Surgical Procedures

We offer a variety of services at The Foot Institute including several different surgical procedures to cure any foot injury or ailment. Select a surgical procedure from the list below to learn more.

Arthroscopy

Arthroscopy is a minimally invasive surgical procedure used to diagnose or treat joint pain. The procedure is performed on an out-patient basis. Two small incisions are made in order to introduce a camera into the joint for evaluation. Once evaluation is made, a treating instrument is used to correct known problems such as cartilage damage or inflammation (synovitis). The advantage of arthroscopic surgery is reduced healing time and a lower infection risk.

Recovery

Recovery for arthroscopic surgery generally is one to two weeks. Often times you are able to walk almost immediately after surgery. It may takes several weeks before your joint maximally recovers. Physical therapy is utilized to help reduce pain, swelling, and increase your maximal recovery time.



Joint Fusion

Arthrodesis (joint fusion) fuses the bones that create a joint. This may be performed on an out-patient basis depending on the number of joints that must be fused. Our surgeons use screws, plates, pins, or rods to hold bones in place while joints fuse. Some joints have a relatively high degree of that joint not fusing(nonunion) which may cause this hardware to break.

This surgery is typically quite successful. A very small percentage of patients have problems such as: wound healing, hardware breakage, and non unions. These problems can be addressed by conservative or surgical means. The most common long term problem with fusion is the development of arthritis in the joints adjacent to the fused joints. This happens due to the increase in demand required by by those joints.

Recovery

Recovery for arthrodesis generally is ten to twelve weeks. Weight bearing on the limb is often not allowed until about six to eight weeks after correction. This is to allow the bones to heal in a satisfactory alignment. Physical therapy is used to increase strength, flexibility, and recovery once weight bearing is allowed.



Bunion Surgery

Bunion surgery is performed when conservative measures have been exhausted and pain still persists. The surgery is performed on an out-patient basis. It typically required about one to two hours of time. During surgery, our surgeons employ the highest quality skills and materials to alleviate your pain but also give you the best possible cosmetic outcome.

An incision is placed over the first metatarsal bone. Once the bone is exposed, the bump is removed. An osteotomy is performed in order to move the bone inward towards the second metatarsal. Our surgeons then use pins, screws, or plates to stabilize the osteotomy. These devices can be removed at a later time if necessary. Bunion surgery is very successful; very few patients experience complications.

Recovery

Recovery for bunion surgery is approximately six to eight weeks. Often times you are able to walk immediately following surgery. Walking is done in protective shoes or boots. This allows you to return to most of your pre-operative activities within 48 to 72 hours. Physical therapy is used to increase mobility after surgery.



Hammer Toe Surgery

Hammer Toe surgery is performed when conservative measures have been exhausted and pain or deformity still persists. The surgery is performed on an out-patient basis. It typically required about one hour of time. During surgery, our surgeons employ the highest quality skills and materials to alleviate your pain but also give you the best possible cosmetic outcome.

An incision is place over the proximal interphangeal joint. Once the bone is exposed, the distal portion of the proximal phalanx is removed. Our surgeons may then use pins or other fixation device to assist in straightening the toe. These devices may be removed at a later date if necessary.

Recovery

Recovery for hammer toe surgery is approximately ten to fourteen days. You are able to walk immediately following the surgery in a surgical shoe. Swelling tends to stick around a lot longer but is managed as needed. Physical therapy is used to help reduce swelling in the toe or toes after surgery.



Tumor Removal

Soft tissue tumors are common in the foot. Often times these tumors cause pain due to compression of surrounding nerves. Here at our surgeons, remove these tumors on an out-patient basis. Once the tumor is exposed and removed, we send them for microscopic examination. This examination gives us the ability to identify, measure, and further treat the tumor. Some of the common foot tumors are ganglion cysts and fibromas.

Recovery

Recovery for removal of tumors is approximately two to three weeks depending on size and location. The location of the tumor also determines whether or not you will be allowed to weight bear. For example, tumors on the bottom of the foot will call for non-weight bearing until the skin is healed completely. Special shoes and padding also are used to help facilitate healing.



Joint Replacement

A prosthesis or artificial joint is used to replace damaged or arthritic joints. Joint replacement surgery is performed if other treatment options will not relieve the pain and disability. Therefore, the goal is to relieve the pain in the joint caused by the damage done to the cartilage. The surgery is performed on a out-patient basis. It generally takes about one to two hours.

During the surgery, the joint is resected and an artificial joint is inserted often cemented in place. The prosthesis is designed to allow to the joint to functional as normal as possible. Joint replacement surgery is successful is the majority of cases but there are some possible complications. These include but are not limited to: infection, loosening of the prosthesis, or dislocation.

Recovery

Recovery for joint replacement surgery is approximately six to eight weeks. Even though, you will be encouraged to walk on your new joint immediately. This will help to strengthen the surrounding muscles, tendons, and ligaments. Physical therapy is a vital part of the recovery process to reduce pain and swelling and improve motion.



Extracorporeal Shockwave

Extracorporeal Shockwave (ESWT) is an office-based non-invasive procedure used to treat heel pain. The procedure starts with a local block in order to create a numbing feeling in your feet. This is the most uncomfortable part of the procedure. Once the heel is numb, a machine is used to deliver several thousand shockwaves to the affected heel.

During this time, an ultrasound is used to measure the fascia at the bottom of the heel. The entire procedure takes about twenty to thirty minutes. The most common side effects of this procedure are soreness and bruising all of which clear up in a couple of days.

Recovery

Recovery for ESWT is approximately twenty-four to forty-eight hours. You are able to walk the day of surgery in your shoes. Maximum benefit from the procedure is notice in approximately three to six weeks.



Endoscopic Surgery

Endoscopic plantar fasciotomy (EPF) is performed to treat plantar fasciitis resistant to conservative treatment. This is an outpatient procedure performed through one or two small incisions on the medial and/or lateral aspect of the heel. Through these incisions under direct visualization a fasciotomy is performed. Fasciotomy is a surgical procedure that cuts away the fascia to relieve tension or pressure. EPF is a very successful procedure for reducing pain due to plantar fasciitis or heel spur syndrome.

Recovery

People who have endoscopic plantar fasciotomy can walk without pain almost immediately, return to wearing their regular shoes within three to five days, and return to normal activities within three weeks. Most will benefit from wearing arch supports in their shoes.



Tendon Repair

Tendon repair refers to the surgical repair of damaged or torn tendons, which are cord-like structures that connect muscles to bones. After the overlying skin has been cleansed with an antiseptic solution and covered with a sterile drape, our surgeons make an incision over the injured tendon.

When the tendon has been located and identified, the surgeon sutures the damaged or torn ends of the tendon together. If the tendon has been severely injured, a tendon graft may be required. If required, tendons are reattached to the surrounding connective tissue.

We then inspect the area for injuries to nerves and blood vessels, and close the incision. There are some possible complications to tendon surgery including formation of scar tissue, nerve damage, and partial loss of function of the involved joints. Nonetheless, tendon repair is still very successful.

Recovery

Recovery for tendon repair is approximately six to eight weeks. Weight bearing is not allowed for several weeks after surgery. The involved tendon should be immobilized until it is strong enough to accept the stress of weight bearing. Often time splints and casts are used. Physical therapy is used to help reduce scar tissue formation and improve strength and range of motion.



Flatfoot Surgery

Flatfoot surgery (arthroresis) is blocking the motion within a joint. Most commonly the subtalar joint is blocked by placing a large screw-like object into the joint. This procedure which is very common in children with flat feet have gain popularity in adults with similar conditions. Arthroresis is an out patient procedure that limits pronation and not supination.

A small incision is placed on the lateral aspect of the foot and a motion limiting implant is place between the calcaneus and the talus. The procedure usually takes about twenty to thirty minutes to perform. The procedure is very successful in correcting certain types to flatfoot deformities. Possible complications include implant failure, joint stiffness, pain, and swelling.

Recovery

Recovery for arthroresis is about four to six weeks. Weight bearing is often allowed shortly after surgery. Weight bearing is done with the use of protective boots or braces. Physical therapy is used to increase strength and mobility post operatively.



Fracture Repair

Fracture repair is the process of realigning broken bones. Bones are most commonly broken due to trauma or injury. Fracture repair is required because there is a need to restore the normal position and function of broken bones. The bones must be held firmly in the correct position to facilitate bone healing. In the event the fracture is not properly repaired, malalignment of the bone may occur, resulting in possible physical dysfunction of the bone or joint of that region of the foot.

Fracture repair is mostly an out-patient procedure. An incision is placed over the broken bone. Once the broken bone is identified and properly aligned pins, screws, plates, or wires are used to maintain the corrected position. Bone graft may be used to fill any gaps that exist within the bone. Possible complications following fracture repair include excessive bleeding, improper fit of joined bone ends, pressure on nearby nerves, delayed healing, and a permanent incomplete healing of the fracture.

Recovery

Recovery for fracture repair is approximately six to eight weeks. Weight bearing may or may not be allowed depending the severity and location of the broken bone. Splints, casts, and boots are used to immobilize the limb while the healing process is taking place. Physical therapy is used to strengthen weakened muscles and ligaments during the recovery period.



Nerve Surgery

Nerve entrapment is when a space occupying vessel or mass is applying unnecessary pressure to a nerve. The is commonly found in the forefoot neuroma and the rearfoot(tarsal tunnel syndrome). The nerves become inflamed and irritated causing pain.

An incision is placed over the affected nerve. The nerve is identified and any mass that appears to be impeding the nerve is removed or repositioned. Smaller nerves may be removed from the area all together. Nerve surgery is plagued with a relatively high recurrence rate due to nerve re-growth. Pain relief could almost be noticed immediately post operatively, therefore short term success is high.

Recovery

Recovery from nerve surgery is approximately ten to fourteen days. Weight bearing is often allowed immediately post operatively. Once stitches are removed, you may return to your pre-operative activities which is no longer than twenty one days.

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