Foot and Ankle Surgeon in Nashik

• Foot and ankle are important structures of the body as they play vital role in locomotion & biomechanics of the body including posture.
• Foot is often the most neglected part of the body and is one of the commonest regions to get injuries due to sports, household falls, and vehicular accidents.
• Knowledge of biomechanics, pathologies and their proper treatment is vital for achieving good results in problems of foot & ankle.

Ankle Sprains: 

• Ankle sprains are common ankle problems 
• They are often associated with lateral or medial ankle ligamentous injuries and hence one can have associated pain, swelling or skin discolouration
• Ankle twisting injuries shouldn’t be neglected as the injuries can be associated with fractures around ankle joint 
• Depending on the grades of injury the ankle ligament sprains can be treated in conservative manner using brace, bandages, cast or surgically i.e. ankle ligamentous reconstruction procedures.
• Ankle ligament reconstruction procedures can be either done arthroscopically or by open method.

Ankle Osteochondral Lesions

• Ankle osteochondral lesions (OCDs) mainly involve articular surface at the talus bone. Rarely it can be seen on the distal tibial articular surfaces. 
• OCDs can occur as a result of twisting injuries to the ankle.
• Patients can present with problems such as pain, locking, & instability.
• Depending on size of the OCDs duration and locations, the OCDs can be treated either conservatively using physiotherapy, PRP injections etc. or surgically.
• Surgical treatment of ankle OCDs requires arthroscopic or open approach

Ankle synovitis 

• Ankle synovitis inflammation of the ankle joint synovium is a lining tissue of the joint capsules.
•  It can present as ankle joint pain swelling, due to underlying conditions like infection, inflammation due to rheumatological conditions, such as various types of arthritis.
• Mostly management of ankle joint synovium involves management of underlying ethology such as rheumatological conditions etc .

Ankle Arthritis:

• Ankle arthritis involves the tibiotalar joint. Associated arthritis of other adjacent joints such as subtalar joint, talonavicular or calcaneocuboid joints can be present. 
• Leads to swelling, pain, restricted range of motion of the ankle.
• Often this issue can be treated conservatively in the initial phases with medications, orthoses and physiotherapy. 
• In cases of advanced arthritis, patients may require either arthroscopy assisted or open ankle arthrodesis i.e. fusion or ankle replacement.

Achilles Tendon pain / rupture: 

• Tendoachilles (TA) is a strong tendon, which inserts at the back of the heel.
• Because of trauma, repeated activities, underlying disorders like hypothyroidism diabetes etc. the tendoachilles can get damaged / swollen or sometimes can even rupture.
• Damage to tendoachilles leads to pain, swelling, difficulty in doing heel raises
• At the insertion on the heel, inflammation around tendoachilles can cause retrocalcaneal bursitis.
• Partial tears can be treated conservatively with medications, orthotics but complete tears may require repairs and augmentation

Flat Foot:

• Flat foot or pes planus is a well-known entity, commonly found in children.
• Similar conditions like forefoot pronation have similar clinical presentation. 
• Absent or severely decreased medial arch of the foot is called the flat foot
• Patients often present with complaints of absent arch, abnormal gait pattern, abnormal callosities, pain on the medical aspect of the ankle.
• Initial management comprises of use of orthotics, physiotherapy, & medications.
• Severe flat foot with gross deformation may require surgical correction

Bunion:

• Bunion is a bony bump that forms on the joint at the base of great toe, this is often secondary to conditions which involves maligned toes e.g. hallux valgus etc.
• Bunion may be asymptomatic or can be associated with swelling, redness, pain.
• If associated with decreased range of motion of the great toe, may suggest associated arthritis of the joint.
• Immunological conditions like rheumatoid arthritis, use of high heels etc, may be the under lying cause.
• Management usually requires proper shoe use, ant inflammatory medications, treatment of underlying pathologies.

Cavus foot:

• Can be considered as exact opposite condition than a flat foot. It’s a condition than the flat foot has excessively high arch. Its more pathological condition.
• Can be because of underlying neurological conditions such as polio, cerebral palsy, spina bifida and is likely to worsen progressively, hence early diagnosis & management is important.
• It can cause painful, swollen foots, hammer toes, unstable ankle etc.
• Usually it can be treated non-surgically using orthotics, medications etc. but those refractory to this treatment may require surgery.

Toe Deformity:

• Apart from a ‘bunion’ other toe deformity are also common; they are hammer toes where toe bents at the proximal joint. It can lead to callosities, pressure sores etc. Inappropriate footwear usage may aggregate the condition.
• Mallet toe is a distally bent toe mainly seen on the 2^nd, 3^rd toe sides.
• Claw toes are toes which are bent both proximally and distally. They may be tell-tale sign of an underlying neurological condition and hence should be treated with precautions, and should be thoroughly investigated.

Neuromas:

• Neuroma means a soft tissue swelling around a nerve which can lead to nerve irritation and symptoms like pain, burning sensations etc. 
• Morton’s neuroma is a condition which affects foot. Most commonly seen in the area between 3^rd & 4^th toes.
• Use of high heels, cavus feet etc. are few causative factors linked to the Morton’s neuroma.
• Initially they van be managed by using medications, orthotics, etc. & if patient persists to have complaints can be treated with local injections or surgery.

Fractures around ankle & foot:

• Fractures around the ankle involves medial or lateral malleolus, posterior malleolus, talus and calcareous.
• Foot fractures involve metatarsal and phalange fractures.
• Being a weight bearing region, these lead to inability to bear weight, early deformities etc.
• Anatomical reduction & fixation of these is required for better function.

Stiff Ankle:

• A stiff ankle can be a sequel of trauma, malunited fractures, rheumatoid or osteoarthritis.
• Intraarticular damage to the cartilage can lead to decreased range of motion, progressive degeneration of the ankle.
• Early and aggressive physiotherapy after prolong immobilization can prevent development of the stiff ankle.
• Conservative management includes physiotherapy; while surgically it can be treated with either arthroscopic or open procedure i.e. Adhesiolysis 

Dr. Sagar Kakatkar is well-known Foot and Ankle Surgeon in Nashik . he has experience of many successful foot and ankle surgeries. He provides effective and relieving treatment for your joints problems.

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