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