What Is Rearfoot Surgery?
Numerous problems can occur along the back half of the foot and ankle. In most cases, these can be treated conservatively. However, if conservative treatments are unsuccessful, patients may require rearfoot surgery, where the podiatric surgeon will cut into the back of the foot or ankle to repair structures, reduce pain, and correct any deformities.
Reasons for Rearfoot Surgery
A patient may require rearfoot surgery for numerous reasons, including plantar fasciitis, heel spurs, Haglund’s deformity, insertional Achilles calcification or spur, and reconstruction due to trauma, instability or congenital defects.
In plantar fasciitis, the band of tissue along the bottom of the foot becomes inflamed. Patients may feel pain along their heel and up to the toes. Risk factors for plantar fasciitis include excessive stress on the feet, tightness in the calf muscle, obesity, nerve entrapments, and flat feet or high arches.
Heel spurs are another type of stress injury that results in a spur on the bottom of the heel. It can happen if the patient puts constant stress on the foot muscles or fascia and often results from chronic plantar fasciitis.
A Haglund’s deformity, also known as pump bump, is a bony enlargement behind the heel. This condition may not be painful at first, but can eventually become painful if the patient wears shoes that irritate the Achilles tendon. A podiatrist will suggest footwear modifications or more conventional treatments first, but if these are unsuccessful, rearfoot surgery may be necessary.
Insertional Achilles Calcification or Spur
Although similar to Haglund’s deformity, insertional Achilles calcification differs in that, as the name suggests, the spur forms right at the insertion of the Achilles tendon. This condition can be resistant to conservative treatment, so foot surgery may be necessary to remove the bone spur and repair the tendon. Usually, this condition is caused by repetitive injury to the area where the Achilles attaches to the heel.
Rearfoot pathology can be congenital, developmental, or traumatic in origin. These pathologies include everything from tendon injuries to joint disease to bone and soft tissue tumors. Reconstructive surgery is one way to correct these conditions. Reconstructive surgery allows the podiatrist to prevent further deterioration, decrease pain, and improve the function of the foot and ankle. Depending on the exact type of reconstruction the patient undergoes, the surgery may involve staples, wires, pins, plates or screws in the foot.
What to Expect Before Rearfoot Surgery
As with all foot surgeries, rearfoot and ankle surgery requires patients to undergo testing to ensure they’re healthy enough to make a full recovery. The foot and ankle specialist or surgeon will review the patient’s medical history and underlying conditions, paying particular attention to current medications, allergies, or illnesses that might pose complications.
The physician may also order a circulation study, x-ray, EKG, urinalysis, and blood tests to evaluate the patient’s health.
What to Expect After Rearfoot Surgery
After rearfoot and ankle surgery, patients will need to follow recovery instructions to ensure successful post operation results. This may include icing and compressing the area, as well as elevating it above the level of the heart. Rest is also essential. Patients may require a cane or crutches, a knee scooter or a wheel chair to get around, or be fitted with a surgical shoe, walking boot, cast, splint or bandage. Some surgeries may require an extended period of avoiding putting weight on the operated area.