The Anatomy of the Foot
Look down at your feet. Those amazing appendages get you everywhere you need to go. There are 26 bones, 33 joints, numerous tendons and ligaments, and muscles all residing right there from your ankle down. For productive mobility, we need healthy and strong feet. Through life, the feet take more wear and tire than any other appendage.
Our feet are like the tires on our cars. When the tires are bad, the ride isn’t so smooth and the journey may stop completely. Foot maintenance is essential and we have to take care of our feet early on in life to be sure they will still get us from point A to point B in a relatively quick and painless fashion when needed.
When Conservative Treatments Fail, Surgery Becomes Inevitable
The structure and mechanics of your feet can and will change over time for a multitude of reasons. The average 80-year-old human will have walked 110,000 miles. That is 216,262,500 steps. There should be no surprise that our feet change over the years. Arches fall, bones shift, and this can result in pain and swelling of the connective tissues and joints.
Chances are if you, or a loved one, have some problems with your feet, your primary care physician has referred you to a podiatrist. Conservative treatment measures can include physical therapy, corrective devices such as orthotics, and cortisone injections. Sometimes, these measures are just not enough and surgery becomes a necessity.
Reasons For Surgery
As with any type of surgery, there are some risks and benefits alike. A few of the benefits of undergoing a surgical treatment measure for your foot problem(s) include the reductions of foot pain that can be chronic and have a negative impact on your mobility. Your foot may not tolerate any weight or pressure before surgery. After surgery, (beyond recovery time), the surgery can prove to increase the strength in your foot.
Your feet may have developed deformities throughout the years such as bunions or hammertoes. Surgery can greatly improve the appearance of your feet by correcting these bone conditions while simultaneously improving their function. Keep In mind, though, that foot surgery is not to be used as cosmetic surgery. It can, and usually will, improve the appearance of your foot but this is not to be the sole reason for undergoing surgical treatment.
Some of the Main Types of Surgeries
Achilles Tendon Surgery
Achilles tendon surgery is a procedure that is used to repair injuries in patients who have damaged their Achilles tendon. The injuries may be the result of sports, a fall, or maybe a vehicle accident.
The tendon is a fibrous cord. It’s located in the lower leg, connecting the muscles of your calf to your heel and has a great impact on your ability to walk (let alone run or jump). The Achilles tendon is the largest tendon found in the human body. If you have “Achilles Heel”, which some people will call an injury to this tendon, your mobility will be severely negatively impacted.
Prepping for Your Achilles Tendon Surgery
Depending on your health, you may have to gain authorization from your team of doctors before you are “cleared” for surgery. Your surgeon will need a list of all the medications you are on. Some medications thin the blood, such as blood thinners or anticoagulants, and create a crucial risk for bleeding uncontrollably. Other medications may have an interaction with the anesthesia you are administered before surgery.
If you are a smoker, you need to do your best to quit before the day of your procedure. Smoking delays healing in the body. If you quit, you will provide your body with the optimal opportunity to recover on time and not have to fight an incision becoming a stubborn or chronic wound.
Likely, imaging has already been done on your foot/feet, but the physician may want more done before the date of your surgery.
If you’ve never had a surgical procedure, you won’t know the extreme urgency of not eating or drinking anything after midnight the night before your procedure. You may think you can drink “just a few ounces of pop” or “a glass of water won’t hurt”. Or maybe you won’t see any harm in eating an apple in the morning just to take the bite of hunger of your belly. Who wants a nervous tummy along with hunger pains, right? Well, there’s a very good reason why the clinician instructs you that you should follow a “nothing by mouth” protocol.
If you eat or drink and then are given anesthesia, there is a very good chance that aspiration will occur while you are being operated on. When a person aspirates, the stomach acids in your belly combine with the food you ate and you regurgitate. Aspiration occurs when the vomit backs up into your lungs. It can result in extreme morbidity and even morality.
So, that sip of juice or piece of toast is a bigger deal than you may initially think.
After your surgery, you will have to have a driver and a caregiver will be needed. Before the surgery, your caregiver should assist in rearranging your home so that there is minimal demand for mobility. A bedside commode may be necessary for the first day or two. Household routines will be changed, but as healing occurs getting back to the normal will come into being as well.
Two Types of Bunion Surgery: Bunionectomy and Osteotomy.
For example, a bunionectomy is performed to remove layers of swollen tissue that can build up around the joint of the big toe one or both feet.
What is a Bunion?
As we age, the mechanics of our feet change as well. It is very common to see feet that appear to have deformities in older people, especially women. The “pretty” shoes are quite often the cause of foot problems and the reason a podiatry visit becomes necessary. A bunion will cause the big toe to lean in toward all the other toes.
Time is a catalyst for bunions. The base bone of the big toe on bunion feet gets aggressive and pushes all the other toes outward in a painfully awkward position against the metatarsal bone. The outcome of the big toe’s painful pushing is a bunion. A bump at the base of the big toe will form through time. To touch it feels like the bone is protruding and that’s because the bones have indeed shifted.
Bunions form at the join and result in what can be debilitating pain and often are accompanied by inflammation. When you walk, each step you take on the bunion-plagued foot results in all of your weight resting on that joint, thus making the bunion angry and rebellions. On top of the bunion agitation, calluses on the bunion aren’t a rarity because of the shift in the mechanics of the foot causing the bunion to rub against your shoe with each step that you take.
What Are the Causes of Bunion?
It is not uncommon for foot problems to occur in early adulthood, especially in women. Foot problems, such as bunions, can be hereditary. You may have been born with a weak foot structure or you may have inherited a propensity for arthritis or gout.
Some people are born with one leg measuring longer than the other. In these cases, it is common for bunions to set in on the big toe of the leg that is the longer one.
Bunions are more likely to occur in women rather than in men because of women’s propensity for wearing shoes that are tighter with heels as high as six inches. This is part of the wear and tear aftermath that we all can experience.
Bunion Surgery Prep
It is important to know that if your podiatrist has tried all other forms of conservative treatment measures and they have failed, surgery will be needed if the bunion problem is severe. This is not cosmetic surgery. You should not get this procedure done because you don’t like the way your foot looks. The risks could greatly outweigh the benefits. If you’re not experiencing great pain and an impact on your ability to be mobile, you should not be getting this procedure.
You will have a pre-op appointment to go over all of the information you need regarding the preparation for your surgery and the doctor will also advise you as to what you will need to do during recovery. It is ideal to have the family member, friend, or caregiver that will care for you post-op there for this appointment.
The chances of infection and any risks associated with your recovery will be covered during this appointment as well. If you are at a risk for slow wound healing or you have any pre-existing conditions such as diabetes, a wound care specialist will likely be involved in your healing process to be sure that a chronic wound does not evolve from the surgical incision.
Your surgery will either take place at a surgical center or on an outpatient basis at a hospital. At your pre-op appointment, your doctor will go over your choices for anesthesia (general or local) and then you will see an anesthesiologist upon registration and arrival for your procedure who will explain the anesthesia that will be used for the surgery in more detail.
During Your Surgery
Sometimes, the bone can be realigned by the surgeon behind the big toe. This is done by cutting the ligaments at the join. If the bunion is extreme in severity, the surgeon may need to cut the bone and shave it. Screws and/or wire will be inserted into the foot to hold the bones in place during recovery.