Most of the time, we hardly give a thought to getting places by walking. But when out feet hurt, even a short distance can be an agonizing ordeal. It is estimated approximately, 75% of Americans will have foot or ankle problems at some time during their lives. Unfortunately, some of these problems go untreated due to the mistaken belief that foot discomfort is a natural part of getting older. In reality, a lot can be done about a pain in the foot.
The foot contains 26 bones, 33 joints, and a network of more than 100 tendons, muscles, and ligaments. While this complex structure allows us to walk, run, and jump, it also exposes us to a variety of injuries when we wear improperly fitting shoes or subject our feet to repetitive stress in sports and other activities. If we have misaligned bones or tight muscles, walking function can also be impaired.
The Decision for Surgery
Many foot and ankle problems can be successfully managed without surgery. Medication, physical therapy, orthotics, shoe modification or walking aids, weight control or modification of leisure/sporting activities are suggested. Your surgeon may recommend you try some of these approaches before you decide if surgery is necessary.
But other foot and ankle problems may require surgery to resolve longstanding joint pain or deformity or to remove diseased tissue. These procedures may help to slow down the damaging process or to structurally realign the foot and ankle and reduce abnormal stresses.
During your first visit with the foot and ankle surgical team, they will ask you questions about your foot and ankle history. We will examine your foot and ankle to check for pain, swelling, open sores (ulcers) range of motion, alignment, strength and stability. X-rays may be taken to allow further assessment of your foot and ankle.
Foot and ankle surgery is considered mainly for those people with problems that can no longer be successfully managed by conservative means.
Surgery is performed for most of the following reasons:
- To improve alignment and correct deformity
- To improve function (such as walking, standing, bathing, etc.)
- To prevent future problems
- To treat infection
- To reduce or relieve pain
Importance of Leisure & Recreation for Health
You may not be able to fully participate in the activities you love due to foot and ankle complications. Nothing is more painful than wanting to enjoy such activities fully knowing you can’t due to pain or discomfort you are experiencing in your foot or ankle. This is where surgery can help, surgery that can bring your well-being and body function back to its normally functioning state.
It is highly recommended to consult with a medical professional who specializes in foot and ankle surgery prior to getting any surgery done, this way you can be sure of the benefits and risks. Improving the quality of your life should be the goal, people who make their well-being a priority are likely to have more positive health outcomes than those that don’t take any actions to improve their health.
When is Foot Surgery Necessary?
Some foot and ankle problems can’t be helped by conservative means, this may indicate that such complications may require surgery. Your podiatrist can determine when surgical intervention may be helpful. Often when pain or deformity persist, surgery may be appropriate to alleviate discomfort or to restore the function of your foot or ankle.
Types of Foot Surgery
Bunion Surgery: There are many different types of bunion surgery depending on the severity of the bunion and the joint involvement. Your podiatrist can explain the bunion procedure that is most appropriate for your bunion. Depending on the surgical procedure, the recovery time can be very different, particularly if you need to be on crutches after the surgery or in a cast.
Fusions: Fusions are usually performed to treat arthritic or painful conditions of the foot and ankle. A fusion involves removing all cartilage from a joint and then joining two or more bones together so that they do not move. Fusions can be done with screws, plates, or pins, or a combination of these.
Hammer Toe Surgery: Hammer toe surgery may involve removing a portion of one of the bones in the toe to realign the toe or could involve fusing the joints in the toe. In some cases, it may involve placing a temporary wire to hold the toes straight or a permanent implant in the toe to maintain realignment.
Heel Spur Surgery: Based on the condition and nature of the disease, heel surgery can provide relief of pain and restore mobility in many cases. The type of procedure is based on examination and usually consists of plantar fascia release, with or without heel spur excision. There have been various modifications and surgical enhancements regarding surgery of the heel. Your podiatrist will determine which method is best suited for you.
Metatarsal Surgery: Surgery on the long bones of the feet behind the second, third, fourth, and fifth toes is performed for a variety of reasons but is commonly performed to redistribute the weight bearing on the ball of the foot. In some severe cases, such as rheumatoid arthritis, surgery may involve removing the metatarsal heads (the bones in the ball of the foot area).
Nail Surgery: Toenails can become deformed, damaged, or infected. It may be determined that the best treatment may involve surgery. Surgery is typically performed in the office under local anesthetic, and many patients can walk out and return to activities. Surgery involves either partial or total removal of the nail. An avulsion is a non-permanent type of surgery that allows relief, but the nail will grow back. A matrixectomy is a permanent type of surgery, which involves destroying and/or removing the nail root so that no new nail grows.
Neuroma Surgery: Neuroma surgery involves removing a benign enlargement of a nerve, which may be causing tingling/burning/numbness to certain toes, usually between the metatarsal heads in the ball of the foot. This soft tissue surgery tends to have a shorter recovery time than bone procedures, but it leaves some residual numbness related to the removal of the piece of nerve tissue.
Reconstructive Surgery: Reconstructive surgery of the foot and ankle consists of complex surgical repair(s) that may be necessary to regain function or stability, reduce pain, and/or prevent further deformity or disease. Unfortunately, there are many conditions or diseases that range from trauma to congenital defects that necessitate surgery of the foot and/or ankle. Reconstructive surgery in many of these cases may require any of the following: tendon repair/transfer, fusion of bone, joint implantation, bone grafting, skin or soft tissue repair, tumor excision, amputation, and/or the osteotomy of bone (cutting of bones in a precise fashion). Bone screws, pins, wires, staples, and other fixation devices (both internal and external), and casts may be utilized to stabilize and repair bone in reconstructive procedures.
Skin Surgery: Lipomas, fibromas, warts, moles, and rashes can occur on any part of the foot skin surface. Some of these conditions can be painful and impact function. In other cases, they can be questionable because they are new in appearance and a biopsy may be recommended. These skin conditions may or may not be painful. Depending on the size and depth of the condition, surgery may be performed in the office under local anesthesia or take place in the operating room.
Tendon Surgery: Surgery on the tendons can be performed for acute injuries such as ruptures and can also be performed for chronic conditions to lengthen or shorten the tendon, depending on the problem. In some cases, tendons may be re-routed to improve foot and ankle function.