Foot and ankle surgery

When surgery is considered

Surgery is considered when pain or deformity limits your daily life and appropriate non-surgical treatment hasn’t helped, or when an injury needs it (an unstable fracture or a ruptured tendon, for example), or to protect a foot at risk, as in diabetic foot infections and Charcot foot. The decision is made with you, after a clear explanation of what the operation can and can’t do, the recovery, and the risks.

Surgery we perform

• Reconstructive surgery to restore alignment and function: bunions and big-toe arthritis, hammertoes, flatfoot and high-arched foot, and joint fusions for arthritis.
• Minimally invasive surgery, performed through small incisions for selected bunion and forefoot problems. For bunions, a meta-analysis found no clinically important difference in outcomes between minimally invasive and open surgery, so the choice rests on your foot and the procedure.^[1]
• Ankle arthroscopy, using a small camera and instruments passed through tiny incisions to treat problems inside the ankle joint, such as impingement, loose bodies and cartilage injuries.^[2]
• Tendon and ligament surgery: Achilles and peroneal tendon repair, and ankle ligament reconstruction for chronic instability. For acute Achilles ruptures, randomized trials found open and minimally invasive repair gave similar function.^[3]
• Fracture and trauma surgery for ankle, foot and toe fractures and dislocations. See fractures and trauma.
• Diabetic limb preservation: draining infection, removing infected bone, correcting deformities that cause ulcers, and Charcot reconstruction. See Charcot foot and wound care.
• Cartilage and joint-preserving surgery. See cartilage repair.

Your health and surgical risk

Healing after foot and ankle surgery depends on your overall health. Diabetes, especially with neuropathy or poorly controlled blood sugar, and smoking raise the risk of infection and wound problems after surgery, so we work with your other physicians to prepare.^[4,5]

Common questions

Will I be asleep for the operation?

It depends on the operation and on you. Many foot and ankle operations use a nerve block that numbs the foot and leg, often with sedation or a general anesthetic; blocks also control pain for hours afterward and reduce the need for opioids, which helps people go home the same day.^[6] The anesthesiologist goes through the options with you before surgery.

How should I prepare?

Stop smoking, since it raises the risk of wound and healing problems, and if you have diabetes, work with us and your physician to bring your blood sugar under good control before surgery.^[5] Plan for help at home and a way to get around without putting weight on the foot if your operation requires it. The Center for Lower Extremity Surgery has a full guide to preparing for foot and ankle surgery (external site).

How long is the recovery?

It ranges from a few weeks in a surgical shoe after a small forefoot procedure to several months after a reconstruction or fusion. We give you a written timeline for your operation before you decide, covering weight-bearing, work, driving and sport.

Second opinions

If you’ve been told you need foot or ankle surgery, or had surgery that didn’t go as hoped, a second opinion can confirm the diagnosis and look at every option, including non-surgical ones.

When to seek care