Injuries to the foot and ankle are a fairly common occurrence.
Feet alone are made up of 26 bones and more than 30 joints, all of which can be affected by injury, infection, or underlying conditions like arthritis. The ankle is just as susceptible to damage that can affect tendons, ligaments, muscles, or the ankle joint itself.
If initial treatment efforts that may include activity modification, splinting, medication, and therapeutic exercise aren’t effective, foot and/or ankle surgery may become an option.
Usually found on the side of the foot or at the base of the big toe, bunions (hallux valgus) are bony lumps. These growths sometimes cause the big toe to be deformed to the point where it leans in towards other toes and contributes to pain associated with foot movement. If symptoms persist and changes with footwear and other common treatment recommendations aren’t effective, surgery may involve:
- Removal of part of the big toe bone
- Fusion (“bone joining”) surgery
- Tissue removal
- Removal of rheumatoid nodules if bunions are caused by rheumatoid arthritis
Toes that are permanently clawed or bent are referred to as “hammer toes.” Surgical options to correct damaged caused by this deformity include arthroplasty to remove the deformed joint and immobilization with joint fusion surgery (arthrodesis).
Responsible for giving your foot its arch, the metatarsal bones are a group of five long toe bones. Some forms of arthritis may damage the lining of the metatarsophalangeal joints (MTPJs) or dislocate the joints. For severe issues with metatarsals, surgery may involve the big toe and/or removal of the heads of the MTPJs.
Plantar Fasciitis and Other Foot Problems
The tough band of fibrous tissue that links the toes and heel bone (the plantar fascia) is sometimes affected by inflammation. If the irritation is severe, surgery may be necessary to release the plantar fascia from the calcaneus (heel bone). The following foot problems may also require surgery:
- Mallet toe
- Morton’s neuroma
- Flatfoot (“fallen arches”)
- Damage caused by changes to tendons that affect the foot’s arch (posterior tibial tendon dysfunction)
Cartilage covering the ends of ankle bones is sometimes damaged by osteoarthritis (OA) and similar forms of arthritis. If symptoms are severe, an ankle fusion (ankle arthrodesis) may be performed. Some patients are good candidates for a less invasive corrective procedure sometimes termed “keyhole surgery” (arthroscopy). In some situations, three ankle bones (talonavicular, subtalar, and calcaneocuboid joints) need to be fused together.
If the ends of the tibia and talus bones become worn or damaged, an ankle replacement may be recommended. It’s a procedure that involves replacing damaged parts with artificial ones. Unlike fusion surgery, the procedure does not limit ankle movement. If only part of ankle is damaged, partial replacement may be performed instead of a total ankle replacement.
Achilles Tendon Disorders
The largest tendon in the body, the Achilles tendon can be affected by age-related wear, degenerative diseases, or serious injuries. Arthroscopic surgery is often performed to evaluate this tendon to determine the extent of damage and make the necessary repairs. Ankle ligaments may be repaired in a similar way.
Most foot and ankle problems don’t require surgery. However, you may benefit from any of the procedures discussed here if your pain isn’t reasonably controlled with custom orthotics and other efforts. Your lifestyle is another factor that will determine if surgery is right for you. For instance, athletes often opt for surgery to restore full stability so they can return to their desired level of performance. Additional factors include your personal goals and how your symptoms are affecting your overall quality of life.