Surgical Intervention for Foot and Ankle Issues
For most foot ankle conditions, surgery is considered a last resort. Conservative measures have been tried and failed to provide sufficient pain relief or correction of the problem. That’s when surgery is approached as an option.
In some cases, like ruptured connective tissues or displaced broken bones, surgical intervention is actually the best way to avoid chronic pain, weakness, or even deformities. Serious arthritis, joint disease, tumors, and birth deformities may need more invasive remedies as well.
There are many different kinds of foot and ankle surgeries, but you can take comfort knowing that the Aadvanced Footcare Associates team has extensive experience and provides compassionate care for you and your loved ones.
Reconstructive Foot Surgery
There are several reasons we might recommend surgery to address your foot or ankle problem. In some instances, conservative care is not working. At other times, the condition is progressive—such as with bunions and hammertoes—and will continue to worsen if left unaddressed. There are also cases where surgery is used to restore normal foot function and/or relieve severe pain.
Certain medical issues are more likely to require surgical intervention than others, including arthritis, injury resulting from physical trauma, and compound fractures. That said, there are times when conservative care for arthritis is effective at relieving symptoms and some trauma injuries can be resolved without surgery (it is just more likely that they will need surgical procedures).
Our goal is always to resolve your foot conditions and injuries with nonsurgical care as often as possible. Unfortunately, surgery is sometimes the best course of treatment. There is good news in the fact our doctors have the proven ability to perform successful procedures for conditions like:
- Bunions. This is both a common and progressive toe deformity a patient might develop. The progressive label means we might be able to treat symptoms and slow its development with nonsurgical care, but surgery is the only way to truly correct it.
- Flatfoot. If you have flexible flatfoot, or a child has pediatric flatfoot, there is not likely need for surgical reconstruction, but a rigid condition causing difficulty and pain with your daily activities may benefit from surgery.
- Hammertoes. This particular deformity, along with the related mallet and claw toe conditions, develops when an imbalance in strength between the muscles and tendons located on the bottoms and tops of toes leads to abnormal bending of the toe(s). Much like with bunions, these are progressive conditions, and they are best resolved at early stages, so do not wait to seek treatment.
- Bone fractures. There are different types and severity of broken bones, including ones where multiple pieces or the broken ends do not line up correctly for proper healing. In these cases, reconstructive surgery can be used to place everything back where it belongs.
Some of the key diagnostic tools we use to determine whether or not to recommend surgery include MRI (magnetic resonance imagining) scans, CT (computed tomography) scans, and x-rays.
Depending on various factors in any patient’s case, some of the potential surgical procedures we might use include:
- Bone fusion. Separate foot or toe bones can be fused together to restrict movement by a procedure sometimes used to treat severe arthritic conditions.
- Bone grafting. Bone grafts are taking a graft of bone from a different location to help repair bone tissue damaged in physical trauma.
- Joint implantation. This procedure essentially entails replacing a damaged or dysfunctional joint with an artificial joint or an orthopedic prosthesis.
- Osteotomy. Depending on your condition, we need to make cuts in bones, reposition them, and then hold the bones in place with the use of screws, pins, or plates.
- Tendon repair/transfer. In some reconstructive surgeries, we either repair a damaged tendon by making cuts and sewing the ends together or transferring a tendon from one location to another.
Ankle Surgery and Reconstruction
The ankle joints are instrumental for your ability to stay mobile and independent. When medical conditions like bone fractures or arthritis cause pain in an ankle and/or impairs its functionality, the affected ankle will need to be treated.
Arthroscopy is a minimally-invasive procedure. An advantage of using this surgery is there only needs to be a small incision to be made. This eliminates most of the difficulties (including patient pain and potential infection risk) that can accompany larger surgical cuts.
In the case of arthritis in an ankle joint, some of the surgical procedures we may recommend include joint fusion or joint replacement. With ankle fusion, we might use plates, screws, pins, and bone grafts to permanently connect the bones that form the ankle joints. This type of procedure does eliminate pain from bone-on-bone grinding in a joint, but it also takes away a certain degree of joint mobility.
Conversely, a joint replacement uses metal and plastic components to recreate the functionality of the natural ankle joint. Depending on the patient, we sometimes need to lengthen a tight Achilles tendon to increase range of motion.
Postoperative Care and Recovery
The actual procedure is, of course, an important part of the whole process, but you do not want to underestimate the importance of postsurgical care. This stage is essential for your safety and optimal recovery. We will provide specific postoperative instructions, and your ability to heal correctly will depend on you following them, but some general considerations include:
- Rest – Surgery is a big deal. If it wasn’t, we wouldn’t take as many measures as possible to avoid using it as a treatment option. Since it is, though, you will need to give your body the chance to perform its natural healing processes after the procedure.
- Medication – Depending on your procedure and situation, we will likely recommend or prescribe some form of medication for you. The pain relieving properties of medicine certainly plays a role, but the anti-inflammatory ones can be immensely helpful in assisting with your recovery.
- Restricted movement – In time, the amount and range of movement will increase, but we may recommend you limit how much you move the affected area for at least a certain period of time.
- Assistive devices – Braces, casts, or other devices may be prescribed to help you keep weight off of the repaired, but still allow you to be mobile.
- Physical therapy – As you recover, it will be necessary for you to gradually ease into physical movement. To that end, physical therapy is a key part of postsurgical care. Stretching and strengthening exercises are essential for making sure your movement is as natural as possible.
- Hygienic practices – The potential for infection is one of the risks of surgery. This risk doesn’t end once the procedure is completed, though. It is essential that you keep any insertion points clean to reduce your infection risk.
- Follow-up appointments – Don’t worry, you’re not on your own after the surgery! We will schedule follow-up appointments to monitor your progress and ensure everything is mending like it should.
If you are experiencing pain in your foot and ankle, there is a chance our doctors may recommend surgery to address it. When this is the case, there’s no need to worry – we have a proven track record of helping numerous patients through surgical intervention.
For more information or to request an appointment with one of our podiatrists, contact Aadvanced Footcare Associates by calling:
- Our Rego Park office at (718) 896-4433
- Our Plainview office at (516) 822-9595
- Our Flushing office at (718) 969-2266