Foot and Ankle Surgery

Your feet and ankles are composed of numerous joints, bones, muscles, tendons, ligaments and nerves that together provide your body with the support, balance and mobility required to walk, run and get around. They bear a lot of pressure and so wear and tear problems and injuries are common. Arthritis, sports injuries and ill-fitting shoes are frequent causes of foot and ankle problems.

As your feet and ankles are essential elements in your mobility, we understand that if you’re suffering from pain in these areas or an inability to get around, you need access to prompt medical care to resolve these issues.

At Duchy we offer our patients access to expert consultant orthopaedic surgeons without waiting who will assess and diagnose your foot and ankle condition using the latest diagnostic facilities. They perform routine foot and ankle surgery for a wide variety of foot and ankle problems including: bunions, Morton’s neuroma, in-growing toenails, arthritic toe and lesser toe deformities. Foot and ankle surgery reduces pain and increases mobility.

The range of foot and ankle surgeries we offer


If your big toe leans over too much onto the smaller toes, a bony lump at the joint of the base of the big toe may appear. This is called a bunion or hallux valgus. There is often thickening of the skin and tissues next to the affected joint and this may become inflamed, swollen and painful. When you wear shoes your bunion may rub and your bunion may make it difficult to find shoes that fit.

You may be offered footwear advice to ease your symptoms of pain and discomfort. Painkillers may also relieve the pain. Surgery may be recommended if a change of footwear doesn’t ease your pain. There are many different types of bunion surgery, ranging from an operation to trim parts of your joint to a total artificial replacement of your big toe joint. Surgery aims to straighten the joint as much as possible and relieve pain.

Morton’s neuroma

Morton's neuroma is a condition that normally affects the nerve that runs between the long bones in the third and fourth toes of your foot. It’s thought that Morton’s neuroma occurs when the nerve suffers chronic stress and irritation from the toe bones pressing on it due to a narrow gap between the bones and it then becomes enlarged or swollen.

Poorly fitting, constricting and high-heeled shoes can contribute to Morton's neuroma. Injury, flat feet, being overweight and playing sports that put pressure on your feet can also result in this condition.

Often changing your footwear, orthotic devices, losing weight, painkillers, calf stretching exercises, avoiding some leisure activities and injections help relieve the pain. Minor surgery may be required to create more space around the affected nerve (nerve decompression) or to remove the nerve.

Zadeks procedure

If you’ve a painful and inflamed in-growing toenail your orthopaedic surgeon may recommend Zadeks procedure. It’s a simple technique performed under local anaesthetic that removes your whole toenail and the surrounding area of tissue where the toenail grows from.

Arthritic toe

Osteoporosis may affect the main joint in your big toe. Arthritic toe or hallux rigidus can cause damage to the joint surfaces of your big toe so that they don’t move smoothly. Your big toe can become inflamed, stiff and painful, making walking difficult.

Pain relief, anti-inflammatory medicines, shoe modifications or injections into the joint will be recommended initially to reduce your pain and stiffness.

If these approaches don’t relieve your pain, your foot and ankle surgeon may recommend surgery. There are a number of surgeries available for arthritic toes. Surgical treatments can range from the trimming of upper part of your joint and washing out the joint to joint replacement. The best approach to relieve your pain will be discussed with you.

Claw/hammer toe

The lesser toes are all toes excluding your big toe and they have two interphalangeal joints as opposed to the big toe which has only one. Lesser toes can suffer from deformities called claw and hammer toes. These conditions cause your lesser toes to look strange and can be painful. They are caused by one of the tendons in the foot contracting often due to wearing poor fitting shoes or an underlying muscle imbalance.

A claw toe is so called due to your toe looking like a claw. The first bone is raised and the second two bones point downwards.

A hammer toe resembles a hammer. The first bone is slightly raised, the second bone tilts downwards and the third bone is almost flat.

Most cases of claw or hammer toes require surgery to straighten the toes although alternative shoes and orthotics, toe exercises, splints and medicines may help. Your surgeon may operate to release trapped soft tissue and to lengthen your tendon. For acute problems, they may perform fusion surgery where they remove the cartilage from the end of the toe bones in the middle joint and insert a pin to hold the two ends together to allow the bones to fuse together.

The following consultants offer foot and ankle surgery at Duchy Hospital:

Mr Butler

Mr Parsons

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