Conditions and treatments involving the foot and ankle
What conditions do we treat at the foot and ankle unit?
Major foot deformity
Foot deformity can be a problem that is present at birth (such as club foot). It can also occur in adults as a result of conditions such as arthritis, muscle imbalance and tendon failure. Patients may come to clinic because of the deformity, but may also come because of the problems that the deformity causes (problems with balance and difficulty walking). Sometimes these conditions can be treated successfully with physiotherapy and orthotics (insoles, splints and footwear). However sometimes surgery is required to give the patient a functional foot. If surgery is necessary, then it may be because the deformity is severe, so recovery times after surgery can be up to a year, with the possibility of other operations being needed.
Ankle and foot arthritis
Patients with wear and tear in the joints usually come to clinic with pain. This pain can be bad enough to keep people awake at night and often limits how far people can walk. Swelling and stiffness of the affected joint are other regular problems. Often several joints are affected, and the joints are all very close together. Working out which joint(s) is/are painful is important (we need to treat the right joint) but can take some time: please be patient. Occasionally orthotics can help with arthritis, but often surgery is needed. Usually the joint is fused to treat the arthritis: the joint is cut out and the bones fixed together. However ankle arthritis can be treated with a metal and plastic joint replacement: be aware that this is not an option for everyone!
Soft tissue problems
There are lots of tendons and ligaments in the foot and ankle, and they work hard as they have to support your body weight. Ligaments hold the bones together and maintain the shape and stability of the foot and ankle. Ankle sprains are the most common injury seen in the A & E Department, and most people have gone over on their ankle at some time. Sprains are mostly minor, but sometimes they are more serious than a broken ankle. Most injuries settle on their own, or with physiotherapy: our specialist physiotherapist sees lots of people and arranges physiotherapy if required. It is only very occasionally that surgery is needed, and may not involve repairing the ligament.
Tendons make the foot move. Like ropes, tendons can wear, but unlike ropes they can be helped to heal themselves. Sometimes an operation is needed to repair the tendon, but usually only after other treatments have failed.
This is a very common problem, but be warned surgery is not for the way the foot looks or to fit it into certain shoes! Sometimes the problem is due to arthritis and sometimes because the mechanics of the foot are wrong. Either way often the problem can be improved with orthotics. Surgery is appropriate for a SMALL NUMBER of very specific problems only.
There are lots of problems which do not fit into the general categories above. Examples are plantar fascia problems, ganglions, corns and hard skin, ulcers, verrucas et cetera. Many of these problems can be dealt with by your GP and their team, but sometimes these problems do not settle with standard treatment and need referral to the hospital.