The Center for Podiatric Care and Sports Medicine

Top 10 Reasons To Consider Foot Surgery

Posted by on Thursday, April 18th, 2013

It can be very difficult to get around with severe foot pain, especially in a fast-moving city like New York. Yet, do you really need foot surgery? Foot pain is very common, with about 75 percent of the U.S. population suffering from it at some point in their lives. Usually, improper foot wear or strenuous activity is the root cause; but the foot — by its very nature — is designed to absorb much impact. The 26 bones and 33 joints, in addition to the 120 muscles, ligaments and nerves of the foot form a complex system that can absorb a force 50 percent greater than a person’s body weight. Multiply that by the 10,000 steps the average person takes in a day and you’ve got the equivalent force of several hundred tons each day, pounding down on our feet. Injuries are bound to happen!

Here we discuss 10 of the most common reasons for foot surgery that we see in our NYC podiatric office:

1. Reconstructive Surgery

Reconstructive surgery may be necessary following a traumatic injury or as the result of a congenital deformity. This complex procedure could require tendon transfer, bone fusion, joint implantation, bone grafting, and soft tissue repair. Sometimes screws, wires, staples or other devices need to be implanted to stabilize the structure of the foot.

2. Bunion Surgery

Bunions are joint deformities at the base of the big toe, causing irritation, swelling and a misshapen toe. Bunions are considered hereditary, but can be further aggravated by improper footwear. Surgery can remove the bony growth on the side of the toe and relieve pressure. An estimated 23 percent of the U.S. population suffers from bunions, including two-thirds of people over 65, according to the Wall Street Journal. Recovery from this type of surgery usually takes 6-8 weeks.

3. Hammer Toe Surgery

Hammer toes often accompany a bunion, but do sometimes occur on their own as well. With this condition, the bones of the toe are fixed in a claw-like position. They may be flexible and require soft tissue/tendon surgery, or they may be rigid and require bone removal. Recovery can be anywhere from a week for soft tissue or four weeks for bone removal.

4. Fusions

Patients who have arthritis may require fusion surgery to relieve extreme foot pain and deformity. This surgery involves the removal of joint cartilage and fusing bones together with screws, pins, or plates. Sometimes a bone graft is also needed. This type of surgery is quite generally very successful, with a very small percentage of patients reporting difficulty with wound healing, according to the American Academy of Orth0paedic Surgeons.

5. Heel Surgery

Heel surgery is usually a last resort for patients with plantar fasciitis. It can relieve pain and restore mobility for chronic sufferers who have not responded to other types of treatment. However, “it is the rare patient who has a truly enlarged and problematic spur requiring surgery,” according to the John Hopkins Department of Orthopaedic Surgery website. In rare cases, the patient needs an incision to relieve the fascia’s attachment to the heel bone. Recovery generally takes 6-10 weeks.

6. Nail problems

Nail problems are one of the more common reasons for foot surgery and are often done as a quick outpatient surgery. Ingrown toenails can be hereditary or occur as the result of an injury or improper nail care. Since they are associated with infection, it’s important to get these addressed.

7. Neuroma Surgery

Neuroma surgery removes a benign soft tissue tumor on a nerve, usually between the third and fourth toes. This is a quick outpatient procedure and most people walk out of the office following their surgery. However, they will need to wear foot dressings and return to the podiatrist to monitor the healing over the next couple of weeks.

8. Metatarsal Surgery

Very few people require this rare type of surgery, which is done to redistribute the weight bearing on the ball of the foot. Sometimes patients with severe rheumatoid arthritis need the bones in the  ball of the foot actually removed. Usually, the metatarsal bone is cut and held in the correct position with a metal pin or screw. The pin can be removed in 3-4 weeks and overall recovery will usually take a total of 6-8 weeks. Unfortunately, the failure rate is high (as great as 60%), according to Dr. Kirk A. Koepsel D.P.M., because most patients walk on the foot prematurely, causing the bones to shift and heal incorrectly.

9. Tendon Surgery

Painful tears in the foot tendons may require foot surgery — especially for athletes. Sometimes tendons are lengthened or shortened, while other times they may be rerouted. The surgery is usually an outpatient treatment done under general anesthesia. Sports activities cannot be resumed for 4-6 months, usually, and a 3-4 inch scar is common.

10. Plantar warts

Warts are caused by a virus and can usually be treated with a topical prescription cream. Other times, they may be frozen off. In very rare cases, a surgical procedure is needed to remove multiple clusters of warts that have been neglected for a long period of time. The recovery is generally quick, but recovery can take up to 5 weeks — and the wart removal is not seen as a cure-all.

When NOT To Get Foot Surgery: Cosmetic Foot Surgery

Ever since the debut of “Sex and the City,” cosmetic foot surgery has been a growing trend, reports the Wall Street Journal. Now women want Botox injections, fat fillers, foot slimming, and toe lengthening, shortening, or straightening to make their feet fit into their shoes better.

“Every stylish woman I know wants to do this operation, and as soon as they can figure out a more efficient way, it will become as common as a nose job,” Manhattan public-relations maven Peggy Siegal told the newspaper. However, it is our professional opinion that surgery should not be taken lightly and should be regarded as a last resort for very serious foot injuries and conditions.

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.