Ankle and foot surgery
What does ankle and foot surgery deal with?
The most used part of everyday life is the foot. The kind of ground we walk on, the shoes we wear, the type of load, or even the weight we carry all over our body makes a difference. In the long run, all of these can contribute to orthopedic problems, lesions, and pain. Not only the shape of the foot, but also its biomechanics can change, and this is not primarily an aesthetic issue but rather a health issue. In many cases, insoles, physiotherapy, or physical therapy help, but with the intensification of complaints, surgery is the ultimate solution.
Ankle and foot surgery deals with forefoot lesions, deformities, and ankle injuries.
What diseases or complaints are most common here?
Description of the disease: One of the most common foot deformities. Normally, the big toe is parallel to the other toes, but when bunion appears, the toe tilts and a protrusion, a bone outgrowth, forms on the inside. This is called a bunion. In improperly selected footwear, especially when wearing high-heeled or narrow-toed shoes, the foot and toes receive an abnormal load that can cause deformities, including bunion, to appear over time. Improper load and special sports load can also contribute to its development, but in a large percentage of the evenings there is an inherited tendency in the background.
Symptoms: The lesion is often asymptomatic in the early stages. Later, discomfort and pain may occur and wearing shoes becomes difficult. Regular irritation can also lead to inflammation.
Treatment: It is possible to relieve pain by using a unique specific insole (arch-support) made of vibration absorbing materials but forefoot deformities need surgery to improve. Recurrence after surgery was still common decades ago, but thanks to modern foot surgery procedures, there is now a definitive solution for bunion repair. The most important thing is to restore the statics and original anatomical condition of the foot, as this will prevent the protrusion from growing back. The surgery can be performed as a one-day surgical procedure and the patient can leave the hospital on the day of the surgersy and then he/she has to attend physiotherapy for two to three months. You can read more about the surgery here. Thanks to modern implants, there is no plaster fixation during rehabilitation and in a special heel-loaded treatment shoe, recovery can be made more comfortable.
Mallet toe deformity
Description of the disease: Mallet toe is a forefoot deformity that usually develops on the second toe but it is not uncommon on the third, fourth, or fifth toe either. The name comes from the fact that the toe bends upwards resembling the shape of a hammer in the middle joint. Lowered foot arches, accidents, developmental disorders, improper loading, wearing inappropriate shoes, special sports load, and an inherited predisposition may also be the background of the lesion. It most often appears with bunion deformity.
Symptoms: At the junction of the basal and middle phalanges, the toe protrudes, resulting in the frequent development of irritation, hardening of the skin, an corns. Wearing high heels or tight-toed shoes can make the situation worse.
Treatment: In less severe cases, it is possible to wear a corrective toe spacer. Once the extent of the lesion is such, it is advisable to undergo surgery, as you can also regain the smoothness of everyday life with the procedure. You will be able to wear any shoes again and say goodbye to the pain. During the operation, the toes are restored to their original shape. The surgery can be performed as a one-day surgery, so the patient can leave our private hospital on the day of the operation. You can read more about the surgery here. However, post-treatment is necessary: during rehabilitation, the foot can be loaded with special treatment shoes for six weeks. Physiotherapy – tailored to the individual at Emineo Private Hospital – is essential.
Tailor’s bunion deformity
Description of the disease: It is a not very common forefoot deformity, but it may cause cumbersome, painful gait. In case of tailor’s bunion, a protrusion, that is, a bone outgrowth, appears on the outside of the foot, on the outside edge of the little toe. Its development is usually due to an inherited tendency, but wearing the wrong shoes can also cause the lesion.
Symptoms: A protrusion or bone growth appears on the outside of the little toe, accompanied by swelling, redness, pain, and the forefoot widens.
Treatment: It is possible to relieve pain by using a unique specific insole made of vibration absorbing materials but forefoot deformities need surgery to improve. In our private hospital, we use state-of-the-art procedures and implants so that patients can return to their daily routine as soon as possible, without any foot pain. You can read more about the surgery here. We recommend wearing special treatment shoes for 4 weeks after tailor’s bunion surgery, and in addition, an individual physiotherapy is also required.
Stiff big toe – Hallux Rigidus
Description of the disease: In the case of the rigid big toe or Hallux Rigidus, the movements of the big toe become restricted, and bone growths can be palpeted. Hereditary factors play an important role in its development, but it may also occur as a result of a fracture or other injury. In many cases, the problem occurs on both sides.
Symptoms: The patient is unable to move his big toe properly, often feels pain, and walking becomes difficult.
Treatment: This foot deformity has different degrees of severity. In the initial stage, conservative treatment helps, during which the most effective solution is regular physiotherapy and intermittent anti-inflammatory physical therapy. In more severe cases, surgery is the solution. You can read more about the surgery here. Wearing special treatment shoes is required for 6 weeks after surgery. Individualized physiotherapy is performed regularly throughout the rehabilitation from the second week after surgery.
Morton’s neuroma (benign nerve nodule)
Description of the disease: Benign tissue proliferation at the junction of nerves running through the foot between the toes. It affects four times more women than men. The cause of the disease is not clear.
Symptoms: Most often characterized by pain, numbness, burning sensation, prickling on the foot, between the toes. Although pain may occur, it is only felt for a few minutes and may not reappear for weeks. The complaints may return and may cause distress more and more often.
Treatment: In our experience, the only reassuring, definitive solution is surgery, in which Morton’s neuroma, the nerve nodule found at the junction of the nerve fibers is removed during a one-day surgical procedure. The removed foreign body is always sent for histological examination. Recurrence may occur, although very rarely. You can read more about the surgery here. After a very quick 2-week postoperative rehabilitation, the patient can return to their usual, painless daily routine.
Bony outgrowths of the heel (spurs)
Description of the disease: There is excess bone on the posterior or lower edge of the heel bone. There may be an underlying inherited predisposition but bone growth can also be caused by overwork, overweight, standing work, the use of inappropriate shoes, or even flat foot, which results in inflammation at the tendon-periosteum junction.
Symptoms: As the disease progresses, swelling, inflammation, and pain may become increasingly common at the insertion area of the Achilles tendon or the plantar connective tissue (plantar fascia) which can eventually cause difficulty walking.
Treatment: In the initial stage, the lesion is treated with physical therapy and medications. In advanced conditions, injection therapy is recommended. In more severe cases, surgery is the solution, with a minimal incision to remove the outgrowth from the heel bone. You can read more about the surgery here. Physiotherapy is essential during rehabilitation, for which we set up individual treatment therapy in Emineo.
Lateral ankle instability
Description of the disease: The twisting of the ankle can cause sprain, stretching, but also partial or complete ligament rupture. The lateral ankle ligaments are injured more often than the medial ankle ligaments. During sports and physical activity, ankle injury one of the most common injuries. It is advisable to consult an orthopedic specialist or a foot surgeon with even minor complaints, as an undiagnosed complaint can later cause more serious musculoskeletal problems, instability, and joint wear.
Symptoms: In case of sprain, there is less pain and swelling. In case of partial or complete rupture of the ankle ligament, the ankle swells very quickly up to twice its original size, bruising appears and the injured leg can’t be loaded at all or only with difficulty.
Treatment: Sprain heals in a few days, rest, ice packs, and compression bandages are enough. In case of ankle sprains and ankle ligament injury, 2 to 4 weeks of ankle fixation is required. Individualized physiotherapy begins from the third week during fixation and lasts until the scarring of the ligaments takes place, the ankle becomes stable, and the weakened muscles become stronger. In the case of chronic, recurrent lateral ankle sprains, the ultimate solution is surgery. During the surgery, the lateral ankle ligament system is stabilized. You can read more about the surgery here. After the operation, a four-week ankle fixation and an individualized physiotherapy treatment lasting 2 to 3 months are required.
Description of the disease: One of the most common lesions in which the arched system of the foot lowers. Several reasons may lead to its development. Hereditary factors are present in most of the cases but it can also be caused by several risk factors that could be avoided with some attention. Improper loading or overloading, being overweight, wearing extreme footwear can also contribute to the development of flat feet. In this condition, the small leg muscles that maintain the arch of the foot become tired and an incorrect load develops.
Symptoms: at rest, the ankle turns inwards and the inner arch is flattened. Chronic inflammation and severe pain can also be caused by flat feet, which many people suffer from, but most only go to the doctor when they have significant, regularly recurring pain.
Treatment: One of the most important things in healing is prevention, that is, strengthening the muscles of the foot. We do not routinely recommend arch-support for children under the age of 12 , regular physiotherapy is more important to strengthen the plantar muscles. Over the age of 12, or in adulthood, we recommend a custom insole to encourage less used muscles to work. In the case of severe deformities between the ages of 9 and 11, surgery may be the solution, correcting the arch of the foot by inserting a screw. You can read more about the surgery here.
What happens in a personal consultation?
At Emineo Private Hospital, regardless of the extent and type of lesion, in addition to the physical examination, an imaging examination (loaded foot X-ray, ultrasound) is also performed if necessary. In more complicated cases, our specialist can also request an MRI examination, which we will arrange for our patients in one of our partner institutions as soon as possible.
Whether surgery is recommended, depends on the extent and severity of the foot complaint. In less severe cases, we recommend conservative solutions (insoles, fixation, physiotherapy). If, on the other hand, surgery cannot be avoided, special implants are used, thus speeding up the healing period. True to a private institution, in all surgeries, we keep in mind to provide the patient with the most appropriate medical solution so that they can return to their normal, normal daily routine as soon as possible.
Introduction of video consultation
Even in the epidemiological situation related to the coronavirus, we endeavor to resolve the complaints of our patients and reduce their pain. To this end, we have launched our video consultation service, in which our specialists are at our patients’ service on-line.