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Arthroscopy (ahr-THROS-skuh-pee) is a procedure for diagnosing and treating joint problems. A surgeon inserts a narrow tube attached to a fiber-optic video camera through a small incision — about the size of a buttonhole. The view inside your joint is transmitted to a high-definition video monitor.
Arthroscopy allows the surgeon to see inside your joint without making a large incision. Surgeons can even repair some types of joint damage during arthroscopy, with pencil-thin surgical instruments inserted through additional small incisions.
Surgery for flat feet is separated into three kinds: soft tissue procedures, bone cuts, and bone fusions. Depending on the severity of the flat foot, a person’s age, and whether or not the foot is stiff determines just how the foot can be fixed. In most cases a combination of procedures are performed.
With flexible flat feet, surgery is geared at maintaining the motion of the foot and recreating the arch. Commonly this may involve tendon repairs along the inside of the foot to reinforce the main tendon that lifts the arch. When the bone collapse is significant, bone procedures are included to physically rebuild the arch, and realign the heel. The presence of bunions with flat feet is often contributing to the collapse and in most situations requires correction.
With rigid flat feet, surgery is focused on restoring the shape of the foot through procedures that eliminate motion. In this case, motion does not exist pre-operatively, so realigning the foot is of utmost importance. The exception, are rigid flat feet due to tarsal coalition (fused segment of bone) in the back of the foot where freeing the blockage can restore function.
FOOT & ANKLE SURGERY
Orthopaedic foot and ankle surgeons are medical doctors (MD and DO) who specialize in the diagnosis, care, and treatment of patients with disorders of the musculoskeletal system of the foot and ankle. This includes the bones, joints, ligaments, muscles tendons, nerves, and skin. Orthopaedic foot and ankle surgeons use medical, physical, and rehabilitative methods as well as surgery to treat patients of all ages. They perform reconstructive procedures, treat sports injuries, and manage and treat trauma of the foot and ankle.
Orthopaedic foot and ankle surgeons work with physicians of many other specialties, including internal medicine, pediatrics, vascular surgery, endocrinology, radiology, anesthesiology, and others.
Medical school curriculum and post-graduate training provides the solid clinical background necessary to recognize medical problems, admit patients to a hospital when necessary, and contribute significantly to the coordination of care appropriate for each patient.
HEEL PAIN (CONTEMPORARY SURGICAL)
Must be pursued for several months before any surgical intervention is contemplated. It is unwise to operate on a patient who has had only a limited trial of conservative treatment and who has incomplete control of the abnormal mechanics that have caused the symptoms. Surgical intervention may be indicated in the small percentage of patients who have failed to benefit from conservative methods and who still have significant plantar heel pain after a lengthy period of treatment.
It is well documented that plantar fasciotomy alone, without inferior calcaneal exostectomy, is an effective surgical approach to this condition5,6 (Figure 2). Endoscopic plantar fasciotomy was developed as a minimally invasive way of accomplishing this.5–7 Endoscopic plantar fasciotomy is less traumatic than traditional open heel-spur surgery and allows earlier weight-bearing after surgery. Some authorities consider the technique controversial, but a study8 of 652 endoscopic plantar fasciotomy procedures, performed by 25 different surgeons, reported a success rate (resolution of chronic plantar fasciitis) as high as 97 percent. Results of a recent study9 that compared 29 endoscopic procedures with 84 open fasciotomies with spur resection indicate that patients who underwent endoscopic plantar fasciotomy returned to work an average of 55 days sooner than those who had an open heel approach (29 days versus 84 days). Depending on their job, patients may return to work as soon as the next day. Those whose work involves standing or walking or is otherwise physically demanding may need up to eight weeks of partial weight-bearing.
INGROWN TOENAILS (PERMANENT CORRECTION)
You should see a podiatrist immediately if any drainage or excessive redness is present around the toenail. Also, if a short trial of home treatment has not resulted in improvement of the condition, see your podiatrist. If you have diabetes or poor circulation, you should seek immediate treatment at the first signs of an ingrown toenail, as it can lead to more severe complications.
A podiatrist will remove the ingrown portion of the nail and may prescribe a topical or oral medication to treat the infection. If ingrown nails are a chronic problem, your podiatrist can perform a procedure to permanently prevent ingrown nails. The corner of the nail that ingrows, along with the matrix or root of that piece of nail, are removed by use of a chemical, a laser, or other methods.
MINIMAL SCAR RECONSTRUCTIVE SURGERIES FOR BUNIONS, HAMMERTOES, AND OTHER FOOT
Surgery to treat bunions is often used for more severe cases, or after conservative methods have failed. There are several different surgical options available, depending on the cause and symptoms of the bunion.
The most common surgical procedure for bunions is a bunionectomy, which includes:
- Removing the swollen tissue from the big toe joint
- Removing part of the bone to straighten the big toe
- Permanently joining the bones of the big toe joint
Most bunion procedures are performed on an outpatient basis under local anesthesia. General anesthesia may be used in certain situations depending on the complexity of the procedure and the preference of the patient. Complications from these procedures are rare but may include infection, recurring bunion or nerve damage. While these procedures can be beneficial, they are usually only recommended for patients with bunions that cause severe pain. There is also a chance that a bunion may form again after surgery. Patients with realistic expectations are usually satisfied with the results of their surgery.
Treatment for hammertoes depends on the severity of the condition, but may home remedies, anti-inflammatory medications, orthotics or surgery for severe cases. Surgery involves removing a small section of bone from the affected joint through a procedure called arthroplasty. Arthrodesis may also be performed to treat hammertoes, which involves fusing together one of the joints in the toe in order to keep it straight. This procedure requires the use of a metal pin to hold the toe in position while it heals.
Treatment for these structural abnormalities depends on the type and severity of the condition, but may include changing shoes, wearing orthotics, anti-inflammatory medication and physical therapy. Surgery for severe cases may involve removing or reshaping a bone or bone spur, or fusing one or more bones in the foot together.