Treatments

A Haglund's deformity is a bump in the back of the heel bone. The Achilles tendon runs over the bump. Patients with a Haglund's deformity may or may not have pain. Sometimes, the pain is caused by shoes rubbing against the bump. At other times it can be part of pain of degeneration in the Achilles tendon due to the pressure placed there. It is not always clear how much of this Achilles tendon problem is due to the Haglund's deformity.

If prominence is the main issue, then the goal of Haglund's deformity surgery simply is to make the heel bone less prominent. If the Achilles tendon has degenerated as well, then the procedure may involve the Achilles tendon directly.

A hammertoe is a deformity that causes a toe to become bent upward in the middle so it resembles a hammer. This can cause the toe to rub against the top of the shoe or irritate the end of the toe by jamming it into the ground. Hammertoes often occur in conjunction with other toe problems. It is possible to develop corns (calluses) on top of the middle joint of the hammertoe from rubbing against the top of the shoe.

Patients who have hammertoes try to manage them by treating the symptoms. This involves padding the toe and changing or stretching shoes for comfort. If you still experience discomfort from the hammertoe you may consider surgery.

The hammertoe can be flexible or stiff. Depending on the flexibility of the toe and the preference of your orthopaedic foot and ankle surgeon, several different surgeries are used to treat the hammertoe.

A joint injection is a procedure your doctor uses to introduce medication into a joint. The injection is done under sterile conditions using a syringe and needle.

The goals of a joint injection are to relieve pain and improve joint function. Your foot and ankle orthopaedic specialist also may confirm your diagnosis when giving a joint injection.

The Lapidus procedure is a surgical procedure used to treat a bunion deformity, also known as hallux valgus. It involves fusing the joint between the first metatarsal and one of the small bones in your midfoot, the medial cuneiform. Surgery includes removing the cartilage surfaces from both bones, correcting the angular deformity, then placing hardware (screws and often a small plate) to allow the two bones to grow together, or fuse. This surgery often is done to correct a bunion deformity with a very large angle, or when there is increased mobility through the tarsometatarsal (TMT) joint. When the TMT joint has too much looseness or movement, the condition is known as hypermobility or instability. When this joint becomes hypermobile, the first metatarsal moves too far in one direction and the big toe compensates by moving too much in the other direction. When this happens, a bunion can develop. 

The goal of the Lapidus procedure is to surgically treat hallux valgus that is caused by first TMT joint hypermobility. When the first TMT joint is fused, the first metatarsal will not move abnormally. This will allow the first toe to stay straight and decrease the risk of the bunion coming back. 

Ankle sprains are one of the most common sports-related injuries. They affect 10,000 people per day. When the ligaments on the outside of the ankle are stretched or torn, patients can have pain and feelings of instability. If symptoms persist after non-surgical treatment, surgery may be required. The goal of this surgery is to restore normal stability to the ankle. This should also fix your feeling that the ankle “gives way” and any pain that is associated with an unstable ankle.

Each foot has five metatarsals. These are the long bones of the foot. They connect the toes to the rest of the foot. They also make the ball of the foot. The lesser metatarsals are the bones that connect to the second through fifth toes (not the first, or big toe). 

An osteotomy is a cut made in the bone. It is similar to breaking the bone but in a very controlled manner. A lesser metatarsal shortening osteotomy changes the pressure distribution under the ball of the foot, relieving pain. It also can be used to put a chronically dislocated toe back in position.

The Lisfranc ligament runs between two bones in the middle of the foot called the medial cuneiform and the second metatarsal. The place where these two bones meet is called the Lisfranc joint. The name comes from French surgeon Jacques Lisfranc de St. Martin (1790-1847), who was the first physician to describe injuries to this ligament.  

Tearing of the Lisfranc ligament and other ligaments around the Lisfranc joint can lead to instability and disruption of the joints in the middle of the foot. The goal of surgery is to restore normal alignment to the foot. Whether the injury results in a subtle misalignment of the bones or a more obvious dislocation of joints, the surgery is intended to put the bones back into their original position.

The midfoot is the middle of the foot. It refers to the bones and joints that make up the arch and connect the forefoot (front of the foot including the bones of the toes) to the hindfoot (back of the foot including the ankle bone and the heel bone).

Midfoot fusion is a procedure in which the different bones that make up the arch of the foot are fused together. Fusion eliminates the normal motion that occurs between two bones. Since there is very little movement in the small joints of the midfoot, the function of the foot can be preserved.

The naviculocuneiform (NC) joint is located in the middle of the foot. It consists of four bones: the tarsal navicular and the medial, middle, and lateral cuneiforms. 

The main reason to perform NC joint fusion is to relieve pain related to arthritis. Arthritic joints in the midfoot typically occur after trauma to that region or as part of a collapsing foot arch. When a joint is arthritic, the cartilage has worn away and the bony surfaces rub together, which causes pain. The goal of the fusion is to get the bones to heal together so the pain goes away. Sometimes patients whose arches have collapsed will have a deformity that requires NC fusion to correct it.

Percutaneous Achilles tendon lengthening in a procedure used to stretch a tight Achilles tendon and increase motion at the ankle joint.