Introduction, assessment & benefits
Whilst foot surgery has traditionally been thought to be
extremely painful, advances in techniques, local anaesthetics and
pain killers mean that many people can now benefit from corrective
surgery with minimal post operative discomfort. Surgery should not
be the first choice for treating foot pathology as many conditions
respond to non-surgical treatments. However, in some cases the
conservative measures are insufficient and surgery is necessary.
You should ensure that your surgeon has specific training in foot
surgery and regularly undertakes foot operations. Podiatric
Surgeons are able to provide this service.
Assessment
In order to determine the nature of your condition, your
suitability for surgery and the most appropriate operation for you,
a detailed assessment is necessary which includes:
- A detailed medical and personal social history
- Physical examination
- X rays
- Further investigations; Ultrasound / CT / MRI scans, blood
tests etc.
The initial consultation will allow a history to be taken and
your feet to be examined. A provisional diagnosis and potential
treatment plan will be outlined including the benefits and risks,
and necessary investigations requested. Information sheets will be
provided if surgery is a possibility so that you can consider the
options in more detail. Depending on the type of surgery you
require, a second consultation is usually necessary to review any
investigations, allow a more detailed assessment and the consent
process.
If this assessment raises any questions regarding any health
problems or the safety of surgery for you, further investigations
and a medical opinion may prove necessary. This may result in the
postponement or cancellation of surgery. Attention to detail at
this stage minimises the risks of potential problems following
surgery.
Informed Consent
All patients undergoing surgery are required to give informed
consent. This means that the nature of the operation, intended
benefits and potential risks are clearly and carefully explained.
Whenever possible, the consent form will be signed in advance of
surgery and you will be provided with a copy of the consent form.
If for any reason you decide not to proceed with surgery, the
operation will be cancelled, even if this decision is made on the
day of the planned operation. The choice to proceed with surgery is
entirely yours assuming there are no contra-indications.
Anaesthesia
The majority of foot operations can be performed easily and
safely under local anaesthetic. Although you will be awake, a
screen is used so that you cannot see the operation. The injections
are generally given around the ankle and knee as these allow better
and longer lasting anaesthetic. In some instances it can take 24-36
hours for the anaesthetic to wear off completely.
However, some patients feel nervous and prefer to be asleep.
General anaesthetic techniques are extremely safe and are available
when required. You will still be given the local anaesthetic
injections so that there is no pain when you wake up and less
anaesthetic is required during the operation. This reduces the risk
and post operative nausea and sickness.
If you do not like the thought of a general anaesthetic but
still feel nervous then a sedative can be given. You still require
the local anaesthetic injections but this is an extremely effective
combination for foot surgery.
Will I need to stay in hospital overnight?
Whichever anaesthetic technique is used, the majority of foot
surgery can be performed on a day case basis, meaning that you do
not need to stay in hospital overnight. As long as you have
sufficient home support, you can go home on the same day.
What are the potential benefits of surgery?
- Early return to activity
- Correction of the underlying deformity
- Reduced pain
- Improved function