Podiatry is a medical speciality involving the feet. Here at North Downs Hospital in Surrey we specialise in the treatment and diagnosis of podiatric conditions.
The foot is made up of an astonishing 26 bones and 33 joints – making it particularly intricate and susceptible to damage. It also contains over 100 tendons, muscles and ligaments allowing for extreme flexibility.
This complex system allows for a variety of movements ranging from walking to jumping – making them increasingly vulnerable to injury. At North Downs Hospital in Surrey we offer a variety of non-surgical and surgical solutions to ease your pain and discomfort. We also provide surgeries e.g. for bunions for aesthetic reasons.
Podiatric Surgeries on offer
Bunions (Hallux Valgus)
Bunions otherwise known as hallux valgus is a bone joint deformity. It presents at the bottom of the large toe at the side of your foot.
The main symptom of having a bunion is the large toe leaning towards the smaller toes, creating a large “bump” on the side of the foot. Due to this you may find it difficult to get shoes that fit properly. The bunion may be painful and swollen and the skin over the bunion may become irritated and callused.
There are a range of non-surgical solutions for the treatment of bunions including the use of insoles, painkillers and steroid injections. Surgical treatment may be necessary if you are suffering from intense pain for longer than 3 months - note that surgeries for aesthetic reasons are no longer provided by the NHS.
An osteotomy is the most common surgical procedure in the treatment of bunions. It involves the removal of bones within the large toe and the realignment of the toe in retrospect to the others.
Read more about Bunions (Hallux Valgus)
A metatarsal osteotomy is an alternative operation used to treat bunions (hallux valgus). It involves the repositioning of the metatarsal bone.
The surgery involves an incision on the edge of the bunion, the affected joint is then opened up and the bony lump causing the bunion is removed.
The metatarsal bone is then realigned and fixed with screws in order to strengthen the large toe. Surrounding tissue is then made tighter to soften the deformity.
Normally a metatarsal osteotomy is performed under general anaesthetic although it is known for local anaesthetic to be used
Fungal Nail Infection (Onychomycosis)
A fungal nail infection otherwise known as onychomycosis normally affects the toe nails though can be known to reside in the finger nails. It causes the nails to become thick and discoloured – they may also start to break. It is also common for the skin around the nail to become infected and swollen.
In order to prevent a fungal nail infection it is encouraged for you to keep your feet clean and dry as well as keeping them covered in communal areas where infections are likely to spread.
Non-surgical treatment options include a course of anti-fungal medication across a few months and anti-fungal nail paint to cover the infected nail.
The surgical solution involves the complete or part removal of the nail affected.
Ingrown Toe Nails
In Growing toe nails are caused by the outward growth of the nail into the surrounding skin. The nail can grow into the skin causing it to become inflamed and tender to touch. Fluid can also develop in the surrounding areas of the toe.
If you notice pus or bleeding of the toe it is advised to seek medical assistance as the ingrown toe nail may have become infected.
In order to prevent an ingrown toe nail it is advised for you to cut your nail in a straight line and to clean your feet regularly.
Surgery is normally recommended when your ingrown toe nail has been causing you great discomfort and is not improving through non-surgical methods such as gently pushing the nail away from the skin. Nail avulsion is the formal name of the surgery and involves either partial or total removal of the affected nail.
Mid Foot Fusion (Arthrodesis)
The midfoot encompasses the middle section of the foot, it comprises of 5 bones: 3 cuneiform bones, the cuboid and the navicular. These bones create an arch and gives the foot its natural “curve”.
Many conditions affect the midfoot such as arthritis and injury. These then lead to the need for an arthrodesis - a fusion of the affected joint to reduce pain where non-surgical methods fail.
During surgery incisions are made to the top of the foot and metal hardware such as screws are placed into the joint to stabalise and immobilise it. This then promotes the fusion of the bone across the joint.
Morton’s Neuroma known as Morton’s metatarsalgia is a condition which affects the nerves in the foot. The nerve between either the third or fourth toes or second and third toes becomes increasingly thick and starts to cause discomfort and in some cases severe pain.
Morton’s Neuroma starts to present at the beginning stages as a tingling and/or numbness between your toes. It then leads on to a sharp pain residing in the ball of the foot.
There are a range of non-surgical solutions such as the use of orthotic equipment and pain killers. Some people find that changing their footwear provides them with relief. However, if you have been suffering from this condition for a while and are gaining no relief from non-surgical methods surgery may be your best option.
The procedure involves removing part of the affected nerve or increasing the space around the nerve to provide relief. The surgery is normally a day a case and usually is completed under general anaesthetic.
Treatment for Hammer, Mallet & Claw Toe
A hammer toe deformity normally resides in the proximal interphalangeal joint of toes bar the large toe. It normally presents as a permanent bending of the toe. It is a similar condition to claw and mallet toe where the metatarsophalangeal joint and distal interphalangeal joint are affected instead.
Hammer toe is due to the shortening of the muscle within the toe – caused frequently by ill-fitting shoes and arthritis.
The surgical procedure to treat this condition involves freeing the trapped tissue and altering the length of the affected tendon.
Here at North Downs Hospital we offer a range of podiatric treatments from non-surgical solutions to full surgical procedures. We are happy to talk through your treatment options in order to relieve your pain and discomfort. Our treatment plans are fully flexible and arranged around the individual’s needs.
Mr E Baldwin
Mr R Graham
Mr S Hewitt