Foot and Ankle Disorders Treatments
- Achilles tendon rupture
- Ankle ligament tear
- Heel pain/ heel spur
- Bunion (hallux valgus)
- Flat foot
- Hammer toes
- Ankle osteoarthritis
- Fractures around Foot & ankle
Achilles tendon rupture
The Achilles tendon is a strong, cord-like band that connects the calf muscles to the heel bone. It plays an important role in walking by helping you lift your heel off the ground. An Achilles tendon tear can happen from a sudden stretch or a direct injury to the tendon. People with this injury often find it difficult or weak to raise their heel.
Non-surgical treatment usually involves keeping the ankle immobilized in a cast or special brace to hold the torn ends of the tendon together and allow healing. Surgery may be needed depending on the severity of the tear and the gap between the tendon ends. Surgical options include direct tendon repair, V-Y tendon advancement, gastrocnemius fascia flap, or flexor hallucis longus tendon transfer.
Ankle ligament tear
Ligaments are strong, fibrous tissues that connect bones to other bones across the joint. They provide stability to the joint. Ankle joint has multiple ligaments. The severity of ligament injury can range minor sprains to complete tears. Complete tears of the ligament cause unstable ankle. The cause for ligament tear is twisting injury to the foot or ankle. Symptoms include swelling and painful ankle joint. Treatment- Most ankle sprains can be treated without surgery. Even a complete ligament tear (Grade 3) will heal without surgical repair if it is immobilized and rehabilitated appropriately. Surgery is reserved for injuries that fail to respond to nonsurgical treatment, and for patients who experience persistent ankle instability and pain after months of rehabilitation and nonsurgical treatment.
Heel pain/ heel spur
A heel spur is a bony growth on the underside of the heel caused by a calcium deposit. Heel spurs often develop from strains on foot muscles and ligaments or from stretching of the plantar fascia, the band of tissue that runs along the bottom of the foot. While heel spurs are sometimes painless, they can cause heel pain, often alongside plantar fasciitis, which is inflammation of the plantar fascia.
Non-surgical treatments include stretching exercises, shoe modifications, taping or strapping, shoe inserts or orthotics, physiotherapy, and night splints. In some cases, a corticosteroid injection may be given to reduce inflammation. If these measures do not relieve symptoms after 9 to 12 months, surgery may be needed to reduce pain and restore movement. Surgical options include releasing the plantar fascia or removing the heel spur.
Bunion (hallux valgus)
Hallux valgus manifests with the proximal phalanx deviating laterally and the first metatarsal head deviating medially. It tends to occur more commonly in women than in men and occurs more in those who wear tight shoes or heels. Patients typically present with a chronic onset of sharp or deep pain at the MTP joint that is exacerbated by ambulation. Non-operative treatment include shoe modification, orthosis, analgesics, ice pack therapy, medial bunion pads and stretching. When not
responding to conservative treatment, surgery is advised which involves osteotomy, arthroplasty, arthrodesis and soft tissue procedures.
Flat foot
Adult acquired flatfoot (AAFD), also called posterior tibial tendon dysfunction (PTTD), is a condition where the arch of the foot collapses, leading to a progressive deformity of the foot and ankle. Flatfoot can develop due to several factors, including overuse or injury of the posterior tibial tendon, obesity, poor blood supply to the tendon, previous trauma, steroid injections, neuromuscular conditions, or diabetes.
Conservative treatment is usually tried first and includes orthotic devices like ankle-foot braces, cast-boot walkers, or other supportive devices, often combined with anti-inflammatory medications (NSAIDs) and physical therapy.
If the deformity is severe or does not improve with conservative care, surgery may be needed. In mild cases, this can include cleaning or repairing the tendon or using a tendon graft. In advanced stages, more extensive procedures such as bone realignment (osteotomy), joint fusion (arthrodesis), or ankle replacement, sometimes along with deltoid ligament repair, may be performed to restore foot function and reduce pain.
Hammer toes
Hammer toe and mallet toe are conditions where one or more toes become bent or curled. They can be caused by tight or poorly fitting shoes, foot injuries, or certain medical conditions like diabetes or muscle imbalances in the toes.
Common symptoms include pain when wearing shoes, difficulty moving the affected toe, stiffness, and calluses or corns from rubbing against shoes or the ground.
For toes that can still be straightened, wider shoes, shoe inserts (orthotics), or protective pads may help relieve discomfort. If these treatments do not work, surgery may be recommended. Surgery can release the tendon that is keeping the toe bent, and sometimes a small piece of bone is removed to help straighten the toe.
Ankle osteoarthritis
There are 2 types of osteoarthritis: primary (unknown cause) and secondary. Compared with the knee and hip joints, there is a substantially lower rate of primary ankle OA due to unique anatomic, biomechanical and cartilage characteristics of the ankle. Secondary ankle OA can be caused by old trauma, metabolic disease, congenital malformations. Symptoms include slow and progressive pain,
aggravated on exertion and relieved on rest. Non-surgical management include anti-inflammatory medications, intraarticular injection of corticosteroids, hyaluronic acid. Non responding patients can
be advised for surgical treatment in the form of arthroscopic debridement, fusion of the joint (arthrodesis) or replacement of the joint.
Fractures around Foot & ankle
Fractures around the foot and ankle are common injuries that can result from falls, sports, or accidents. These fractures involve the bones of the foot, such as the metatarsals, or the bones of the ankle, like the tibia and fibula. Symptoms include pain, swelling, bruising, and difficulty walking. Treatment varies based on the severity and location of the fracture, ranging from rest and immobilization with a cast or boot to surgical intervention. Prompt medical attention is crucial for proper healing and to prevent complications. Rehabilitation exercises and physical therapy may also be needed for a full recovery.