What Is Reconstructive Foot and Ankle Surgery?
Reconstructive surgery corrects the structure of the foot when a deformity is causing ongoing pain or difficulty walking and non-surgical care hasn’t helped. That can mean realigning the bones of the big toe in a bunion, straightening severe or rigid hammer toes, or correcting deformity in the rearfoot, such as a collapsing flat foot.
Every procedure is planned around your imaging, how your foot functions and what you need to get back to. Before any procedure is booked, you’ll be told what it involves, the expected recovery time and the risks.
Conditions treated surgically at the clinic
- Tarsal tunnel pain
- Flat foot
- Bunion surgery
- Hammer toe
- Morton’s neuroma
- Heel pain
- Ingrown toenail
- Haglund’s deformity
Who It Helps
Surgery is considered when non-surgical treatment has failed to relieve pain and the problem interferes with daily activities. At Manly Foot Clinic the common indications are bunions, hammer toes, Morton’s neuroma, flat feet, Haglund’s deformity, persistent heel pain and recurrent ingrown toenails. Each case is assessed on the extent of the deformity, the x-ray findings, age and activity level.
Bunions
If non-surgical treatments fail to relieve bunion pain and when the pain of a bunion interferes with daily activities. The goal of surgery is the reduction of pain. A variety of surgical procedures is available to treat bunions. In selecting the procedure or combination of procedures for your particular case, Dr Ozan Amir will take into consideration the extent of your deformity based on the x-ray findings, your age, your activity level, and other factors.
Hammer toes
In some cases, usually when the hammertoe has become more rigid and painful, or when an open sore has developed, surgery is needed. Often patients with hammertoe have bunions or other foot deformities corrected at the same time.
In selecting the procedure or combination of procedures for your particular case, Ozan will take into consideration the extent of your deformity, the number of toes involved, your age, your activity level, and other factors. The length of the recovery period will vary, depending on the procedure or procedures performed.
Flat feet
Flatfeet can be broadly classified into flexible and rigid in nature. The type of flatfoot is determined through clinical testing. Most flatfeet are flexible and can be treated well with orthoses and specific exercises. Dr Ozan Amir works closely with Podiatrists and will refer you to one of his colleagues near your area to have orthoses fabricated.
In a minority of cases, conservative care does not alleviate the symptoms that can be associated with flatfeet. When this is the case Ozan will order the appropriate x-rays to evaluate the severity of deformity.
There are a number of surgical procedures available to correct and restore the alignment of the flatfoot, including minimally invasive procedures such as the hyprocure extra-articular subtalar joint implants and a multitude of other ‘traditional open’ tendon and bone re-alignment procedures. Ozan will discuss in depth with you which procedure(s) would be suitable for you, so you can make an informed decision on how to proceed.
Morton’s neuroma
Majority of publications including peer review journal articles, surgical technique description and textbooks promote surgical excision as a gold standard treatment. Surgical excision is described as the most definitive mode of treatment for symptomatic Morton’s neuroma with reported success rates varying between 79% and 93%.
Various surgical techniques are described, essentially categorised as dorsal versus plantar incision approaches. Beyond this the commonest technical variation described as influencing the outcome of surgery involves burying and anchoring the transected nerve into soft tissue such as muscle.
Surgery to excise the neuroma is usually performed under general anaesthetic in a day surgery facility. After surgery you will have to keep your foot dry for two weeks. Generally neuroma surgery allows for early weight bearing and protection in some type of post op shoe gear. Some neuromas may reoccur, but this is rare. Most studies on patient satisfaction after neuroma surgery show approximately 90% reduction of pain and about 85% of all patients rated the overall satisfaction with the results as excellent or good.
Interdigital neurectomy (removal of the diseased nerve) in the right hands, should give satisfactory results almost all the time. Some of the reasons behind failure is when not enough nerve is dissected, mistakes in initial diagnosis, or bad handling of adjacent nerves, tendons and joint capsules during the operation. It is very common and acceptable to have some numbness in the area where the nerve used to be. This never causes any discomfort and often gets better in a few years.
Haglund’s deformity
If non-surgical treatment fails to provide adequate pain relief, surgery may be needed. Ozan will determine the procedure that is best suited to your case.
Heel pain
Although most patients with plantar fasciosis respond to non-surgical treatment, a small percentage of patients may require surgery. If, after several months of non-surgical treatment, you continue to have heel pain, surgery will be considered. Ozan Amir will discuss the surgical options with you and determine which approach would be most beneficial for you.
Ingrown toenails
After examining the toe, Ozan will select the treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed. Sometimes a minor surgical procedure, often performed in the office, will ease the pain and remove the offending nail. After applying a local anaesthetic, Ozan removes part of the nail’s side border.
Some nails may become ingrown again, requiring removal of the nail root. Following the nail procedure, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day.
Are you a candidate?
The table below sets out, condition by condition, when surgery is considered and what Ozan weighs in choosing a procedure.
| Condition | Surgery is considered when | What Ozan weighs |
|---|---|---|
| Bunions | Non-surgical treatments fail to relieve pain and the pain interferes with daily activities | Extent of the deformity on x-ray, age, activity level and other factors |
| Hammer toes | The toe has become more rigid and painful, or an open sore has developed | Extent of the deformity, number of toes involved, age and activity level |
| Flat feet | Conservative care with orthoses and exercises does not alleviate the symptoms | Severity of the deformity on x-ray, and whether a minimally invasive implant or an open re-alignment suits |
| Morton’s neuroma | Conservative care and injection therapy have not settled the symptoms | Confirmation of the diagnosis by examination, with MRI or high definition ultrasound where useful |
| Haglund’s deformity | Non-surgical treatment fails to provide adequate pain relief | The procedure best suited to your case |
| Heel pain | Heel pain continues after several months of non-surgical treatment | Which surgical approach would be most beneficial |
| Ingrown toenails | The nail is painful or infected, or has become ingrown again | Whether to remove part of the nail border or the nail root |
What to Expect
Every surgical pathway at Manly Foot Clinic follows the same four stages: a consultation with Dr Ozan Amir, the procedure itself, a recovery period that depends on what was done, and structured review afterwards. Nothing is booked until you have the information to make an informed decision.
Assessment first
Ozan will obtain a thorough history and physical examination of your foot, and will correlate the findings with x-rays. For Morton’s neuroma, MRI and high definition ultrasound examination may be useful to confirm the diagnosis. You leave the consultation knowing whether surgery is appropriate and, if it is, which procedure or combination of procedures Ozan recommends and why.
The treatment
The procedure depends on the problem. It can mean correcting the bones of a bunion, straightening rigid hammer toes, rebuilding a collapsing arch or correcting deformity in the rearfoot, planned around your X-rays and how your foot works.
Recovery
Recovery depends on the procedure or procedures performed. Dr Ozan Amir tells you the expected recovery time, and the risks, before anything is booked. Manly Foot Clinic has not published a recovery timeline for reconstructive procedures, so this page does not state one.
Review and progress
It is crucial to address the biomechanical pathologies underlying the impingement of the nerve during and after the surgery. Ozan will work closely with your Podiatrist in providing appropriate orthotic therapy to address these biomechanical issues.
Follow-up is structured: review appointments, outcome measurement and a report back to your referring practitioner.
Why Consider Reconstructive Surgery at Manly Foot Clinic
A surgical podiatrist consults here, and complex forefoot and rearfoot correction is planned and managed within the clinic.
- Dr Ozan Amir completed his surgical training with the Australasian College of Podiatric Surgeons in 2012, with further surgical training in the United Kingdom and the United States.
- Every procedure is planned around your imaging, how your foot functions and what you need to get back to.
- Injection therapy and 3D-scanned orthoses are delivered in-house, before and after surgery.
- The clinic has treated Northern Beaches feet since 1989.
What it costs
Consultation fees, including Dr Ozan Amir’s surgical consultations, are on our FAQ page and on What to Expect. All of the major private health funds recognise the clinic.
The surgical fee is separate and is quoted to you in writing after your consultation, because it depends on the procedure and on the facility. You will not be asked to commit to anything before you have that figure.
Reconstructive Foot Surgery FAQs
Reconstructive surgery corrects the structure of the foot when a deformity is causing ongoing pain or difficulty walking and non-surgical care hasn’t helped. That can mean realigning the bones of the big toe in a bunion, straightening severe or rigid hammer toes, or correcting deformity in the rearfoot, such as a collapsing flat foot. Each procedure is planned around your X-rays, how your foot functions and what you need to get back to. Dr Ozan Amir trained in podiatric surgery with the Australasian College of Podiatric Surgeons. He completed further surgical training in the United Kingdom and at the Podiatry Institute in Atlanta, where he focused on rearfoot reconstruction. Before any procedure is booked, you’ll be told what it involves, the expected recovery time and the risks.
Costs vary according to the practitioner and type of assessment. Consultation fees are published on our FAQ page. Anything beyond the consultation is quoted before it is booked.
No, you can book directly without a referral. If you’d like, we’ll send a short report to your GP after your appointment so your foot care stays part of your overall health record. If your appointment is through a Medicare care plan, DVA or another funded program, you will need a referral, so check with us when you book.
All instruments are sterilised on site to Australian standards, and procedures use aseptic technique.
Ingrown toenails that keep coming back often need a minor procedure to remove the problem edge of the nail. All our podiatrists perform nail surgery here at the clinic under local anaesthetic, with no hospital stay needed. Sterile instruments and aseptic technique are used throughout. At Manly Foot Clinic, we are able to offer both the partial nail avulsion and Winograd procedure for ingrown nails.
Serving Manly and the Northern Beaches.
Manly Foot Clinic is at Shop 3/3 Corrie Rd, North Manly, NSW 2100. Patients come for surgical opinions from Manly, Dee Why, Brookvale, Freshwater and Balgowlah, and from further across Sydney on referral. The clinic is open Monday to Friday from 8:30am to 5:30pm and Saturday from 8:00am to 2:00pm.