A Major Health Concern
Many foot problems do not respond to "conservative"
management. Your podiatric surgeon can determine when surgical
intervention may be helpful. Often when pain or deformity persists,
surgery may be appropriate to help alleviate them, or to restore
the function of your foot. However, sometimes all you need is a pair of comfortable shoes.
A common deformity of the foot, a bunion is
an enlargement of the bone and tissue around the joint of the
big toe. Heredity frequently plays a role in the occurrence of
bunions (especially among women), as it does in other foot conditions.
When symptomatic, the tissue may become red, swollen, and inflamed,
making shoe gear and walking uncomfortable and difficult. If
conservative care fails to reduce these symptoms, surgical intervention
may be warranted. Your podiatric surgeon will determine the type
of surgical procedure best suited for your deformity, based on
a variety of information which may include X-rays and gait examination.
A hammertoe deformity is a contracture of
the toe(s), frequently caused by an imbalance in the tendon or
joints of the toes. Due to the "buckling" effect of
the toe(s), hammertoes may become painful secondary to footwear
irritation and pressure. Corn and callus formation may occur
as a hammertoe becomes more rigid over time, making it difficult
to wear shoes. Your podiatric surgeon may suggest correction
of this deformity through a surgical procedure to realign the
An irritation of a nerve may produce a neuroma,
which is a benign enlargement of a nerve segment, commonly found
between the third and fourth toes. Several factors may contribute
to the formation of a neuroma. Trauma, arthritis, high-heeled
shoes, or an abnormal bone structure are just some of the conditions
that may cause a neuroma. Symptoms such as burning or tingling
to adjacent toes and even numbness are commonly seen with this
condition. If conservative treatment does not relieve the symptoms,
then your podiatric physician will decide based on your symptoms
whether surgical treatment is appropriate.
Bunionette (tailor's bunion)
A protuberance of bone at the outside of the
foot behind the fifth (small) toe, the bunionette or "small
bunion" is caused by a variety of conditions including heredity,
faulty biomechanics (the way you walk) or trauma, to name a few.
Pain is often associated with this deformity, making shoes very
uncomfortable and at times even walking becomes difficult. If
severe and conservative treatments fail to improve the symptoms
of this condition, surgical repair may be suggested. Your podiatric
surgeon will develop a surgical plan specific to the condition
Ingrown or deformed toenail tissue may be
severe enough to warrant surgical treatment. Removal of part
or all the nail may be necessary, depending on the deformity.
Sometimes soft tissue near or at the nail plate must be removed
to adequately treat specific conditions of the toenail. Your
podiatric physician will decide the surgical procedure best suited
to treat your nail condition.
A bone spur is an overgrowth of bone as a
result of trauma or reactive stress of a ligament or tendon.
This growth can cause pain and even restrict motion of a joint,
depending on its location and size. Spurs may also be located
under the toenail plate, causing nail deformity and pain. Surgical
treatment and procedure is based on the size, location, and symptoms
of the bone spur. Your podiatric physician will determine the
surgical method best suited for your condition.
PREOPERATIVE TESTING AND CARE
As with anyone facing any surgical procedure,
those undergoing foot and ankle surgery require specific tests
or examinations before surgery to improve a successful surgical
outcome. Prior to surgery, the podiatric surgeon will review
your medical history and medical conditions. Specific diseases,
illnesses, allergies, and current medications need to be evaluated.
Other tests that help evaluate your health status may be ordered
by the podiatric physician, such as blood studies, urinalysis,
EKG, X-rays, blood flow studies (to better evaluate the circulatory
status of the foot/legs), and biomechanical examination. A consultation
with another medical specialist is sometimes advised by a podiatric
physician, depending on your test results or a specific medical
The type of foot surgery performed determines
the length and kind of aftercare required to assure that your
recovery from surgery is rapid and uneventful. The basics of
all postoperative care involves to some degree each of the following:
rest, ice, compression
and elevation. Bandages, splints, surgical shoes, casts, crutches,
or canes may be necessary to improve and insure a safe recovery
after foot surgery. A satisfactory recovery can be hastened by
carefully following instructions from your podiatric surgeon.