Another method—angioplasty—involves passing a deflated balloon on a tube to the point where the blockage occurs. The balloon is carefully inflated to open the narrowed artery, and sometimes a stent (a tiny metal device shaped like a spring) is inserted in the artery to keep it open. This surgery is most successful with a small blockage in a healthy artery. A third surgical method is to bypass the blocked area by using a blood vessel from another part of the body (or an artificial blood vessel). While complicated, this surgery can help save a foot, a leg, or a life. People with diabetes often have blockages in the arteries of the lower legs and feet, making it difficult to restore circulation. The relatively new ability to do bypass surgery on the small arteries of the foot has saved many legs. Not all vascular surgeons do this surgery, so check to be sure that yours can. Your providers will carefully evaluate your condition before recommending surgery.
A foot deformity is any change in the normal shape of the foot. For people with diabetes, a deformity may be complicated by the additional risk factors of poor sensation and poor circulation. It is the combination of these factors that can make foot deformities dangerous.
Common deformities include bunions, hammertoes, claw toes or mallet toes, curving of the toes toward each other, tailor’s bunions, enlargements or bumps of bone behind the heels or on the top or bottom of the foot, and Charcot deformities, which may look like a collapsing of the foot at the arch. These deformities are associated with increased pressure and sheer stress on the skin, resulting in skin breakdown.
A bunion is a deformity in the joint of the big toe that causes the toe to point away from the arch instead of straight ahead. There is usually an unsightly bump on the inside of the foot, just behind the big toe. It is believed that uneven weight distribution during walking and stresses in the joints cause bunions. Heredity is an issue in the cause of bunions, so if you have a family member who suffers with bunions, your risk of developing them is higher. Wearing shoes with pointed toes probably contributes to developing bunions. Tight shoes can exacerbate bunion pain.
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