Treating patients of all ages, Calabasas Podiatry Group offers complete medical and surgical podiatric care for San Fernando Valley families.
Initial therapies for common foot and ankle conditions often include resting and icing the affected area, using Advil (ibuprofen) or corticosteroid injections to manage pain and inflammation, wearing custom orthotics or braces, and undergoing physical therapy. However, surgical intervention may be necessary for a full recovery if these treatments don’t provide sufficient relief – or you suffer a debilitating tendon, ligament, or muscle tear.
Our skilled podiatric surgeon, Dr. Dana Brems, DPM, offers wide-ranging surgical solutions to meet your needs, goals, and lifestyle. Here’s an overview of some of the high-level procedures we perform at our Woodland Hills practice.
Tendon Surgery
Tendons are strong bands of tissue that attach muscles to bones. There are multiple types of tendons in the feet and ankles – including the peroneal, Achilles, extensor, flexor, and tibialis anterior and posterior tendons – all of which provide stability and are vital for foot and ankle function. Injured or torn tendons can cause pain, swelling, and weakness in the foot and ankle, resulting in discomfort when standing, walking, or running.
When conservative approaches don’t produce the desired results, surgery may be necessary to repair damaged tendons. The surgeon makes a small incision just above the affected tendon and removes the damaged tissue. In some cases, replacing a severely injured tendon with a healthy tendon from another part of the body may be required.
Recovering from podiatric tendon surgery can take months. Physical therapy can help patients get back on their feet.
Webbed-Toe Separation
Syndactyly is a common limb difference in which the skin of two or more toes on a child’s foot is fused, appearing webbed. The problem can be inherited or caused by a medical condition such as Apert syndrome (acrocephalosyndactyly), Poland-Moebius syndrome, or Holt-Oram syndrome (HOS).
Because syndactyly can interfere with a child’s normal foot function and development, we recommend surgery to correct webbed toes as early as possible, before the baby can miss any major milestones. During the procedure, the surgeon makes a series of zigzag incisions that separate the fused toes, then grafts pieces of healthy skin over the separated area.
Recovery involves approximately three weeks in a cast, followed by several weeks in a splint, and physical therapy to help improve the functionality. After the surgery, the child’s feet should develop normally. However, some children may require additional surgery when they reach adolescence and their feet fully mature.
Flat Foot Surgery
Adults with little to no arches to their feet can experience wide-ranging dysfunction, including pain or numbness when walking or running, swollen ankles, damaged nerves, arthritis, and loss of foot flexibility.
Fortunately, Dr. Brems can perform flat foot surgery to repair or replace damaged tendons and ligaments and reshape the bone to create an arch. In some cases, making a small incision in the heel bone and affixing a metal screw may be required. Inserting a metal plate can also give the reconstructed arch much-needed support. The surgery improves the foot’s alignment and helps it distribute weight more evenly. Usually an outpatient procedure, most people can go home the same day as the surgery. Foot strength and flexibility will gradually improve, allowing patients to return to normal activities.
Recovering from flat foot surgery requires spending up to six weeks in a plaster case, during which rest, keeping weight of the affected foot, and elevating it above heart level is essential. Patients can walk short distances after a week and begin physical therapy five to six weeks later.
Fat Pad Augmentation
The natural fat pads on the bottoms of the feet provide cushioning and serve as shock absorbers when walking, running, and jumping. These pads can start to thin and break down due to aging, traumatic injuries, playing sports, standing for long periods, or health problems like diabetes or vascular issues. High arches, toe deformities, misaligned bones, and frequently wearing high heels can contribute to the problem. Known as fat pad atrophy, the condition can make walking and other activities extremely painful.
Fat pad augmentation, also known as fat pad transfer, is a simple, minimally invasive procedure that relieves foot pain by increasing the fatty padding with fat cells from other body parts. Fat pads can also be augmented with an injectable fat matrix like Leneva or a filler like Sculptra.
Foot Neuroma Surgery
Morton’s neuroma is the inflammation or thickening of the tissue surrounding an injured or damaged nerve in the foot, most commonly between the third and fourth toes. This thickening compresses the nerve, causing pain, inflammation, burning, numbness, and tingling that can make it difficult to perform daily activities. People with flat feet, high arches, high heels, or poorly fitting shoes are at an increased risk of developing Morton’s neuroma.
When conservative therapies fail, Calabasas Podiatry Group’s highly skilled specialist can use a minimally invasive surgical technique to remove the compressed nerve and release tight ligaments as needed to provide relief. After surgery, patients must wear a cast or boot to help protect their foot.
Recovering from Morton’s neuroma surgery usually takes two to four weeks and often requires physical therapy.
Cosmetic Foot Surgery: Toe Lengthening, Shortening, and Straightening
Short, long, or crooked toes aren’t just unsightly; they can cause significant pain during regular activities like standing or walking. Our cosmetic toe lengthening, shortening, and straightening surgeries can relieve pain, restore appearance, and improve quality of life.
To shorten a long toe, we can remove part or all of one of the small toe joints. A straightening surgery can correct crooked toes. Surgical solutions for toe lengthening include sliding bone, cut lengthening, bone grafting, or external fixator lengthening techniques.
Bunionectomy Revision Surgery
When a bunion returns after surgery and pain, toe stiffness, and other symptoms persist and interfere with everyday activities, you may require revision surgery to correct the failed bunionectomy. Bunion revision surgery isn’t for everyone who’s suffered a surgical failure. Still, it may be the right option for those with post-operative arthritis, bone problems, or issues with foot function.
However, bunionectomy revision – and the recovery process – is more challenging than an initial bunionectomy. The procedure requires a skilled surgeon and comes with numerous risks, including nerve damage, healing issues, circulation problems, pain, and swelling.
It’s crucial not to rush the recovery process, which can last up to six months. Patients should keep weight off the affected foot for six to eight weeks. Planning time off work, making necessary home modifications, and arranging for in-home help can make recovery more successful.
Big Toe Joint Replacement
People with severe osteoarthritis, rheumatoid arthritis, or bone spurs in their big toe joints may suffer from joint swelling, pain, and inability to bend the toe. Replacing the joint can significantly reduce arthritis pain and improve the big toe’s range of motion. The procedure involves placing the patient under general anesthesia, preparing the bone surfaces for an artificial joint, such as the Cartiva synthetic cartilage implant, removing the damaged cartilage, and inserting the new joint.
After a traditional big joint replacement surgery, patients may need to wear a cast for six weeks and keep their full weight off the foot for eight weeks. Physical therapy can help patients learn to walk with the artificial joint.
However, the Cartiva synthetic cartilage implant uses a minimally invasive surgical technique that doesn’t require wearing a cast afterward – and patients can put weight on their foot almost immediately.
Lipoma Treatment
A lipoma is a benign (non-cancerous) soft tissue tumor that can appear anywhere on the body, including the foot, as a soft lump under the skin. Though lipomas grow slowly and aren’t considered harmful, they can cause pain if they compress nerves or interfere with other structures in the foot.
Family history and health conditions such as high cholesterol, obesity, Garner syndrome, Madelung's disease, adiposis dolorosa, and Cowden syndrome can increase the risk for lipomas.
Patients should see a podiatrist if more lumps appear or the lipoma becomes red, painful, hard, or changes in size and shape. At Calabasas Podiatry Group, we offer effective surgical solutions for painful, unsightly lipomas.
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