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It is estimated that in an average lifetime, we use our feet to walk the equivalent of five times the circumference of the earth.

The foot and ankle bear the stress of our body weight as we walk and go about our daily activities. This stress is relentless.

Aging and overweight also increase the risk of having foot problems. Often, a pair of ill-fitting shoes is a common cause for bunions, corns and calluses.

Treatment

As in most degenerative problems, the initial management can include a period of rest, change of activities and anti-inflammatory medications. Finding shoes that help relieve the pain can be useful. Most family physicians can adequately manage the majority of such conditions conservatively. If a period of rest or oral anti-inflammatory medications does not adequately relieve the pain, a referral to the orthopaedic surgeon might be necessary. Having made the proper diagnosis, your surgeon will discuss with you the options available. If you have tried conservative options but have had no relief of symptoms, you might be offered surgery.

Surgery

  • This can range from keyhole or arthroscopic surgery, to major deformity corrections.
  • Painful deformities can be reliably corrected via;
    • Osteotomies (bone re-shaping) without sacrificing or fusing any joints.
    • With modern internal fixation devices, the outcome of surgery has improved and patients can expect to move about fairly conveniently.
  • In advanced deformity with arthritis, fusion might have to be done.
    • This will mean that the diseased joints are permanently held together and movement is sacrificed. These are usually salvage procedures for end stage diseases.
    • Therefore, early diagnosis and treatment might allow us to avoid this.
  • In the ankle however, advanced osteoarthritis can be treated with total ankle replacement.
    • This involves implanting an artificial ankle joint.
  • Soft tissue injuries can variably be treated by surgical repair or by transplanting healthy soft tissue to the damaged area (reconstruction).
  • Common procedures performed would be ligament reconstruction of an unstable ankle and arthroscopic (keyhole) ankle surgery to resect painful soft tissue impingement at the ankle.

Ref: S13