Foot / Ankle
- Arthroscopic Surgery
- Instability / Ligament Repairs
- Jones / 5th Metatarsal Fractures
- Arthroscopic Ankle Arthrodesis
- Open Ankle Arthrodesis
- Tibiotalocalcaneal (TTC) Fusion
- Total Ankle Replacement, or Arthroplasty
- Patient Education – Animated Procedures & Conditions
Arthroscopy is a minimally invasive procedure used to diagnose and treat injuries and abnormalities within the joints. This procedure is commonly used to confirm a diagnosis made by physical examination and imaging techniques. It can also be used to treat conditions within the joints, if they are not too complicated.
Although most commonly performed in the knee and hip, arthroscopy can also be beneficial in diagnosing and treating conditions of the ankle joint. While ankle surgery once required an invasive open procedure that left patients with long hospital stays and recovery times, many of those procedures can now be performed with the simpler, less invasive arthroscopy.
Instability / Ligament Repairs
Chronic ankle instability is a condition in which the outer portion of the ankle constantly “gives way.” This condition typically occurs after walking or running, although it may also occur while standing still. Chronic ankle instability commonly affects athletes.
The most common symptom of chronic ankle instability is a wobbly, unstable feeling within your ankle. Additional symptoms may include pain or tenderness of the ankle, constant swelling and discomfort, and continuous turning of the ankle when walking or running on uneven surfaces.
Most cases of chronic ankle instability can be treated through non-surgical measures; these may include physical therapy, painkillers, or ankle bracing. Severe cases of chronic ankle instability that remain unresponsive to conservative treatment methods may require surgical correction. Surgery for chronic ankle instability involves repairing or reconstructing the damaged ligaments that are responsible for your symptoms.
An ankle sprain is a common injury that occurs when the ankle is twisted or turned, and results in torn ligaments within the joint. This injury often causes pain, swelling and bruising, and may lead to ankle instability as the condition is prone to recur. Ankle ligament reconstruction is commonly performed on patients with ankle instability or repeated sprains, as it is effective in tightening loosened ligaments and improving the overall stability of the joint.
The ankle ligament reconstruction procedure is performed on an outpatient basis under general anesthesia. Most procedures take two to three hours to perform. During the procedure, the two ligaments may be simply reattached, or part of a lateral tendon around the ankle may be used to repair the torn ligament.
Jones / 5th Metatarsal Fractures
A Jones fracture involves an injury to the fifth metatarsal bone of the foot, which is the bone at the base of the small toe. It was named for Sir Robert Jones, who first described the fracture in an article in 1902. This type of injury most often occurs as a result of an ankle sprain or other type of inversion foot injury, and not as a result of direct impact to the area. A Jones fracture may also be caused by a stress or fatigue fracture.
Patients with a Jones fracture may experience pain on the middle and outside of their foot, along with swelling and difficulty walking. Treatment for a Jones fracture is most often done by immobilizing the area with a cast and using crutches to avoid putting weight on the bone. If a Jones fracture does not heal properly, it can become a chronic condition and may require surgery to repair the fracture and keep the bone in place with a screw or bone graft. Surgery may also be performed as the initial treatment option for competitive athletes or other patients who require a speedy healing period from this type of injury.
Arthroscopic Ankle Arthrodesis
This is a minimally invasive technique of ankle arthrodesis where the remaining cartilage is removed arthroscopically (through a “scope”) through two small incisions at the front of the ankle. The screws that are utilized for fixation are placed through two to three small incisions in the skin under x ray gUidance. This procedure results in minimal trauma to the soft tissue, decreased postoperative pain and excellent healing rates.
Open Ankle Arthrodesis
Sometimes due to abundant arthritic spurring, deformity or retained screws or plates an open ankle arthrodesis is performed. In this case an incision is made on the outside of the ankle and the outside ankle bone is partially removed and the remaining cartilage and bone spurring is removed. Cuts in the bone can be made to correct for deformity. A small incision is typically made at the front of the joint medially to access that portion of the joint. Screws or plates are typically used for fixation. This procedure can be done from an incision on the front of the joint as well with the development of special plates specifically made for this procedure.
Tibiotalocalcaneal (TTC) Fusion
This procedure eliminates painful joints between the tibia, talus and calcaneal bones. During surgery, the cartilage is removed and a metal rod, also known as an “intramedullary nail” (intramedullary means within the bone), is inserted through a small incision in the bottom of the foot and up into the tibia. Screws are used to hold the nail and bones in place and to compress the joints together. Compression encourages the bones to grow together.
Total Ankle Replacement, or Arthroplasty
Total ankle replacement involves replacing the ankle joint with mechanical parts. Ankle replacement is intended to restore mobility by reducing pain, restoring alignment, and replacing the flexion and extension movement in the ankle joint. During surgery, an incision is made on the front portion of the ankle and precise bone cuts are made in the tibia and talus to remove arthritic bone and cartilage. The bone that is removed is replaced with metal components shaped similar to the bone they are replacing. A plastic spacer is inserted between the metal components, alloWing the ankle to move in a smooth motion.
Patient Education – Animated Procedures & Conditions
Foot / Ankle Procedures:
This surgical procedure is performed to remove portions of the ankle that are diseased or severely injured and to implant a device that will help manage pain and restore mobility to the ankle. » Watch the animation
Bunionectomy With Distal Head Osteotomy
A bunionectomy is performed to correct a deformity of the toe joint. One of the most common and effective bunion removal procedures is an osteotomy, which removes a portion of bone from the big toe. » Watch the animation
Bunionectomy With Wedge Osteotomy
A bunionectomy is performed to correct a deformity of the big toe joint. One of the most common and effective bunion removal procedures is an osteotomy, which removes a portion of bone from the big toe. » Watch the animation
This surgical procedure is used to help relieve symptoms of hallux rigidus by removing bony growths on top of the big toe’s main joint. This procedure improves joint movement and is most successful in patients with less severe arthritis. » Watch the animation
First Metatarsal-phalangeal Joint (MTP) Arthrodesis
This surgical procedure is performed to help relieve pain in the front of the foot and correct deformities in the MTP joint of the big toe caused by injury, arthritis or genetic defect. The procedure fuses the bone at the base of the big toe to the first metatarsal bone of the foot. » Watch the animation
Hammertoe Correction (PIP Joint Arthroplasty)
This surgical procedure is used to correct a hammertoe, a deformity of the toe that causes the toe to become permanently frozen in a bent position. During this procedure, a small piece of bone is removed to shorten the toe and allow it to straighten. » Watch the animation
Lateral Ankle Ligament Reconstruction
This procedure is performed to correct chronic ankle instability that has not responded to treatment such as physical therapy. Ankle instability occurs when ligaments are stretched or torn. A simple repair, known as the Bröstrom-Gould technique, is ideal for athletes who need to retain full range of motion. » Watch the animation
Lateral Column Lengthening (Evans Osteotomy) for Adult Acquired Flatfoot
This surgical procedure is used to modify the shape of the foot, creating an arch to correct the condition of pes planus (commonly called flat foot or fallen arch). It can dramatically change the shape of the foot, giving the foot a more normal appearance. » Watch the animation
This surgical procedure is used to help relieve pain in the ankle joint and correct deformities in the hindfoot caused by injury, arthritis, or genetic defect. The procedure fuses the three main joints in the hindfoot that allow side-to-side movement – the calcaneo-cuboid, talonavicular, and subtalar joints. » Watch the animation
Weil Osteotomy for Claw Toe
This procedure relieves the symptoms of claw toe, persistent metatarsalgia, metatarsal phalangeal (MTP) joint synovitis or MTP subluxation by shortening the end of the metatarsal at the base of the affected toe. This provides room for the toe to relax and return to its normal position. » Watch the animation
Foot / Ankle Conditions
Adult Acquired Flatfoot
This condition is a progressive collapse of the tendons and ligaments that hold up the foot’s arch. This condition most commonly affects women. It typically occurs in only one foot, but in some cases, both feet are afflicted. » Watch the animation
Charcot’s Neuroarthropathy (CN)
This condition, which most often occurs as a complication of long-term diabetes, is a progressive degenerative condition that affects the foot. It is characterized by nerve damage in the foot along with severely weakened foot bones. This combination can result in a person fracturing the foot, but continuing to walk on the broken bones, which leads to debilitating foot deformity. » Watch the animation
Complex Regional Pain Syndrome (CRPS)
This chronic condition, also known as reflex sympathetic dystrophy, is an unexplained feeling of pain and discomfort that most commonly affects an arm, leg, hand or foot. Often, it begins in the hand or foot and then spreads to affect the entire limb. » Watch the animation
LisFranc (Midfoot) Fracture-Dislocation
This injury occurs when the base of the second metatarsal is broken, or when a ligament that connects this metatarsal to one of the cuneiform bones of the midfoot is ruptured. » Watch the animation
MTP Synovitis (Capsulitis)
This condition is a sharp or aching pain in the ball of the foot that is most often centered beneath the base of the second toe. This pain is an indication that the bone at the base of the toe, called the proximal phalanx, is beginning to separate from the long bone of the foot, called the metatarsal. » Watch the animation
Osteochondral Injuries of the Talus
The talus, lined with articular cartilage, connects to the tibia and fibula to make up the ankle joint. An osteochondral injury occurs when the talus and/or surrounding cartilage is bruised, fractured, or chipped from an injury. » Watch the animation
Posterior Tibial Tendon Dysfunction (PTTD)
This condition is an overstretching and inflammation of the posterior tibial tendon, which travels from a muscle in the calf down to the arch of the foot. This tendon is one of the major supporting structures of the foot’s arch and aids in walking. » Watch the animation
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