Foot Surgery

There are different reasons why your child may need foot surgery. This factsheet explains the different surgeries for certain medical conditions.

Your child will need to be admitted to hospital for foot surgery. The length of stay in hospital will depend on the type of surgery that is done.

What is a posterior medial release?

A posterior medial release (PMR) is an operation to correct club foot (talipes). The medical term for club foot is congenital talipes equinovarus (CTEV). Club foot is a deformity that is present at birth and may affect one or both feet. Surgery may be needed to release the ligaments and tendons that pull the foot out of position. Often a pin is inserted to hold the correct position and a plaster cast is applied.

What is a triple arthrodesis/subtalar fusion?

A triple arthrodesis is an operation to stabilise three joints within the ankle. A subtalar fusion is an operation to stabilise one joint within the foot. Either of these operations may be required for patients with residual club foot or foot deformities. Surgery involves fusing or joining the joints using metal screws and a bone graft. A plaster cast below the knees is then applied.

What is a tarsal coalition?

A tarsal coalition occurs when the joints in the foot do not form correctly. This results in a stiff flat-foot deformity. Movement of the foot is restricted, it is often painful and needs surgery. Surgery is done to remove the affected bone and a below knee plaster cast is applied.

What is a tendon transfer or lengthening?

The soft tissue of the foot includes ligaments, tendons and muscles. Surgery is done on the soft tissues (mostly tendons) to correct foot deformities that do not involve bones. Children with cerebral palsy or spina bifida often need this operation. A plaster or walking cast is then applied to hold the foot in the correct position.

What should I expect

Your child will need to be admitted to hospital for foot surgery.
The length of time your child needs to stay in hospital depends on the type of surgery performed, but your child will be in hospital for at least one night.

While in hospital your child's care may include the following:

Close observation of the affected foot to watch for swelling.
Elevation of the foot to help reduce swelling and pain.
Pain relief that may be given directly into a vein by intravenous therapy, often called an IV or a drip.
Antibiotics may be given if your child has had metal pins/screws put in during the operation.
Care of the plaster cast.
Physiotherapy - your child may not be able to put all their weight on their foot and crutches or a wheelchair may be needed.

Your child will be discharged from hospital when:

He or she is comfortable.
There is little swelling of their foot
They can move about safely and comfortably.

Care at home

Keep your child's foot elevated or raised as discussed on discharge from hospital. The injured foot should be raised on a pillow or cushion when your child is resting.
After going home it is important that your child's foot is protected. Returning to normal activities (i.e. school, sport) should be on the advice of the doctor.
Pain relief is usually needed for the first few days after going home. Your nurse will discuss your child's individual needs with you before you leave hospital.
Plaster care and limb observation is very important - refer to the Kids Health Info factsheet: Day Surgery: Plaster cast - discharge care.

Follow up

An appointment, either in the outpatient clinic at the hospital or in your surgeon's private rooms, will be made two to six weeks after surgery (depending on the type of surgery).
Your child may need X-rays, a wound check or change of plaster. Your nurse will provide individual follow up instructions before you leave hospital.

Key points to remember

Each child is different and some may heal quicker or more slowly than others. The length of time taken for healing depends on the type of surgery performed.
Swelling may still be present when you leave hospital. Elevate your child's foot to help reduce swelling and assist with pain relief.
All follow up appointments with your doctor should be attended. Often further X-rays are taken so that healing and bone position can be checked.

Credits & Documentation references

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