Complications can occur following any foot operation. The common complications to all foot operations have been outlined below. However, there are specific complications to each individual procedure and anyone considering foot surgery should ensure they are aware of these before undergoing surgery.
The complication rate is generally low and most are easily treated. A thorough pre-operative history and assessment helps to identify potential complications and therefore minimise the risk.
However, due to these risks surgery should only considered if conservative treatment (non-operative treatment) has failed and there is regular discomfort.
- Pain / swelling
- Deep vein Thrombosis (blood clot)
- Delayed healing
- Complex regional pain syndrome (Reflex sympathetic dystrophy)
- Continued shoe difficulty
All surgery results in a degree of pain and swelling, generally dependent upon the type of operation. Swelling causes discomfort and , following foot surgery, this can be reduced by keeping the foot and leg elevated level with your heart. Increased / too much activity in the early post operative period can increase the amount of swelling. Following the post operative instructions specific for the operation will help to minimise this complication.
There is a small risk of infection which is generally superficial, around the wound. If this occurs, this is usually managed successfully with antibiotics.
However, it can be deeper and involve the bone (osteomyelitis). This is infrequent with foot surgery but is a serious complication if it occurs. It often requires treatment with intravenous antibiotics, requiring a stay in hospital, followed by a long period of oral (tablets) antibiotics. In some cases, surgical removal of the bone is required and this can leave the foot less functional.
Although very uncommon, foot infections can be fatal as can any infection. Early recognition and treatment is essential to reduce the risk of serious complication.
Due to the relative immobility following foot surgery, there is a risk of DVT much like there is a risk when flying. Fortunately, this is infrequent and appropriate exercises during the post operative period can reduce the risk. Certain operations, requiring plaster cast immobilisation can increase this risk. Preventative treatments are available if a patient has a known risk.
Although information is provided regarding the likely healing time following surgery, this does vary between individuals. There is always a risk that it may take longer. This could either be the skin (soft tissue) or bone.
Delayed bone healing can take several months to settle and in some cases, it does not heal properly. This is termed a non union and can occur with any bone operation but is more common in some than others. Cessation of smoking reduces the risk. If non union occurs, it is not always painful. However, if it is causing a problem, further surgery may be required. This usually involves removing the area of non healing bone and replacing it with healthy bone from another site (bone grafting). This obviously prolongs the healing time considerably.
All operations result in a scar. Whilst the vast majority settle, some can take longer to heal. It is possible that it will be painful, have some nerve entrapment, be discoloured and may become thickened. Whilst every care is taken during the operation, problems can occur. Fortunately, they are usually short term but can be long term. Certain skin types (e.g. Afro-Caribbean) are more predisposed to thickened scars known as keloid scars.
Previously called reflex sympathetic dystrophy, this is an extremely uncommon condition that can occur following injury (including surgery). The exact process is not fully understood but, essentially, the body over reacts to the injury and becomes extremely sensitive and painful. Even the lightest touch or movement can be unbearable and this can be disabling. Treatment is required by a specialist pain clinic and successful treatment is significantly improved by an early diagnosis (within 6 months).
Despite the best planning and surgery, studies evaluating the outcomes of foot surgery all indicate that problems can re-occur. Whilst every effort is taken to ensure a successful long term outcome this cannot be guaranteed.
The nature of foot surgery is such that, even if the underlying problem is resolved / corrected, there may still be residual discomfort or prolonged swelling. As a result, there could be continued difficulty with shoes. Women often wish to return to fashionable court shoes and this can by no means be guaranteed.