful is also called Pes Valgus, and is seen in children and adults.  This is not a condition that we grow out of as we get older.  Adults with flat feet are more likely to develop degenerative arthritis in their joints.  Typically, flat feet are managed with stiff-soled shoes,  arch supports or custom orthotics, and sometimes require surgical correction.

Hammertoe – Contracture of the toe joints causes the toe to bend downwards.  This occurs due to mechanics of the foot and the person’s bone structure. Pads, tapings, and accommodative shoes can help with current symptoms.  Rigid arch supports can slow this down.  Various surgical procedures are needed to fix the deformity.  Clinical exam and x-rays generally guide treatment.

Heel pain – This is probably the most common condition we treat.  Children with painful heels may experience a growth plate condition known as Sever’s Disease.  Adults may experience Plantar Fasciitis or Achilles Tendonitis.  This commonly causes pain which can be severe and crippling, especially in the mornings when first getting out of bed or after any period of rest.  These conditions are managed with rest, stretching, rigid shoes and insoles and anti-inflammatories.  Generally, these conditions can be resolved with proper management, without surgery.

Ingrown Nails – Curved or pinched toenails can cause irritation or even infection.  These are avoided by not cutting the nails too short and by cutting the nail straight or on a gentle curve only.  Permanent procedures are commonly performed in our office to prevent the removed segment of the nail from returning.  Patients can drive and return to work on the same day as the procedure.  Soaking is usually recommended for 2 weeks following the procedure.

Lis Franc – This joint complex (tarsal-metatarsal joints 1-3) can be sprained or even broken with a sudden force to the front of the foot ( example: foot jammed by a brake pedal in a car accident). If non displaced this is treated with casting. If displaced, the condition will require surgery.

Neuroma – A swollen, pinched and inflamed nerve in the ball of the foot.  This usually occurs between the 3rd and 4th toes and feels stabbing or burning.  The pain can radiate.  Patients sometimes describe this as a “stone bruise” or describe the feeling that their sock is balled up under this area, although it is not.  Proper shoe gear, orthotics, and anti-inflammatories are helpful.  Cortisone and alcohol injections are commonly required to get relief.  Sometimes, surgery is needed if the patient does not improve with conservative treatments.

Orthotics – Rigid insoles that support the foot’s bone structure and distributes the pressure off the joints, ligaments and tendons.  These are commonly used to offload painful areas, to shield stresses, and support the arch structure to reduce development or progression of deformities.

Painful Feet – There are many reasons for painful feet.  Our practice aims to identify the cause(s) for each patient individually and offer the best treatment plan that is simple, affordable and fast.

Pediatric Foot Surgery – Congenital deformities sometimes require surgical correction.  Children generally heal well and once recovered have a definitive correction with resolution of deformity and pain.

Pes Valgus – See “Flat Feet”, above.

Plantar Fasciitis – See “Heel Pain”, above.

Plantar Wart – A wart or verucca is a viral skin condition that generally occurs on the bottom of the foot.  This is painful as pressure is placed on the area.  Common treatments include offloading and chemical treatments to pull the wart out.  This can take multiple treatments but it is rather non-painful and a definitive correction.  Severe cases however, may require surgical intervention.

Smoking – Nicotine affects the blood’s ability to supply the tissues with oxygen and nutrients.  Soft tissue and bone healing are affected – especially in the lower extremities which are so far from the heart.  Smokers are more likely to experience delayed healing, infection and overall poor prognosis.  Discuss smoking cessation with your primary care physician.

Sports Injuries – Foot and ankle injuries are common in most sports.  Our physicians are all former athletes and can relate with the physical demands of the sport, while making the best recommendations to ensure you are not causing yourself further harm.

Toe Walking – “Toe walkers” have a tight heel cord and cannot place their heel flat on the ground surface.  Conservative treatments include heel lifts and stretching.  Often times, surgery is indicated.

Work Injuries – In our practice, we see many patients with work-related injuries.  Document your injury, when it occurs, with your employer.  We assess each patient individually to determine their diagnoses and treatment options.

Wound Care – Each patient is assessed on an individual basis to determine why a wound developed and to determine the best way to heal it. When present, infection must be managed with topical medication, antibiotics, or surgery.  Bone infection is dangerous as it can expand through the body.  This increases the chances of a toe, partial foot or leg amputation.  Serious infection can also be fatal.  Wound care focuses to optimize the patient’s ability to heal the wound.  Wound debridements, offloading, medications, grafting, direct repair, etc. are all performed in our office.  Sometimes surgery is required to address underlying issues.  Dr. Ogden specializes in Wound Care and, when not in our office, works at the Norton Wound Care Clinic.