Foot and Ankle Surgery

Foot and ankle problems are common.  Your feet and ankles take a lot of impact from standing, walking, jumping and standing on tip toes. They are a complicated area made up of 26 bones and more than 33 joints. The muscles in your lower leg are attached to the bones in your feet by tendons and they move your toes and the position of your foot as it hits the ground when you move.

In addition to wear and tear, injury and ill-fitting shoes can also cause problems in your feet and ankles. Pain in the feet and ankles can be particularly challenging. Even the smallest movement can cause distress and everyone needs to be able to get around to assume their daily activities.

Here at Ashtead Hospital, many of our highly experienced consultant orthopaedic surgeons have a special interest in foot and ankle surgery. They aim to rapidly diagnose your foot and ankle problem and offer advice on your best treatment options.

The range of foot and ankle surgeries we offer

Bunion (hallux valgus)

A bunion, also known as hallux valgus, is an enlargement or deformity of the big toe joint. The big toe tilts over towards the smaller toes and a bony prominence appears on the inside of the foot. This bony lump often causes discomfort or pain, sometimes the skin over the lump becomes red or blistered and the foot can become so wide that it’s difficult to get shoes to fit.

It’s thought that footwear may be a factor in the cause of a bunion.  We can provide advice on shoes and surgery if required to straighten the big toe.

Bunions can be treated through minimally invasive keyhole surgery or open bunion surgery.

Morton’s neuroma

Morton's neuroma, also known as Morton's metatarsalgia or interdigital neuroma, affects one of the nerves between the toes usually the nerve between the third and fourth toes. The nerve and surrounding tissue is compressed and irritated by the toe bones (metatarsal bones) pressing against the nerve when the gap between the bones is narrow. The nerve thickens and can cause severe pain in the ball of your foot or at the base of your toes. There may also be some numbness in your toes.

Being overweight, wearing high-heeled or tight pointed shoes, playing sports particularly those that place pressure on your foot such as running and racquet sports and some foot problems including flat feet, high arches, bunions and hammer toes, are linked to Morton’s neuroma and may make it worse.

Initially non-surgical methods such as losing weight, changing your footwear, orthotic devices, painkillers, avoiding some activities and injections may relieve the pain. In severe cases surgery may be required to remove some of the surrounding tissue and increase the space around the nerve, or to remove part of the nerve.

Zadeks procedure

Zadeks procedure involves the removal of your whole toenail and cutting away the area of tissue that your toenail grows from. It’s performed if your toenail is significantly in-grown or for recurrent in-growing toenail problems. As the toenail and its growing point are removed the nail never re-grows. This simple and quick procedure is performed under local anaesthetic.

The commonest cause of an ingrowing toenail is improper cutting of the nail causing it to push into the flesh and results in pain and inflammation.

Arthritic toe

Arthritic toe is when you develop osteoarthritis in the main joint of your big toe and it becomes painful, inflamed and stiff and overtime can restrict your movement. It’s often referred to as hallux rigidus which is a Latin name where hallux translates to ‘of the big toes’ and rigidus is ‘stiffness’. It is caused by the surfaces within your joint becoming damaged and so the joint doesn’t move as smoothly as it should.

Initially non-surgical treatment will be recommended such as: pain relief, anti-inflammatory medicines, changes to your footwear or shoe modifications, or injections into the joint to reduce pain and stiffness.

Your foot and ankle surgeon may feel that surgery is the best option for your arthritic toe to relieve or eliminate your pain. There are several surgeries available to treat hallux rigidus and your orthopaedic consultant will discuss the best one for you.

Claw/hammer toe

Claw and hammer toes are conditions that happen in the four smaller toes and cause them to abnormally bend. They may look strange or may hurt, or both. Claw toes cause your lesser toes to curl under your foot like a claw. Hammer toe is a deformity of the second, third or fourth toes where your toe is bent at the middle joint, so that it resembles a hammer.

These conditions are primarily caused by wearing tight and poor fitting footwear or an underlying muscle imbalance and result in toe and foot pain and often corns and calluses form.

Initially, claw and hammer toes are flexible and can be corrected using non-surgical methods such as soft, roomy toe box shoes, toe exercises, orthotics, splints and medicines. If your claw or hammer toes becomes rigid and painful or an open sore forms you may need toe straightening surgery. The procedure will depend on the type and extent of the deformity.

Ashtead Hospital Specialists

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