Questions & Answers
Questions and Answers – Foot and Ankle Surgery
I’ve got a problem with my foot or ankle – What do I do?
Thorough clinical assessment by a specialist is the first thing needed. Sometimes X-rays, ultrasound, CT or MRI scans are required to delineate the problem and plan its management.
Some of foot and ankle conditions can be alleviated with simple measures such as stretching exercises, insoles, shock wave therapy or injection. Others, however, may require surgery and a significant recovery period.
What is the bunion?
Bunion also called Hallux Valgus is a condition where the big toe over time gradually deviates outwards. This may lead to prominent bony bump with persistent throbbing pain over the inner side of the foot as well as great difficulty wearing shoes. Also, the big toe can encroach on neighbouring 2nd toe and make it to go either over or under it with crowding of other lesser toes. Typically, the condition progresses gradually sometimes making it nearly impossible to wear normal shoes.
How can my bunion be helped?
Although occasionally splints helping to realign the big toe better can alleviate the discomfort to some extent, as a rule this condition is likely to progress, and the surgical correction is required to sort out the problem.
What does bunion surgery entail?
The surgery consists of precise cutting and resetting bones in the foot with soft tissue adjustment in a particular way to straighten the big toe as well as realign lesser toes. Also, specially made screws are placed into the bone to maintain the correction. These screws stay in the foot permanently and in vast majority of the time do not give any problems.
Will I have a big scar?
Bunion surgery is not a cosmetic operation. It is aimed to relieve the pain and help to wear shoes comfortably. Traditional open surgery would leave at 2-3 inches scar on an inner side of the big toe which often fades away and is barely visible. At the same time, with modern minimally invasive surgical techniques surgical scars are even less visible with few small skin marks over the same area of the foot.
I have wonky toes – how can this be helped?
What does lesser toes surgery entail
Correction of lesser toe deformities can be challenging. In general, it requires cutting and resetting toe bones as well as soft tissues through tiny incisions. To hold these corrections specific sutures, special tapings, dressings and sometimes small metal pins are placed into toes for several weeks. Maintaining the correction needs strong compliance and following specific instructions.
How straight will my toes be after the surgery? What will these likely to feel?
The operation is aimed to improve your toes position. It is not possible to guarantee the “ideal” toes position due to their complex intricate mechanism and small size. Majority of the time new position feels much more comfortable.
Toes can feel strange with numbness, discomfort and pins and needles for several weeks after the operation and most of the time these sensations gradually settle.
Will I have to wear special shoe or special bandage?
Yes – you will have to wear a special Velcro type shoe or even boot depending on the extent of the operation for 5-6 weeks after the surgery. The front of your foot and toes will be wrapped up in a special snug fitting bandage.
How often my dressings will be changed?
You will have a post-operative bandage for 2 weeks after the operation. At this point it will be changed in clinic for another 2-3 weeks for a similar one or other type of dressing and you will be shown how to look after it for this period.
Will I have much pain?
Yes – after surgery you can feel some pain which will gradually settles over 2 weeks or so. With minimally invasive operation the pain is usually much less intense than in open surgery. Also, with big and lesser toes procedures we will give you a block of local anaesthetic around the operated area of your foot which will make it comfortable for several hours after the operation.
When can I walk on my operated foot?
The great news is that you will be able to fully walk on your foot straight away after surgery in a special shoe. In fact, you will be encouraged to walk as soon as possible. The combination of surgical correction, fixation, special bandage and shoe ensures your ability to walk.
Will I need crutches?
Everyone is different – some people feel more reassured with crutches for a couple of weeks, and we will show you how to use those. Others can walk without them straight away.
Will I have much swelling?
Some swelling is normal after foot surgery. Keeping your leg elevated for first 2 weeks of surgery helps to reduce it. Depending on the extent of correction it can be present even for 6 months or so. Bones in your foot especially with lesser toes correction may feel clunky for first 6-12 weeks. Most of the time swelling improves significantly by 3 months. At dressing changes we will advise you how to reduce the swelling.
When can I drive after surgery?
You will not able to drive for 6 weeks after surgery because of wearing special shoe or boot. This is aimed to ensure good result of your foot surgery and your own safety.
Will I need X-ray? Is having an X-ray a risk
Yes – you will need X-rays before the surgery to plan the procedure. X-rays will be taken during the operation to make sure all is in order. Also, you will have and X-ray at 3 to 6 months after the surgery to see the eventual result.
Modern X-ray machines provide very small dose of radiation which does not have an adverse effect on your health.
I have a painful heel bump – how can it helped? Would I need surgery?
Painful heel bump also called Haglund’s deformity is a painful bulky area at the very back of your heel bone where Achilles tendon – strongest one in the body connects to it. This condition can give a great deal of discomfort – rubbing on footwear, getting painful skin sores and making it very difficult to wear shoes. Sometimes precise injection of local anaesthetic and steroid under the ultrasound guidance or wearing heel cups can help. Often, however, if this problem persists an operation is needed.
Thankfully, modern minimally invasive surgery technique can help to resolve or dramatically improve this stubborn condition. The surgery involves cutting and shortening your heel bone through tiny skin incision using special tools to relieve the pressure. You will have one or two metal screws inserted into your heel bone to hold the correction which will stay there permanently. These should not give you any discomfort.
For how long will I have to keep weight off my leg after heel bump surgery?
The great news is that with modern surgical technique and pain relief provision you should be able to weight bear in a special boot straight away for about 4 weeks after the surgery. We will advise you to keep your leg elevated for 4 weeks after the operation. We will check your wound in 4 weeks and remove the boot then to allow you to go to your normal shoes.
Will I need X-Ray or MRI with heel bump surgery?
Is foot surgery risk free?
No surgical procedure is risk free. Although with modern techniques risks are reduced substantially, there are still general and procedure specific potential problems and complications which will be thoroughly discussed during the consultation and informed consent process.
