Reconstructive Surgery of the Foot
Foot reconstruction is a surgery performed to correct the structures of the foot and restore the natural functionality of the foot that has been lost due to injury or illness. Ideally, any foot surgery for reconstruction is done to improve the appearance and function of the foot so that patients can maintain their quality of life.
The foot is formed by several bones, ligaments, joints and muscles, which function collectively to control the various movements like walking and running. This complicated structure of the foot permits them to resist heavy forces every day. As the feet are a common area for wounds and injuries, they are susceptible to various mistreatments in the form of ill-fitting shoes, sports injuries, work-related trauma, or the strain of walking. Various outside forces tend to harm the feet and cause pain and discomfort.
Indications for foot reconstruction:
A variety of reconstructive procedures are designed to treat many foot disorders and restore your foot back to its original health and function. Following are the indications:
- Common foot ailments like bunions or hammertoes
- Postural deformity such as severe flat feet
- Pain while walking on hard surfaces
- Difficulty wearing shoes
- Problems with standing or other movements of the foot
- Fractures sustained as a result of accident/trauma
- Athletic injuries like Achilles tendon tears, foot/ankle fractures, ligament injuries and several others
- Plantar fasciitis, a common cause of heel pain
- Heel and bone spurs
- Joint or bone deformities due to arthritis
- Infections
- Tumours and lesions
- Metabolic disease such as diabetes
Foot reconstruction surgery:
The primary objectives of foot reconstruction are reduction of pain and restoration of function and appearance. The surgery to be performed depends on several factors such as the age of the individual, type of foot disorder, and severity and duration of the symptoms.
Reconstructive foot surgery facilitates to correct birth defects, diseases and other foot ailments that can greatly benefit patients’ medical and aesthetic needs. It is often recommended when conservative treatments fail to resolve the symptoms. It is a good choice in permanently treating various foot disorders.
With the new advancements in surgical technology, the traditional method of treating foot disorders is replaced by a minimally invasive technique (arthroscopy) which can be performed on an outpatient basis.
This procedure is usually performed under general anaesthesia. Several tiny incisions are made by your surgeon to insert an arthroscope and miniature surgical instruments into the joint. The camera attached to the arthroscope displays the internal structures on a monitor and your surgeon uses these pictures to evaluate the joint and direct the small surgical instruments either to repair or remove the damaged bone or tendon depending upon the extent of injury.
At the end of the procedure, the surgical incisions are closed by sutures or protected with skin tapes and a soft dressing pad is applied. Depending upon the surgery, your surgeon will place a cast or a splint to prevent movement of the foot until it regains normal functioning capacity.
Some of the advantages of arthroscopic surgery include:
- Minimal trauma to the surrounding structures
- Shorter recovery time with less post-surgical complications
- Greater range of motion with less post-operative pain
- Decreased muscle atrophy
Post-operative care:
Following are the post-surgical guidelines to be followed after reconstruction:
- Make sure you get adequate rest. Avoid using the affected foot for a few weeks.
- Take medications to help alleviate pain and inflammation as prescribed by your doctor.
- Apply ice bags over a towel to the affected area for about 15-20 minutes to reduce post-operative pain and swelling.
- Compression dressings (bandage) are used to support the foot to reduce swelling. Take care not to wrap too tightly which could constrict the blood vessels.
- Keep the foot elevated at or above the level of your heart. This helps minimize swelling and discomfort.
- A wheelchair might be required for a few days in more severe cases.
- Start rehabilitation (physiotherapy) as recommended by your surgeon to improve range of motion.
- Crutches or a walker may be used to maintain balance or stability while walking. You should begin appropriate exercises to stretch and strengthen the muscles.
- Cover the splint while showering to keep it clean and dry.
- Return to sports once the foot has regained normal strength and function with your surgeon’s approval.
The outcome of foot reconstruction surgery is greatly improved when you, your surgeon, and the physical therapist work together as a team.
Reconstructive Surgery of the Ankle
A sprain is stretching or tearing of a ligament. Ligaments connect adjacent bones in a joint and provide stability to the joint.
An ankle sprain is a common injury and occurs when you fall or suddenly twist the ankle joint or when you land your foot in an awkward position after a jump. It most commonly occurs when you participate in sports or when you jump or run on a surface that is irregular.
Ankle sprains can cause pain, swelling, tenderness, bruising, and stiffness, numbness in the toes, and inability to walk or bear weight on the ankle accompanied by persistent discomfort.
Inadequate healing of a sprained ligament or incomplete rehabilitation of the affected ligament can result in instability of the ankle.
A complete medical history, including a history of any previous ankle injuries, and a physical examination is essential for an accurate diagnosis of the condition. An X-ray may be ordered to confirm the diagnosis.
Treatment
Acute injuries can be managed with conservative treatment measures such as RICE method (rest, ice, compression and elevation), medications, bracing, and physical therapy.
Surgical intervention to reconstruct the injured ligament may be considered in patients with a high degree of instability and in those who have failed to respond to non-surgical treatments.
Ankle ligament reconstruction may be performed arthroscopically under general anesthesia. Your surgeon will make small incisions in your ankle. A tiny camera and few special instruments are inserted through the incisions to repair and strengthen the ligaments. Stretched or torn ligaments will be shortened and stitched as needed. Sometimes, a weakened ligament is reconstructed with a section of tendon derived from the foot and around the ankle.
The recovery time after ankle ligament reconstruction depends on the extent of injury and the procedure performed. For the first few weeks after surgery, you will be instructed to use crutches or a wheelchair and avoid bearing any weight on the reconstructed ankle joint.
Specific complications of ankle ligament reconstruction include infection, nerve damage, ankle joint stiffness, and recurrent instability.
