Steroid injections
Corticosteroids can be injected locally for a concentrated anti-inflammatory effect and are indicated for the treatment of plantar fasciitis (heel pain) and Morton's neuroma. In joint inflammation they are injected intra-articularly to relieve pain, and increase mobility.
Nail surgery
Nail surgery should be cosmetically pleasing as well as resolving the pain and/or infection usually associated
There are basically two methods of surgically correcting a deformed nail plate that is painful or prone to recurrent infections. These are performed under a local anaesthetic.
Phenolisation partial where a sliver of nail is removed from the side of the nail plate and the nail root and bed is chemically prevented from growing again. Total where the whole of the nail plate is removed and prevented from growing again.
Incisional techniques which allow for the removal of part or all of the nail plate with additional removal of hypertrophied (thickened or overlapping) flesh or scar tissue.
Recovery rates differ significantly and the merits of each procedure should be discussed thoroughly before deciding.
An information sheet is available from the Unit.
Morton's neurectomies
Morton's' neuroma describes a trapped digital (toe) nerve that swells and becomes chronically painful between the third (middle) and fourth toes. The same condition in the other inter-metatarsal spaces revels in the name of plantar digital neuroma (not named after anyone in particular). The patient is often limited to flat roomy footwear and complain of a burning or shooting/electric shock like pain with numbness in the lesser toes. Steroid therapy and/or surgery often resolve the problem.
Digital / lesser toe correction
Hammer / mallet / claw toes or fixed flexion deformity is the term used to describe a series of symptoms and joint changes seen in the lesser toes and the MP joints (knuckle joints in the ball of the foot). They may occur singularly or as part of a group in which all lesser digits display abnormality and are often associated with painful corns and callus.
These deformities are readily treated surgically to give a straight flat toe that does not rub in the shoes or poke up in sandals.
Surgery for hallux limitus / rigidus
Osteo-arthritis of the big toe joint is so common it has its own names - hallux limitus with reduced range of joint mobility which worsens to become hallux rigidus where all normal functional joint motion is lost. It can be treated surgically by cutting at an angle the excess bone away or shortening the first metatarsal or by permanently fusing the joint or by joint replacement.
Clearly with such choices a patient must take individual advice with the surgeon while reviewing the radiographs of the foot.
Haglund's and heel spur surgery
This condition is also known as "pump bumps", where extra bone forms at the back of the heel from shoe pressure. Resection of bone is required for some patients.
Patient information leaflets
Please note that the leaflets available for download on this page are from The Society of Chiropodists and Podiatrists, an external website.
- Verrucae and skin surgery
- Morton's neurectomies
- Digital / lesser toe correction
- Surgery for hallux limitus / rigidus
- Surgery for hallux valgus
- Haglund's and heel spur surgery
- Plantar fasciitis / heel spur surgery
A patient specific leaflet will be issued from The Unit at the time of the first consultation.
Verrucae and skin surgery
Persistent verrucae that have resisted other forms of treatment may be surgically treated by an excision and electrocautery method. This form of treatment has a high success rate and is performed under a local anaesthetic.
Cyst and ganglia excision
Epidermoid cysts are common lesions and derive from the hair follicle. They are filled with creamy keratinous debris - layers of skin cells interspersed with keratin.
Mucoid inclusion cysts are fluid filled structures that often arise from a reaction to a foreign body or surface tissues becoming trapped under the skin.
Ganglion cysts are benign, fluid-filled soft tissue masses commonly seen in the foot. If allowed to enlarge they can cause pain and loss of function by pressing on other structures within the foot. Some ganglion can grow large enough to make fitting a pair of shoes almost impossible.
All such lesions and structures can be surgically excised to leave a cosmetically pleasing result and are performed under a local anaesthetic.
Sub ungual exostectomies
Exostoses (bone spurs) usually form in the foot as a result of localized acute or a chronic insult (injury). They can occur under the nail deforming its normal appearance and are often misdiagnosed as an ingrown toenail. The lesions can also be present under the nail bed area projecting forward or sideways protruding the flesh with no disturbance to the nail itself.
These deformities can often be operated upon to remove the pain and return the toe to a more normal cosmetically pleasing appearance.
Lesser metatarsal
Surgery for plantar corns
Many patients suffer from long term painful corns under the ball of the foot. This type of lesion can be cured; by surgically cutting and re-setting the bones in the forefoot, the pressure can be taken off the painful area of the foot, where the pressure is abnormally high.
These types of procedure can be very effective in selected cases preventing the painful corn growth and reducing the overloading that can lead to arthritic change.
This type of foot condition can often be helped pre-operatively and made more comfortable with the use of a biomechanically designed orthosis (insole) and worn in good fitting footwear.
Surgery for hallux valgus
Bunion surgery aims to correct the structural deformity and improve joint function. This is a complex condition that requires individual guidance following the review of the weightbearing radiographs (x-ray views).
The subsequent choice of surgery and advice on biomechanical stabilization post operatively is too complex a matter for this website. Individual consultation and explanation is required with your Podiatric Surgeon (see one example at the link below).
Plantar fasciitis / heel spur surgery
Chronic early morning heel shooting and then deep ache that has not responded to orthotic management.
