Feet and ankles are complex structures that can be subject to a range of problems and conditions. Our feet have 26 bones and 33 joints, arranged in columns and arches. The heel bone is connected to our calf muscles by the Achilles tendon, which controls movement of the foot and ankle.
The decision whether or not to have surgery for foot and ankle problems will depend on a number of factors including: the nature of the problem; severity of the symptoms and whether or not you respond to other treatments like medication, orthoses and special footwear. If your feet are becoming deformed or your skin is affected, it is important to talk to your doctor immediately to avoid the risk of infection.
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Benefits
Pain in the feet and ankles can have far-reaching impacts, affecting our mobility and quality of life. Surgery can bring about long-lasting pain relief, better function and mobility, an improvement in the appearance of feet and, in some instances, a greater choice of comfortable footwear.
What it treats
Some conditions of the feet and ankle that might require surgery include:
- Damaged metatarsals – Arthritis can damage the joints in the forefoot. This causes pain and discomfort that sufferers describe as feeling like walking on pebbles. Surgery to remove the ends of the metatarsophalangeal joints can relieve pain and make walking easier.
- Arthritis of the ankle – Osteoarthritis can cause the cartilage covering the ends of the bones to roughen and thin, so the bone underneath thickens. The result is pain, swelling and restricted movement of the joint. If the condition becomes severe, there are a range of surgical treatments that can help, including:
- Ankle fusion: removing the damaged ankle joint and fusing the talus bone to the tibia to form a stiff but pain-free ankle. The foot is fused at right angles to the leg, as it would be if you were standing up. The procedure can be carried out using keyhole surgery. Recovery takes between 12 and 14 weeks. You will need to wear a cast for 6-12 weeks. It should be easier to walk normally after surgery although running is not recommended.
- Triple fusion: this is where three joints – the talonavicular, subtalar and calcaneocuboid – are fused either to correct foot deformity or as a treatment for arthritis. Fusion is carried out with metal plates or staples and has a recovery time of 12-14 weeks.
- Achilles tendon disorders – The Achilles tendon is the largest tendon in the body and, as we age, it can start to wear, leading to pain and swelling. On rare occasions, surgery can be used to treat disorders of the Achilles tendon.
- Morton’s neuroma – This is a painful condition affecting the nerves of two neighbouring toes. In severe cases, surgery to remove the painful nerve might be recommended.
- Tibialis posterior dysfunction – the Tibialis posterior is the muscle that supports the arch of the instep. The tendon connecting this muscle to the bone can become inflamed, leading to swelling and flat footedness over time. Sometimes surgery may be recommended to rebuild the instep arch.
- Plantar fascilitis – the plantar fascia is a band of fibrous tissues stretching across the sole of the foot from the heel bones to the toes. Fascilitis is inflammation of the area under the heel where the fascia attaches. In severe cases, surgery can release the plantar fascia from the heel bone to relieve pain.
Who it helps
Foot and ankle surgery can help people of all ages with a broad range of conditions.
Risk Factors
Any type of surgery carries risks and your doctor will normally recommend a range of non-surgical treatments before deciding on surgery. These might include:
- Exercises
- Steroid or Platelet Rich Plasma injections
- Painkillers and anti-inflammatories
- Insoles, orthoses and specially designed shoes
If you do need surgery, some of the risks associated with it include:
- increased pain and/or stiffness
- loss of feeling or reduced feeling
- infection
- reduced function
FAQ’s
How will I know if I’m suitable for surgery?
You need to talk to your doctor who will discuss your individual symptoms, lifestyle and general state of health. Generally you will normally be advised to try other non-invasive treatments before choosing a surgical route as it carries a greater risk of complications.
What are the post-surgical symptoms to look out for that might indicate there are complications?
If you notice any signs of infection you should talk to your doctor immediately. These include heat in the area of surgery, redness, pain or an unusual smell. Antibiotics will normally resolve the problem.
Is it normal to have bleeding from the site of the surgery?
A certain amount of blood loss is normal. However, sometimes blood can collect under the skin causing a swelling. This is called a wound haematoma and it may require further surgery to drain the blood.
Personal outcomes – what to expect
Each year, foot and ankle treatments enable thousands of patients to enjoy an active life, free of chronic pain.
Our patient-care process
- Once all of your diagnostic procedures are completed, we will be able to explain whether surgery is recommended.
- We will go through the procedures with you, covering the operation itself, the recovery process and the future prospects.
- Your orthopaedic surgeon will also explain the risks: these are small, but it is important for you to understand them.
- You can feel reassured that you will receive expert care from the start of the process, including your after-care.
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If you are experiencing pain in your pelvis, hip, knee or ankle, or are suffering from a sports injury, seek specialist help to get you back to living your life. Contact can be made direct, or through your GP.
Email:
enquiries@carrothersorthopaedics.co.uk
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+ 44 (0) 1223 667 376.