The Surgeon’s Perspective

Emma had the unfortunate combination of a flat right foot with hallux valgus. In this situation combining a bunion correction with a flat foot procedure can be very effective but can be a major undertaking.  

In Emma’s case we combined both and carried out the following procedures.

  • Modified Lapidus and Akin osteotomies to correct hallux valgus.  
  • Flexor digitorum longus tendon transfer to reconstruct tibial in posterior tendon that had failed.  
  • Os cal is osteotomy to help correct her valgus heel.  
  • Arthroreisis screw to maintain correction whilst the soft tissue elements healed.  

Emma’s feet before surgery – click on the images below to view full size.

Before-front
Before-rear
Xrays 1
xrays 2

Emma did well and has an excellent result.  Click on the images below to view full size.

Front-after
Rear-after
Xrays 3
xrays 4

The Patient’s Perspective

I was experiencing significant pain in my inside right ankle which caused me to limp when walking.  A diagnosis of tibialis posterior tendinopathy followed after a visit to my doctor and physiotherapist.  I underwent physiotheraphy and tried custom made orthotics over the course of over a year in an attempt to alleviate the pain, and although they did help, I still struggled on a daily basis.  During this time the same issue had arisen with my left ankle.  Even a short walk or standing cooking dinner was uncomfortable so I decided to investigate surgical options.

I went to see Mr Savva at the Winterbourne hospital in the August and following a consultation and diagnostic imaging he confirmed not only the tendinopathy but also collapsed arches in both feet.  I also had bunions on both feet that had started to cause issues and pain.  Mr Savva was extremely thorough and explained that he could undertake several procedures during surgery to basically re-build my foot.  He stressed several times during the consultations that I had with him that the full recovery period following the surgery was lengthy and that it could take a year to experience full results.  When I considered the discomfort I was in and the potential benefits I could have, it was an easy decision for me to go ahead.

Surgery took place in the November and for the 2 weeks following this I laid with my foot elevated as strictly instructed.  The foot was uncomfortable but the pain was less than I’d imagined.  I spent the first 6 weeks wearing a cast and was completely non weight bearing during this time.  After the initial 2 week period I used crutches to move around, but to be honest I continued to lie with my leg elevated for most of this time with my laptop on my lap so that I could work!  The leg felt more comfortable elevated and I wanted to aid recovery as much as I could.  After the cast was removed I wore a CAM boot and could start to bear weight using the crutches.  I also started physiotherapy during this time and I went swimming twice a week.  After 5-6 weeks of wearing the boot I moved into trainers.  I was still using the crutches at this time but over the next 3 weeks I was able to walk without these and things started to feel normal again, especially when I got back into the driving seat of my car!

It is now over 4 months since the surgery and my foot and ankle feel stronger and more normal with each week that passes.  I still have some swelling and discomfort but I know this is normal at this stage.  I now have a properly shaped and supported foot and ankle and I can already feel the difference in stability between my ‘new’ right foot and my left one.  It feels more solid and stronger and I’m delighted with the outcome.  It will soon be time to start thinking about the surgery for foot number 2!

Thank you Mr Savva on an amazing job!