How is the Surgery Performed?

The nature of the surgery depends on what is causing the deformity. The problem may lie in the back of the foot, the forefoot or both, and a combination of procedures is often required.

If younger patients, the big toe is pointing down too much, pushing the heel inwards. If the joints in the back of the foot are mobile, lifting the big toe may allow the heel to be corrected, but this is seldom performed alone.

If the deformity of the heel is fixed, then different surgery is necessary. The heel bone may need to be broken and reset to allow the foot to become flatter. The bone is allowed to drift up, backwards and to the outer side of the foot.

The tight ligaments in the sole of the foot may be released, and this will help to flatten the arch of the foot, in combination with other procedures.

Sometimes, the foot cannot be corrected with these simple measures, and several joints will require a fusion operation - a triple fusion. This involves the fusion of three joints in the back of the foot that will correct the foot deformity but at the cost of loss of side to side movement in the back of the foot which is useful for compensating when walking on uneven ground.

Often, surgery is required for claw toes or metatarsalgia if these exist, and would be performed at the same time.

Surgery is carried out under general anaesthetic, but can be carried out with local anaesthetic injections behind the knee or around the ankle. The injections are normally given while you are asleep for your comfort. They can give good pain relief for the first day after the operation. You can go home the same day in the evening.


Risks of Surgery


Bleeding, infection, poor bone healing, poor skin healing, injury to tendons, injury to nerves, recurrence, and a need for further surgery.

There is a small risk of blood clots in the legs or lungs (DVT and PE), and there are also risks from anaesthesia - the process of being put to sleep for your operation.

Risks of Anaesthesia

The injection behind your knee is given using an ultrasound machine to guide the needle. There is a less than 1% chance of injury to the nerve. General anaesthetic also carries risks. These risks are proportional to your general health. You will need to be assessed for your fitness for surgery and an Anaesthetist will be able to advise you on your individual risk.

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