Foot and Ankle Surgery is a versatile approach employed to address a range of conditions affecting the foot and ankle, including bunions, tendon tears, and severe arthritis. Typically, surgical intervention is considered when nonsurgical treatments have been exhausted without achieving the desired outcome. However, certain urgent cases like ankle fractures may necessitate immediate surgery.
Various surgical procedures are available for treating foot and ankle conditions. The specific procedure depends on the type of condition present. The surgical goals may involve realigning fractured bones, fusing painful joints, excising overgrown tissue, or repairing torn ligaments or tendons. In instances of extensive damage and intense pain in the ankle joint, a total ankle replacement might be recommended as a viable option.
Bunion surgery aims to alleviate pain and correct the deformity caused by a bunion, which is an enlargement of the bone or tissue around the joint at the base of either the big toe or the little toe. The former is known as a "bunion" or "hallux valgus," while the latter is referred to as a "bunionette" or "tailor's bunion." Bunions usually develop due to prolonged stress on the joint, and they are more commonly observed in women, often associated with wearing tight, pointed, and restrictive shoes.
Additionally, bunions can be hereditary or result from arthritis, particularly affecting the big toe joint. In such cases, surgical intervention becomes a viable option to address the discomfort and correct the deformity. What are the risks of bunion surgery? As with any surgical procedure, complications can happen. Some possible complications may include:
- Delayed healing
Achilles tendon repair surgery
Achilles tendon repair surgery is a type of surgery to fix a damaged Achilles tendon. The Achilles tendon is a strong, fibrous cord in the lower leg. It connects the muscles of your calf to your heel. It’s the largest tendon in your body. It helps you walk, run, and jump.
Posterior tibialis tendon surgery
Posterior tibialis tendon surgery is a procedure aimed at repairing the tendon located at the back of your calf, which extends down the inside part of your ankle. There are several types of surgery that a surgeon can perform to address issues with this tendon.
The posterior tibialis tendon is a robust cord of tissue and holds significant importance in your leg. It connects the posterior tibialis muscle at the back of your calf to the bones on the inner side of your foot. This tendon plays a crucial role in supporting your foot and maintaining its arch while walking.
Lateral ankle ligament reconstruction
Lateral ankle ligament reconstruction, also known as the Brostrom procedure, is a surgical method used to tighten and strengthen one or more ankle ligaments situated on the outer side of the ankle. This outpatient surgery allows patients to return home on the same day.
Your ankle serves as a hinge joint, enabling both upward and downward movements, as well as side-to-side motions. To maintain the stability of the ankle and foot, several ligaments act as strong band-like structures, securely connecting the bones in your ankle and feet.
Notably, the outer side of your foot houses significant ligaments, such as the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL), which play a crucial role in providing stability and steadiness to your ankle and foot during walking and other activities.
The Brostrom procedure addresses any laxity or damage in these ligaments, promoting enhanced stability and function of the lateral aspect of the ankle.
Certain mechanical problems with your foot can make you more likely to develop an unstable ankle, such as:
- Hindfoot varus
- Plantar flexion of the first ray
- Midfoot cavus (high arches)
- General looseness of your ligaments—for example, from a medical condition like Ehlers-Danlos
Ankle replacement surgery
Ankle replacement surgery is the replacement of a damaged ankle joint with an artificial implant.
The ankle joint (tibiotalar joint) is where your shinbone (tibia) rests on top of a bone of your foot, the talus.
Arthritis can affect this joint as well as other joints in the foot. Over time, the smooth cartilage on the surface of the bones wears away. This can result in pain, inflammation, and swelling of your joint.
Why might I need ankle replacement surgery?
Ankle replacement surgery may make sense for you if you have severe arthritis in your ankle. This can cause symptoms like severe pain, inflammation, and stiffness, which can lead to difficulty walking. The main types of ankle arthritis are:
- Osteoarthritis. This is “wear and tear” arthritis that develops in older adults.
- Rheumatoid arthritis. This is a system-wide autoimmune disease that affects the joints.
- Arthritis. This can happen because of a past injury of your joint.
Minimally Invasive Surgery (MIS)
Due to the standardization of the operation and the follow-up treatment, minimally invasive techniques have prevailed in recent years and have brought very good results.
Advantages of minimally invasive surgery:
- Small wounds l small scares
- Little pain postoperatively
- Mostly no implants
- Less risk of infection
- Less operation time
- Less anesthesia time
Which foot deformity and foot diseases can be performed surgically in the minimally invasive procedure?
- Hammer toe, claw toe, curly toe, and post-traumatic toe deformity
- Tailor's bunion (bunion of the fifth toe)
- DMMO (distal metaphyseal metatarsal osteotomy)
- Haglund's heel (Haglund exsostosis)
- Bone exostosis removal
- Arthroereisis of the subtalar joint in flexible symptomatic planovalgus in children