Podiatric Surgery

Podiatric surgery is surgery performed on the foot, and ankle,  by highly qualified Consultant Podiatric Surgeons who are trained specifically to deal with these problems. Problems can arise from birth defects, heredity, trauma, arthritis, physical stress, improper shoes, muscle and joint imbalances. Consultant Podiatric Surgeons are the practitioners most thoroughly trained to manage these problems. Podiatric surgery differs from other surgical procedures because of the special characteristics and functions of the lower extremity. In addition to supporting your weight, the foot is subjected to potential repeated abuse with each step. Providing immediate treatment and preserving the best function possible are key factors in podiatric surgery.

What Causes Foot and Ankle Problems?

Foot and ankle problems are quite common and include: congenital, acquired, traumatic, infectious, neoplastic (tumors, as seen in the picture) and arthritis. When foot and ankle problems occur at birth, they are called congenital and are generally inherited. Acquired problems may result from improper footwear, physical stress, or small mechanical changes within the foot, which can slowly increase with aging. Traumatic problems are associated with injuries to the foot and ankle such as a sprained or broken ankle or a fracture of the foot. Infectious problems are the result of bacterial, viral, or fungal disorders that may affect superficial or deep tissues. Neoplastic disorders (tumors) are the result of abnormal growth of tissue and may be benign or malignant.

In the picture above we can see a Maliginant Tumour (Squamous Cell Carcinoma) in the Patient's Foot

What Conditions Respond Well to Surgery?

Conditions that are often alleviated through surgical procedures include: (PLEASE CLICK ON EACH TOPIC FOR MORE INFORMATION)

• Arthritis, joint disease and digital deformities
• Bunions
• Ingrown toenails
• Neuromas (nerve tumours)

Podiatric surgery sometimes may be used for cosmetic reasons:

• Cosmetic Nail Surgery

Why Surgery?

Conservative treatment of many foot and ankle problems often produces temporary relief of pain. If pain persists, surgery is sometimes the more definitive answer to a persistent problem and the best way to prevent more serious conditions. On the other hand, surgery is not always the best approach for all patients. Your podiatric surgeon can tell if you are an appropriate surgical candidate.

What are the Benefits and Risks With Podiatric Surgery?

Podiatric surgery is a proven and effective aspect of foot health care. Podiatric surgery is performed on a day case basis under local anaesthetic. The benefits for patients include not experiencing the side effects of a general anaesthetic especially nausea and vomiting.

Early post-operative mobilisation and a discharge home reduce the potential for hospital-acquired infections. You will be back home with your loved ones immediately after the surgery.

The quicker we can get you walking the quicker you start healing! The calf muscles within the back of the legs act as excellent pumps, they deliver fresh new blood to the operation site and remove swelling, this helps in a speedy recovery from surgery. No operation can be deemed to be without risk and it's important that you are aware of this, however small, before consenting to foot surgery.

We can avoid complications via a system of screening and investigations. This includes a detailed medical and surgical history including questions about various body systems. Tests and investigations may be needed such as X-rays, blood / urine analysis, blood pressure. If any of these raises health problems, further investigations or medical opinion may be sought. It may be decided to avoid surgery or defer it until the problem is treated or under control.

This is an abnormal sample of urine showing BLOOD, when situations like this arise we may need to retest the urine or sending a patient for further tests.

Podiatric Surgery Complications

• Prolonged swelling
• Haematoma - accumulation of blood at the operation site
• Thick / sensitive scar
• Loosening / movement is screws and pins used to stabilise joints
• Irritation of screws and pins
• Reactions to the local anaesthetic or prescribed pain killers
• Infections (deep and superficial)
• Temporary / permanent loss of sensation
• Delayed healing of soft tissues or bones
• Circulatory impairment and tissue loss
• *RARELY* thrombosis of the deep veins which can be life threatening

Complications specific to the planned surgical procedure are contained within an information sheet and will be discussed with you. If you have any particular concerns please do not hesitate to discuss them with the Consultant Podiatric Surgeon or any member of staff.

Does Foot Surgery Require Hospitalization?

Not usually. Surgical procedures are performed in an outpatient setting. Your podiatric surgeon is well qualified to discuss the needs of your particular case. Surgery may be performed under local anaesthesia or with light sedation administered, occasionally patients request an epidural or General anaesthetic this can be administered by a Consultant Anaesthetist. Your surgeon will advise you on the best possible postoperative care, so that your recovery will be rapid and as comfortable as possible.

What Is Worn on the Foot Following Surgery?

 Immediately after surgery, the entire foot will be carefully wrapped in a bulky dressing or cast as protection for the first few days. Keeping the foot elevated during this time will help minimize swelling. Some swelling and stiffness can be expected following surgery, for as long as eight to twelve weeks. Crutches may be needed for walking or standing as the foot heals. Possible side effects are delayed non-union of both, these is treated by splinting the foot, or if this is unresponsive re-operation. Each surgical procedure requires a different type of foot immobilization such as a bandage, splint, surgical shoe, cast, or open sandal. Good postoperative results require proper foot support to prevent future problems. Early use of leg and foot muscles hastens recovery. After sufficient healing time, most patients can resume wearing their usual footwear.

 Is Special Treatment Needed After Surgery?

Some patients require postoperative care, such as physiotherapy, Orthotics devices (foot supports), and special footwear. This care helps ensure that the results of the operation are long lasting.

Are There Risks Involved for Older Patients?

Attention is given to the special needs of older patients. This may include a consultation with other specialists to evaluate your condition and determine the safest procedures.

Is Foot Surgery Advisable for Diabetics?

Diabetics must take special care of their feet. Proper control of the diabetic's blood sugar and thorough evaluation of circulation and healing abilities are necessary before surgery is considered. Foot and ankle surgery on diabetics who are well controlled is usually successful and may serve to prevent severe diabetic complications from occurring.

What will I do For Pain Relief?

Information is given on pain relief before any operation. Further information can be sought by consulting your Podiatrist.