Common Foot & Ankle Injuries & Conditions

Common Ankle and Foot Injuries

 

The feet are constantly under stress. It's no wonder that 80 percent of people will have some sort of problem with their feet at some point. Many things affect the condition of your feet: activity level, occupation, certain health conditions, genetics and perhaps most importantly, your choice of footwear.

One of the most common foot problems is Plantar Fasciitis, a painful condition affecting the bottom of the foot. It is a common cause of heel pain and is usually most pronounced in the morning when the foot is first placed on the floor. Prolonged standing can also increase the painful symptoms.  In about 90 percent of all cases, the injury can be resolved without surgical intervention.

The ankle is a hinge joint made up of several important structures. The unique design of the ankle makes it a very stable joint. This joint has to be stable in order to withstand 1.5 times your body weight when you walk and up to eight times your body weight when you run.

Injuries of the ankle joint are common among skiers and snowboarders. While ankle fractures and ankle sprains heal pretty well, they can lead to problems much later in life such as osteoarthritis (OA) or posttraumatic arthritis. Injuries to the Achilles Tendon often result from impact injuries.

Common Foot & Ankle Conditions

Ankle Fracture Surgery


Overview This surgery fixes an unstable break in your ankle. The break could be in the small bone of your lower leg, called the "fibula" or the larger bone, called the "tibia." Sometimes, they're both broken. Your surgeon will stabilize your bones so your ankle can heal. Preparation To begin, you are given medicine to put you to sleep. The surgeon makes one or more incisions in your skin. These may be on one or both sides of your ankle. The surgeon carefully inspects your ankle. If small, loose pieces of bone are found, they are taken out. Stabilization Your surgeon may use one or more implants to stabilize your joint. The type of implants chosen is based on your needs. Screws, plates and rods can be used. End of Procedure When the repair is done, the incisions are closed. Your ankle is immobilized. You are watched for a brief time. Most patients can go home the same day. Your healthcare provider will give you tips to help you as you heal. You will need physical therapy.




Arthroscopy of the Ankle


Overview - Arthroscopy of the Ankle This procedure identifies and treats problems in your ankle. With it, the surgeon can access your ankle without creating a large incision. Preparation - Arthroscopy of the Ankle In preparation for the procedure, you are positioned and anesthetized. Fluid pumped into your ankle expands the joint and makes it easier to see. The surgeon typically creates two small openings in your skin. An arthroscope is placed through one opening. This device is a camera attached to a thin tube. It shows live images on a monitor. Other instruments are placed through the second opening. Inspection Your ankle is carefully inspected for signs of damage. The surgeon may decide to correct a problem during the procedure. Or, your problem may be treated during a later procedure. End of Procedure and Aftercare - Arthroscopy of the Ankle When the procedure is complete, the instruments are removed and the openings in your skin are closed. Your ankle is bandaged. You may be placed in a splint or a boot. You will be monitored for a brief time before you are allowed to go home. Your healthcare provider will provide instructions to help with your recovery




Calcaneal Fracture Fixation (Open Reduction and Internal Fixation)


Overview - Calcaneal Fracture Fixation (Open Reduction and Internal Fixation) This procedure is used to correct a severe fracture of the calcaneus (the heel bone). During this procedure, the surgeon stabilizes the bone with hardware to allow the bone to heal properly. Preparation - Calcaneal Fracture Fixation (Open Reduction and Internal Fixation) In preparation for the procedure, the patient is positioned and anesthesia is administered. The surgeon creates one or more incisions on the foot to access the fractured calcaneus. Fixation - Calcaneal Fracture Fixation (Open Reduction and Internal Fixation) The surgeon carefully realigns the fracture and inserts guide wires into the bone. Bone graft may be used to fill any spaces created by the fracture. Screws are then inserted to stabilize the fracture. The surgeon may choose from a variety of types of screws, along with rigid plates or wires. End of Procedure and Aftercare - Calcaneal Fracture Fixation (Open Reduction and Internal Fixation) When the procedure is complete, the incisions are closed and the foot is bandaged and placed in a splint. The patient will not be allowed to bear weight on the foot for about six to twelve weeks. A walking brace or shoe may be required until the fracture has fully healed.




First MTP Joint Fusion (Locking Plate)


Overview This procedure treats severe arthritis of the joint at the base of the big toe. This is the first metatarsophalangeal joint, commonly called the first "MTP" joint. Arthritis in this joint can cause pain and swelling. It can limit your ability to walk, and it can limit the types of shoes you can wear comfortably. During this procedure, a metal plate is implanted to prevent movement of the MTP joint. Preparation - First MTP Joint Fusion In preparation for the procedure, you are given general or regional anesthesia. The surgeon makes an incision in your skin to expose the MTP joint. Removing Bony Growths - First MTP Joint Fusion The surgeon carefully clears away the bony growths from the ends of the two bones that meet at this joint. These are the proximal phalanx and the first metatarsal. The surgeon removes the cartilage that lines the ends of these bones and reshapes the bones so they fit together. Inserting the Implant The surgeon secures the bones with a metal plate and screws. Another screw placed through the bones provides extra stability, pulling the ends of the bones together tightly. Over time, the two bones will fuse. End of Procedure - First MTP Joint Fusion and Aftercare When the procedure is complete, the incision is closed. Your foot is bandaged. It may be protected with a splint, a postoperative shoe or a special boot. You will be monitored for a brief time before you are allowed to go home. You may be asked to temporarily refrain from putting weight on the foot after the surgery. Your doctor will give you specific instructions to aid your recovery.




Hammertoe Correction (PIP Joint Arthroplasty)


Overview - Hammertoe Correction This surgical procedure is used to correct a hammertoe, a deformity of the toe that causes the toe to become permanently frozen in a bent position. During this procedure, a small piece of bone is removed to shorten the toe and allow it to straighten. Preparation Overview - Hammertoe Correction In preparation for the procedure, the patient is positioned and anesthesia is administered. The surgeon creates a small incision on the upper side of the affected toe to access the phalanges and the proximal interphalangeal (PIP) joint. Shortening the Bone Overview - Hammertoe Correction The surgeon uses a cutting instrument to carefully remove the head of the proximal phalanx at the PIP joint. By shortening this bone, the surgeon relieves pressure on the joint, creating more space so that the bones can be aligned properly. The surgeon carefully straightens the toe, moving the bones into a relaxed and natural position. Stabilizing the Toe Overview - Hammertoe Correction Once the bones have been properly aligned, the surgeon inserts a fixation device or pin into the toe. This holds the bones in place while the joint heals. Scar tissue will form between the phalanges during the healing process, stabilizing the joint. End of Procedure Overview - Hammertoe Correction When the procedure is complete, the incision is closed and the foot is bandaged. The patient may be placed in a postoperative shoe or boot. Most patients will recover within six to eight weeks of the procedure.




Lateral Ankle Ligament Reconstruction (ALR)


Overview - Lateral Ankle Ligament Reconstruction This surgery corrects an unstable ankle. It tightens one or more ligaments that support your ankle. It helps people who've had repeated ankle sprains. It can also help people who have certain foot deformities. Preparation - Lateral Ankle Ligament Reconstruction To begin, you are anesthetized. Most patients are put to sleep. An incision is made on the outer side of your ankle. The surgeon examines your ligaments and looks for problems. The ligaments may be torn or stretched. There are many ways to repair these ligaments. Your surgeon chooses the repairs that are right for you. Procedure - Lateral Ankle Ligament Reconstruction Stretched ligaments may be shortened. To do this, a ligament is cut from the bone, trimmed and then reattached with anchors. Damaged ligaments are repaired and strengthened with sutures, with other tissues or with synthetic materials. End of procedure - Lateral Ankle Ligament Reconstruction When the surgery is finished, the opening in your skin is closed and bandaged. Your ankle is protected with a splint. You're watched for a brief time as you wake up. Then, you can go home. You'll come back later, and your ankle will be put in a cast or a boot. Your healthcare provider will give you tips to help your recovery.




Lisfranc Injury Surgery


Overview - Lisfranc Injury Surgery This surgery repairs an injury of the Lisfranc joint complex. That's a cluster of small bones and ligaments in the midfoot. This surgery stabilizes broken or dislocated bones. Preparation - Lisfranc Injury Surgery To begin, you are put to sleep. An incision is made along the top of your foot. Your surgeon carefully examines the Lisfranc joint complex. There are many ways to repair your injuries. Your surgeon chooses the repairs that are right for you. Procedure - Lisfranc Injury Surgery Your bones can be realigned and stabilized with the help of wires, plates, screws and specialized implants. Your surgeon may choose to modify your bones so that they will grow together to form a solid bone mass. We call this a "fusion." End of procedure - Lisfranc Injury Surgery When the surgery is done, the incision is closed and bandaged. Your foot is protected with a splint. You are watched for a brief time as you wake up. Then, you can go home. You'll come back later, and your foot will be put in a cast or a boot. Your healthcare provider will give you tips to help your recovery.




Popliteal Fossa Block


Overview - Popliteal Fossa Block This outpatient procedure numbs the lower leg with an injection of local anesthesia. Typically, it is used for surgery on the lower leg, ankle and foot. Preparation Overview - Popliteal Fossa Block It is common for the patient to lie face down with the back of the leg exposed. The back of the knee joint, called the popliteal fossa, is cleaned and sterilized, and a local anesthetic is administered to numb the tissue at the injection site. Locating the Nerve The physician locates the tibial and peroneal branches of the sciatic nerve, either with ultrasound or with a special needle that stimulates nerves with an electrical impulse. The nerve branches travel down the rear of the leg to the feet. A needle is carefully guided through the back of the knee and down to the nerve. Injecting the Anesthetic Anesthetic is slowly injected through the needle, bathing one or both nerves and temporarily blocking sensation in the lower leg, ankle and foot. After Care The numbing sensation will last for several hours after the injection. When the anesthesia wears off, painkillers may be needed to alleviate pain from the procedure.




Talar Fracture Fixation (Open Reduction and Internal Fixation)


Overview - Talar Fracture Fixation This procedure is used to correct a fracture of the talus, one of the three main bones that form the ankle joint. During this procedure, the surgeon stabilizes the bone with hardware to allow the bone to heal properly. Preparation Overview - Talar Fracture Fixation In preparation for the procedure, the patient is positioned and anesthesia is administered. The surgeon creates one or more incisions on the foot to access the fractured talus. Fixation The surgeon carefully realigns the fracture and inserts guide wires into the bone. Screws are then inserted to stabilize the fracture. The surgeon may choose from a variety of types of screws, along with rigid plates or wires. End of Procedure and Aftercare Overview - Talar Fracture Fixation When the procedure is complete, the incisions are closed and the foot is bandaged and placed in a splint. The patient will not be allowed to bear weight on the foot for about six to twelve weeks. A walking brace or shoe may be required until the fracture has fully healed.




Total Ankle Joint Replacement


Overview This surgical procedure is performed to remove portions of the ankle that are diseased or severely injured and to implant a device that will help manage pain and restore mobility to the ankle. STAR Implant The STAR mobile-bearing implant is a cementless implant made of three parts: a metal talus component, a metal tibia component, and a polyethylene insert, called the mobile bearing, which fits between them. The mobile bearing allows the parts of the implant to move and glide against each other smoothly. Preparation n preparation for the procedure, the patient is positioned and anesthetized. The surgeon creates an incision in the front of the ankle to access the joint. Reshaping the Bones The surgeon carefully reshapes the end of the tibia and the top of the talus to provide a stable surface for the implant. Special cutting guides are used during this part of the procedure to ensure the exact fit of the STAR device. Inserting the Implant The surgeon inserts the talar component and seats it on the talus, and then inserts the tibial component and fits it snugly into the prepared end of the tibia. Once these pieces are in place, the surgeon selects the appropriately-sized mobile bearing component and places it between the tibial and talar components to complete the joint. The surgeon performs a series of range-of-motion tests to ensure that implant is well positioned and is functioning properly.