This is something we often hear patients say, but it’s a common misconception, along with the mistaken belief that foot surgery is extremely painful. A lot of Orthopaedic surgery is focused on hip and knee replacement, and so you’d be forgiven for thinking that sprains and pains below the knee are less treatable. In fact, nothing could be further from the truth.
With nearly 30 bones and even more joints bearing the full weight of the body, as well as a whole host of tendons and ligaments, the foot and ankle are very complicated structures.
This makes the job of an Orthopaedic Foot and Ankle surgeon a varied and enjoyable one. Often the process of diagnosing problems can be far more complex than in other areas of the musculo-skeletal system. Factors such as posture, alignment, foot shape and a detailed knowledge of ‘bio-mechanics’ all play an important part in this process. Sometimes we work closely with Podiatrists, who will try and correct abnormal biomechanics with specialised insoles called “Orthotics”.
The complexity of the human foot means that there are a whole host of things that can go wrong. Arguably a torn Achilles tendon is one of the worst sports injuries, whilst a sprained ankle is certainly the most common. Fractures in the foot and ankle bones are among the most complex orthopaedic injuries of all, and often require our expertise for surgical repair after the initial “first aid” treatments have been given.
Quite apart from injuries, deformities of the foot can be present from birth or develop during adult life; either way getting into shoes can pose a significant and painful challenge. Sometimes the solution is custom-made shoes, created by another group of colleagues called Orthotists. Foot and Ankle surgeons can also perform surgical correction of deformities, ranging from toe-straightening procedures (for example, bunion surgery) through to major foot and ankle reconstruction.
Unfortunately, the foot and ankle joints are not immune to the development of osteoarthritis. Although arthritis of the ankle is less common than in the hip or knee, it is every bit as painful and debilitating. Previously the only reliable surgical option was to “fuse” the arthritic joint (join the bones together) but innovation in foot and ankle surgical techniques has been particularly rapid in the last 10-15 years.
Ankle replacement is now a realistic option for some patients with ankle arthritis. Over the last few years surgeons have moved towards using 3D printing technology to improve surgical accuracy and now even have the ability to print bespoke implants to replace “missing” bones in complex operations.
Minimally invasive techniques mean that more and more surgeons strive to perform surgery with the minimum possible trauma to the tissues, even when cutting the bones. Less trauma potentially means quicker recovery times. On the other hand, to save a limb or even a life in a severe and potentially catastrophic diabetic foot complication, very invasive and prompt surgery is required.