In-office management of common geriatric foot problems.

Foot disorders can be a major source of pain, discomfort, and disability for older adults. Neuropathy, impaired leukocyte function, vascular insufficiency, and trauma predispose older diabetics to limb-threatening complications. Therefore, examine the diabetic patient's foot during each visit. Painful foot disorders and lower extremity joint impairment represent major causes of treatable gait disturbance. Treatment of hyperkeratotic lesions (corns, calluses) consists of aseptic debridement and weight dispersion. Interspace maceration, fungal infections, and ulceration must also be managed with care. It is important to distinguish mycotic nail infections from nail dystrophies secondary to systemic disease, vascular insufficiency, and trauma.