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Foot and Ankle Surgery

Evaluating Your Foot & Ankle Pain

After your exam, your physician may recommend surgery to solve your pain.

  • An extensive health history and lab tests help prepare you for surgery.
  • Ask your doctor how long your recovery time will be; if you will need help at home after surgery; if you will need any pre-surgical medications; and whether you should fast before your operation.
  • Your doctor will choose the type of anesthesia that is best for you. It may be a local anesthetic (no pain at the site of your surgery), sedatives (keeping you awake but relaxed during the procedure), or general anesthesia (putting you to sleep during the surgery).
  • Some minor procedures can be done in the surgeon’s office, while others may be scheduled at Cape Cod Hospital or Falmouth Hospital. Some surgeries require a 3-to-4 day hospital stay.

What to expect after surgery

Your doctor will give you detailed instructions to follow after your surgery.

  • Some pain is expected 2-3 days after your surgery.
  • Ice can help reduce the pain.
  • Elevate your foot above your heart.
  • Take medications as directed.
  • Keep your incision clean and dry.
  • Notify your physician if you notice any redness, heat, drainage or increased pain at or around the incision site.

Treating Foot Pain

Crutches or Casts: May be necessary for severe injuries.

Orthotics: Custom-made shoe inserts made to fit your feet and give support.

Physical Therapy: Strengthens weakened muscles and tendons and teaches you how to avoid future injury. Physical therapy can include ultrasound, massage and whirlpool treatments.

RICE:

  • Rest—Taking it easy will allow your body to begin to repair itself.
  • Ice—Reduces pain and swelling. From one to three days, ice your injury for 20 minutes every 2 hours.
  • Compression—Can decrease your pain and swelling by immobilizing your foot and ankle.
  • Elevation—Raising your foot above the level of your heart reduces swelling by allowing the fluid to drain away from the injury.

Common Injuries

Because of their many movable parts, your feet and ankles are prone to injury and the effects of wear and tear. Diabetic and arthritic patients are extremely vulnerable to foot problems.

Forward Motion Injuries: Repeated flattening of the foot can cause the plantar fascia (the tendon in your heel) to stretch. This is a common injury from over use, jogging, walking or biking. It may cause tendonitis and pain at the heel.

Excessive Up & Down Foot motion: Repeated pounding may cause stress fractures (hairline cracks in the bones of your feet) or shin splints (pain in the lower leg above your ankle).

Sideways Foot Motion: May cause over stretching of the ankle ligament resulting in ankle sprain.

Foot & Ankle Conditions

Bunions—A bunion is an enlargement of bone or tissue on the side of your foot where your big toe meets your foot. Surgery to remove the bone or tissue and reduce the distance between the first and second metatarsal bones will help reduce the pain and swelling of your foot.

Arthritis—Arthritis can occur in any joint. For mild cases, the damaged bone in your joint can be trimmed or removed. Post-surgery you may need to wear protective shoes. Once your foot has healed, the joint will move normally. If the joint can’t be repaired, a bone fusion may be done.

Arthroplasty—Surgical procedure using a pin to align the foot’s bones. After removing arthritic bone growth, the pin is inserted and removed after healing. The entire joint may be replaced with an artificial joint. After a few days you will be able to walk. You may need a splint or a surgical shoe for a few weeks.

Heel Problems: Can be caused by a strain on the plantar fascia and can be treated:

  • A small cut in the fascia near the heel bone.
  • Shockwave therapy stimulates the plantar fascia and promotes healing without incision.

Bone Spurs: Can grow on the bottom or back of the heel or on the top of your foot. The spur is removed and adjustments made to the surrounding tendons or fascia. You may need to wear a cast or use crutches for a few weeks while healing.

Toe Problems: There are many problems of the toes such as flexible and rigid hammertoes, curled fifth toes, toe spurs and corns.

Hammertoe Symptoms: Also known as corns, Hammertoe can cause irritation and pain when you wear shoes. It is treated by repositioning the top or bottom of the toe, or it may require removal of the joint. The toe will remain flexible after this surgery. Fusion is necessary when both sides of the joint are removed. The toe is straightened out and a pin is used to hold the bones together. After recovery, your toe will be less flexible, but more stable than before your surgery.

Flexible Hammertoes: Treated by repositioning the tendon on the top or bottom of the toe.

Rigid Hammertoes: Painful and may require removal of the joint or arthroplasty. Sometimes the joint is replaced by an implant. The toe will remain flexible after this surgery. Fusion is used when both sides of the joint are removed, the toe straightened and a pin used to hold the bones together. After recovery, your toe will be less flexible but more stable than before your surgery.

Curled Fifth Toe: When your fifth, or little toe curls in and goes under your fourth toe, it rotates causing you to walk on the toe’s side. Some skin and a section of bone may be removed allowing the toe to straighten. After this procedure you may need a protective shoe for a few weeks.

Tarsal Tunnel Syndrome: Caused by pressure on the tibial nerve (inside of the ankle.) Symptoms include pain, a burning sensation or a tingling on the bottom of the foot. Treatments include:

  • Orthotics or foot support devices
  • A small cut in the fascia near the heel bone
  • Steroid injections
  • Anti-inflammatory drugs
  • Surgical alternatives include: Incisions into the tissue to allow the nerve to expand; removal of a cyst or other obstruction pressing on the nerves.

Exercise and Rest — Prolonged rest and days of inactivity will increase stiffness and make it harder to move around. At the same time, excessive or improper exercise can overwork your arthritic joint and cause further damage. A balanced routine of rest and exercise is best. Your physical therapist will instruct you in walking and rehab exercises starting the day after your surgery.