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Sheffield Podiatry Service
Podiatric Surgery
Introduction
This information is designed to familiarize you with those procedures most commonly performed by the podiatric surgery service. A complete range of foot surgery is not detailed here.
Almost all procedures are undertaken under local anesthesia.
The immediate post-operative care required is relatively minimal. The patient is usually required to rest and elevate the foot for the first 48 hours after the operation. This is followed by a gradual re-introduction to normal daily activities, with certain exceptions for some more complex operations. Patients are given specific verbal and written instructions with regard to post-operative rehabilitation.
Patients are usually in the unit for only a few hours.
Current Service Provision:
Monday AM - New patient, follow-ups and dressing clinics
Monday PM - Operating session
Tuesday AM/PM (alternate wks) - New patients and follow-ups
Wednesday PM (alternate wks) - New patients and follow-ups
Thursday AM - New patient, follow-ups and dressing clinics
Thursday PM - Operating session
Podiatric Surgery Team
1 Consultant Podiatric Surgeon
1 Podiatric Specialist Registrar
4 Staff Podiatrists
1 medical secretary
Referrals
Referrals should be addressed to:
Mr Brian T Brown BSc (Hons) FCPodS
Consultant Podiatric Surgeon
Jordanthorpe Health Centre
1 Dyche Close
Sheffield
S8 8DJ
Tel: 0114 2371167, Fax: 0114 2371185
Common Surgical Procedures undertaken by the Surgical Podiatry Team:
- Hallux Valgus (bunion) corrective osteotomies Neuroma Excisions
- Lesser toe arthroplasties/arthrodeses for correction of hammer toes,claw toes and mallet toes
- Soft tissue lesion excisions e.g. ganglions, lipomas, bursas, fibromas, epidermoid cysts, mucoid cysts
- Tendon procedures- repairs and transfers
- Skin plasties
- Lesser toe amputations
- Lesser metatarsal osteotomies
- Intractable plantar keratoses excisions
Patients may be referred directly by their GP or from secondary care to the surgery unit. Referrers should refer via the Referral Information Service (RIS).
It should be noted that referral does not automatically indicate that a patient will proceed to surgery. At initial consultation and after appropriate history, examination and diagnostic tests a treatment plan is formulated which may include non-surgical treatments such as biomechanical, physical and injection therapy.
Generally, a surgical intervention will not be proposed unless or until conservative options are exhausted or deemed inappropriate. In addition to any discussion and counseling about treatment options, a range of informative leaflets is used to indicate the treatment options and the risks, benefits and aftercare requirements of surgical interventions and to help patients make informed decisions about their treatment.
Definitions
Podiatric surgery:
Podiatric surgery is a specialized form of foot surgery performed by podiatric surgeons. This specialized approach to foot surgery was developed, originally in the United States of America, in order to improve on the existing methods of surgery which tended often to have poor results and often meant patients having to stay off their feet for several weeks after surgery. Up until the development of podiatric surgery, orthopaedic surgeons undertook almost all foot surgery and very few people were referred for foot surgery because the waiting lists for foot surgery were so long.
The vast majority of podiatric surgery:
- is performed using local anaesthetic
- is undertaken on a day case basis (with the patient going home on the day of the operation).
Podiatrist:
Has trained for three years to obtain a qualification (diploma or degree) in podiatry and become registered with the Health Professions Council (HPC). Podiatrists are independent clinicians, qualified to diagnose and treat foot problems.
Podiatric Surgeon:
Is a non-medically qualified specialist in the treatment of all foot problems by both surgical and non-surgical methods. Podiatric surgeons graduate as podiatrists initially, then after at least 2 years general podiatric practice, train for a further 4 years to obtain the Fellowship of the College of Podiatrists (Faculty of Surgery) to specialise in the surgical management of foot problems. Podiatric surgeons are not doctors (i.e. registered medical practitioners) but instead are registered with the Health Professions Council and specialise purely in foot problems.
Consultant Podiatric Surgeon:
After a minimum of a further 3 years practice within a Podiatric Surgery Department, and after obtaining the Certificate of Completion of Specialist Training (Faculty of Surgery) a podiatric surgeon may be appointed as a consultant i.e. the lead clinician appointed by an NHS Trust to provide a podiatric surgery service. The consultant appointment panel will include a member of the Faculty of Surgery.
