Surgery may be suitable for people who have certain problems affecting the shape of their feet and who are experiencing symptoms as a result. This is usually offered where there is a fixed deformity or permanent joint damage within your foot, that is not helped by protective pads or different shoes. Conditions which respond well to surgery include bunions, hammer toes, chronic corns, bony lumps, neuromas, arthritis and in certain cases, flat feet.
Foot and ankle surgery at The Westbourne Centre is usually carried out as a day case using local anaesthetic and sedation. The right anaesthetic option will be discussed with you by your surgeon and anaesthetist.
A bunion is a bony lump on the side of the foot at the base of the big toe, associated with the big toe pointing more to the side rather than straight ahead. It may be painful and make it difficult to wear certain shoes. Different surgical procedures can be used to treat this condition and your surgeon will advise the most appropriate for you. Only rarely will your foot be in plaster after an operation and you will usually walk out of the clinic using crutches. More information regarding bunion surgery is available on request.
This is an arthritic condition of the big toe joint which causes restriction in movement. There is usually pain within or around the joint that can cause loss of movement. When you walk, you need to bend the big toe upwards and if you are unable to bend this joint, it will cause changes to the way you walk and sometimes hip or knee pain. Different surgical procedures can be used to treat this condition including cleaning up the joint, fusing it and occassionally replacing it.
Arthritis of the joints in the arch of the foot often goes unnoticed until it has become quite advanced. Osteoarthritis is the most common type of arthritis to affect these joints. Early symptoms include achy joints, often occurring after activity. In later stages, there may be persistent swelling around the joint or hard lumps around the edge of the joints.
In some patients, these lumps can cause added symptoms because they cause pressure on adjacent soft tissue structures and rub on shoes. Surgical treatment usually involves removing these lumps or surgically fusing the damaged joints.
These terms refer to permanently bent toes other than the big toe. Hammer toes can be painful, often with corns developing on top. Surgery to correct the hammer, mallet or claw toe deformity will usually permanently cure the formation of painful corns on skin overlying these joints by straightening them out and releasing any tight tissues around them.
Many corns or calluses under the foot are often the result of a prominent metatarsal bone. Those that cannot be resolved with non-surgical treatment may be suitable for surgery. Various operations are used to raise the metatarsal bone so that the corn no longer forms.
An enlarged nerve, often between the third and fourth toes, can cause pain in the forefoot. These neuromas can be confirmed on ultrasound scanning and if they fail to respond to injection, they can be removed with an operation. Delicate surgical techniques generally result in a permanent resolution of this sometimes extremely painful condition.
This is an enlargement of the bone at the back of the heel that can encourage bursitis to develop, which is a painful inflammation of a sac that develops over the bone lump. There is often irritation at the bottom of the achilles tendon. Various operations are possible, which usually involves removing the underlying bony bump.
Many foot problems are related to the way your foot and leg work when you walk. There is so much work undertaken by your foot, each and every step, that even small changes can make a huge difference to how the foot performs. As a podiatric surgeon, Helen Williams has superb knowledge regarding how the foot should function. A Biomechanical test can usually provide a huge insight into what is causing foot, leg joint and often back pain. A Biomechanical test includes watching how you stand and walk and then feeling how your joints move. Mrs Williams can advise you on whether she feels that prescription inserts are likely to help your symptoms. Measurements can be made and sent to the lab for fabrication of your own custom made insoles.
Painful lumps that press and rub on the shoe are common. If changing your footwear doesn't resolve the problem, surgery may be recommended to remove the bony prominences or soft tissue formations.
Arthritis of the joints in the arch of the foot often goes unnoticed until it has become quite advanced. Osteoarthritis is the most common type of arthritis to affect these joints. Symptoms include pain (often occurring after activity) and deformity with collapse or flattening of the arch of the foot. In later stages, there may be persistent swelling around the joints or hard lumps around the edge of the joints. In some patients these lumps can cause added symptoms because they cause pressure on adjacent soft tissue structures and rub on shoes. Surgical treatment can involve removing these lumps and fusing the damaged joints.
Arthritis of the ankle joint or the joints adjacent to it is a common condition causing pain, stiffness and deformity. It is usually diagnosed on xrays and clinical examination. Initial treatment is with lifestyle changes, painkillers and shoewear modification. This is often combined with targeted joint injections to confirm the source of the pain and to relieve it. Fusion surgery to try to relieve the pain and to correct any deformity may be offered if symptoms are more severe.
If stretching, rest and footwear changes do not help, then several different treatment options exist before more major procedures become indicated. Certain problems are suitable for injection or minor surgical procedures. More severe problems may require more major surgery such as tendon decompression or tendon transfer. If a tendon transfer is required, one of the tendons to your big toe is 'rerouted' to your heel to do the job of the diseased achilles tendon. This does not usually cause any problems with toe function afterwards.
Ankles can become unstable after a ligament tear if the damaged tissues fail to heal properly. Patients complain of the ankle repeatedly 'going over', often whilst doing normal activities. This can stop or reduce sports and everyday activities and can cause damage to the joint surfaces of the ankle. If you have an unstable ankle, you will usually require a scan to see if there is any damage to the joint, followed by physiotherapy. If the ankle remains unstable you may require an arthroscopic or keyhole procedure clean up of the ankle joint and/or an operation to 'tighten up' the loose structures. This surgery would hopefully allow a return to full activities within 8-12 weeks.
This can be a very stubborn condition that causes pain in the heels, especially when you stand up after a period of rest. This is caused by inflammation of the connective tissue found on the underside of the heel. Orthotic arch support insoles may help to support the foot or provide shock absorption. Other treatments such as physiotherapy, shockwave therapy, injections and night splints may be helpful and some people who have tightness in their calves may benefit from surgery. This condition is not caused by a bone spur on the heel and surgery directly to the plantar fascia is rarely, if ever helpful.
If you would like to find out more about our Foot Clinic, foot and ankle services, or book an initial consultation with our consultants, Alastair Marsh or Paul Bewick, then please call our friendly team on 0121 456 0880 or