Ambulatory Foot Surgery
You are here because you are experiencing discomfort caused by one or several foot ailments. In some cases, surgery is required to correct the condition and relieve your pain. Surgery, as practiced in this office, does not usually mean overnight hospitalization, incapacitation, or discomfort. The objective of ambulatory foot surgery is to aid the sufferer with a minimum of inconvenience, discomfort and expense.
Ambulatory Foot Surgery – How Does It Differ From Other Surgery?
Many surgical procedures that are performed in a hospital require large incisions. A major factor in recovery time and discomfort is the amount of tissue that has been involved by the incision.
The Surgical Setting
Some foot surgeries can be performed properly and safely in a podiatrist’s office or clinic; if a procedure is more complex, it will be done in a hospital outpatient setting, or with a hospital stay that generally will not exceed three or four days. Sometimes, a patient’s preference can be a factor in the selection of a setting.
When a surgical procedure is done in a podiatrist’s office a patient will be in and out on the same day. The doctor will provide cautions about eating before surgery, and it may be necessary to alter temporarily the dosage level of prescription medications the patient is taking.
The use of anesthesia: In the office or clinic, a local anesthetic that numbs an area of the foot will suffice.
Typical Surgery
The correction of bunions and hammertoes, surgical treatment of nail problems, removal of warts and soft-tissue benign tumors, and tendon operations comprise the bulk of surgical treatments recommended by podiatrists.
There is a growing number of surgeons who specialize in less common and more complex rear foot and ankle procedures.
None of the procedures is truly “routine,” since normal anatomical variations and acquired changes to the bone and soft tissue are involved. The most common surgeries performed in an office setting are as follows:
Nail problems are perhaps the commonest reason for podiatric surgical intervention. The correction of ingrown nails, which can be partially or totally ingrown and are frequently associated with fungus infections or injuries, generally can be performed in an office or clinic. Nail deformities are also sometimes associated with small bone spurs under the nail, which also can be removed in office procedures.
Spurs, which are an overgrowth or enlargement of bone, can occur elsewhere, and ordinarily can be removed in similar fashion. Generally, a patient is able to bear weight on the feet following such surgery, but the podiatrist will probably schedule a return visit in a few days to check bleeding and healing.
Plantar warts which are caused by a virus, can be removed in a doctor’s office, using various relatively simple surgical procedures, and the patient probably will be able to walk immediately following the process. However, warts can occur in multiples and clusters, and may require that more than one visit be paid to a podiatrist. They can also recur, like other viral infections.
- Persistent swelling which may be permanent
- Recurrence of deformity / corn (this tends to be more of a problem with the little toe)
- Regrowth of removed bone
- Residual pain
- Stiffness or flail (floppy) toe
- The toe may not sit on the ground – floating toe (there is an increased risk of this with arthrodesis)
- You may get discomfort in other parts of your foot during the recovery period. This generally settles.
- There is always a possibility that the deformity may return in later life.
- You may develop a toe deformity in the long term.
When will I be able to walk again and wear shoes?
In the majority of cases, you will able to walk with the aid of crutches within 2-4 days but you will remain somewhat limited for the first 2 weeks.
Some patients are able to return to wider shoes within two weeks with 60% of patients in shoes at 6 weeks and 90% in 8 weeks. This period is longer for arthrodesis as shoes cannot be worn until the wire/pin has been removed (generally 3-6 weeks).
Swelling generally starts to reduce at 6-8 weeks and the foot will be beginning to feel more normal at 3 months although the healing process continues for 1year.
When will I be able to drive again?
This is generally between 4-8 weeks post operatively but you should always check with your insurance company first.
Are there a lot of complications?
There are risks and complications with all operations and these should be discussed in detail with your specialist. However, with most foot surgery it is important to remember that you may be left with some pain and stiffness and the deformity may reoccur in the future. This is why it is not advisable to have surgery if the deformity is not painful and does not limit your walking. A thorough examination of your foot and general health is important so that these complications can be minimized.
Although every effort is made to reduce complications, these can occur. In addition to the general complications that can occur with foot surgery, there are some specific risks with toe surgery: