Foot and Ankle Surgery at The Cherwell HospitalThe foot is a complex structure that contains 26 bones to provide structure and more than 100 tendons, ligaments, and muscles that move 33 joints. The ankle joint is formed by the union of the lower leg bones and the talus bone of the foot.
Your foot bears your weight, provides balance and assists in mobility through many diverse activities, such as standing, walking, running, and jumping so it’s not surprising that problems can occur in this area of your body.
Treatment for foot and ankle painAt The Cherwell Hospital we have a foot and ankle service dedicated to the investigation, diagnosis and treatment of all types of foot and ankle problems deriving from sports injuries, accidents and all aspects of arthritis.
Here are the main foot and ankle surgeries we perform at The Cherwell Hospital:
This is a common cause of forefoot pain and tingling, typically affecting the 2nd and 3rd toes. It is due to a swelling on the nerve in the sole of the foot. Conservative treatment involves the use of an insole which offloads this area. An ultrasound guided steroid injection is often helpful. Surgical excision of the neuroma is reserved for cases resistant to conservative treatment.
Hammer and claw toes
A hammer toe is a deformity of the second, third or fourth toes. In this condition, the toe is bent at the middle joint, so that it resembles a hammer. A claw toe is a deformity where your toes are bent upward from the joints at the ball of the foot, downward at the middle joints toward the sole of your shoe and sometimes your toes also bend downward at the top joints, curling under the foot into a claw-like position.
A bunion is a bony prominence on the inner aspect of the base of the big toe. Bunions are extremely common in the United Kingdom. The cause of bunions remains uncertain although they seem to be more common in families where bunions are prevalent and there is some evidence to suggest that wearing narrow shoes may also be a cause. A large number of patients with bunions do not require surgical treatment. It is only when they become painful and when conservative treatment is unsuccessful that surgery should be considered.
Bunions normally coexist with hallux valgus; a condition characterised by the big toe drifting off towards the second toe. Provided that there is no arthritis in the big toe joint, surgical treatment for bunions involves removing the bony prominence and also correcting the associated hallux valgus deformity by cutting and realigning the bone; an operation known as an osteotomy.
There are three different type of osteotomies ; the chevron, the scarf and the basal osteotomies to treat the spectrum of bunion deformities which all have good results in the scientific literature. The type of osteotomy recommended is dependent on how severe the deformity is.
Lesser toe deformities
These are common deformities that often present with the affected toe being painful and rubbing on shoes or the neighbouring toe. Surgical correction is indicated if conservative measures fail. The correction recommended depends on the nature of the deformity which may be of two types; flexable or fixed.
For a flexable deformity, when the toe can be easily corrected, a soft tissue procedure is recommended. The soft tissue procedure performed depends on the position of the toe but would involve either a tenotomy (tendon release), a tendon lengthening, a capsulotomy (soft tissue joint release), or tendon transfer (reattaching one tendon to another).
For a fixed deformity, when the toe cannot be corrected, a bony correction is required. This involves removal of the stiff joint affected and stabilisation with a wire which is removed after 4-6 weeks.
Heel pain (Plantar Fascitis)
Plantar fasciitis is a common cause of heel pain which typically presents at the base of the heel and is worse in the morning. It is normally self-limiting but may take 18 months to resolve.
Conservative treatment involves pain killers, heel pads and physio. Night splints, steroid injections and ultrasound therapy may also be helpful. Surgical treatment involves the release of the plantar fascia, although this is rarely necessary.
Arthritis of the foot and ankle
There are many different types of arthritis that may affect joints; osteoarthritis and rheumatoid arthritis are the two commonest seen in the foot and ankle. Osteoarthritis refers to a degenerative loss of cartilage that normally lines the joint. It is seen as patients get older or may be a result of a previous injury that has disrupted the joint.
Rheumatoid arthritis is an inflammatory condition that causes destruction of bone and cartilage. Both conditions commonly present with pain, swelling and reduced mobility. If the pain is severe and does not respond to conservative measures, then surgery is considered. The options of surgical intervention for arthritis of the foot and ankle include.
Steriod/local anaesthetic injection
This may be helpful in rheumatoid disease or osteoarthritis of the big toe joint but it is unlikely to provide long lasting pain relief.
Performed for the big toe where the upper part of the arthritic joint is removed.
Arthoroscopy with debridement
Useful for osteochondral defects and tears in the cartilage in the ankle joint which may be curetted or shaved.
This involves the refashioning and subsequent stiffening of the joint with high levels of patient satisfaction when correctly performed.
Which Consultants can I see about my foot and ankle pain?• Mr Sadai Appan
• Mr Gurbinder Nandhara
• Dr Nicolas Pinar
How do I see a Consultant?If you are suffering from joint pain that is affecting your quality of life, talk to your GP and ask for a referral to The Cherwell Hospital. We provide orthopaedic services for NHS patients and those self-paying or using medical insurance.
If you have any questions about using your Private Medical Insurance or self-paying for treatment, please call Karen Nicholls, our Private Patient advisor on 01295 755010. She is also available via email, firstname.lastname@example.org
If you have any questions call us on 01295 230 340 or email us via our contact form.
Finance packages are available via a medical loan with 0% finance, further details are available here.
Read more about the other Orthopaedic procedures available at The Cherwell Hospital.