Foot and ankle surgery Sunnybank are experts at diagnosing and treating a range of foot and ankle conditions. When conservative treatments such as exercise, medication and specially-fitted shoes don’t ease your pain, surgery may be recommended.
Surgery is only considered as a last resort. However, it can provide lasting pain relief and improved function and help prevent some conditions from worsening.
Foot and ankle arthritis
When the cartilage that cushions the ends of bones where they meet to form joints breaks down, you develop arthritis. This can cause stiffness, pain and loss of movement in the affected joint. Osteoarthritis (also called wear-and-tear arthritis) is common in the feet and can also affect the ankle joints, causing them to become swollen and tender.
Our orthopedic surgeons have expertise in minimally invasive arthroscopic surgery. This technique uses smaller incisions and has a quicker recovery time than traditional open surgery.
Our team can help if you have hallux valgus, a type of foot and ankle arthritis that causes stiffness in your big toe joint. We can remove painful osteophytes and reduce your symptoms. If your condition is more advanced, we may suggest fusing your toe bones together (arthrodesis). This will limit the amount of movement in the affected joint but will provide pain relief. You’ll need to wear shoes with flat soles after this operation.
Morton’s neuroma
Morton’s neuroma is a painful condition caused by compression of a nerve in the ball of your foot. The problem can be relieved by reducing pressure on the affected area, such as by wearing shoes with wide toe boxes and by applying pads or orthotics. You can also get pain relief from a local anesthetic injection.
Treatment of a neuroma depends on the severity of symptoms and how long you have had them. Early diagnosis often helps avoid more invasive treatments.
During surgery, your foot and ankle surgeon will premark the space between the second and third or fourth toes (the “third space”). A longitudinal incision is made, and the surrounding tissue is released so that the nerve can be identified and excised. The surgeon removes the part of the nerve that causes pain and any other associated numbness. Some numbness may remain after the surgery but this usually remits in time. This surgery can be performed under local anesthesia or sedation and has an excellent success rate.
Tibialis posterior tendonitis
Tibialis posterior tendonitis (PTTD) occurs when the posterior tibial tendon — which runs from your calf muscle to your ankle’s bones — becomes overused or damaged. If it’s not treated, this condition can lead to flatfoot. Symptoms include pain behind your inner ankle and difficulty standing on your toes.
Your doctor diagnoses PTTD by examining your foot, and often x-rays or an MRI are needed to confirm the diagnosis and see the extent of the tendon damage. The MRI helps your doctor determine the stage of the disease and guide treatment.
Your doctor may use surgery to help repair or replace the posterior tibial tendon. Surgery is typically performed in the early stages of PTTD, when the tendon still has some strength. Your surgeon can perform a procedure called debridement, which involves cleaning away the inflamed tissue and removing part of the tendon. They can also perform an osteotomy, which is a surgery that realigns the bone in your foot. They can also graft a healthy piece of tendon to the area to take stress off the affected posterior tibial tendon.
Bunions and hammer toes
Bunion and hammer toes can affect the ability to wear shoes, perform daily activities and cause pain and discomfort. The condition is usually diagnosed through a clinical examination by a trained healthcare professional including touching and moving the toes and the foot. This is done in both a standing and seated position for a complete evaluation of the foot’s biomechanics. X-rays can also be helpful in evaluating the underlying structures.
Nonsurgical treatment options include padding the toes, taping and wearing shoes with a wide toe box and custom shoe inserts. Medications can help relieve symptoms as well.
If a bunion or hammer toe becomes fixed in its rigid, painful position and limits activity, surgery may be recommended. Procedures may involve removing the bunion, realigning the toe joint and/or transferring or releasing tendons to improve toe function. More severe deformities can sometimes be corrected by fusing one or more toe joints together. This surgical option is generally a last resort when conservative methods fail to provide relief.