Harker Heights foot and ankle surgeon Dr. H. Ashley Ledger is seen at his office.


HARKER HEIGHTS — Unexplained foot and ankle pain may lead to osteomyelitis, a bone infection that can affect healthy children and adults, patients with diabetes mellitus, the elderly, or anyone with a compromised immune system.

According to Harker Heights foot and ankle surgeon Dr. H. Ashley Ledger, osteomyelitis can occur in bones within days of an infection on the skin, known as cellulitis; from a wound, traumatic or surgical; and spontaneously. Ledger explained that the porous nature of bones in people allows infection a fast path of travel, which makes the bone susceptible to amputation.

“Because the bones in the feet are close to the skin surface, it’s a short distance to travel from the skin to inside the bone. Infections can eat a hole in bone quickly,” Ledger said. “In fact, many patients visit their foot and ankle surgeon for an infection too late and the damage to skin and bone is too advanced to save the affected area of the foot and/or the leg. Patients may have to go on long-term antibiotics, or worse, amputation.”

While osteomyelitis is most commonly seen in diabetic wounds, healthy adults and children also are affected. Early symptoms can include increased pain, redness, increased temperature of skin, swelling, and difficulty with normal weight on the foot.

“Oftentimes patients don’t seek treatment for their symptoms for days or weeks thinking the pain will pass or there is delay with their referral to see someone for an infection,” Ledger said.

“The best advice is don’t ignore foot pain of any type. Early intervention can make all the difference in your treatment and recovery.”


Foot and ankle surgeons are able to diagnose osteomyelitis through X-rays, MRI and/or bone biopsy. Bone biopsies are the most accurate.

“This is why prevention and early intervention are key; you never want to be too late in treatment of an infection,” Ledger said.

If you are diagnosed with osteomyelitis, it is important to identify the bacteria and start the appropriate antibiotic.

MRSA, Methicillin Resistant Staph. Aureus, is the hardest to treat. Its resistance to multiple drugs make it costly to treat and hard to get rid of.

“In a recent study, hospital curtains were tested twice a week for three weeks. The 180 samples produced 119 germs. Twenty-six percent tested positive for MRSA and 44 percent tested positive for enterococcus. Thirteen new curtains were replaced during the study and 12 were contaminated within a week.”

Based on the study, Ledger Foot and Ankle Clinic will be having SparGuard sprayed on all surfaces to prevent clinic acquired infection from occurring and reduce its spread. Texas Bioguard, the exclusive distributor for SparGuard, is already using this green technology in Texas schools and day cares.

Very soon hospitals will be using this to reduce hospital acquired infections, HAI’s.

“We want to do everything possible to keep our patients that do not have infections from getting ones that we treat in the office,’ Ledger said.

If you are suffering from foot pain or suspect you may have a foot or ankle infection, call Ledger Foot and Ankle Clinic at 254-519-3668 for an evaluation.

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