info@ogwa.com.au
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Foot & Ankle Surgery
The Orthopaedic Group WA foot and ankle surgeons have sub-specialty knowledge of foot and ankle anatomy and pathology and are experienced in the management of both degenerative and traumatic conditions. They are fellows of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association, and can advise on both surgical and non-surgical care.
Their skill set as doctors ensures not only optimal surgery, but appropriate and complete management of any complications should they occur.
Our surgeons are up to date with the latest advances in surgical techniques including minimally invasive tendon repair, osteotomy, and bunion correction in appropriate patients.
Conditions
Foot and Ankle Arthritis
Foot and Ankle Arthritis
Arthritis describes a loss of cartilage from a joint resulting in pain and stiffness. All of the small joints of the foot and ankle can be involved. Common presenting complaints include pain and stiffness in the ankle joint felt in the front of the ankle, the sub talar joint (between the ankle and heel bones) felt on either side of the heel, or the 1st Metacarpophalangeal joint (MCPJ) felt at base of the big toe.
Bunion (Hallux Valgus)
Bunion (Hallux Valgus)
A bunion describes a deformity where the big toe angles towards the second toe at the metacarpophalengeal joint (MCPJ) causing a prominent “bump” at the base. It is typically considered a cosmetic deformity, but may cause rubbing and difficulty with shoe wear or pain and stiffness in conjunction with 1st MCPJ arthritis.
Lesser Toe Deformity
Lesser Toe Deformity
Deformities of the lesser toes described as Hammer toe, Claw toe, or Curly toes (in children) may be unsightly cosmetically and cause difficulties with shoe wear, resulting in rubbing and pain . They may also result in an abnormal transfer of pressure to the adjacent metacarpal bones, resulting in pain with weightbearing on the forefoot.
Lesser toe abnormalities may occur spontaneously and are also commonly seen in association with inflammatory conditions such as Rheumatoid arthritis.
Plantar Fasciitis
Plantar Fasciitis
The plantar fascia is a band of thick fibrous tissue connecting the heel to the base of the toes across the arch of the foot. Inflammation may spontaneously occur resulting in heel or instep pain. It is often aggravated by sporting activity, but may also be troublesome when you first begin to walk after a long pause (such as the first steps in the morning).
Typically this is treated non-operatively, but when resistant to treatment may benefit from surgical release.
Achilles Tendonopathy / Rupture
Achilles Tendonopathy / Rupture
The Achilles tendon connects the calf muscles (Soleus and Gastrocnemius) to the heel and is essential for push off during gait. Inflammation of the tendon (tendonitis) may occur as a result of a sudden increase in activity (e.g. increased running distance) or as a result of a combination of moderate activity and age related degeneration (classically in middle aged squash or tennis players) .
It presents with pain around the heel and lower part of the calf related to activity. Rupture may occur as a result of underlying tendonitis or following trauma. Patients typically describe a sensation “like being kicked in the back of the heel”.
Adult Flatfoot (Posterior Tibial Tendon Dysfunction)
Adult Flatfoot (Posterior Tibial Tendon Dysfunction)
The Tibialis Posterior tendon functions to support the arch of the foot and helps “lock” the heel onto the ankle bone to give power in push-off.
Dysfunction of the tendon in the form of tendonitis, partial, or complete tearing gives rise to a “flat foot” appearance, and results in an inability to stand on tiptoe or push off strongly when walking. Inflammation over the tendon may cause pain on the inside of the ankle and impingement of the heel and ankle bones may cause pain on the outside.
Procedures:
- Foot and Ankle Arthritis Procedures
Techniques for management of foot and ankle arthritis vary, reflecting the complex articulations involved. In many instances modification of shoe wear, or use of a custom orthotic may adequately address symptoms. If symptoms are not manageable with non-operative techniques, then surgery is appropriate.
The goal of all procedures is to relieve pain. In general this is achieved by either replacing (arthroplasty) or fusing (arthrodesis) the joint. Commonly the ankle joint can be replaced in lower demand individuals, but is better fused in younger patients with heavier functional demands.
The suitability of each joint for replacement versus arthrodesis depends on age, work and social demands, and the cause of the joint degeneration (e.g. Rheumatoid arthritis versus Infection) and should be discussed with your surgeon.
- Bunion Correction
Bunion correction is a cosmetically pleasing procedure that removes the excess bony “bump” from the base of the big toe and also corrects angulation of the big toe. It is achieved through a combination of soft tissue balancing and cutting of the bone (osteotomy). It is appropriate for management of bunions in the absence of significant Metacarpophalangeal joint (MCPJ) arthritis. Where a bunion correction is required in the setting of significant arthritis, a fusion of the MCPJ may be required.
Bunion correction can be performed through minimally invasive techniques in many instances and should be discussed with your surgeon.
- Achilles Tendon Repair
A torn Achilles tendon often, but not always, requires surgical repair. Tendonitis, or an Achilles tendon tear without significant separation of the tendon ends, can be managed with a combination of CAM boot immobilisation and physiotherapy. More substantial tears or patients with specific sporting demands may benefit from surgical repair, either as an open or minimally invasive procedure.
- Osteotomy
Osteotomy describes cutting of the bone. Osteotomies can be useful to help change the shape of the foot and relieve pressure and pain. Osteotomies are commonly performed as part of the correction for flat foot and lesser toe deformities, but may be of benefit in number of other congenital and acquired foot problems. Some osteotomies including a “calcaneal slide” procedure for flat foot correction can be performed with a minimally invasive technique.
