Cornwall LivingIssue #67

A step in the right direction

If you’re having foot trouble, surgery at Duchy Hospital may help to get you back on your feet.

What better than a walk along the many miles of beautiful Cornish coastline? We’re spoilt for choice when it comes to getting outside and into the great outdoors, but being out our feet for long stretches means we need to look after them! Michael Butler, Consultant Orthopaedic Surgeon at Duchy Hospital, Truro says: “A lot of demand is put on the forefoot.” The foot is an extremely complex structure, made up of 26 bones, 33 joints, more than 100 ligaments and 19 muscles and tendons. In fact, 25% of the bones in your body are found in your feet!

“… studies have shown that more than 90% of patients are satisfied with the result.”

According to Michael, a common problem is Hallux Valgus or ‘bunions’, causing a deformity at the base of the big toe. The enlarged joint can become inflamed as extra bone and tissue swelling grow, which may cause painful rubbing on previously comfortable shoe wear, as well as pain and deformity in the lesser toes.

Initial steps involve adjusting your shoes or getting ones with a wider fit. Often, referral to a podiatrist can help advise on footwear and exercises, often leading to the recommendation of a special insole for your shoe. Anti-inflammatory medication can also help. In more severe cases, corrective surgery may be useful, but only if conservative measures prove unsuccessful.

Another common condition is Hallux Rigidus, or arthritis of the big toe, causing the toe’s base to stiffen. This can be very painful and lead to bone spurs. As it progresses you may notice a prominent bump, which will affect your gait and potentially contribute to metatarsalgia, forcing the lesser toes to work too hard. If conservative treatment fails, then injections or a big toe fusion, or, in rare cases, a partial joint replacement may help.

Other conditions include claw toes, hammer toes and mallet toes, which may cause severe pain and rubbing, or may contribute to metatarsalgia. Again, conservative measures are always the first option, measures such as a podiatry review, orthotics and a review of footwear.

Surgery should only be considered as a last resort, bearing in mind that there are risks as well as benefits. With proper patient selection and appropriate surgery with an expert orthopaedic surgeon, there is a very high chance of success in most patients.

Surgery aims to improve symptoms, not provide a cure, and while there can be some associated complications, such as numbness or poor alignment, studies have shown that more than 90% of patients are satisfied with the result. If you suffer with foot pain, perhaps it would be useful to consult an expert to ensure you have the correct diagnosis and treatment.

"... studies have shown that more than 90% of patients are satisfied with the result."