{"id":4371,"date":"2024-10-26T05:33:08","date_gmt":"2024-10-26T05:33:08","guid":{"rendered":"https:\/\/sgito.org\/kn\/?page_id=4371"},"modified":"2024-12-19T07:33:02","modified_gmt":"2024-12-19T07:33:02","slug":"foot-and-ankle","status":"publish","type":"page","link":"https:\/\/sgito.org\/kn\/foot-and-ankle\/","title":{"rendered":"Foot And Ankle"},"content":{"rendered":"\t\t
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Foot And Ankle<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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Although the foot and ankle disorders and injuries are quite a common occurrence, these have seen a \u2018willful neglect\u2019 until the recent past. In the developing world, most of these clinical problems were either neglected or undertreated by the clinicians, perhaps due to lack of interest, understanding and knowledge and lack of appropriate training. In the last couple of decades, the sub-specialty of foot and ankle has been growing both in the developed and developing worlds. The recent interest in this subspeciality is reflected by an increasing number of practicing foot and ankle specialists, focused, national and international conferences, workshops, courses, regional networks and publications related to the foot and ankle conditions. The variety of problems in foot & ankle range from fractures, arthritis, diabetic foot problems, hallux valgus, flat foot, pes cavus deformity, ligament injuries, osteochondral defects in talus, neurological & tendon problems, Achilles tendon disorders, soft tissue & bony tumours etc.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Ankle Ligament Reconstruction:
<\/strong>Ankle Ligament Reconstruction is a surgery to tighten or firm up the ankle ligaments on the outside of your ankle. It is usually done as an outpatient surgery under general anaesthesia, which means you can go home on the same day. Your ankle consists of ligaments and tendons that hold it together with the bone. When you turn or awkwardly twist your ankle, this causes the ligaments to stretch and tear causing an ankle sprain. When the ankle sprain is not treated properly, it may cause repeated sprains which loosen the ligaments more causing \uf0b7 Pain, swelling and bruising in the affected area \uf0b7 A feeling that your ankle is catching or locking \uf0b7 Lack of stability leads to the ankle giving way frequently \uf0b7 Possible ankle dislocation or injury in the cartilage at the tip of the bones. \uf0b7 Chronic ankle instability can lead to development of arthritis of ankle joint. Clinical tests are done to assess ankle instability. Ultrasound and MRI are used as confirmatory tool for diagnosis. Grade 1 is microscopic tears to Grade 3 which is complete ligament tear. Non operative management includes modifying daily activities, anti-inflammatory medications, bracing, ankle wrapping, casting, icing the area, physical therapy, etc. When conservative treatment fails to improve symptoms or in case of high demanding conditions such as sports person, Ligament repair or reconstruction is done by Brostrom-Gould technique and Tendon Transfer. In the Brostrom-Gould technique, the tightening or adjusting the ligaments with sutures done to set them right. In the latter technique, replacing the weakened ligament with a tendon from another part of the body or a donor. Usual recovery time varies from 3 – 6 months.<\/p>

Bunion Surgery:
<\/strong> Bunion surgery is the operation performed to correct the deformity caused by a bunion. A bunion(aka the hallux valgus) is a deformity caused by the enlargement of the bone or tissue around a joint at the base of the big toe or the smallest toe. This small toe bunion is often called a bunionette or a tailor\u2019s bunion. Bunions form mostly in women due to frequent use of tight, high heeled shoes. Bunions can also be inherited as a family trait or as a result of arthritis. Bunions may cause pain and swelling, cause deformity in the toe, big toe drifts towards the smaller ones, inability to bend or straighten the big toe, shoes stop fitting. Conservative treatment includes wearing comfortable shoes with customised splints and orthotics. But if the bunion is too painful or the inflammation or swelling does not relieve with medication or rest and is causing functional problems, then you will need surgery. There are different techniques at the disposal of a surgeon. They are-
\u25cf Exostectomy – During this, the bunion is shaved, often using it along with Osteotomy to reposition the toe. This procedure is rarely done and only for the most minor bunions.
\u25cf Osteotomy – This is the most common form of surgery where several small cut on the bones and then use screws or pins to realign the joint. This can happen at the big toe or further down where the metatarsal meets midfoot.
\u25cf Arthrodesis – When Arthritis inflammation leads to bunions, removal of the parts of the big toe that has arthritis and place screws to hold the bones together as they heal. This is usually done with the most severe of bunions. Post surgery, you may need to continue the bandage and dressing for around 6-8 weeks. Regular exercising and physiotherapy can help regain strength and help find your footing again. High heels should be avoided for at least 6 months.\u00a0<\/p>

Ankle Sprain Treatment:
<\/strong> Ankle Sprain occurs when the ligaments supporting the ankle are stretched beyond their limits leading to tearing. This can happen to people of all ages. Symptoms include pain, swelling, bruising, tenderness to touch, instability, stiffness, coldness or numbness in your foot, inability to walk or put weight on that foot. There could be many causes for ankle sprains such as walking or exercising on an uneven surface, falling down, playing sports with rapid twisting foot movement, getting your foot stepped on by others, etc. Without proper treatment the sprain can weaken your ankle, making it likely to get sprained again. Repeated sprains can cause chronic pain, arthritis, instability, etc. Based on clinical & radiological investigations, will assign a particular grade to the sprain.
\u25cf Grade 1 – Most common type of sprain, you will find microscopic tears of the ligament with mild tenderness and maybe swelling around the ankle.
\u25cf Grade 2 – Partial tearing of the ligament with moderate tenderness and swelling around the ankle. There is an abnormal looseness of the ankle joint in some angles, will be hard to stand on foot.
\u25cf Grade 3 – Complete tear of the ligament with significant tenderness and swelling, causing substantial instability, severe pain and inability to move the ankle. The immediate treatment for ankle sprains follows the RICE method.
R –<\/strong> Rest the ankle till the sprain is cured.
I –<\/strong> Apply an ice pack frequently in the first 2-3 days to reduce swelling.
C –<\/strong> Apply pressure by wearing an elastic compression wrap to reduce swelling for 2-3 days.
E –<\/strong> Elevate the ankle above your heart for 2-3 hours a day to reduce swelling and bruising. Treatment include medication, physical therapy, a cast, boot, or brace to wear which helps keep the ligaments and joint in place while they heal. If the sprain still doesn\u2019t go away, may require surgery.<\/p>

Foot Deformities<\/strong> :
Foot Deformity is a catch-all term referring to any condition that alters the shape or structure of the foot causing pain and discomfort usually through misalignment of joints and bones. This could be the result of genetics, from years of wear and tear or a combination of both. There is a wide array of foot deformities that occur in both adults and children, they are-
\u25cf Clubfoot –<\/strong> A congenital condition where one or both feet are severely twisted. Treatment works best when started as soon as possible since that\u2019s when the bones, ligaments etc are the most responsive.
\u25cf Flat feet –<\/strong> A condition where one or both feet have little to no arch. While it can be inherited, it can also happen due to gradual wear and tear.
\u25cf Cavus foot –<\/strong> A condition where the patient has an unusually high arch in their feet. Patients can experience pain, develop calluses, can even cause ankle sprains or stress fractures.
\u25cf Bunion –<\/strong> When the joint at the base of the big toe or smallest toe moves out of alignment forming a noticeable bump causing pain.
\u25cf Accessory Navicular –<\/strong> Describes an extra bone growth leading to a bony prominence, pain and tenderness.
\u25cf Tarsal Coalition –<\/strong> When there is an abnormal connection between bones in the midsection and back of the foot, limiting movement and causing pain and stiffness. Every deformity is unique with different problems and requires a tailor-made treatment plan. Clinical & radiological investigations are done to assess the condition. non-operative treatment such as medication, stretching, physical therapy, custom orthotics and adjustments to the deformity, lifestyle modifications, etc. In case the problem persists, may require surgery<\/p>

Trauma: Fixation of following fractures:
<\/strong>The ankle is mainly made up of three bones the tibia(shin), fibula and talus. Breakage in any of these bones or the joints around it causes a fracture. If not treated properly it can lead to long term complications and disability. There are many types of fractures. They are
1. Fractures around the ankle<\/strong> The joints usually responsible for fractures around the ankle are the Ankle Joint where the tibia, fibula & talus meet and the Syndesmosis Joint which is the joint between the tibia & fibula held together by ligaments.
2. Tibial plafond (Pilon) fractures<\/strong> A pilon fracture occurs at the bottom of the shin bone. Pilon fractures can have a permanent effect on the ankle joint.
3. Talus fractures<\/strong> Talus is one of the bones that form the ankle. A fracture in the Talus leads to a significant loss of motion & function. If not treated properly can result in limping, arthritis, and chronic pain.
4. Calcaneum fractures<\/strong> Calcaneus or the heel bone fracture can be a painful and disabling injury. When this occurs the heel can widen, shorten or become deformed. Even with appropriate treatment, there may be long term complications like pain, swelling, loss of motion and arthritis.
5. Lisfranc Injuries Ligament failures<\/strong> and fractures in the midfoot region of the foot are called Lisfranc Injuries. They are commonly misdiagnosed on the initial X-Rays as an ankle sprain.
6. Metatarsal & Phalangeal fractures<\/strong> The metatarsal is the bone connecting the ankle to the toe. Each toe is called a phalange. Metatarsal & Phalangeal fractures usually heal without surgery. The common causes for these fractures include twisting, rotating or rolling your ankle, tripping, getting your foot stepped on, high energy events like car collisions, falling from a height, etc. The symptoms include severe pain, swelling, bruising, tenderness to touch, instability, loss of motion, etc. The treatments include medication, physical therapy, casts, custom orthotics, and in some cases surgery<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Elective procedures<\/strong> :
Elective procedure or surgery is surgery that is scheduled in advance because it does not involve a medical emergency. The various elective procedures are
\u25cf Hallux Rigidus, IP joint fusion, Modified Jones procedure are corrections of the disorders related to the big toe.
\u25cf PIP fusion, Weil\u2019s Osteotomy, MTP release & debridement are surgeries performed to correct deformities in the other toes.
\u25cf Tarsal Tunnel Release is done to treat Tarsal Tunnel Syndrome which is the damage of the nerve behind the shin bone.
\u25cf Plantar Fasciitis Surgeries are performed to relieve chronic heel pain.
\u25cf Ankle Arthroscopy is the surgery where a small incision is made and a tiny camera is inserted to observe the issues with your ankle or as part of the surgery.
\u25cf Morton\u2019s Neuroma Excision is the surgery performed to reduce or remove the nerve swelling in between toes.
\u25cf Ganglion Excision is the removal of cysts formed in the ankle and foot.
\u25cf Achilles\u2019 Tendon Repair & FHL Tendon transfer help repair the tendon attaching the calf muscle to the heel.
\u25cf Insertional & Non-insertional Achilles\u2019 Tendinopathy Surgery is performed to cure Achilles\u2019 Tendinitis which is the irritation & inflammation of the large tendon that runs down the back of your lower leg.
\u25cf Haglund\u2019s Excision cures Haglund\u2019s syndrome where the bony section of the heel is enlarged and inflamed.
\u25cf Autologous matrix-induced chondrogenesis is performed to fix cartilage damage.
\u25cf Mid-Hindfoot & Ankle Fusion is used to treat many painful deformities.
\u25cf Tibiotalocalcaneal Fusion (TTC) is a salvage procedure for patients with substantial foot deformity and bone loss.
\u25cf Total ankle arthroplasty (TAR) is used to treat Ankle Arthritis where the arthritic joint is removed and replaced with metal or plastic parts.
\u25cf Foot Drop Correction is used to correct Foot Drop, a general term for difficulty in lifting the front part of the foot caused due to underlying neurological, muscular or anatomical problems.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t

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Dr. Shekar M. <\/span>MBBS, D\u2019ORTHO, DNB(ORTHO), MIPD (Edinburgh)<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Fellow in Foot & Ankle (Glasgow, UK),<\/strong>
Completed MBBS in 2003 from JJMMC, Davangere. Did D\u2019Ortho at Mysore medical college from 2005 to 2007. Later pursued DNB in orthopaedics at Sparsh Hospital, Bengaluru between 2007 to 2009. Worked as Registrar, senior resident and Asst Prof at corporate hospital and medical colleges in Bangalore. Joined as Asst Prof in Orthopaedics at Sanjay Gandhi institute of trauma of orthopaedics in 2015. Was selected for registrar\/ clinical fellow job at Golden Jubilee hospital, NHS at Glasgow, UK. Did fellowship in foot & ankle for 2 years. Presently working as Assoc Prof at Sanjay Gandhi Inst of trauma & orthopaedics. He has more than 15 years of experience in Orthopaedics and expertise in foot & ankle sub speciality. He has done successfully many surgeries such as complex trauma, hip & knee replacement. He has treated all kinds of foot & ankle problems such as deformity correction, ligament repair, arthroscopy, arthritis. He is the academic co Ordinator & NMC co Ordinator. He takes active part in conducting regular teaching programme for post graduate students and also conduct CMEs, workshops at the institute. He has been faculty in many local, state & national conferences and delivered talks on many topics of the speciality. He has done presentations & publications in national & international journals. He also takes part in hospital administration and help the Senior authorities in the institute. <\/p>

He was the organising secretary, Bangalore orthopaedic society during the period 2024- 25 and conducted regular monthly meetings, academic activities.<\/p>

Areas of Interests:
<\/strong><\/p>

  • Foot and ankle & limb reconstruction.<\/li>
  • Arthroplasty\u00a0<\/li>
  • Trauma<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

    Foot And Ankle Although the foot and ankle disorders and injuries are quite a common occurrence, these have seen a \u2018willful neglect\u2019 until the recent past. In the developing world, most of these clinical problems were either neglected or undertreated by the clinicians, perhaps due to lack of interest, understanding and knowledge and lack of appropriate training. In the last couple of decades, the sub-specialty of foot and ankle has been growing both in the developed and developing worlds. The recent interest in this subspeciality is reflected by an increasing number of practicing foot and ankle specialists, focused, national and international conferences, workshops, courses, regional networks and publications related to the foot and ankle conditions. The variety of problems in foot & ankle range from fractures, arthritis, diabetic foot problems, hallux valgus, flat foot, pes cavus deformity, ligament injuries, osteochondral defects in talus, neurological & tendon problems, Achilles tendon disorders, soft tissue & bony tumours etc. Ankle Ligament Reconstruction: Ankle Ligament Reconstruction is a surgery to tighten or firm up the ankle ligaments on the outside of your ankle. It is usually done as an outpatient surgery under general anaesthesia, which means you can go home on the same day. Your ankle consists of ligaments and tendons that hold it together with the bone. When you turn or awkwardly twist your ankle, this causes the ligaments to stretch and tear causing an ankle sprain. When the ankle sprain is not treated properly, it may cause repeated sprains which loosen the ligaments more causing \uf0b7 Pain, swelling and bruising in the affected area \uf0b7 A feeling that your ankle is catching or locking \uf0b7 Lack of stability leads to the ankle giving way frequently \uf0b7 Possible ankle dislocation or injury in the cartilage at the tip of the bones. \uf0b7 Chronic ankle instability can lead to development of arthritis of ankle joint. Clinical tests are done to assess ankle instability. Ultrasound and MRI are used as confirmatory tool for diagnosis. Grade 1 is microscopic tears to Grade 3 which is complete ligament tear. Non operative management includes modifying daily activities, anti-inflammatory medications, bracing, ankle wrapping, casting, icing the area, physical therapy, etc. When conservative treatment fails to improve symptoms or in case of high demanding conditions such as sports person, Ligament repair or reconstruction is done by Brostrom-Gould technique and Tendon Transfer. In the Brostrom-Gould technique, the tightening or adjusting the ligaments with sutures done to set them right. In the latter technique, replacing the weakened ligament with a tendon from another part of the body or a donor. Usual recovery time varies from 3 – 6 months. Bunion Surgery: Bunion surgery is the operation performed to correct the deformity caused by a bunion. A bunion(aka the hallux valgus) is a deformity caused by the enlargement of the bone or tissue around a joint at the base of the big toe or the smallest toe. This small toe bunion is often called a bunionette or a tailor\u2019s bunion. Bunions form mostly in women due to frequent use of tight, high heeled shoes. Bunions can also be inherited as a family trait or as a result of arthritis. Bunions may cause pain and swelling, cause deformity in the toe, big toe drifts towards the smaller ones, inability to bend or straighten the big toe, shoes stop fitting. Conservative treatment includes wearing comfortable shoes with customised splints and orthotics. But if the bunion is too painful or the inflammation or swelling does not relieve with medication or rest and is causing functional problems, then you will need surgery. There are different techniques at the disposal of a surgeon. They are- \u25cf Exostectomy – During this, the bunion is shaved, often using it along with Osteotomy to reposition the toe. This procedure is rarely done and only for the most minor bunions. \u25cf Osteotomy – This is the most common form of surgery where several small cut on the bones and then use screws or pins to realign the joint. This can happen at the big toe or further down where the metatarsal meets midfoot. \u25cf Arthrodesis – When Arthritis inflammation leads to bunions, removal of the parts of the big toe that has arthritis and place screws to hold the bones together as they heal. This is usually done with the most severe of bunions. Post surgery, you may need to continue the bandage and dressing for around 6-8 weeks. Regular exercising and physiotherapy can help regain strength and help find your footing again. High heels should be avoided for at least 6 months.\u00a0 Ankle Sprain Treatment: Ankle Sprain occurs when the ligaments supporting the ankle are stretched beyond their limits leading to tearing. This can happen to people of all ages. Symptoms include pain, swelling, bruising, tenderness to touch, instability, stiffness, coldness or numbness in your foot, inability to walk or put weight on that foot. There could be many causes for ankle sprains such as walking or exercising on an uneven surface, falling down, playing sports with rapid twisting foot movement, getting your foot stepped on by others, etc. Without proper treatment the sprain can weaken your ankle, making it likely to get sprained again. Repeated sprains can cause chronic pain, arthritis, instability, etc. Based on clinical & radiological investigations, will assign a particular grade to the sprain. \u25cf Grade 1 – Most common type of sprain, you will find microscopic tears of the ligament with mild tenderness and maybe swelling around the ankle. \u25cf Grade 2 – Partial tearing of the ligament with moderate tenderness and swelling around the ankle. There is an abnormal looseness of the ankle joint in some angles, will be hard to stand on foot. \u25cf Grade 3 – Complete tear of the ligament with significant tenderness and swelling, causing substantial instability, severe pain and inability to move the ankle. The immediate treatment for ankle sprains follows the RICE method. R – Rest the ankle till the sprain is cured. I – Apply an ice<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-4371","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/sgito.org\/kn\/wp-json\/wp\/v2\/pages\/4371","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sgito.org\/kn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/sgito.org\/kn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/sgito.org\/kn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sgito.org\/kn\/wp-json\/wp\/v2\/comments?post=4371"}],"version-history":[{"count":0,"href":"https:\/\/sgito.org\/kn\/wp-json\/wp\/v2\/pages\/4371\/revisions"}],"wp:attachment":[{"href":"https:\/\/sgito.org\/kn\/wp-json\/wp\/v2\/media?parent=4371"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}