Foot Surgeries

Anatomy of the Foot

The feet are subject to heavy loads since they carry entire body weight. The foot is classified into three sections:

• The tarsus
• The metatarsus
• The big toe and the four other toes

The foot is connected to the lower ends of the tibia and fibula via the upper ankle joint.

The foot has many strong ligaments, which tighten by muscles and tendons to form a longitudinal and transverse arch underneath. This cushions the body's weight during stress, e.g., jumping or walking.

When Does a Foot Require Surgery?

Sometimes the anatomy of the foot deviates from the norm described above, whether due to an accident, a congenital defect, or even incorrect load.

Usually, the first step in treating foot complaints is to try a conservative approach. However, in the case of persistent complaints such as pain or significant deformities of the foot, surgical correction may be indicated to prevent consequential damage.

Which Types of Foot Surgery Are There?

The most common surgical interventions include:

Ankle Joint Surgery

If conservative treatment of the ankle joint has not been successful, surgery may be necessary.

• Ankle joint arthroscopy: A minimally invasive procedure in which all articulated elements are removed.
• Ligament surgery: If the ligaments of the ankle joint are torn, it may be necessary to surgically refix or reconstruct them to prevent long-term damage to the cartilage surfaces.
• Reconstruction surgery: In the case of incorrect load on the ankle joint, a change in the load axes can be brought about by the surgical removal of a bone wedge. This can also prevent late damage.
• Ankle arthrodesis: The ankle joint is stiffened to eliminate pain.

Foot Surgery on the Toe

Foot surgery on the toe ranges from surgical treatment of an ingrown nail to correcting toe deformities. These are often acquired, e.g., wearing shoes that are too tight or originate from a family predisposition.

Surgery of the Metatarsus

The most frequent need for metatarsal surgery is a complicated fracture. In this case, the bone fragments are brought into their anatomically correct position and are usually fixed with screws. In comminuted fractures with many fragments, plates are also used.

Hallux Valgus Surgery

In case of permanent pain and problems, while walking caused by a hallux valgus (bunion), surgery may be necessary. First, the big toe, inclined towards the other toes, is brought into its anatomically correct position. First, the joint capsule of the metatarsophalangeal joint is operated on to ensure subsequent mobility, and then the bone axis of the metatarsal and the big toe. For this purpose, the metatarsal bone is cut and then fixed in a corrected position with screws. This is followed by removing the characteristic swelling above the big toe joint, closure of the joint capsule, and the surgical incision.

Healing time after foot surgery

Depending on the type of surgery, healing takes between two weeks and one year.

Sources:

• Schünke, Michael et al.: Prometheus - Allgemeine Anatomie und Bewegungssystem. 4. Auflage. Stuttgart: Thieme, 2014
• Wülker, Nikolaus: Taschenlehrbuch Orthopädie und Unfallchirurgie. 3. Auflage. Stuttgart: Thieme, 2015
• Jerosch, Jörg: Operative Therapie von Fuß und Sprunggelenk. Köln: Deutscher Ärzteverlag, 2008
• Debrunner, Alfred M.: Orthopädie - Orthopädische Chirurgie. 4. Auflage. Bern: Huber, 2005
• Galla, Mellany et al.: Arthroskopie an Sprunggelenk und Fuß. Stuttgart: Schattauer, 2016