Welcome to the Website of

Dr. Michael Zapf, DPM, MPH, FACFAS

Call: (818) 707-3668

 Thank you for visiting my website. I have been placing information and articles on this site for many years and have received millions of  hits during that time (and not that many of them were mine). I have designed it for people who like to read about their foot and ankle problems. Since I started the web site, I have added two associates to my practice, Dr. Darren Payne and Dr. Stephen Benson.  Since my site is filled with just my thoughts and opinions they are not, necessarily, shared by my colleagues. To see our less controversial (and less windy) practice web site, I offer you: www.ConejoFeet.com, the practice site for The Agoura Los Robles Podiatry Centers (ALRPC). The ALRPC practice site has a lot of material about our office, many of our policies and the registration forms to be filled out before your visit. I suggest all prospective patients visit www.ConejoFeet.com.

 I made the web site to give my patients the extra depth information that I donít always have time to cover in the office visit. Visitors who are not my patients are welcome to browse the information found here. I am from a generation that likes to read in depth about all sorts of things, including our ailments. This site is dedicated to all those who want more information that what can be contained in a series of bullet points. If you like this philosophy then let me know when you see me or if you ask a question.

Remember, this site is in no way intended to tell you how your own ailment or problem should be treated, only the approach I use when confronted with certain situations. Your problem may well be different from what you think it is and should always be evaluated by the appropriate professional, whether podiatrist, orthopedist or other authority. Please understand that I, nor anyone else, can offer you a proper diagnosis or treatment plan without seeing and feeling the problem at hand (foot?) Happy reading.

 Sincerely, Michael Zapf, DPM, MPH, FACFAS, FACFAOM

 P.S. All the information in this web site is © by me and it is mine alone. No picture and none of the articles can be used by anyone without permission from me, personally.

P.P.S. Comments about this web site or questions about your feet can be directed to me at zfootdoc (at) doctor (dot) com.

P.P.P.S.  I was going to offer a nice prize to the person who could send me a screen shot of being the 3 Millionth person to visit this web site. I am sorry I missed that opportunity. But wait until you see what I offer the 4 Millionth visitor.




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Alda 1.jpg (33868 bytes)Sometimes a small cyst or ganglion will form on the toes at the joint just behind the toe nail. If punctured a thick gelatinous fluid escapes. These are technically tiny toe ganglions but in this location they are more correctly knows as a mucked cyst. They are frequently treated by a "puncture" and the injection of a bit of cortisone. Unfortunately they often recur. A more permanent correction involves the removal of a little bone.  This second picture is a copy of the x-ray of this patient's toe. In this patient there is an unusual proliferation of bone at this joint. This lady has a diagnosis of osteoarthritis (degenerative joint disease). The swelling in this part of the toe is called Heberden's Nodes.



alda 2.jpg (13485 bytes) In the picture the same 4th toe as pictured above has been raised so that you can see if from the side.

Solving this problem will require a "hammertoe" surgery that can be done in the office with local anesthesia or the surgery center under local anesthesia with a bit of sedation. A surgical shoe will need to be worn for a week or two followed by a tennis shoe for another week or so.

This is a photograph of another woman with a little  ganglion on her the inside of her right 4th toe. It is that little swelling just below the center of the picture.

I injected this lesion with a little cortisone twice and it has remained steadfast. She has elected to remove the lesion and I can do this under local anesthesia right in the office. To learn how I can anesthetize this toe with the least amount of pain see -->

Mucoid cyst.jpg (115677 bytes)

Double click this to see a 

mucoid cyst on the top of a toe in all its glory. This is a fluid filled cyst that balloons out from the underlying joint (much like the inner tube of a bicycle tire can squeeze out between the cracks of an old tire).  Sometimes these pesky little things will go away by puncturing the cyst with a needle (of course, after anesthetizing the toe first!) and injecting a drop or tow of cortisone. Most of the time they come back after this kind of I&D (incision and drainage) and they need to be removed surgically. Even surgery will fail if you are not aggressive and take the entire cyst, down to the bone.

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Copyright © 2000 Michael A. Zapf, D.P.M., F.A.C.F.A.S., F.A.C.F.AOA.M.
Last modified: November 12, 2013