Whenever possible, we take conservative (nonsurgical) approaches to foot and ankle conditions and injuries. Fortunately, surgical intervention isn’t necessary for the majority of problems that develop in lower limbs.
In fact, we usually consider surgery to be a last resort in treating issues – something reserved to be used in cases wherein conservative treatment is not providing sufficient relief from pain or correction of dysfunction. At that point, we will likely recommend surgical procedures to address the problem for you.
For some cases—such as with fractured bones that have become displaced or ruptured connective tissues—surgery constitutes the best way to avoid chronic pain, weakness, or even deformities. At other times, severe arthritic conditions, other joint diseases, tumors (benign or malignant), and genetically-inherited deformities may also need more invasive remedies as well.
As you’ll see, there are many different types of foot and ankle surgeries, but one thing that is consistent is this – you can take comfort in knowing that 1) we’ve attempted every other avenue, and 2) we have been able to perform successful surgical intervention for other patients and can do the same for you.
Foot Conditions That Might Benefit from Reconstructive Surgery
Essentially, our goal at the office of Bruce Scudday, DPM is to resolve your foot condition with nonsurgical care if possible. When surgery is the appropriate course of treatment, it might be used for conditions like:
- Bone fractures. Whereas simple, closed fractures do not typically require surgical intervention, there are other types and severity of fractures – including ones wherein the bone has broken into multiple pieces or the broken ends are not aligned correctly for proper healing. In these kinds of cases, reconstructive surgery can be used to place everything back where it belongs (and equipment used to keep everything in place).
- Bunions. This particular condition is both common and progressive. The fact that it’s progressive means that the condition will continue to worsen over time when left untreated, and this highlights the importance of early intervention. More than that, progressive condition can only be truly corrected with surgery. Now, we may be able to treat symptoms and slow the progression through nonsurgical means, but a wayward toe can only be properly straightened with a bunionectomy.
- Hammertoes. This particular toe deformity, along with the related mallet and claw toe conditions, develops when an imbalance in strength between the muscles and tendons located on the bottoms and tops of toes leads to abnormal bending of the toe(s). As with bunions, these are progressive conditions. If you seek treatment early, we may be able to use conservative care to relieve symptoms and prevent affected toes from worsening. Once they become rigid (something that happens over time), these toe deformities can be quite painful. At that point, surgery is probably going to be your only option.
- Charcot foot. Along with diabetic foot ulcers, this deformity is one of the major lower limb concerns from diabetes. Impaired blood flow and damaged nerves can weaken bones, make them more susceptible to fractures, and leave you unaware problems have developed. Normal usage leads to further deformity and an eventual need for reconstructive surgery. You can reduce your risk of ending up with this condition by practicing smart diabetic foot care.
- Flatfoot. If you have flexible flatfoot, or a child has pediatric flatfoot, there is not likely need for surgical reconstruction, but a rigid condition causing difficulty and pain with your daily activities may benefit from surgery.
Types of Foot Reconstructive Surgeries
Those are some of the conditions that might require surgery, but what are the actual procedures we may need to use?
Naturally, this will vary depending on the case, but some types of reconstructive surgeries include:
- Tendon repair/transfer. In some reconstructive surgeries, we either repair a damaged tendon by making cuts and sewing the ends together or transferring a tendon from one location to another.
- Osteotomy. Depending on your condition, we need to make cuts in bones, reposition them, and then hold the bones in place with the use of screws, pins, or plates.
- Bone fusion. Separate foot or toe bones can be fused together to restrict movement by a procedure sometimes used to treat severe arthritic conditions.
- Bone grafting. Bone grafts are taking a graft of bone from a different location to help repair bone tissue damaged in physical trauma.
- Joint implantation. This procedure essentially entails replacing a damaged or dysfunctional joint with an artificial joint or an orthopedic prosthesis.
Ankle Surgery and Reconstruction
The ankle joints are instrumental for your ability to stay mobile and independent. When medical conditions like bone fractures or arthritis cause pain in an ankle and/or impairs its functionality, the affected ankle will need to be treated.
Arthroscopy is a minimally-invasive procedure. An advantage of using this surgery is there only needs to be a small incision to be made. This eliminates most of the difficulties (including patient pain and potential infection risk) that can accompany larger surgical cuts.
Of course, sometimes we need to use a more traditional procedure known as open reduction and internal fixation (ORIF) – which is more invasive than arthroscopy, but necessary for setting fractured bones back into place.
The larger incision provides a better view of the entire broken bone. It also allows fractured pieces to be placed into the proper position and secured with the use of metal screws and/or plates.
For arthritic conditions in the ankle, some of the surgical procedures we may recommend include joint fusion and joint replacement. In ankle fusion, we can use plates, screws, pins, and bone grafts to permanently connect the bones that make up the ankle joint. This type of procedure does eliminate pain from bone-on-bone grinding in a joint, but it takes away a certain degree of joint mobility.
A joint replacement, on the other hand, uses metal and plastic components that recreate the functionality of the natural ankle joint. Depending on the patient, we may need to lengthen a tight Achilles tendon to improve range of motion.
Surgical Experience and Skill at the Office of Bruce Scudday, DPM
When you come see us for treatment, we will start with assessing the situation and then attempting to resolve it through conservative methods (if possible). The good news is that we are able to treat many patients without needing to use surgery.
That said, we have also been able to help many patients find relief and return to their favorite activities through surgical intervention – and can do the same for you!
For more information on any of the podiatric services we provide, contact our El Paso office by calling (915) 533-5151. While on the phone, make sure you request your appointment so you can receive the expert foot care you need!