Foot Seas Podiatry
Rearfoot surgery is defined as surgery of arch heel and ankle. There are many different problems that warrant surgery of the rearfoot. Each of these problems may have several different procedures that can be applied depending on the type of problem and the severity.
One common rearfoot surgery is an endoscopic plantar fasciotomy. This procedure is performed on patients who have long-term pain from plantar fasciitis. When the patient first presents to the office with plantar fasciitis a significant amount of conservative treatment is tried before any surgical treatment is discussed. If conservative treatment fails then as a last resort an endoscopic plantar fasciotomy may be performed. The endoscopic plantar fasciotomy is performed by inserting a camera or endoscope into the side of the heel. The plantar fascia is visualized. Then two thirds of the plantar fascia is released. This elongates the plantar fascia and releases the tension on the heel.
A common use for rearfoot surgery is to correct flatfoot deformity. Correcting flatfoot deformity is a complicated task to undertake. First the flatfoot deformity has to be evaluated to identify the type of flatfoot deformity and what is causing it. There are many different procedures designed to correct specific types of flatfoot deformity. Often these procedures can be performed together in order to correct the entire deformity. Some of the procedures involve soft tissue adjustments including tightening tendons or releasing ligaments. In more severe cases it may be required to perform procedures that involve bone work. In these cases the bones are often cut and repositioned. Then they are held together with screws or plates until the healing process has concluded.
Another more specialized procedure that we perform at Florida Foot Specialist for the correction of flatfoot deformity is a subtalar joint implant. The subtalar joint is the joint below the ankle joint. This is the joint responsible for allowing the heel to move from side to side. In flat feet often this joint moves too much. A subtalar joint implant is designed to decrease the motion at this joint. This prevents the arch from being able to collapse.
Ankle injuries are extremely common in all ages. Ankle sprains are more common than an ankle fracture. Often times when there is an ankle sprain another injury is missed during the evaluation process. The x-rays are reviewed and there are no fractures of the ankle noted, however there is damage to the cartilage in the ankle joint. This is not visible on regular x-rays. Often times the patient is treated for the ankle sprain, however they continue to have pain for several months. The damage to the cartilage, also called an osteochondral defect, will not be seen unless an MRI is performed. This is not to say that an MRI should be performed on every ankle sprain. However, the presence of an osteochondral defect should be ruled out if pain continues past a normal timeframe. In cases of osteochondral defects the cartilage needs to be repaired. This can be performed possibly with a arthroscopic procedure of the ankle or in more severe cases a surgery needs to be performed that opens the ankle and repairs the cartilage. The cartilage is repaired by removing the damaged cartilage then drilling the underlying bone. This drilling promotes cartilage growth in the area to replace the damaged cartilage.
Rearfoot surgery encompasses a significant number of procedures of which this was just a few. If you are having pain in your foot, heel, or ankle you should present to the office for evaluation. The majority of the time surgery is not warranted.
