Surgery is usually the final treatment in an attempt to fix a foot problem; however, what can surgery really do for you?
There are many answers to this question and some patients may feel scared thinking about having surgery, while other patients may feel that only surgery will fix their problem and pain. Ultimately, surgery should never be the first treatment of choice until all the conservative treatments have been exhausted and failed to provide relief. It is difficult to fix failed surgeries and a failed surgery may even lead to more pain, which is why trying any and all conservative treatment is crucial. Conservative treatment will depend on the foot problem, but may include treatments such as orthoses, physical therapy, medications, injections, etc. The ultimate goal of surgery will be a final attempt to try to relieve the foot pain that a patient will be experiencing. Surgery can be done on almost any tissue in the body, but the most common types include:
Bone surgery: This is commonly performed on patients which have bony deformities, such as bunions, hammer toes, haglund deformities, etc. The procedures will involve cutting the bone. Bone that is healthy can heal quickly, total healing time may be as fast as in 3 months; however, it is possible that the surgical site may not heal and develop into what is call a non-union, because the bone does not fill in the gap. This non-union may lead to an unstable foot and may not help to relieve any pain.
Tendon surgery: Tendon surgery is commonly performed in cases of tight Achilles tendons, and hammertoe procedures. The surgery may involve either lengthening or shortening the tendon depending on the type of deformity present.
Ligament surgery: Surgical reconstruction of the ligaments may be needed in cases of severe ankle sprains, Lisfranc ligament injuries, or any other traumatic event that may cause damage to the ligament. There are procedures that use pieces of tendons to substitute for ligament in order to help do the original job of the ligament, which was to stabilize the joint.
Joints: It may seem odd, but sometimes the treatment for painful arthritic joints is to fuse the joint, so it is no longer able to move. In this case, the patient’s pain will be due to the damaged arthritic joint attempting to move. In addition, a joint may be replaced with an artificial joint that is made out of steel and plastic like materials. With these types of procedures, the joint will still be able to move back and forth.
Amputations: Losing a toe or part of the foot is definitely a very serious procedure and therefore will only usually be performed in the presence of serious infection of the bone, which is called osteomyelitis. If the infection cannot be treated with medications, it must be removed to prevent the infection from spreading and causing illness or more damaged bones.
Nerve surgery: Nerve surgery is not as common as the other types, but a podiatrist can fix some nerve problems such as neuromas and nerve entrapment syndromes. The surgeon may need to cut out a part of the nerve completely or may need to cut surrounding structures if they are impinging on the nerves. Nerve surgery is complicated, because nerves may or may not grow back. Often times if a nerve grows back, it will not re-grow properly and may ultimately cause pain.
If you have been struggling with a foot deformity and have tried many of the conservative treatments, considering surgery may be the next appropriate option. . If you are reading this and are considering surgery, one of the most important requirements in order to carry out the surgery is to not be using cigarettes or any other nicotine products two months prior to having surgery. Nicotine shrinks blood vessels, which will lead to poorer and slower healing results.
Visit Boulder County Foot and Ankle or Platte Valley Foot and Ankle Clinic for evaluation to make sure all conservative efforts have been attempted and possible evaluation for surgery.
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American Academy of Podiatric Sports Medicine