The feet and ankles have the important job of carrying you around every day, but you may not think about them until they start hurting. There are more than 300 different foot ailments, caused by sources that include heredity, overuse injuries and poorly fitting shoes.
The MedStar Orthopaedic Institute's specialists diagnose and treat a wide range of foot and ankle conditions, from the most common to those that are very rare. This comprehensive list of treatments includes, but is not limited to, the following:
Ankle fusion is a surgical procedure that helps relieve pain and maintain or improve function in patients with a traumatic injury or severe arthritis who did not benefit from more conservative treatments. It is also an option for people with a severe deformity such as a flat foot, high-arched foot or a club foot in which the ankle joint is also deformed, unstable or damaged.
During the procedure, your surgeon makes incisions in and around your ankle to access you joint. Your surgeon then removes any remaining cartilage within your ankle joint and locks the ankle joint with screws, stopping the upward and downward motion of the ankle. X-rays are used during the procedure to check the alignment of the joint and the placement of the screws.
Following the procedure, you will likely need to wear a splint or plastic boot to protect the ankle fusion. Your ankle bones typically take between six and 12 weeks before they are fused enough for you to walk on them.
Ankle replacement (ankle arthroplasty) is a surgical procedure that is used to treat ankle arthritis, a condition that causes loss of cartilage, pain and/or deformity, in patients who have not benefitted from conservative treatments.
During the procedure, your surgeon makes a cut on the front or side of your ankle, depending on what type of implant is being used. The surgeon then cuts your bone, removing your worn out ankle joint, and places the metal and plastic components that make up your new ankle. You will need to wear a cast or boot following the replacement to make sure your implants heal in place. You should be able to start putting weight on your ankle a few weeks after surgery.
Infected ankle replacement is a critical treatment because if your total joint replacement becomes infected, the health of your ankle and leg, as well as your overall health, become an immediate concern. Not all orthopaedic specialists are trained to manage and treat infected total joints, but foot and ankle surgeons at the MedStar Orthopaedic Institute appropriately manage and aggressively treat infections. This often requires removal of the total joint implant and a course of antibiotics, followed by revision joint replacement. While this is unfortunate, it is critical for removing the bacteria from your system and maximizing your overall health and outcome.
Bunion care varies depending on the type and severity of each bunion, although identifying the deformity early in its development is important in avoiding surgery. You should seek medical attention at the first indication of pain or discomfort because, left untreated, bunions tend to get larger and more painful, making nonsurgical treatment less of an option.
The primary goal of most early treatment options is to relieve pressure on the bunion and stop the progression of the joint deformity. An orthopedic surgeon may recommend padding, medication or orthotics (shoe inserts). When early treatments fail or the bunion continues to get worse, you may require surgery to realign bone, ligaments, tendons, and nerves so the big toe can be brought back to its correct position.
Fracture Care treatment is different for each individual and depends on the extent of the fracture. If your ankle fracture involves only a small portion of the bone and the segments of bone are close together, your physician can usually treat your injury by placing your ankle and foot in a cast for six to eight weeks. After the cast is removed, you will receive physical therapy to restore the normal range of motion in your ankle joint.
If you have more extensive ankle damage, or if the fragments of broken bone are separated from one another, you physician will repair your fractured ankle surgically, using plates, metal or absorbable screws, pins, staples, or tension bands to hold the bones in place. You will require physical therapy following surgery.
Tendon Reconstruction is a surgical treatment used to treat a torn or otherwise damaged tendon (soft tissues that connect muscles to bone). When the muscles contract, your tendons pull your bones and cause the joints to move. Tendon damage can limit your movement or make it extremely painful, making treatment necessary.
For less severe tears, stitching may suffice. If you have a more severe tear, your doctor may need to perform tendon reconstruction. During the procedure, your surgeon will make one or more cuts over the damaged tendon. Your surgeon will then use tendon tissue grafts, taken either from elsewhere in the leg or from a tissue bank, to repair your tendon.
Wound care is an important part of foot and ankle treatment because wounds on the foot and ankle are slow to heal on certain people, especially those with diabetes. Wounds can develop into ulcers from such conditions as poor circulation, foot deformities, irritation, and trauma. Vascular disease can also complicate a foot ulcer, reducing the body's ability to heal and increasing the risk for an infection. In addition, diabetic patients sometimes develop neuropathy (lack of feeling) in the feet that can leave wounds undetected.
Tarsal Tunnel Syndrome Care begins with conservative treatments such as rest, elevation, massage, anti-inflammatory medications, steroid injections, arch supports (orthotics), and/or better-fitting shoes. If conservative treatment does not improve your condition, your physician may suggest surgery, during which an incision made in the ligament, located below the inside of your ankle, allowing room for the nerve to expand. If a cyst is touching the nerve, it can be removed at the same time.