Although as podiatrists we treat many different foot conditions with conservative and minor surgical approaches. There are conditions that do not respond sufficiently and we therefore need to refer you to a surgeon (sometimes via your GP).
Bunions- Where the big toe joint pain is too severe and doesn’t respond to orthotics or shoe modifications then surgery may be the only option.
Bunionette or tailors bunion- This is a ‘bunion-like’ deformity on the outside of the foot instead of the inside. If the prominence is too big and cannot be made more comfortable with insoles, shoe stretching or modifications then surgery may be the only option.
Hallux Limitus or Rigidus – This is a stiff immobile and enlarged big toe joint, often with no angular change like a bunion. If shoe stiffeners, rocker soles and orthotics can’t help then some form of surgical intervention may be indicated. This is often fusion of the joint in a more tolerable fixed position.
Hammer and mallet toe – These are deformities of the lesser toes (2 to 5) . If they do not respond to silicone orthodigital splints, polymer gel products, felt padding, general chiropody, footwear stretching and modifications or for aesthetic reasons surgery may be the only option.
Morton’s Neuroma – Long term presentations of this nerve inflammation / fibrosis condition may only respond to surgery. Early interventions of orthotics, shoe advice, and physical therapies may settle the problem, but often surgical referral is required.
All of these problems can be treated in a day case surgery unit under local anaesthesia ; Surgery for bunions , hammer toe and hallux rigidus may require internal fixation.