When is Foot Surgery Necessary?

Foot Health Awareness Month is a time to encourage everyone to be mindful that foot health has an overall impact on total body health. A podiatrist is key to ensuring optimal foot health. How do you know when you need to have surgery on your feet? Dr. Harris, JRMC Podiatrist, would like to give you some tips on foot surgery and when it is necessary.

Ankle braceWhen is Foot Surgery Necessary?
Many foot problems do not respond to “conservative management”. Your podiatrist can determine when surgical intervention may be helpful. Often when pain or deformity persists, surgery may be appropriate to alleviate discomfort or to restore the function of your foot.

Types of Foot Surgery
Fusions: Fusions are usually performed to treat arthritic conditions of the foot and ankle. A fusion involves removing all cartilage from a joint and then joining two or more bones together so that they do not move. Fusions can be done with screws, plates or pins or a combination of these.

Tendon Surgery: Surgery on the tendons can be performed for acute injuries such as ruptures but is also commonly done to lengthen or shorten the tendon, depending on the problem. In some cases, tendons may be re-routed to improve foot and ankle function.

Metatarsal Surgery: Surgery on the lesser metatarsals is performed for a variety of reasons but is commonly done to redistribute the weight bearing on the ball of the foot. In some severe cases, such as rheumatoid arthritis, surgery may involve removing the metatarsal heads (the bones in the ball of the foot area).

Bunion Surgery: There are many different types of bunion surgery depending on the severity of the bunion and the joint involvement. Your podiatrist can explain the bunion procedure that is most appropriate for your bunion. Depending on the surgery necessary, the recovery time can be very different – particularly if you need to be on crutches after the surgery or in a cast.

Hammer Toe Surgery: Hammer toe surgery may involve removing a portion of the toe bone to realign the toe or could involve fusing the toe joint (see Fusions, above). In some cases, it may involve placing an implant in the toe to maintain realignment.

Neuroma Surgery: Neuroma surgery involves removing a benign enlargement of a nerve, usually between the metatarsal heads in the ball of the foot. This soft tissue surgery tends to have a shorter recovery time than bone procedures, but it leaves some residual numbness related to the removal of the piece of nerve tissue.

Heel Surgery: based on the condition and the chronic nature of the disease, heel surgery can provide relief of pain and restore mobility in many cases. The type of procedure is based on examination and usually consists of plantar fascia release, with or without heel spur excision. There have been various modifications and surgical enhancements regarding surgery of the heel. Your podiatrist will determine which method is best suited for you.

Reconstructive Surgery: Reconstructive surgery of the foot and ankle consists of complex surgical repair(s) that may be necessary to regain function or stability, reduce pain, and/or prevent further deformity or disease. Unfortunately, there are many conditions or diseases that range from trauma to congenital defects that necessitate surgery of the foot and/or ankle. Reconstructive surgery in many of these cases may require any of the following: tendon repair/transfer, fusion of bone, joint implantation, bone grafting, skin or soft tissue repair, tumor excision, amputation, and/or the osteotomy of bone (cutting of bones in a precise fashion). Bone screws, pins, wires, staples, and other fixation devices (both internal and external), and casts may be utilized to stabilize and repair bone in reconstructive procedures.

Preoperative Testing and Care
As with anyone preparing for any surgical procedure, those undergoing foot and ankle surgery require specific tests or examinations before surgery to improve a successful surgical outcome. Prior to surgery, the podiatrist will review your medical history and medical conditions. Specific diseases, illnesses, allergies, and current medications need to be evaluated. Other tests that help evaluate your health status may be ordered by your podiatrist, such as blood studies, urinalysis, EKG, X-rays, a blood flow study (to better evaluate the circulatory status of the foot and legs), and a biomechanical examination. A consultation with another medical specialist may be advised by a podiatrist, depending on your test results or a specific medical condition.

Postoperative Care
The type of foot surgery performed determines the length and kind of aftercare required to assure that your recovery from surgery is rapid and uneventful. The basics of all postoperative care involve to some degree each of the following: rest, ice, compression and elevation. Bandages, splints, surgical shoes, casts, crutches or canes may be necessary to improve and ensure a safe recovery after foot surgery. Your podiatric surgeon will also determine if and when you can bear weight on your foot after the operation. A satisfactory recovery can be hastened by carefully instructions from your podiatrist.

From the American Podiatric Medical Association (APMA)

Welcome Essentia Health-Jamestown Clinic to the Campus of JRMC

We would like to welcome Essentia Health-Jamestown Clinic to the campus of Jamestown Regional Medical Center! We are excited for them to join us in the new Jamestown Clinic Building. The new location will allow patients and providers the opportunity to have convenient access to the hospital for services such as mammograms and CAT scans.

Jamestown Regional Medical Center is conveniently located just off Interstate 94 at the exit for U.S. Highways 281 and 52. The new clinic has 30 exam rooms, three procedure rooms, a laboratory, imaging services, offices and patient education areas. The clinic will work to coordinate clinic appointments with appointments for hospital services so patients only have to make one trip to the medical campus.

JRMC is excited to welcome Essentia Health –Jamestown Clinic to the campus. This is just another step towards creating a medical campus for the region.

New clinic building close to opening in Jamestown

Originally published in The Jamestown Sun December 1, 2012
By Keith Norman, The Jamestown Sun

Workers are installing countertops, cabinets and interior doors as construction on the clinic attached to the Jamestown Regional Medical Center winds down.

“We move on Dec. 26 and see patients in the new clinic on Dec. 27,” said Todd Hudspeth, president and CEO of the hospital. “Essentia Health moves beginning on Jan. 4 and is open for patients on Jan. 7.”

The move for the doctors associated with the Jamestown Regional Medical Center is short. They have been working from a modular clinic facility on the hospital grounds across the parking lot from the new clinic.

The move also provides the physicians associated with the hospital more space to work. The hospital staff currently includes physicians specializing in podiatry, obstetrics and orthopedic surgery. It also provides space for visiting specialists as needed.

“A lot more exam rooms,” said Cindy Gohner, vice president of clinical services. “We’ll go from 11 exam rooms that we share with the Veterans Administration to 22 exam rooms for our own staff.”

The Veterans Affairs clinic currently utilizes the same modular clinic as the JRMC clinic. It is scheduled to move to the new clinic building in February.

Essentia Health will be leaving its current location in downtown Jamestown.

“We’re very excited about the move,” said Dr. Scott Rowe, physician at Essentia Health. “It will not be too difficult. We’re taking so little equipment with us. We’re getting pretty much all new equipment at the new location.”

Rowe said the new equipment and the design of the clinic should improve the efficiency of the operation and the patient experience.

“The traffic flow (within the clinic) is so much more efficient given how we practice medicine now,” he said. “And it should be one visit for the patient for a lot of problems. That will be real advantageous for a lot of patients.”

The new clinic is attached to the west end of the JRMC building. This wing of the hospital includes the radiology department and labs that will be shared between the clinic and hospital.

“The ‘back door’ access to the hospital from the clinic will be convenient especially for orthopedic patients,” Hudspeth said.

The clinic is another step in a project that started years ago.

“The long-term goal has always been to have a complete medical campus in one location,” Hudspeth said. “We would like to see Sanford ultimately there also. Realistically, they operate two clinics now and they will want to consolidate sometime. It would be good to see that operation here.”

Sun reporter Keith Norman can be reached at 701-952-8452 or by email at knorman@jamestownsun.com

Hudspeth shares on JRMC at Rotary

Todd Hudspeth, CEO of JRMC, gave an overview of what has been happening at JRMC at Rotary.

The new center opened July 31, 2011, with a state-of-the-art facility. It was created with the latest in equipment, technology, a design with the patient in mind and input by the employees, he said.

The goal of JRMC is to be the best rural hospital in America, Hudspeth said. To accomplish this, JRMC must have outstanding patient care, a workplace where the employees enjoy coming and have qualified physicians and specialist who enjoy being a part of the care. When employees are happy in their work it translates into better care for the patient, he said.

Hudspeth said the Medical Office Building construction is on schedule. He said JRMC will lease a portion of the space along with Essentia Clinic and the VA clinic. The goal is to be open and using the new space by January 2013.

Medical Building Progress: First Phase of Project on Track to Finish in August

Todd Hudspeth, president and CEO of the Jamestown Regional Medical Center, talks Friday about the construction of the new medical building being attached to the hospital.

Originally published in The Jamestown Sun, June 30th.
By: Ben Rogers, The Jamestown Sun

Work on the Jamestown Medical Building is right on schedule, according to a hospital administrator.

“I think there’s a lot of excitement from employees and a lot of patients ask what’s going on,” said Todd Hudspeth, Jamestown Regional Medical Center president and CEO.

What’s going on is that crews from the Davis Group are making headway on the construction of the shell of a 46,000-square foot building connected to JRMC.

“Technically we’re not the landlord but we’ll be a tenant in the building,” Hudspeth said. Davis Group will own the building on land it will lease from JRMC.

JRMC will use 14,000 square feet as space for clinic space. Essentia Health will use 18,000 square feet as its new clinic. And the Veterans Affairs clinic could take up about 5,000 square feet, though nothing has been announced yet, he said.

The project is being completed in two phases. The first is the construction of the building’s shell. When completed in August the shell will be the outside walls, a cement floor and a ceiling overhead.

The second phase is the construction of the inside. JRMC has not designed its space yet and is currently working with architects. Essentia has its clinic space designed.

“It’s a pretty tight timeframe to get it done in six months,” Hudspeth said. “… Putting the shell up takes less time than filling it up.”.

Hudspeth said he’d like to see Jamestown’s other two health care clinics relocate to the JMB.

“We’re hopeful additional development will occur out near us too,” he said.

The steel outline of the building was complete in early June and the parking lot also started to take shape then. In the middle of June some outside structures were complete like columns at the entrance canopy. The north side of the building also had drywall installed at that time.

Exterior drywall work started around the middle of June and brickwork is being installed on the outside wall. Asphalt was laid Thursday and the roof is about 80 percent complete.

In the middle of July interior stud wall framing will begin and the main ductwork for heating and cooling will begin.

In August, interior design work will start.

Hudspeth said construction is on schedule for a January 2013 opening.

Sun reporter Ben Rodgers can be reached at 701-952-8455 or by email at brodgers@jamestownsun.com

JCB Construction Progress

Week of June 25-29

Construction continues on the Jamestown Clinic Building and is right on schedule. Curbs and gutters around the building and parking lots have been finished. The entire building will soon be enclosed as sheet rock and brick is installed.

Projects outside the building

  • Thursday (6/28): First layer of blacktop will be laid starting on the south parking lot and working the way around the west side to the north.
  • Once the brick is installed on the exterior of the building, sidewalks will be poured.

Roof construction

  • The roofing is 80% complete. It will be completed in the next couple weeks.

Main building

  • Installation of exterior brick has begun on the north side of the building. This will continue around the western side to the south side.
  • Starting July 9th, cement will be poured for the main hallway, bathrooms and lobby.
  • The week of July 16th, interior stud wall framing will begin and main duct work for heating and cooling will begin to be installed.

Future projects

  • Pouring concrete for MRI pad. Once this is complete the MRI trailer will be moved back to the west side of the hospital.
  • Interior construction of  Essentia and JRMC Clinics