Foot & Ankle Treatments
The joints in the forefoot can be damaged by inflammation of the lining on your joint in some forms of arthritis, usually rheumatoid arthritis. These small joints are called the metatarsal-phalangeal joints, and they can become dislocated when damaged by arthritis.
If the symptoms persist and become too painful then you may require surgery. The exact surgical procedure and the follow-up you’ll need depends on how severe the problem is, but often surgery to your big toe and removal of the heads of your metatarsal-phalangeal joints, making walking easier and more comfortable.
Ankle arthritis is where the cartilage covering the ends of your bones gradually roughens and becomes thin, and the bone underneath thickens. Just one of the causes is when you have experienced an injury in the past that has led to pain, swelling and an occasional deformity of the joint.
Ankle fusion is required when an ankle joint is damaged severely and ends with the patient having a stiff ankle but completely pain free. The foot is fused at a right angle to your leg in the walking stance creating one bone where there used to be two. Recovery time to optimum standard is usually 12 to 14 weeks.
This procedure can sometimes be done arthroscipally which would decrease the recovery period and cause less trauma to the area, this would all depend on the severity of the problem.
An ankle replacement involves taking out the damaged ends of your tibia and talus bones and replacing them with artificial ends made out of plastic or metal. The procedure takes approximately 2 hours and the patient will be kept in hospital for 2 days. The foot will be placed in a temporary cast replaced soon after by bandaging, a walking aid may be required for a short time after.
Replacement ankle joints usually last for about 10–15 years, and as with many joint replacements the new joint may become worn and further surgery may be required in the form of an ankle fusion. There are steps you can take to look after the new joint and your occupational physiotherapist will advise you on these areas.
Achilles tendon disorders
As we get older the Achilles Tendon can start to wear, which can lead to painful swellings. In some cases surgery can be used as a method of treatment. This procedure is usually performed as a day case and a bandage will need to be worn.
The plantar fascia is a tough area of tissue starting at the heel bone and stretching across the sole of the foot to the toes. The condition is an inflammation of the area and in very bad cases surgery may be required. This procedure is usually performed as a day case and it takes less than an hour and a bandage will be worn for a short period thereafter.
Bunions are bony lumps that develop on the side of your foot and at the base of your big toe. They’re the result of a condition called hallux valgus, which causes your big toe joint to bend towards the other toes and become deformed. If symptoms carry on over a long period, your toe may need to be surgically corrected. This involves straightening your big toe, a process called an osteotomy. Although this may make your joint stiffer, it works to relieve the pain.
Most surgery can be performed as a day case and takes up to an hour. Your foot will be bandaged and you’ll need to wear a Velcro surgical shoe for 4–6 weeks afterwards. Sometimes swellings or bursae on the joints in your feet are also called bunions, but these aren’t the same as bunions caused by hallux valgus and don’t need surgery.
Damages caused by hammer toes can be eased by:
- arthroplasty – removing the deformed joint between your phalanges, which leaves the joint flexible
- arthrodesis – fusing your phalanges together, which leaves your toe more stable but means you’ll only be able to wear flat shoes after the operation.
Both procedures are performed as day cases and last around an hour. Your stitches will be removed about 2–3 weeks following surgery and you’ll need another dressing for 2–6 weeks after that.