Foot Problems?

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By Dr. Joseph Alencherry

SURGERY MAY BE A STEP IN THE RIGHT DIRECTION

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What do you consider when buying shoes – style or comfort? The majority of women buy shoes based on style alone, which often comes at a cost. Bunions and hammertoes are common unsightly foot deformities caused by fashionable shoes. Many continue to suffer with the pain and put off any treatment, especially surgery, often due to a lack of information about treatment options.

A bunion is a bump at the inner side of the foot at the big toe joint, usually a progressively worsening condition. Hammertoes are contractures of the smaller toes that can be present from
the early teen years through any age. Bunions and hammertoes are hereditary and are most often caused by an inherited faulty biomechanical structure of the foot that’s then made worse by shoe choices. Considering these are bony structural problems, the most effective treatment is surgery. Many people postpone surgery due to certain misconceptions that are still widely present but, for the most part, are no longer applicable.

A very common misconception is that foot surgery requires a long healing time, necessitating extended time off from work and use of crutches and casts. While this was common in the past, new techniques allow patients to return to activities more quickly. Today, the majority of patients

who have bunion surgery can walk immediately after surgery in a walking boot thanks to recent technological advancements. Usually, the patient can advance to sneakers in three weeks and to most activities by six weeks.

While pain is very much subjective, foot procedures are no more painful than any other surgery. Today’s more modern techniques utilize smaller incisions

and less extensive soft tissue dissection, which in turn, minimizes pain and healing time.

Those considering foot surgery often cite an unsightly scar as a deterrent. While scarring is often influenced by one’s genetics, there are several factors to consider in minimizing their visibility. Smaller incisions and placement on the inside of the foot where it is not visible from the top are possible. The same is true for hammertoes. Plastic surgery techniques can be utilized to greatly minimize scarring.

Timing for bunion surgery is often debated. It was thought best to avoid surgery unless a bunion is very painful, but this is slowly changing. Since these deformities worsen over time, it is sensible to address them earlier rather than later in life. There are also advantages to this since putting off surgery may worsen the condition, leading to more aggressive procedures and longer recuperation. Also, healing time after surgery usually increases with age. In terms of bunion surgery longevity, most patients will maintain their results and are satisfied long term. Certain foot types are prone to recurrence, such as those with excessive laxity of the foot joints. These patients should pay closer attention to shoe choices and should consider the role of orthotics after surgery. Bunion surgery is a more common option nowadays and can be less daunting when done using the latest and most advanced techniques. The results will allow you to experience a better quality of life and put an end to the pain that conservative options cannot resolve. Discuss your condition with your foot and ankle surgeon and choose what would provide you with the best results. Ultimately, an individualized care plan should be created that is unique to your needs.

Affiliated with NorthShore LIJ, New York Hospital Queens, and Beth Israel Mount Sinai, Dr. Joseph Alencherry is extensively trained in elective, reconstructive, and trauma surgery of the foot and ankle. He has offices in Long Island and New York City. Call 516-492-3515, 212-242- 7718, or visit FAASNY.com for more information.

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