Reasons for Foot Surgery

Ill-fitting shoes cause most foot pain. However, exercise that injures the foot, certain medications or medical conditions such as rheumatoid arthritis, diabetes, neurological disorders and pregnancy can cause foot pain as well. There are many different reasons a person might need foot surgery. Sometimes surgery is needed to prevent or relieve pain, especially when no other treatments have helped.

Common Types of Foot Problems

• Many common foot problems respond to non-surgical treatments, but when the foot is deformed or pain is persistent, surgery is sometimes the best option. General foot surgeries and procedures include removing bunions, ingrown toenails and bony prominences causing corns or calluses. Surgery is often required to treat heel pain or a toe deformity known as hammertoe, and on rare occasions may be needed to remove plantar warts. While most bunions can be treated successfully without surgery, sometimes surgery is the best option for correcting the problem and relieving pain.

Common Causes

• Heredity and arthritis sometimes cause bunions; however, poorly fitting shoes is the most common cause. Ingrown toenails is another inherited trait, but in most cases, cutting the toenail too short brings about the problem. Again, narrow or tight shoes can contribute to this painful condition, along with a fungal infection that causes the nail to grow into the skin. Wearing shoes that don't fit, or physical activities that cause friction on the skin, are common causes of corns and calluses. When self-care measures or medical treatment fail to alleviate the pain, minor surgery may be required. In some cases, additional surgery may be recommended to correct foot deformities, which could be making the problem worse. Heredity, tight footwear or weak muscles in the foot are all causes of a medical condition known as hammertoe. When more conservative treatment options fail, several different surgical procedures can be considered. Plantar warts are often caused by pressure from standing or walking. These benign growths can be quite painful and may require surgical removal if all else fails.

Benefits of Surgery

• Pain, swelling and redness are early symptoms of an ingrown toenail. If the nail is not infected, a podiatrist can cut away the nail that is digging into the skin. If the toenail becomes infected, the entire nail may have to be surgically removed. To decrease the risk that the ingrown toenail may recur, the surgeon may suggest removing cells from the nail bed. If all of the cells are removed, the toenail will not grow back again. Surgical removal of a bunion involves repairing deformed bones of the big toe. Without treatment, bunions can continue to grow, becoming more painful and limiting foot function. Curettage is the type of surgery often used to remove plantar warts. Treatment relieves pain when you walk. Minor surgery may be required to shave off corns or calluses, which are rough, thickened areas of skin usually located on or between the toes. Surgery for hammertoe is intended to alleviate pain and allow a person to wear normal shoes. The surgeon removes the bony prominence on the toe or releases a tendon that is too short in order to correct the position of the toe.

Risks Associated With Surgery

• No matter what the purpose for foot surgery, ask the surgeon what the benefits are. Be sure to find out what risks might be involved. It always makes sense to weigh the benefits of having surgery against the risk of possible complications. Although complications occur infrequently, the type of risk involved depends on the foot condition being treated, as well as the general state of a person's health. Post-operative pain and swelling is one of the most common problems following surgery. Infection is always a risk following surgery, although it occurs in fewer than 5 percent of cases. Other complications may include slow healing, temporary loss of sensation, or screws and wires used to fix bones coming loose. While rare, pulmonary embolism caused by a blood clot in the leg is a potentially life-threatening condition. Another very rare complication following surgery of an extremity results in chronic long-term pain.

Considerations

• It's important to understand why surgery is necessary, even if the procedure is minor. Ask about any risks involved, in addition to the availability of alternative treatments. Sometimes there are non-surgical treatments that can help just as well. Because physicians can disagree on the best way to treat a specific medical condition, it never hurts to get a second opinion--especially if more extensive surgery may be required to correct the problem. Patients should discuss any questions or concerns they may have about anesthesia, whether local, regional or general. Find out about possible side effects and let the doctor know which medications you are taking.

Warning

• Foot problems experienced by diabetics is a serious issue. Even minor foot problems can lead to infection, ulceration or gangrene if not properly treated. For a diabetic, this can lead to amputation of a toe, foot or leg. Appropriate footwear and regular podiatric care are essential for recognizing and treating problems in the earliest stages. Foot problems in diabetics are usually caused by poor circulation, decreased resistance to infection or loss of sensation in the feet and legs. Common foot deformities associated with bunions, corns or calluses and hammertoes can cause ulcerations and infections. Corrective foot surgery may be required to prevent deformities from worsening over time, which would put a diabetic more at risk for serious complications.