How to

Use this three-part guide to help make your orthopaedic foot or ankle surgery and recovery go smoothly. You achieve the best results when you work with your surgeon to prepare for surgery and post-surgical recovery. Part 3 will focus on what to do in the days immediately after your surgery.

Most children learn to walk at about the time of their first birthday, although some learn months earlier or later. As your child begins to walk, you may have your first questions about what shoes he or she should wear. A growing child will need new shoes frequently, and more questions will arise.

You should ask yourself the following questions when selecting your child's shoes:

• How does the shoe fit?
• How is the shoe made?
• Is the type of shoe appropriate for your child's age? 

Following an ankle sprain, you should start strengthening exercises once you can bear weight comfortably and your range of motion is near full. There are several types of strengthening exercises. It is easiest to begin with isometric exercises that you do by pushing against a fixed object with your ankle.

Once you have mastered isometric exercises, you can progress to isotonic exercises. In isotonic exercises, you use your ankle's range of motion against some form of resistance. The photos below show isotonic exercises performed with a resistance band, which you can get from your local physical therapist or a sporting goods store.

High-heeled shoes are a popular fashion choice, but wearing them can lead to foot pain and injury. Some common injuries and pain associated with wearing high heels may be prevented with the following steps. 

Vitamin D is important for maintaining bone health. It affects bones by controlling the body’s levels of calcium and phosphate, which are critical for building new bone. Vitamin D controls calcium and phosphate levels in three ways: by regulating how much we absorb from our diet, how much is within our bones, and how much we excrete.

We get vitamin D from our diet, sun exposure, and oral supplements like multivitamins. Only a few foods naturally contain vitamin D. These include some oil-rich fish, certain mushrooms, and egg yolks. Most of our dietary vitamin D comes from fortified dairy products, cereals, and bread products. The sun provides a major source of vitamin D, but sunscreen, which protects against sunburn and skin cancer, decreases the skin’s production of vitamin D.

Orthotics, also called orthoses, are devices that are worn to relieve pain associated with foot and ankle deformities and help prevent or delay surgery. Most people think of shoe inserts or arch supports when they hear the word orthotics, but they can include devices such as foot pads, shoe inserts, ankle braces, and similar items. Treatment often can begin with less expensive off-the-shelf orthotics and progress to custom orthotics if the symptoms and diagnosis require it.

Many foot and ankle procedures require insertion of metal plates, screws, rods or similar implants for stabilization of the bones while they heal. There are a number of reasons why a foot and ankle orthopaedic surgeon will chose to remove this hardware. Hardware can be removed if it is painful, associated with an infection, or if your bone didn’t heal as hoped, which may require new hardware to be placed.

The goal of the procedure is to safely remove the hardware without causing damage to the surrounding soft tissues. These tissues often are scarred from previous surgery. Nerves and blood vessels and other soft tissue structures in this area may be at greater risk than at the time of the original surgery. A larger incision than the original surgical incision may be required to safely remove the hardware.

Sesamoids are bones that develop within a tendon. The one most people are familiar with is in the kneecap, however they most commonly occur in the foot and hand. Two sesamoids, each about the size of a corn kernel, typically are found near the underside of the big toe.

A stress fracture is a small crack in a bone. These fractures most often are a result of overuse and can occur with an increase in activity. Stress fractures most commonly occur in the weight­bearing bones of the legs. When a bone is subjected to a new stress, such as a new exercise routine, it may not be prepared for the increased workload, and as a result, may develop a stress fracture.

Tendoscopy is a procedure that allows an orthopaedic surgeon to see the inside of a tendon sheath to treat tendon disorders of the foot and ankle. Tendoscopy is very similar to arthroscopy. A small camera and special instruments are placed through small incisions along the course of a tendon. Sterile fluid is used to expand the sheath and provide direct exposure to the tendon.

The goal of tendoscopy is to treat tendon disorders without using large incisions. Patients have less pain and smaller scars than with traditional open surgery. Patients also can return to work and exercise sooner with this procedure versus open surgery.