Common Procedures and Surgeries of the Foot and Ankle
Accessory Navicular
An accessory navicular bone is an accessory bone of the foot that occasionally develops abnormally in front of the ankle towards the inside of the foot. This bone may be present in approximately 2.5% of the general population and is usually asymptomatic. When it is symptomatic, surgery may be necessary.
Surgery can be performed at any age because it does not alter any other bones. Symptoms of an accessory navicular bone may include plantar fasciitis, bunions and heel spurs.
Surgery can be performed at any age because it does not alter any other bones. Symptoms of an accessory navicular bone may include plantar fasciitis, bunions and heel spurs.
Achilles Tendon Lengthening
Achilles tendinitis is a common condition that causes pain along the back of the leg near the heel. The Achilles tendon is the largest tendon in the body. It connects your calf muscles to your heel bone and is used when you walk, run, and jump. Although the Achilles tendon can withstand great stresses from running and jumping, it is also prone to tendinitis, a condition associated with overuse and degeneration. Simply defined, tendinitis is inflammation of a tendon. Inflammation is the body's natural response to injury or disease, and often causes swelling, pain, or irritation.
Ankle Fracture Surgery
"I broke my ankle." A broken ankle is also known as an ankle "fracture." This means that one or more of the bones that make up the ankle joint are separated into pieces. There may be ligaments damaged as well. Simply put, the more bones that are broken, the more unstable the ankle becomes.
A fractured ankle can range from a simple break in one bone, which may not stop you from walking, to several fractures, which forces your ankle out of place and may require that you not put weight on it for three months.
A fractured ankle can range from a simple break in one bone, which may not stop you from walking, to several fractures, which forces your ankle out of place and may require that you not put weight on it for three months.
Ankle Arthroscopy
Arthroscopy is a useful tool in the treatment of a variety of foot and ankle disorders. Multiple indications for ankle arthroscopy exist today, and more than likely these will be expanded in the future. Ankle problems that can be managed arthroscopically include soft-tissue and osseous impingement, loose bodies, adhesions, synovitis, and osteochondral defects of the talus. These conditions can be approached with the use of anterolateral and anteromedial portals and, if necessary, accessory portals. Arthroscopic ankle fusion can also be performed through the use of anterior portals for patients with arthritis of the ankle who do not respond to conservative management. Complications of ankle arthroscopy involve neurologic problems more often than arthroscopy elsewhere in the body. Damage to the branches of the superficial peroneal nerve as well as to the sural nerve makes up most of the complications. A thorough knowledge of the topographic anatomy of the foot and ankle plus use of the "nick and spread technique" can help avoid most of these complications.
Arthroscopic Ankle Cartilage RepaiR
Arthroscopy is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of the ankle is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed either to evaluate or to treat many orthopedic conditions including torn floating cartilage, torn surface cartilage, and trimming damaged cartilage.
Bunionectomy With Distal Head Osteotomy or Wedge Osteotomy
A bunion forms when the bursa (a sac of fluid at friction points between the tendons and bone in some areas and between bone and the skin in others) becomes inflamed along the edge of the joint at the base of the big toe. There are two types of bunions. The acute bunion causes the sharper pain. It develops from a bursitis, a sudden outcropping of a fluid-filled sac. An acute bunion can progress into the second type of bunion, the hallux valgus, a chronic but often painless deformity involving permanent rigidity of the bones. Bunions can form in any part of the foot but occur most often at the big toe joint, where the first metatarsal bone abuts the proximal phalanx of the big toe. Women are more likely than men to get bunions because of the misshapen footwear and elevated heels they wear.
Bursitis is an inflammation of the bursa, which is a sac containing tissue fluid about the consistency of an egg white. The bursa at the big toe joint acts as a lubricant between the skin and the bones. Continual irritation of the skin by an ill-fitting shoe causes the sac to become inflamed and inflated with more fluid. When that occurs, the condition is an acute and painful bursitis.
During the early stages of bursitis, the fluid tries to force itself to the surface of the skin so that it can be discharged. There is minimal but continuous irritation at the joint. If you ignore the irritation, hardening of the skin takes place. The forward displacement that occurs when your foot is fitted into high-heeled shoes, or even into stockings that are too snug, adds to the pressure upon the joint. The bursal fluid begins to solidify into a mass that resembles gelatin. The result will be a bunion, which then enters a subacute phase.
If allowed to progress, the condition can become worse. It does so because of the problem of obtaining a properly fitted shoe. The ball of the foot, with its bulbous outcropping of bunion, is considerably wider than the heel. The shoe with a snug heel that prevents slippage at its back might not fit the normal width of the ball of the foot at the front of the shoe. With the added growth of bunion, the width of the foot can no longer be considered normal. Thus, the proper fit at the ball of the foot leads to an angulation of the big toe. This deformity is a hallux valgus.
Hallux valgus is a serious condition. It strains the foot and produces an abnormal prominence of the joints; it also widens the front of the foot and causes a loss of balance. And any deformation of the big toe interferes with standing and walking. Also, malposition of the big toe bone and loss of power in the foot muscles can lead to arthritis early in life.
Bursitis is an inflammation of the bursa, which is a sac containing tissue fluid about the consistency of an egg white. The bursa at the big toe joint acts as a lubricant between the skin and the bones. Continual irritation of the skin by an ill-fitting shoe causes the sac to become inflamed and inflated with more fluid. When that occurs, the condition is an acute and painful bursitis.
During the early stages of bursitis, the fluid tries to force itself to the surface of the skin so that it can be discharged. There is minimal but continuous irritation at the joint. If you ignore the irritation, hardening of the skin takes place. The forward displacement that occurs when your foot is fitted into high-heeled shoes, or even into stockings that are too snug, adds to the pressure upon the joint. The bursal fluid begins to solidify into a mass that resembles gelatin. The result will be a bunion, which then enters a subacute phase.
If allowed to progress, the condition can become worse. It does so because of the problem of obtaining a properly fitted shoe. The ball of the foot, with its bulbous outcropping of bunion, is considerably wider than the heel. The shoe with a snug heel that prevents slippage at its back might not fit the normal width of the ball of the foot at the front of the shoe. With the added growth of bunion, the width of the foot can no longer be considered normal. Thus, the proper fit at the ball of the foot leads to an angulation of the big toe. This deformity is a hallux valgus.
Hallux valgus is a serious condition. It strains the foot and produces an abnormal prominence of the joints; it also widens the front of the foot and causes a loss of balance. And any deformation of the big toe interferes with standing and walking. Also, malposition of the big toe bone and loss of power in the foot muscles can lead to arthritis early in life.
Excision of Mortons Neuromas
If you sometimes feel that you are "walking on a marble," and you have persistent pain in the ball of your foot, you may have a condition called Morton's neuroma. A neuroma is a benign tumor of a nerve. Morton's neuroma is not actually a tumor, but a thickening of the tissue that surrounds the digital nerve leading to the toes.
First Metatarsal-phalangeal joint (MTP) Arthrodesis
Arthrodesis of the first metatarsophalangeal joint is indicated in patients with symptomatic arthrodesis or advanced hallux valgus deformities that are unresponsive to nonsurgical treatment. Several fixation techniques have been described, including interfragmentary compression screws and/or dorsal plate fixation. Using these modern fixation techniques, the rate of fusion is between 94% to 98%, with high patient satisfaction. Appropriate positioning of the fusion is important for satisfactory outcome.
Lateral Ankle Ligament Reconstruction
The goal of lateral ankle ligament reconstruction should be to permit early functional rehabilitation after surgery and to prevent recurrent injury during strenuous activity.
Planar Fasciitis
Longstanding cases often demonstrate more degenerative changes than inflammatory changes, in which case they are termed plantar fasciosis. The plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along the sole of the foot towards the five toes. It has been reported that plantar fasciitis occurs in two million Americans a year and 10% of the population over a lifetime. It is commonly associated with long periods of weight bearing. Among non-athletic populations, it is associated with a high body mass index. The pain is usually felt on the underside of the heel and is often most intense with the first steps of the day. Another symptom is that the sufferer has difficulty bending the foot so that the toes are brought toward the shin (decreased dorsiflexion of the ankle). A symptom commonly recognized among sufferers of plantar fasciitis is increased probability of knee pains, especially among runners.
Surgery for Achilles Tendon Rupture
A rupture of the Achilles tendon is a catastrophic event that occurs when the forces placed on the Achilles tendon exceed its tensile limits. The annual incidence of Achilles tendon ruptures has been estimated to range from 5.5 to 9.9 ruptures per 100,000 people in North America.
Triple Arthrodesis
A surgical procedure whose purpose is to relieve pain in the rear part of the foot, improve stability of the foot, and in some cases correct deformity of the foot, by fusing of the three main joints of the hindfoot: the subtalar joint, calcaneocuboid joint and the talonavicular joint. It is commonly carried out on patients with joint degeneration resulting fromarthritis or a severe flat foot deformity.
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