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Foot Statistic
The number of bones in your foot, in addition to 30 joints and more than 100 muscles, tendons and ligaments.
*Source: Arthritis Foundation

Understanding Foot and Ankle Surgery

The foot and ankle are complicated and most people will need to see a foot and ankle specialist at some point for a diagnosis, care or treatment. WellStar Health System foot and ankle surgeons treat a wide variety of conditions, from mild sprains to devastating injuries. These highly trained physicians perform surgeries including fracture care for adults and children, trauma and reconstructive surgery, arthroscopic surgery, deformity correction and revisions of prior surgeries.

Dr. Bryan S. Russell, DPM, FACFAS, is a board-certified foot and ankle surgeon who comes to WellStar Health System after starting the foot and ankle service line for a private orthopedic group in Minneapolis/St. Paul. He grew the service line and averages 720 surgical cases a year with 5,200 encounters.

Dr. Russell has extensive experience in all aspects of foot and ankle care, treating the bones, joints, ligaments, tendons and nerves that make up the foot and ankle. Dr. Russell specializes in surgical reconstruction, trauma and sports injuries. He guides patients through a thorough evaluation of all options in order to determine an individualized treatment plan. Dr. Russell is known for his warmth and easy manner. Patients appreciate his creative approach to complex challenges.

While the specialty is known as foot and ankle surgery, Dr. Russell and his team also offer many non-surgical treatments for conditions causing pain, discomfort and musculoskeletal problems. Depending on the diagnosis, treatment can include exercise and physical therapy, medication, casting, bracing, custom orthotics and other techniques.

Patients are referred to a WellStar Health System foot and ankle surgeon by another physician, such as an emergency or urgent care doctor, internist, other surgical specialist, pediatrician (children’s doctor) or family practitioner.

 

Conditions and Symptoms

Patients visit WellStar Health System foot and ankle surgeons for many reasons, including sports injuries, trauma and unexplained pain or discomfort. Common symptoms include:

 
  • Strains
  • Sprains
  • Soreness
  • Stiffness
  • Numbness
  • Trouble walking properly
  • Fracture pain
  • Swelling of the feet and ankles
  • Toes bending oddly
  • Pain in the foot or ankle
  • Foot/ankle in an odd position
 

WellStar foot and ankle specialists treat conditions including the following. Make an appointment if you think you or a loved one may have one of these, something else, or are experiencing unexplained pain or trouble walking.

 

The Achilles tendon is the largest tendon in your body, connecting your calf muscles to your heel bone. This hard-working tendon that helps you walk, run, climb stairs, jump and stand on your toes. A rupture of the Achilles tendon is the most common rupture in the lower body. This injury is sometimes associated with “weekend warriors,” people who exercise excessively but irregularly.

If you have ruptured your Achilles, your WellStar foot and ankle specialist may recommend ways other than surgery to treat the problem. In some people, including those who want to return to activities like running and biking, surgery may be the best choice. Surgery is usually an outpatient procedure, which means you don’t have to stay overnight at the hospital.

Ankle arthroscopy is a minimally invasive procedure used to diagnose and treat foot and ankle problems including arthritis, fractures and ankle instability. Your WellStar foot and ankle surgeon inserts a thin, fiber-optic camera called an arthroscope into the ankle. It transmits images of the ankle onto a video screen. The doctor uses the images to guide miniature surgical instruments. Because the tools are so thin, the incisions are quite small and recovery is quicker than with traditional open surgery. Talk to your doctor about arthroscopy to make sure it’s the right choice for you. In some cases, arthroscopy can make an arthritic joint deteriorate more rapidly.

A fracture is a partial or complete break in one or more of the ankle bones (tibia, fibula and talus). Fractures happen when the ankle rolls or is forced inward or outward. Some ankle fractures involve small pieces of bone that have pulled away; others result from a shattering-type break.

Symptoms of a break include pain, swelling, blisters, bruising, problems walking, an unusual appearance or bone sticking out of the skin. Sometimes people mistake an ankle sprain (stretched or torn ligament) with a fracture. Your WellStar foot and ankle surgeon will determine which you have. Whether it’s a complex fracture or a relatively simple sprain, it’s important to get prompt treatment.

A broken or fractured ankle is a common childhood injury. A fracture is a break in one or more of the bones of the ankle (tibia, fibula and talus). Most commonly the tibia and the fibula—the long bones in the lower leg—are involved. Kids break their ankles for lots of reasons, especially with an unexpected twist of the foot or lower leg during vigorous play or sports.

Ankle fractures in children typically involve growth plates. These are areas of developing tissue that determine the length and shape of adult bones.

One indication of a possible fracture is not being able to put weight on the injured ankle. Others symptoms can include swelling, bruising, torn skin and an odd appearance in the affected area. If you think your child may have a fractured ankle, make an appointment with your WellStar foot and ankle specialist. An untreated fracture can affect a child’s growth.

Arthritis, in the feet or elsewhere in the body, is inflammation of one or more joints. There are more than 100 forms of arthritis, many of which affect the foot and ankle, making it hard to walk and perform daily activities. Arthritis can cause pain, stiffness, swelling, warmth and redness. It can lead to deformity, loss of joint function and a decreased ability to walk.

Osteoarthritis, sometimes called degenerative joint disease or wear-and-tear arthritis, is the most common form of ankle arthritis. The cartilage, the rubbery covering on the ends of the joints, wears away and the joints no longer move or glide easily. Osteoarthritis affects mostly older people, but some younger people get it. Rheumatoid arthritis is an autoimmune disease, meaning that the body’s immune system attacks its own cells. Rheumatoid arthritis affects many joints throughout the body and often starts in the foot and ankle.

While there is no cure for arthritis, your WellStar foot and ankle doctor will examine you and suggest ways to slow the disease and improve comfort. Many of these are nonsurgical approaches, like minimizing activities that cause discomfort, physical therapy, wearing a brace or using a cane. If these are not successful, surgery may be an option. The type of surgery will depend on the type and location of arthritis, and how it is affecting you. More than one type of surgery may be required. Your doctor will discuss the options with you.

A bunion is a bump on the side of the big toe caused by a misalignment of the bones in the foot. Nine out of 10 bunions affect women. The condition is typically genetic, but can be due to wearing tight, narrow shoes. Sometimes the big toe moves toward the second toe, or may move under it. Pressure from the big toe can force the second toe out of alignment. Bunions can be sore, inflamed and painful, especially when wearing tight shoes. In some cases, the skin on the bottom of the foot becomes thick and painful. Bunions tend to run in families.

Most bunions can be treated without surgery. Talk with your WellStar foot and ankle surgeon about ways to relieve the pain, like wearing shoes with a roomy toe box and soft soles and using protective pads. If your doctor recommends bunion surgery, the recovery is considerably shorter than in years past, typically about four to six weeks.

Children, especially girls age 10-15, sometimes get bunions. Surgery is not typically recommended in children, as they have not yet finished growing.

Flatfoot refers to a partial or total collapse of the arch. It is a complex condition with a variety of symptoms and levels of deformity or disability. If you have flatfoot that is causing pain and making it hard to perform daily activities, talk to a WellStar foot and ankle surgeon to see if you are a candidate for reconstruction surgery. The purpose is to rebuild your fallen arch, reduce pain and restore function. The surgery repairs the ligaments and tendons that support the arch, and may involve cuts in the bone to restore the arch.

Ankles become unstable for many reasons, most often as a result of ankle sprains, which affect 10,000 people every day. With a sprain, ligaments on the outside of the ankle become stretched or torn. This can be painful or can make you feel unsteady on our feet.

Your WellStar foot and ankle doctor will suggest non-surgical ways to stabilize your ankle, like physical therapy and using a brace. If those don’t work, you may need surgery to stabilize the ankle by sewing the ends of the damaged ligaments together, then reconnecting the ligaments to your bone.

Pes cavus reconstruction

Pes cavus, sometimes known as claw foot, is a very high arch that is stiff and does not unstiffen when bearing weight. The cause is an imbalance in the muscles of the foot. A similar condition, Cavovarus foot, refers to a high arch plus an inward turning of the heel. These conditions cause stress on the foot, ankle instability and in some cases, fractures to affected bones. They can affect patients with the genetic nerve disease known as Charcot-Marie-Tooth.

If your arch is abnormally high and is causing pain or walking problems, your WellStar foot and ankle surgeon will examine you and take images. The doctor may recommend conservative treatment like wearing a brace or using an orthotic in the shoe. In a few cases, surgery may be the best solution. The goal of surgery is to restructure the arch so that the foot meets the ground evenly.

Some patients who have had foot and ankle surgery in the past continue to experience pain, discomfort and deformity. They may require additional (revision) surgeries to address the ongoing problems.

Tendons are strong tissues that connect muscle to bone. A transfer is a surgical procedure that moves a tendon from one place to another. It’s done to improve joint function or correct a deformity or other problems. Weakness in the affected muscle or tendon can cause problems with walking, lead to ankle instability or change the structure of your foot. The condition runs in some families, or may be the result of neurologic disease, stroke, nerve injury, trauma or wear and tear. Your doctor will help determine if tendon transfer is a solution for your muscle or tendon weakness.

 

Diagnosis of Foot and Ankle Conditions

Your WellStar foot and ankle specialist will use a number of ways to diagnose your condition.

 
  • Physician examination
  • Medical history and detailed questions about your symptoms, level of pain and function, lifestyle, activities, overall health, etc.
  • Gait analysis (an assessment of how you walk) to help the doctor understand the alignment of bones in your leg and foot
 

Tools and Tests

  • Imaging procedures like X-rays
  • Computer tomography (CT) scan
  • Magnetic resonance imaging (MRI) of your foot and other tissues and bone
  • Blood tests to check for some types of arthritis or other conditions
  • Testing the strength in your feet and ankles
 

Treatment of Foot and Ankle Conditions

Many foot and ankle problems can be treated without surgery. Depending on what you have and how severe it is, your doctor may recommend:

 
  • A stretching program
  • Reducing activities that cause discomfort
  • Switching from high-impact activities like jogging, to low-impact activities like swimming
  • Losing weight to reduce stress on joints
  • Using a cast or brace
  • Wearing orthotics in your shoes
  • Physical therapy
  • Anti-inflammatory medications to reduce inflammation and swelling
  • Injections
 

Surgical Options

Depending on the diagnosis and severity of your condition, your WellStar Health System foot and ankle specialist may recommend an operation. Surgical procedures range from less invasive procedures, like arthroscopy, to more invasive techniques like restructuring. This involves moving tendons and altering bones; it can require a lengthy recuperation period.

Your doctor will talk with you about the details of any proposed operation, including where and how it will be done, what recovery will be like and any post-surgery restrictions.