What are the potential benefits of podiatric surgery?
Early return to activity;
Correction of the underlying deformity; Reduced pain;
Below is a brief description of some of the more common surgical procedures that are surgically managed by The Foot Surgery Centre providing foot surgery in London and foot surgery in Surrey.
Bunions are caused by the separation of the metatarsals that the first and second toes are attached to (these are the long bones in your foot). This results in a widening of the angle between these two long bones and a bump or ‘bunion’ on the side or the foot as the big toe migrates towards the second toe. This is due to the influence of tendons, resulting in a ‘kink’ in the shape of the big toe joint. The condition is often hereditary and is progressive and can deteriorate with time therefore it is important to also discuss footwear and biomechanical influences with your podiatrist.
Correction of this very common foot deformity is achieved by reducing the angle between the metatarsals. This is done by cutting the bones and moving them into the corrected position and maintaining this position by way of screws Fig 1. For larger angles between the 1st and 2nd long bones the Lapidus procedure is preferred see figure 2.
Fig. 1 Scarf and Akin osteotomy where the bone is cut in three places.
Fig. 2 Lapidus procedure for large angles between the 1st and 2nd long bones.
This foot condition results from the imbalance in power between the small finer muscles of the foot and the more powerful muscles that have their origin in the lower leg. The cause of this imbalance can be multi-factorial. One possible influence is abnormal biomechanics, therefore discuss this with your podiatrist. The toes start to buckle at the “knuckles” and are then irritated by footwear with resultant corns over the “knuckles” or interphalangeal joints. See Figure 3 for a picture of claw toe deformity.
The correction of these toe deformities will depend on the cause and the procedures used are an arthroplasty (excision of part of the knuckle joint) or an arthrodesis (fusion of the knuckle joint). In toes that require a fusion a surgical steel wire will be used to stabilise the fusion site.
Fig. 3 Claw Toes
This foot condition affects the nerve on the sole of the foot that lies between the 3rd and 4th long bones This is one of the smaller branches of the larger nerves that enter the foot. At the ankle the Tibial Nerve divides into three branches before it courses deep to the skin and divides into smaller nerves that supply the toes.
The cause of this nerve pain is caused by prolonged irritation of the nerve as it is stretched and rolled over the heads of the 3rd and 4th long bones of the foot. This mechanical irritation of the nerve is often associated with abnormal biomechanics. A thickening of the nerve occurs which then results in impaired signals being sent to the 3rd and 4th toes. The pains often experienced is described by patients as ‘sharpness’, ‘shooting’, the sensation of ‘walking on a stone’ ‘cramp-like’ or sometimes ‘numbness’.
The treatment for this foot condition is by correcting any abnormal biomechanical anomaly often with orthoses, possible injection with corticosteroid and local anaesthetic or if persistent pain is experienced excision of the nerve that is thickened.
Fig.4 Arrow pointing to Neuroma / thickened nerve
The Foot Surgery Centre provides foot surgery in London and foot surgery in Surrey. For more information on The Foot Surgery Centre please contact us via phone on 0843 289 0628 or by e-mail: firstname.lastname@example.org.