Podiatric surgery involves procedures both simple and complex: hammertoe to tendon repair, skin biopsy to ankle arthroscopy, bunion correction to flat foot reconstruction. Surgery is often necessary treatment for relief of many painful foot deformities and traumatic injuries.
Prior to any surgery, conservative treatments will be attempted and may include immobilization, physical therapy, injection therapy, anti-inflammatory therapy, orthotics or bracing. Diagnostic imaging: x-rays, bone scans or advanced imaging such as MRI will be used to aid in the diagnosis and assist in surgical planning.
Surgery is usually performed in a surgery centre with sedation anesthesia. Minor procedures may be performed in the office depending on the complexity of the procedure.
Our surgeons will educate you about your problem, the corrective procedures and the expected course and outcomes. You will be informed about possible risks and complications so that you can make an informed decision. In some situations surgery is the only suitable method of treatment, but in most cases it is elective.
When should you consider foot or ankle surgery? We suggest:
- When you experience more painful days than non-painful days.
- When conservative treatments have failed to give adequate relief.
- When your foot pain stops you from doing the things that you need or want to do.
Foot and ankle surgery by a podiatric surgeon at Calgary Foot Clinic is considered private surgery. A benefit of private surgery is that we are able to provide surgical dates quickly. There will be charges for your peri-operative care and any surgical shoes or braces required after surgery. All costs will be disclosed prior to surgery. In some cases, third-party insurance programs may cover some of these costs. It is important that you check with your insurer prior to surgery.
Frequently Asked Questions
If the doctor removes my toenail, will it grow back?
Your podiatrist may recommend the removal of your toenail for a number of reasons. These include infection, severe nail deformity, and a tendency to be ingrown. If all or part of the nail is simply removed, it will eventually re-grow. This may take six months to more than one year. If the nail was deformed, it is likely to re-grow deformed as well. The toenail can be partially or completely removed so as to prevent re-growth. This might be done when the nail is likely to re-grow with recurrence of the same problem. The procedure involves the excision or destruction of the nail growth area (matrix). This might be accomplished by surgical excision of the matrix. More commonly, a chemical is applied to the nail bed and matrix to destroy the growth cells. The advantage to this technique is minimal post-operative discomfort and a low incidence of undesired re-growth. The healing process may last six to eight weeks but only involves simple home care.
Can the doctor cut out my corn or callus and permanently remove it?
In most cases, corns and calluses are caused by pressure over a bony prominence. This might be shoe pressure on the top of a toe or weight-bearing pressure on the ball of the foot. In such cases, surgically cutting out the corn or callus wouldn’t be helpful. The lesion would only return once the pressure resumed. It is necessary to remove and/ or realign the bone. In this way, the pressure is permanently removed and the thick skin disappears. Sometimes the pressure can be removed without surgery. For example, changing shoe type or wearing orthotics. Some lesions appear on corn but are not caused by pressure, for example, warts. Often these occur on non-weight bearing areas and may respond to simple surgical removal.
How can the doctor straighten my crooked toes?
Crooked toes come in many different “forms”. Examples are; hammer toes, mallet toes, and claw toes. It depends on the direction and extent of deviation at each of the small joint of the toe. Most surgeries for these conditions involve realigning the toe by some combination of bone removal and repositioning. Sometimes the abnormal position is not rigidly fixed, and the toe may be realigned by simply cutting or lengthening tendons. Incisions are usually made of the top of the toe, occasionally a steel pin is used to fixate the corrected position of the toe. Most practitioners advise two to three weeks in a surgical shoe. This is an open toes “sandal” with a very rigid sole. It acts like a splint while the surgery is healing. A longer time in the surgical shoe is necessary if pins are used. Comfortably fitting shoes must be worn for a few weeks thereafter. When the healing process is mostly completed, about eight to twelve weeks you may resume your normal shoes. Please remember, shoes can cause toe deformities. The surgical result may be compromised if “severe” dress shoes are worn regularly.
I have a Morton’s Neuroma. What is involved in removing it?
In most cases the surgery has a satisfying result. The incision is usually made on the top of the foot, behind the third and fourth toes. The podiatric surgeon cuts out the involved portion of the interdigital nerve, and sutures the wound. You wear a surgical sandal for two weeks, until the sutures are removed. The surgery leaves some numbness between the toes, but you soon stop noticing this. Before the doctor recommends surgery, he or she usually attempts to control the condition with injections and/or orthotics.
How much pain should I expect during and after foot surgery?
You can expect no pain during the procedure, even with local anesthesia. Modern local anesthetics provide long lasting pain relief during the immediate post-operative period. Subsequently, you may experience some discomfort. For most surgery on the fore part of the foot, this is fairly mild. Most patients relate expecting much more pain then they experienced. Your doctor will prescribe an analgesic (pain pill) to control any discomfort. You may find that the original problem necessitating the surgery was more painful than the surgery itself.
How are bunions corrected?
A bunion deformity can only be corrected with surgery. There are many surgical procedures for bunions. Which one is selected by your podiatric surgeon will depend on your age, general health, x-ray findings, extent of the deformity, and many other considerations. Most bunion procedures involve removing some bone from the “bump” behind your big toe. The first metatarsal bone in your forefoot may be realigned by repositioning this bone and/or releasing ligaments and tendons. Depending on the procedure required, the post-operative period may involve six to eight weeks in a surgical shoe or below-the-knee plaster cast. Because the underlying cause of bunions is mechanical, it is usually advisable to wear functional foot orthotics after the surgery. This may prevent recurrence of the bunion. It should be stressed, bunion surgery is for symptomatic (painful) bunions. By wearing proper shoes, some people are never bothered by their bunions.