Types of Common Foot Surgeries
When it comes to treatment options for most injuries and maladies, surgery is understandably considered a last resort. But if you’re someone who suffers from perpetual ailments and pains in your feet, it’s important to recognize the necessity of surgery in certain cases. This can cause a lot of undue anxiety and stress on your end, but something to remember about foot surgeries is that almost all are done on an outpatient basis. A local anesthesia is administered solely to a portion of the lower legs, and patients stay awake for the entire duration of the procedure. You’ll also be sent home immediately afterwards, with only a handful of the more intense procedures requiring an overnight stay.
Recovery times following foot surgeries depend on the scope of the work done, but you should expect to be up and running again within a few months. Swelling of the feet is expected, as well as the use of a special boot, crutch, or cane to aid with walking and moving in the immediate aftermath. Overall, almost all foot surgeries lead to full recoveries, and as long as you take precautions to ensure that you rectify your lifestyle to avoid a repeat occurrence, you’ll be good to go for much longer.
While there are many different types of foot surgeries all designed to directly target specific issues, this article lists down 11 of the most common procedures to shed some light and provide a brief rundown of the processes in order to ease your worries and hopefully answer any lingering questions you might have.
Bunions are bony lumps found at the base of the big toe, and are deformities of the joint connecting the big toe to the rest of the foot. This occurs when the big toe bends towards the other toes, causing the bump that forms at its base to become red and painful. Bunions are usually caused by wearing shoes that force your toes into unnatural positions for extended periods of time, as the pressure on the joint causes it to extend past the regular shape of the foot.
If you’re afraid of what this might mean, don’t be! Bunions are extremely common, and though they’re something many people live with, it doesn’t mean you have to. If the pain caused by your bunions is starting to impede with your ability to go about your day-to-day routines, then it might be time to consider bunion removal.
Bunion removal is a surgical procedure that corrects the deformed area near the big toe. There are 3 different types of bunion removal surgeries: an osteotomy, where the doctor will cut the big toe joint and realign it to its normal position; an exostectomy, in which the surgeon will remove the bunion without realigning the joint; and an arthrodesis, where the damaged joint is replaced with screws or metal plates.
Recovery from this procedure can take around six to eight weeks, with a full recovery expected after four to six months. Wearing wide or comfortable shoes will ease the process and help you transition into putting weight back on the feet, as well as act as a preventive measure from future bunions.
Similar to bunions, hammertoes are caused by wearing ill-fitting shoes, a case of arthritis, having an unusually high foot arch, or even by bunions themselves. The difference is that the toe curls upwards at the joint, lending the appearance of a hammer. Although hammertoes may be present at birth, like bunions, they usually develop over time.
In the early stages, while the joint of your toe is still flexible, you can attempt to rectify hammertoes by wearing loose footwear and padding your shoes with toe cushions. However, once the joint has grown rigid in its position, what follows next is usually surgery.
The most common form of hammertoe surgery is called a fusion procedure. In this procedure, the attending surgeon removes portions of the joint to allow the bones to grow back together. This will eventually straighten the toe and reduce pain. They will then use pins to keep the joints in place, which will allow the bones to fuse.
Following this surgery, expect swelling to last up to a year. It’s also important to remember that those who have had hammertoes are at risk of developing it again, so it would be wise to invest in regularly practicing exercises that will strengthen the toe and foot muscles, as well as proper footwear.
Heel spurs are bony growths that start at the front of the heel bone and extend towards the arch. Some people with heel spurs may not even realize they have them, as heel spurs tend to cause pain only in conjunction with other foot conditions. They are a result of excessive strain or friction to the heel bone, such as running, jogging, wearing the wrong shoes, having flat feet or an overly high arch, or as a side effect of arthritis.
Most doctors will first recommend non-invasive treatments to remedy heel spurs, such as stretching exercises, shoe inserts, and physical therapy. They may also prescribe over-the-counter pain medication like ibuprofen. However, if these measures are done for as long as a year with no significant results, then surgery might be a more viable option.
The first type of surgery for heel spurs is to release the plantar fascia, or the ligament along the bottom of your foot that connects it to the heel bone. The inflammation of the plantar fascia is the most common cause of heel spurs, as putting pressure on this area is what causes the growth to form. To relieve the pain, the surgeon will cut a part of the plantar fascia to reduce the pressure on it.
A second surgical option for this disorder is for the doctor to remove the heel spur entirely through the use of small incisions in order to dispose of the bony growth. This does not happen with every case, as cutting through to the plantar fascia is usually enough to get rid of the pain.
While metatarsalgia is often a symptom of another condition, such as bunions or hammertoe, it is still considered an overuse injury. This occurs when the ball of your foot becomes painful and inflamed, and is usually the result of high intensity activities like running and jumping, or the product of uneven weight distribution. You can easily detect metatarsalgia through a sharp pain on the section of your sole just behind the toes, one that worsens as you stand.
Metatarsalgia is not serious and can easily be remedied with home-based solutions like icing your feet, wearing proper running shoes, or using a pressure bandage. For athletes, your doctor might recommend swimming as an alternative sport in order to temporarily alleviate some of the pressure on the feet. However, if you feel a persistent burning pain on the ball of your foot, this may mean the condition is serious enough to warrant surgery.
During surgery, the surgeon will cut just behind the toe to reach the bone, and then realign the joints using a pin or a screw. In some procedures, the surgeon can also remove the painful callous on the bottom of the foot entirely.
Ingrown toenails occur when the top corner or side of the toenail grows into the flesh next to it. This happens as a result of cutting your toenails too short, or wearing shoes that are too tight around the toe area. Most ingrown nails can be treated at home through the use of antibiotic cream, soaking your toenails, or taking pain medication. If these do not work, surgery is another choice.
The surgical procedure starts with the attending physician cleaning and numbing the toe with an anesthetic injection. They will then apply an elastic band around the toe to hold up the ingrown area. Once ready, the doctor will use scissors to separate the toenail from the bed, and make vertical cuts from the ingrown side down to the cuticle. The doctor can then choose to remove only this cut section, or, depending on the severity, the entire toenail. Afterwards, the surgeon will cauterize the wound with a heated device or acidic solution to stop the bleeding. A side effect of this step is that the nail may often take longer to regrow. Lastly, the surgeon will bandage the nail after applying petroleum jelly to minimize infection.
Recovery from ingrown toenails is very short, and you should be back to full mobility after two weeks. During this period, keep your toenails clean by washing them with warm water and drying them properly. Wear open-toed shoes and take care to avoid any obstacles that can land on your toes. Regrowth of the nail bed can take up to a year.
Morton’s neuroma is a condition characterized by a pain or uncomfortable sensation on the ball of your foot, usually between the third and fourth toes. The feeling has been likened to walking around with a pebble inside your shoe, and can be understandably inconvenient. It happens due to the thickening of the tissues around one of the nerves leading to your toes. There are no outward signs of this disorder, and it is usually diagnosed through X-ray or ultrasound.
Some people find that injecting steroids into the affected area reduces the pain, but if this non-invasive treatment proves ineffective, decompression surgery is the next solution. In this procedure, the surgeon relieves pressure on the nerve by cutting into the ligament that binds the foot bones. In certain cases, removal of the nerve itself may be more effective if there is no difference in the pain. While surgeries like this are usually successful, they can also result in some numbness in the toes.
It can take up to six weeks to be able to return to regular sporting activities after a Morton’s neuroma surgery, but be sure to check in with your physician if your foot stays swollen for longer.
Tendon repair surgery is needed to treat a torn or damaged tendon. Tendons are the soft tissues that connect muscles to the bones, and when muscles contract, tendons are what pull at the bones and cause the muscles to move. When tendon damage occurs, movement is restricted and can be very painful. The most common causes of tendon injuries are contact sports such as football, rugby, and wresting.
Tendon repair procedures start with the surgeon cutting into the skin over the damaged tendon and sewing the ends together. They will also check the surrounding areas to make sure there aren’t any injuries to the blood vessels or nerves. After suturing the wound, the doctor will then insert a splint to the joint so that the tendon can heal. If there aren’t enough healthy tendons to use to connect the torn ends, the surgeon may also perform a tendon graft by using another tendon from a separate body part, such as from the toes.
Healing from tendon surgery can take up to twelve weeks, and physical therapy will be needed to return the affected area to full mobility. You might also need treatment after the surgery to minimize scar tissue. Stiffness in the joints following a tendon repair is normal and will gradually disappear with time.
Cosmetic Foot Surgery
While cosmetic foot surgeries are usually done to eliminate chronic pain, they can also be used as an avenue to shape the feet for more aesthetic purposes, resulting in smaller, slimmer feet. There are a variety of procedures to choose from, ranging from lengthening or shortening of the toes, shaving off bunions and bones, or removing lumps to slim down the toes and feet.
A popular cosmetic foot surgery has been dubbed the Cinderella surgery, named after the famous fairytale. This surgery aims to reduce the size of the foot by removing bunions and bones in order to allow women to wear high-heeled shoes with less risk. The overall procedure is similar in nature to a bunion removal, but with added options for toe shortening or lengthening and fat pad augmentation that adds cushioning to the feet without the use of shoe inserts. The swelling that follows the procedure will last for three to six months, after which results should be noticeable.
Surface issues that appear on the skin of your feet such as lipomas, a lump under the skin that results from an overgrowth of fat cells; fibromas, a benign, tumor-like growth made of connective tissues; and warts and moles may be nothing more than slightly bothersome, but some run the risk of causing pain or may even be indicative of a more serious issue. Depending on the size and growth of any one of these, getting them removed through surgery could be the best option. Your foot will be given a shot of local anesthesia while the surgeon sets about removing the growth from your foot. Recovery times will very depending on the depth of the invasion done, but surface skin issues will typically take no longer than a few weeks to heal.
More often than not, sprained ankles arise as a result of an accidental twist of the foot or a clumsy fall, but can also be the product of a sports-related injury. Pain and swelling in the ankle is either due to osteoarthritis, in which the cartilage covering the bone ends thin out and the bone underneath thickens, or rheumatoid arthritis resulting from a previous injury. If you have a mild case of arthritis, pain medication, special shoes, and physical therapy may help. But if severe symptoms and inflammation persist, you may have to undergo an ankle fusion.
Ankle fusions are done when a surgeon fuses the bones of the ankle into one piece in order to stop the pain and swelling. This is accomplished through a small incision in the joints used to compress the bones together with nails and screws to keep them in place.
Following an ankle fusion, your leg will likely be kept in a brace for a few weeks. You will also need to undergo several follow up X-rays to check on how well the tissues are reconnecting. Physical therapy is another means to rebuild strength and stability in the ankle area, and following through with all the necessary exercises will enable you to return to the field or the gym in no time.
Achilles Tendon Disorder
You might be familiar with the famous tale of the unstoppable hero Achilles and his only weakness—the soft spot at the back of his heel. This is where the Achilles tendon draws its name from, and appropriately, a rupturing of this particular area is said to be as painful as taking an arrow to the heel. The Achilles tendon connects the calf to the heel bone and is the foundation for high impact movements. As a result, Achilles tendon disorders are due to tears caused by sudden and jarring actions such as quickly changing directions or jumping from high places.
Surgery on the Achilles tendon comes after persistent inflammation and swelling that refuses to die down. In the past, the procedure to treat a ruptured Achilles was to repair the tendon using a large incision on the back of the leg. Nowadays, the process has been refined to be as minimally invasive as possible, using only a tiny incision above the ruptured area to put the tendon ends back together and repair them with sutures. The patient will then wear a splint for ten days, followed by a removable boot that they can gradually increase weight on the ankle with.
Even though most foot conditions can be treated at home, it’s safe to say that surgery can often be a viable and easier alternative, especially for those with recurring disorders. Always make sure to do proper research and consult with your local physician before undertaking any procedure, and follow through with any immediate aftercare to keep your feet active and strong in the years to come.