Surgery for Ankles and Feet
Some foot problems can be treated with non-surgical methods, such as custom shoes or supports, or a cast. When foot pain or deformities persist, surgery may be necessary to restore the function of your foot or to alleviate the pain and discomfort. Your podiatrist will determine when one of these procedures will be helpful.
Types of Foot Surgery
There are several types of surgery performed on feet, each focused on treating a specific part or condition of the foot. The following are common types of foot surgeries.
BUNION SURGERY
Bunions, bony bumps on the joint at the base of your toe (normally your big toe) may require surgery, depending on the severity of the bunion and how much the joint is affected. There are different types of surgery for bunions, and some require a longer recovery time with crutches or a cast.
FUSIONS
Usually performed to treat arthritic conditions in the foot and ankle, a fusion fuses two or more bones together so that they do not move. First, all cartilage in a joint is removed, then the bones are fused together with screws, plates, or pins or a combination of these.
HAMMER TOE SURGERY
Hammer toes are caused by an abnormal bending of at least one joint in your smaller toes. To fix this bending, surgery may involve removing part of the toe bone to realign the toe or a fusion of the joint (see Fusions, above). Other times, implants are inserted to help the toe maintain realignment.
HEEL SURGERY
Your heel can be afflicted by several types of conditions, but an operation on the heel can often relieve the pain and increase your mobility. The podiatrist will examine your heel to determine what procedure is best for you. The common heel surgeries are heel spur (extra bone growth) removal and plantar fascia release. (Plantar fascia is a connective tissue in the foot.)
METATARSAL SURGERY
The metatarsals are the bones in your foot that give your foot its arch. They work with ligaments and tendons to provide movement. When surgery is performed on metatarsals, it in often to redistribute the how the ball of the foot bears your weight. Some severe cases, such as rheumatoid arthritis, can require removing the metatarsal heads.
NEUROMA SURGERY
Neuroma is a benign enlargement of a nerve, usually between the metatarsal heads (part of the ball of the foot). Removal of the piece of nerve leaves some residual numbness, but because this is soft tissue, rather than bone, the recovery time is shorter.
RECONSTRUCTIVE SURGERY
Some injuries or congenital defects can require complex surgical repairs to prevent further deformity or disease, reduce pain, and improve function or stability. Reconstructive surgery can involve tendon repair or transfer, fusion of bone, joint implantation, bone grafting, repairing skin or soft tissue, removing tumors, amputation or osteotomy (precise cutting of the bone). Reconstructive procedures might use bone screws, pins, wires, staples, or other fixation devices (either internal or external) and casts to stabilize and repair bone.
TENDON SURGERY
Tendon surgery is a broad term for any procedure that focuses on the tendons in your foot or ankle. Acute injuries, such as ruptures of the tendon, are treated through surgery on the tendons. Another common tendon operation is the shortening or lengthening of the tendon, depending on the condition. To improve foot and ankle function, surgery may also be done to reroute the tendons.
Testing and Care before the Operation
Undergoing foot or ankle surgery only happens after specific tests and examination so the surgery will have a improved rate of successful outcomes. The podiatrist will review your medical history and medical conditions, including specific diseases, illnesses, allergies, and current medications. Tests that will help your podiatrist know how best to proceed include blood studies, urinalysis, EKGs, X-rays, blood flow studies, and a biomechanical examination. Your podiatrist may bring in another medical specialist depending on the results of the test or your condition.
Care after the Operation
The aftercare required to assure rapid and uneventful recovery from foot surgery depends on the type of surgery, but will nearly always involve using the RICE formula: rest, ice, compression, and elevation. Sometimes, you will have to give your body time to heal before putting weight on your foot again. Your podiatric surgeon will determine if and when that occurs. The surgeon may also insist on your using bandages, splints, surgical shoes, casts, crutches or canes to assist in your recovery. Your recovery time will largely depend on how carefully you follow your podiatrist’s instructions. Some types of surgeries will also necessitate a longer recovery period.