If the doctor removes my toenail, will it grow back?
Your podiatrist may recommend the removal of your toenail for a number
of reasons. These include infection, severe nail deformity, and a tendency
to be ingrown. If all or part of the nail is simply removed, it will eventually
re-grow. This may take six months to more than one year. If the nail was
deformed, it is likely to re-grow deformed as well. The toenail can be
partially or completely removed so as to prevent re-growth. This might
be done when the nail is likely to re-grow with recurrence of the same
problem. The procedure involves the excision or destruction of the nail
growth area (matrix). This might be accomplished by surgical excision of
the matrix. More commonly, a chemical is applied to the nail bed and matrix
to destroy the growth cells. The advantage to this technique is minimal
post-operative discomfort and a low incidence of undesired re-growth. The
healing process may last six to eight weeks, but only involves simple home
care.
Can the doctor cut out my corn or callus and permanently remove it?
In most cases, corns and calluses are caused by pressure over a bony
prominence. This might be shoe pressure on the top of a toe, or weight
bearing pressure on the ball of the foot. In such cases, surgically cutting
out the corn or callus wouldn't be helpful. The lesion would only return
once the pressure resumed. It is necessary to remove and/ or realign bone.
In this way the pressure is permanently removed and the thick skin disappears.
Sometimes the pressure can be removed without surgery. For example, changing
shoe type or wearing orthotics.Some lesions appear to be corns but are
not caused by pressure, for example warts. Often these occur on non-weight
bearing areas, and may respond to simple surgical removal.
How can the doctor straighten my crooked toes?
Crooked toes come in many different "flavors". Examples are; hammer
toes, mallet toes, and claw toes. It depends on the direction and extent
of deviation at each of the small joint of the toe. Most surgeries for
these conditions involve realigning the toe by some combination of bone
removal and repositioning. Sometimes the abnormal position is not rigidly
fixed, and the toe may be realigned by simply cutting or lengthening tendons.
Incisions are usually made of the top of the toe, occasionally a steel
pin is used to fixate the corrected position of the toe. Most practitioners
advise two to three weeks in a surgical shoe. This is an open toes "sandal"
with a very rigid sole. It acts like a splint while the surgery is healing.
A longer time in the surgical shoe is necessary if pins are used. Comfortably
fitting shoes must be worn for a few weeks thereafter. When the healing
process is mostly completed, about eight to twelve weeks you may resume
your normal shoes. Please remember, shoes can cause toe deformities. The
surgical result may be compromised if "severe" dress shoes are worn regularly.
I have a Morton's Neuroma. What is involved in removing it?
In most cases the surgery has a satisfying result. The incision is
usually made on the top of the foot, behind the third and fourth toes.
The podiatric surgeon cuts out the involved portion of the interdigital
nerve, and sutures the wound. You wear a surgical sandal for two weeks,
until the sutures are removed. The surgery leaves some numbness between
the toes, but you soon stop noticing this. Before the doctor recommends
surgery, he or she usually attempts to control the condition with injections
and/or orthotics.
How much pain should I expect during and after foot surgery?
You can expect no pain during the procedure, even with local anesthesia.
Modern local anesthetics provide long lasting pain relief during the immediate
post-operative period. Subsequently, you may experience some discomfort.
For most surgery on the fore part of the foot, this is fairly mild. Most
patients relate expecting much more pain then they experienced. Your doctor
will prescribe an analgesic (pain pill) to control any discomfort. You
may find that the original problem necessitating the surgery was more painful
than the surgery itself.
How are bunions corrected?
A bunion deformity can only be corrected with surgery. There are many
surgical procedures for bunions. Which one is selected by your podiatric
surgeon will depend on your age, general health, x-ray findings, extent
of the deformity, and many other considerations. Most bunion procedures
involve removing some bone from the "bump" behind your big toe. The first
metatarsal bone in you forefoot may be realigned by repositioning this
bone and/or releasing ligaments and tendons. Depending on the procedure
required, the post-operative period may involve six to eight weeks in a
surgical shoe or below-the-knee plaster cast. Because the underlying cause
of bunions is mechanical, it is usually advisable to wear functional foot
orthotics after the surgery. This may prevent recurrence of the bunion.
It should be stressed, bunion surgery is for symptomatic (painful) bunions.
By wearing proper shoes, some people are never bothered by their bunions.
