Foot & Ankle Surgery
| • 拇趾外翻治療與手術 | • Hallux Valgus • Ligament Tear And Repair |
Foot and ankle problems are common in metropolitan life. Hallux valgus and toes deformities bring disturbance to many ladies. The Centre has the expertise to offer orthotic devices and treatment to produce gratifying outcomes.
Hallux Valgus
What is Hallux Valgus?
Hallux valgus literally means deviation of the big toe and is often referred to as a bunion. It is common among ladies. One foot or both feet could be affected and the latter is more common. The main cause is the use of shoes with narrow toe box or high heel forcing the big toe to deviate towards the other toes. With time the deformity cannot be corrected spontaneously. People with flat feet are more commonly affected.
When the deformed toe rubs against the shoe for a certain period, a bursa is formed beneath skin. At times the bursa is inflamed and swollen, causing pain and affecting joint movement when the condition becomes serious. In worse cases, the big toe joint becomes degenerated and damaged, the adjacent toes deformed and corns formed at the sole.
Methods of Treatment
When the condition is not serious, one can use pads at the side of big toe, between toes and beneath the sole. One should avoid wearing shoes with narrow toe box or high heel. When the pain is serious or the other toes are affected, only surgery can help.
The Operation
The choice of operation depends on the severity of the condition. In general, it would be as follows:
- When the condition is not serious: The bunion is excised. The big toe deformity is corrected by either soft tissue reconstruction or bony realignment operation.1
- When the big toe joint is damaged, it is required to fuse the joint. Deformities of the other toes will be corrected at the same time. 2
Possible Complications
Post-operative complications for hallux valgus are not common, while some conditions may affect recovery. Common complications are:
- Deterioration of pre-existing diseases like cardiac disease, hypertension, stroke, diabetes mellitus and etc.
- Wound infection or healing problem.
- The metallic implants could be felt under the skin and cause pain.
- Delayed or poor healing of bone cuts.
- Decreased mobility of toes.
- Nerves damaged causing numbness.
- Recurred deformity or over-correction leading to reversed deformity.
Related prosthetic & Orthotic services
Patients are suggested to get used to the tailored insole and night toe splint, whilst changing shoe-wearing habit to minimize the symptoms.
Ingrown Toenail
What is Ingrown Toenail?
In normal toes, there is a small gap between nail edge and skin. Ingrown toenail develops when the adjacent skin and soft tissues get above the nail plate. As the nail grows, the nail plate grows into the soft tissues, causing damage and leading to bacterial infection.
Ingrown toenail commonly occurs in big toes. The causes are many. Many people like to cut the nail short to avoid damage of the socks. Once too much of the nail edge and nail corners are removed, the skin and soft tissues next to the nail will get above the nail plate. Wearing shoes with narrow toe box is another common contributing factor.
Prevention
- Do not cut the nails too short
- Do not cut away too much of nail corners
- Avoid wearing shoes with narrow toe or shoe box
Methods of Treatment
If the infection is not serious, it is treated with antibiotics and cleansing of the wound. Once the infection is controlled, the nail should be allowed to grow out of the soft tissues. The problem will go away. If the infection is serious or persistent, in addition to taking antibiotics, surgery is necessary.
The Operation
Wedge Excision of the Nail
- It is usually done under local anaesthesia
- Remove the swollen and inflamed tissues
- Make an oblique incision at the base of the nail
- Remove part of the nail plate and nail bed
- Continuous dressing of the wound until it is healed
Possible Complications
- Excessive bleeding: To avoid excessive blessing from the wound, lie flat for 15 to 30 minutes after the operation.
- Recurrence of the ingrown toenail.