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Treatments & Specialties

Foot and Ankle Surgery

Opening Hours: 9am - 6pm Monday to Friday
Contact:Appointments line Team
Telephone:+44(0) 20 7234 2009
Email:

Foot and ankle problems affect three out of four people at some stage of their lives. At London Bridge Hospital we have the leading Consultants that specialise in treating the whole spectrum of foot and ankle problems

Our Foot and Ankle Consultants are supported by our in-house Physiotherapy team which assists with patient’s rehabilitation. 

Common conditions we treat include:

 
  • Ankel spains (acute and chronic)
  • Ankle impingements and osteochondral defects (OCD) of ankle joint
  • Fractures of the ankle and the foot
  • Sports-injuries 
  • Post-traumatic conditions of the ankle
  • Achilles tendon ruptures
  • Achilles tendinopathies
  • Injuries to tendons and ligaments of the foot
  • Plantar fasciitis
  • Osteoarthritis of the ankle and the foot
  • Hallux valgus (bunion)
  • Hallux rigidus
  • Metatarsalgia
  • Morton’s neuroma
  • Hammer toes/claw toes
  • Congenital foot deformities
  • Flat feet/high arched feet
  • Foot drop
Most patients do benefit from conservative treatment including physiotherapy, podiatry and temporary relative rest. In case conservative treatment does not lead to a full recovery surgery might be an option. The following list describes amongst others some types of surgery we perform at the hospital. 

Lateral ligament reconstruction for chronic ankle instability

Lateral ligament reconstruction for chronic ankle instability
After an acute or repeated ankle sprain the ligaments may be torn and the ability to walk on uneven surfaces becomes limited. We call this chronic instability of the ankle and repeated ‘going over’ on the ankle increases the risk of other problems such as bruising of the cartilage and bone spurs, which can lead to ankle arthritis. A physiotherapist led ankle strengthening program maybe all that is required to treat this, but if this fails to stop the ankle ‘going over’ then a surgical repair in specialist hands that tightens up the loose ankle ligaments (Brostrum) can be performed. This allows individuals to return to all forms of athletic activity without risk of recurrent injury to the ankle.

Bunion Surgery

Bunion Surgery
Bunions come in all shapes and sizes causing significant variation in symptoms. If a bunion does not cause pain or crowd the second toe then surgery is generally not necessary. If surgery is indicated, the technique varies with the degree of deformity. For mild deformities, a small corrective procedure may suffice but for more advanced deformities the metatarsal bone will need to be broken and reset to realign the big toe. The cut bone is held in place with small screws that can stay in the patient. The pain after surgery is minimised by special nerve block techniques and patients are allowed to fully bear weight in a special surgical sandal.

Cheilectomy for big toe arthritis

Cheilectomy for big toe arthritis
Arthritis of the big toe may present with pain which is worse with motion, stiffness or bony hard lumps on the top of the toe that get sore when the shoe rubs on them. The initial treatment is non-operative comprising of anti-inflammatory medication, stiffer soled and wide shoes. Surgery is indicted in patients who remain persistently symptomatic. Cheilectomy is performed for milder cases and entails shaving the spur that forms on top of the joint. This eliminates pressure caused by the spurs and often improves joint motion. After this surgery patients can walk from day one. This procedure can be performed open or minimal invasiveA physiotherapist led ankle strengthening program maybe all that is required to treat this, but if this fails to stop the ankle ‘going over’ then a surgical repair in specialist hands that tightens up the loose ankle ligaments (Brostrum) can be performed. This allows individuals to return to all forms of athletic activity without risk of recurrent injury to the ankle.

Fusion for big toe arthritis

Fusion for big toe arthritis
When no good cartilage is left, we fuse the joint by preparing the bone in such a way that the body is tricked into thinking the bones are broken and so it bridges them eliminating the arthritic joint and relieving the pain. Buried metal screws hold the bones while this process occurs after which patients are left with a stiff but pain free toe. They can resume sporting activities and do not walk with a limp. Joint replacement of the big toe is possible but there is no evidence that they work in the long run.

Ankle arthroscopy

Ankle arthroscopy
This is ‘keyhole surgery’ done through two 4 mm incisions allowing direct visualisation with a small camera of problems that may not have even shown up on an x-ray or an scan and special small instruments allow us to treat the problem once it is identified. Arthroscopy means a speedier recovery, less scarring, and fewer complications than open surgery. An ankle arthroscopy is carried for pain, cartilage defects or if there is a build-up of excessive scar tissue and bone spurs at the front of the ankle that can cause pain and restrict movement. Patients have a short anaesthetic and usually go home on the same day with crutches and resume normal activities at three to six weeks.

Achilles tendon rupture

Achilles tendon rupture
This serious condition typically occurs in activities where there is a sudden push off such as Basketball, Squash or Badminton especially in less conditioned athletes. It can be managed either with plaster if it presents fresh or surgery. The surgeon will discuss the benefits of either treatment options but in most cases a direct repair of the ruptured achilles tendon is recommended The healing times are the similar. Surgery entails bringing the separated tendon ends together and resting it in a plaster and later a boot while the healing process takes place. Surgical repair is associated with a lower chance of re-rupture.

Ankle Arthritis

Ankle Arthritis
Mild cases can be managed by clearing debris and bone spurs using ankle arthroscopy. If there is no good cartilage left then the most proven treatment is an ankle fusion. We fuse the ankle by preparing the bone in such a way that the body is tricked into thinking the bones are broken and so it bridges them eliminating the arthritic joint and relieving the pain. Buried metal screws hold the tibia and talus while this process occurs after which patients are left with a stiff but pain free ankle. An alternative option for patients suffering from arthritis of the ankle joint is an ankle joint replacement. Over the last decades the implants have improved significantly and results are getting better and better. The benefit of an ankle joint replacement is that one preserves the range of movement. In selected patients, ankle replacement is an excellent option to treat arthritis of the ankle joint successfully.

Morton’s Neuroma

Morton’s Neuroma
A nerve that lies between the toes, typically in the 3rd webspace may be squashed or damaged. As a result it becomes inflamed and enlarged. Anywhere else in the body, this would not pose a great problem but in the foot we keep walking on this painful nerve, squashing it with each step causing considerable pain and numbness. In cases that have not settled with simple treatments, surgery to release or excise the nerve is a relatively simple procedure that can treat this often very painful condition.

For more information or to book an appointment please contact our Appointments Team on +44(0) 20 7234 2009.
This service is also available in Sevenoaks Medical Centre – visit the website and find out more.