Foot & Ankle Problems
Highgate Foot & Ankle Unit
Our Foot & Ankle Unit takes a collaborative approach to treat and diagnose injuries and conditions affecting the foot and ankle. You’ll have access to world-class Consultant Orthopaedic & MSK Surgeons, Pain Management Consultants, Sports & Exercise Medicine Consultants, Chartered Physiotherapists and onsite diagnostic imaging with reporting from specialist MSK Radiologists.
Highgate Private Hospital is equipped with two state-of-the-art theatres fitted with laminar flow systems to specifically accommodate Orthopaedic procedures. Our theatre staff are highly skilled in MSK & Orthopaedic operations and our nurses are on call to assist with your recovery following surgery.
Services & Treatments
At the Foot & Ankle Unit, we can treat an array of conditions, injuries and problems of the foot and ankle. Whether you are suffering from a common condition to something more complex, we work with London’s leading Consultants and Specialists to provide you with first-class care.
Foot & Ankle Problems and Procedures
The ankle joint is a complex hinge which allows a range of movements. It consists of three bones which are held in place by powerful bands known as ligaments. The talus sits in the foot and slots directly into the two-leg bones, the tibia and fibula, which run parallel to each other.
Pain in the ankle can be attributed to a range of issues including arthritis. There are five types which generally affect this joint, they are ankle arthritis, rheumatoid arthritis, psoriatic arthritis, gout and septic arthritis.
This can happen when a foot twists. It can be very painful and will cause significant swelling. Although the injury is normally a straightforward sprain it is possible to chip the cartilage and damage the tendons around the ankle.
What to do – Typically, treatment will involve rest, the application of ice and a bandage. However, if there is no improvement within three or four days you should visit a hospital.
Most sprains heal and don’t cause any lasting damage but in some cases, there can be some instability. Physiotherapy can significantly improve this and ligament reconstruction is also an option in some cases.
Breaks and cracks are commonly referred to as fractures. It is sometimes difficult to tell if an ankle is broken or just sprained. If any of the following are present you should visit a hospital:
- There is significant pain in the bones around the ankle
- You can’t put any weight on the injured ankle
- You heard cracking when the injury happened
- The ankle looks deformed
- The skin over the ankle is broken
- The swelling worsens after three to four days
Treatment of Ankle Fractures
Injuries can cause lasting damage and pain. There is a range of treatments available including ankle arthroscopy, ankle replacement and ankle fusion.
Straightforward fractures are treated by using a plaster cast which is normally left in place for between six to eight weeks. A removable cast or special boot is sometimes used after the initial four weeks so the patient can put some weight through the injured ankle.
A surgical procedure is necessary to treat badly fractured ankles to realign and fix the bone. Wires, plates and screws are normally used in an operation known as open reduction and internal fixation. It is unusual to remove the metalwork unless it causes problems.
It is difficult to predict how long it will take to fully recover as this will depend on the severity of the fracture. In most cases, it normally takes around 12 weeks but this can vary as every case is different.
Arthroscopy is a less intrusive form of surgery that allows your surgeon to look inside your ankle through a small cut, using a miniature camera. This allows them to quickly diagnose problems such as arthritis, damage to the joint surface or damage to the ligaments, and they may be able to treat the problem at the same time.
During the operation, which uses one of a variety of anaesthetic techniques and usually takes between 30 and 45 minutes, your surgeon will insert a small camera into your ankle area through several small incisions. They will then remove any loose fragments of bone or tissue caused by wear to the joint surfaces. Swelling can also be removed from the lining of the ankle joint. If your ankle ligaments are torn, a reconstruction operation may be required.
You’ll normally be able to go home on the same day as the operation, although your ankle will be slightly swollen for a couple of weeks. It may also be uncomfortable at first, especially whilst walking. Daily, gentle exercise will help your recovery but do check with your doctor. Most people are quickly able to return to their normal activities.
This page offers information regarding an arthroscopy of the ankle. Further information can be supplied by your consultant.
A bunion is a painful, hard lump on the side of your foot, at the bottom of your big toe. They are often caused by poorly fitting shoes that cause pressure on the toes, pushing them out of their natural position. Occasionally bunions are associated with arthritis of the big toe joint. Bunion surgery will straighten your big toe and enable you to wear normal shoes more comfortably.
During the operation, which takes place under general or local anaesthetic and lasts around half an hour, your surgeon might need to release or tighten the ligaments aligning the big toe and straighten the other toes.
You should expect to return home within one to two days and should try to keep your leg raised for a week to reduce any swelling. Your surgeon may decide to put your leg in a plaster cast for a few weeks and you’ll probably need a walking aid such as crutches until the pain and swelling settle down.
Light exercise will help you return to your normal activities quickly but do check with your doctor. You can expect to be wearing normal shoes again in about six weeks, but this varies from patient to patient.
This page describes the process of bunion surgery. If you have any further questions, please discuss them with your consultant.
Chronic Ankle Instability
Ankle instability is the term used when the ligaments of your ankle become stretched and the joint feels like it is constantly ‘giving way’. Common symptoms include pain, tenderness and swelling. You may also notice that your ankle turns inward or feels unbalanced when walking over uneven surfaces.
Ankle instability often happens because a previous sprain hasn’t healed properly. This puts your ankle at greater risk of subsequent sprains, and each time this happens the joint will become more and more unstable.
Our orthopaedic consultants will check the ankle for swelling and instability, which may require an X-ray, CT or MRI scan. Following diagnosis, they’ll recommend the best treatment to suit your needs. This may include:
- Physiotherapy and/or orthotics – these aim to strengthen the ankle, improve motion range and balance, and retrain the muscles
- Ankle brace – this prevents the ankle from turning in and reduces the likelihood of spraining the joint again
- Ankle surgery – this will repair or reconstruct the ankle joint, depending on the severity of your condition
Peripheral nerve block (lower limb)
A peripheral nerve block is an anaesthetic injection in your leg, close to the major nerves, to relieve pain. It’s commonly used to give post-operative pain relief following a lower limb procedure carried out under spinal or general anaesthetic.
The injection can be administered in five different areas: the foot, ankle, behind the knee, near the groin or behind the thigh. Our specialist anaesthetists will locate the appropriate site for your injection using an ultrasound scanner and a nerve stimulator. If it’s likely that you’ll need further anaesthetic injections, they may insert the needle through a tiny tube that can be left in place for further treatments.
This page contains details about peripheral nerve block for your leg. If you still have questions, your consultant will be able to answer them.
EIDO Healthcare Limited – The operation and treatment information on this website is produced using information from EIDO Healthcare Ltd and is licensed by Aspen Healthcare.
The information should not replace advice that your relevant health professional would give you.
Consultants & Specialists
By taking a collaborative approach to your diagnosis and treatment, the Consultants and Specialists as part of the Foot and Ankle Unit are there to support you every step of the way – from diagnosis through treatment.
Foot & Ankle Problems Consultants