Understanding Foot and Ankle Surgery

Types of Foot and Ankle Surgeries

• Bunionectomy – A surgical procedure aimed at correcting bunions, which is a bony bump that forms at the base of the big toe. This is recommended for persistent pain and difficulty walking when non-surgical treatments fail to provide adequate relief.
• Flatfoot Reconstruction – A surgical procedure aimed at correcting the deformities associated with flat feet. This is recommended for functional impairment or failed conservative treatment.
• Ankle Arthroscopy – A minimally invasive procedure to diagnose problems such as damage to the joint surface or ligaments, and arthritis. Sometimes treatment may also be performed. This may be recommended for impingement syndrome, synovitis and ligament tears.
• Achilles Tendon Repair - A surgical procedure performed to address a torn or ruptured Achilles tendon to restore its function and strength. This is usually recommended for cases of a rupture or tendinopathy.

Pre-Surgical Considerations

The need for foot and ankle surgery is determined by various factors, assessed through a comprehensive evaluation by an orthopaedic surgeon. Factors that influence the decision for foot and ankle surgery include traumatic injuries, chronic conditions, failure of conservative treatments, functional limitations, and joint damage or severe arthritis.

Pre-surgical tests and preparations will be required prior to surgery. These tests may include X-rays, MRI scans, blood tests, urine tests, MRSA screening, chest radiograph and electrocardiogram. In addition, patients will also need to take certain precautions such as: fasting, discontinuing any medications advised by the surgeon, and refraining from smoking and alcohol consumption.

Risks and Complications

All surgeries carry inherent risks that patients should be aware of, such as:

• Infection – Symptoms include increased pain or an offensive smell or discharge from the dressings. To prevent infection, patients should ensure the wound is kept clean and dry.
• Excessive Bleeding – If excessive bleeding is noticed despite proper post-operative care, seek immediate medical attention.
• Malunion – Occasionally, bones may heal incorrectly, leading to chronic discomfort or a recurrence of deformity. Speak to your surgeon if additional surgery is required to correct it.

The Recovery Process

Recovery times after various foot and ankle surgeries can vary, influenced by factors such as the specific treatment, the patient's overall health, and adherence to aftercare instructions. Achieving full recovery typically takes between 6 to 12 months. Rehabilitation may commence after 2 months, depending on the individual's progress and the nature of the surgery.

Here is a general guideline of what to expect:

• Early Loading Phase (2-6 Weeks) – Manage pain through medication, elevation, and engage in range of motion and isometric exercises. Early loading and controlled weight-bearing activities may be introduced to prevent joint stiffness.
• Strength Phase (6-12 Weeks) – Progress to progressive weight-bearing, gait training, and joint mobilisation. Initiate strength training for the muscles around the foot and ankle, and introduce balance exercises.
• Return to Function Phase (12 Weeks and Beyond) – Continue with progressive weight-bearing, advanced strengthening exercises, and cardiovascular activities. Integrate functional exercises to mimic daily tasks and sports-specific training (if applicable).

Lifestyle changes during the recovery period involves adhering to weight-bearing restrictions and using assistive devices. Nutrient-rich foods, especially protein sources like soya bean milk, can also support healing. Open communication with your healthcare team, emotional support, and commitment to follow-up appointments all contribute to a successful recovery.

Choosing the Right Surgeon and Facility

Selecting an experienced foot and ankle surgeon and healthcare facility is essential for a successful experience. Read about the surgeon's credentials, education, affiliations with reputable medical organisations and patient reviews. A qualified orthopaedic surgeon, combined with an accredited and reputable hospital will go a long way in ensuring a smooth and successful journey.