Foot and Ankle Surgery
Foot and ankle surgery is a subspecialty of orthopaedics and that deals with the treatment of disorders of the foot and ankle which mainly consists of correction of Deformities of foot and ankle.
Here are some of the most commonly performed ankle surgeries.
Fracture management: The most common reason for ankle surgery is to fixation bones that have been fractured
Ankle arthroscopy
Ankle fusion
Ankle replacement
Bunion correction(Hallux Valgus)
Deformity correction to achieve pain-free plantigrade foot with improvement in gait
Ligament surgeries including repair of Tendo Achilles
Retrocalcaneal bursitis/calcaneal spur with pain management
Ankle arthritis: Ankle arthritis is usually caused by osteoarthritis/ post-trauma. This is where the cartilage covering the ends of your bones gradually roughens and becomes thin, and the bone underneath thickens. It can also be caused by damage from other rheumatic conditions, for example, if you have rheumatoid arthritis, or if you’ve had a previous injury to the area. This leads to pain, swelling and occasional deformity of the joint. You may need surgery if your symptoms are severe. There are three surgical options:
Ankle fusion: Ankle fusion involves removing the damaged ankle joint and fusing your talus bone to your tibia to form a stiff but pain-free ankle. Your foot is fused at a right angle to your leg, in the position it would be if you were standing up. Your bones are held together using screws and new bone grows across, creating one bone where there were two. It normally takes between 12–14 weeks for the fusion to be complete and your bone continues to become stronger after this.
In some cases this procedure can be performed using keyhole surgery (arthroscopy), which means it can be done through just a small cut, so your joint doesn’t have to be opened up. The procedure takes between one and two hours.
After the surgery you’ll need to wear a cast for 4-8weeks, depending on your situation. You should be able to wear normal shoes after the cast is removed, although some alterations are occasionally needed. It should be easier to walk normally or even more comfortably than you did before surgery if your other joints aren’t affected by arthritis, but running isn’t recommended.
Triple Fusion: Triple fusion is the surgical fusion of three joints (the talonavicular, subtalar and calcaneocuboid joints) either as a treatment for arthritis within these joints or as a method of correcting a stiff foot deformity. A combination of plates, screws or staples is often used to do this. It takes 12–14 weeks for the fusion to be complete.
Ankle replacement: An ankle replacement involves taking out the worn-out ends of your tibia and talus bones and replacing them with a man-made (artificial) ends made out of plastic or metal. Unlike an ankle fusion, a replacement allows you to move your joint after surgery. The procedure takes between one and two hours and you’ll normally need to stay in the hospital for two days. Your foot will be put in a temporary cast afterwards but then it’ll be bandaged and you may need a splint for support. This allows you to move it fairly soon after surgery, but you’ll probably need to use crutches for about 4 weeks. Replacement ankle joints can last for about 10–15 years.
Bunions
Bunions are bony lumps that develop on the side of your foot and at the base of your big toe. They’re the result of a condition called hallux valgus, which causes your big toe joint to bend towards the other toes and become deformed. If symptoms carry on over a long period, your toe may need to be surgically corrected.
This involves straightening your big toe and metatarsals, a process called an osteotomy. Although this may make your joint stiffer, it works to ease the pain.
Most surgery can be performed as a day case and takes up to an hour. Your foot will be bandaged and you’ll need to wear a Velcro surgical shoe for four to six weeks afterwards.
If your bunion has been caused by rheumatoid arthritis you may also develop rheumatoid nodules. These firm, pea-sized lumps can occur at pressure points such as your big toe joints, the back of your heels or on your toes, but they can be surgically removed.
Sometimes swellings or bursae on the joints in your feet are also called bunions, but these aren’t the same as bunions caused by hallux valgus and don’t need surgery.
Hallux valgus is different to hallux rigidus, which is osteoarthritis of the big toe joint. Hallux rigidus causes stiffness in your big toe and you won’t be able to move it as far. If treated early, surgery can be used to remove painful osteophytes (overgrowth of new bone) that can develop and allow more joint movement to return. In more advanced cases, fusion surgery (joining bones together to make one stiff bone were there two) gives excellent pain relief, although it will mean that the joint will no longer bend when you walk so you won’t be able to wear high-heeled shoes.
Plantar fasciitis
The plantar fascia is a tough band of fibrous tissue that starts at your heel bone and stretches across the sole of your foot to your toes plantar fasciitis is inflammation at the site where the fascia attaches under your heel. Very rarely, bad cases may need surgery to release the plantar fascia from the heel bone. This procedure is usually performed as a day case and it takes less than an hour. You’ll only need to wear a bandage after the operation.
Achilles tendon disorders
Your Achilles tendon is the largest tendon in your body, and the muscle in your lower leg puts a lot of force through it to make you move. As we get older it can start to wear, which can lead to painful swellings within the main tendon or where it attaches to your heel bone. This is associated with Retrocalcaneal spur Surgical management includes removal of spur and repair of a torn tendon
