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Foot & ankle surgery

Expert help for your foot or ankle condition

One of the most painful areas of the human body is the foot and ankle as anyone will know if they have ever suffered some kind of trauma to this area, especially an ankle or lower leg injury where the Achilles tendon is attached.

But that is just one medical condition from a whole raft of painful conditions that are treated at the South West Wales centered Werndale Hospital by some of the country's top podiatrists, doctors, and consultants.

If you are suffering from pain or discomfort of any sort involving the foot or ankle, please do call our specialist foot and ankle department on 01267 225600 and we'll be pleased to advise you on the root of the problem and offer the best treatment to help you get back to your former health. 

It's not just the Achilles tendon that can cause so much trouble (especially for those into sports such as athletics and football), it's also arthritis of the joints in and around the foot that can cause our quality of life to deteriorate as we get older.

In fact, arthritis (and in particular osteoarthritis) is the most common condition seen at the foot and ankle clinic at Werndale. This is where cartilage (the flexible material found between joints that acts as a kind of shock absorber) becomes damaged.

That can happen over time through natural wear and tear (osteoarthritis) or by direct injury due to tripping on some hazard, sports or even daily exercise such as running on hard surfaces. Arthritis typically affects the mid part of the foot and can also affect the ankle. 

There is also a neurological disease called Charcot-Marie-Tooth (CMT) disease (known as hereditary motor and sensory neuropathy - HMSN) which affects the extremities of our limbs and can result in difficulties in trying to walk.

CMT most often begins in the lower limbs but can extend over time into the arms and hands. It is an inherited disease that affects the nervous system and can result in signals from the brain not getting to their destination (which can result in falls or trips).

Deformities of the foot can also occur as a result of CMT, but it can also affect other normal bodily functions too.

The second most common foot and ankle conditions are deformities. These can be congenital, meaning we are born with them or we are born with genes that may later play a part. Deformities can also happen over time due to a trauma or injury of some sort.

Deformities can occur due to damage to cartilage or the joints and bones that surround them, the result of which can cause a great deal of pain when walking (or even when resting in the worst cases).

The arch of the foot being either non-existent (flat foot or pes planus) or too high (high arch or pes cavus) are two types of deformity that can lead to many problems associated with walking or standing as well as searing pain in certain situations making walking almost impossible.

Another condition is hammer toe. This is where a contraction occurs between the toe bones closest to the foot itself, which results in a toe being pulled out of shape. If the contraction is in the joint nearest the nail, then it's called a claw toe.

It's also possible for a toe (usually the small toe) to become rotated on its axis. This is often caused by the gait of a person's walk, which can happen for many reasons including arch deformities.

The tendons and ligaments throughout the foot and ankle keep your bones in shape by stabilising them, so it makes sense that any problems with those tendons and ligaments can cause deformities. Perhaps the most common of those are bunions (known medically as hallux valgus).

A major cause of bunions are tight fitting (or badly fitting) shoes. If the big toe is too constrained (or bent out of shape) by shoes, the instability that results from that can cause excessive bone growth to the side of the main big toe joint.

When that happens, the area can become inflamed and eventually a bunion forms that further deforms the shape and position of the big toe. 

The big toe joint can also have excessive growth occur on the top of it, resulting in limited movement of the toe (you'll find it difficult to bend the toe upwards, making walking that much harder). This is called hallux limitus.

If left untreated, the joint can ossify eventually resulting in a fusion of the joint (or hallux rigidus), and over time calluses can develop on the side of the joint due to the extra friction between the big toe and its nearest neighbour.

An ingrown toenail (the medical term is unguis incarnatus) is another common deformity affecting all age groups from children to the elderly and should be treated as soon as noticed (especially if there is any discomfort) as once the nail penetrates too deeply into the surrounding skin, infection may set in.

Whilst surgery is always a possibility (and in some cases, is the only way to relieve the pain you may be feeling), we'll always discuss with you all the options you have available to get you back to good health as fast as possible.

For many people, it can be as simple as a change in footwear with the addition of an insole (or other orthopaedic device) to help the foot get back into shape. Foot and ankle braces and support socks along with compression sleeves are also options depending on the condition.

Corticosteroids are used for many complaints of the joints and in many cases are all that is required (apart from rest) to give the foot or ankle what it needs (including time) to recover.

These are injected directly into the affected joint using a local anaesthetic and the patient is usually allowed home directly afterwards. 

Surgery is always the last resort, but can have great benefits, and may be the only option in some cases. However, as with all medical procedures, full advice is always given to patients before any treatment is considered as there are always risks to be taken into account.

Surgery can vary from osteotomies (where a surgeon realigns a bone by making a series of small cuts) to full ankle replacements. Arthritis in the ankle can eventually lead to an ankle replacement being the only option.

Whatever condition you are suffering from, please do call our specialist team here at Werndale Hospital. We will be able to guide you further and let you know all the options open to you.

One of the things we pride ourselves on is being able to offer a complete care service from your initial consultation right through to any medical procedures and after care you may need.

Werndale Hospital has 27 private rooms all with en-suite facilities so if your stay is overnight or longer (for example where an ankle replacement is necessary) you can be rest-assured you will have the best care possible. 

Specialists offering Foot & ankle surgery

Mr John Black

Consultant Orthopaedic Surgeon

LRCP&SI, FRCSI, Orthopaedic Specialist Register

BMI Werndale Hospital

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Mr Anirudh Arvind Gadgil

Consultant Orthopaedic Surgeon

MBBS, M.S. (Orth), FRCS (Ed), FRCS (Trauma & Ortho)

BMI Werndale Hospital

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