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Foot Surgery



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Flat foot

| What is it? | Is this condition always a bad thing? | How can I tell if my foot corrects fully? (What does it mean?) | When might there be a problem? | Are there any other variants in shape? | What makes the arch? | What can cause this condition and how? | What symptoms might I get? | What treatments are available for a painful flat foot? | What happens if I leave my condition untreated? | Tibialis posterior reconstruction | Why can't the tendon simply be repaired? | The operation - operative schematics | Operative stills - a) the calcaneal osteotomy ("heel shift") | Operative stills - b) the tibialis posterior debridement and flexor digitorum transfer | After the operation | Chance of success | The stiff (non correctable) and painful arthritic flat foot | What and why? | Are there any catches? | The operation - operative stills-triple fusion | The operation - pre and post operative appearance | After the operation

 

After the operation

On the Day
Pain relief
After the anaesthetic has worn off your foot should be largely free of pain ,due to the use of nerve blocks(Femoral and Sciatic). You will be given a course of pain killers and anti- inflammatory tablets .These will be working for you when the nerve blocks wear off by 12 hours or so .
You may also require a PCA analgesic pump.

Your foot
Immediately after the operation you will have a temporary plaster cast. The day following this will be changed into a lightweight fibreglass cast.

Mobility
A physiotherapist will instruct you on the use of crutches the day following surgery. You will be non weight bearing on the operated foot for a period of six weeks.

Length of stay
One or two post-operative days depending upon comfort and mobility.

DVT prophylaxis
Aspirin 150mgs for 6 weeks.

At two weeks
You will require an outpatient assessment and wound review. Self absorbing sutures are normally used .Your lightweight cast will be changed and non weight bearing will continue for another four weeks.

At six weeks
You will require an outpatient assessment and check x-ray to confirm union of the calcaneal osteotomy.
At this stage you will be able to return to the orthotic which by itself has failed to control your foot preoperatively. It may require some adjustment by our orthotist.
This should be worn for all weight bearing activity.

Chance of success

  • The chance of significant reduction in pain and improvement in function is of the order of 85%.
  • The chance of a persisting correction in the alignment of the foot is 70-80%
  • The chance of failure of the surgery to the extent that midfoot fusion is required is 10%.

2. The stiff (non correctable)and painful arthritic flat foot

left sided arthritic joint
left sided arthritic subtalar joint
left sided arthritic midfoot joint

Left sided arthritic subtalar and midfoot joints.

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