Surgery for Foot and Ankle Nerve Problems

Why Are the Foot and Ankle Nerves Important?

The nerves in the foot and ankle region make movement possible by transmitting commands from our brain to the muscles, and at the same time enable our interaction with the environment by carrying sensations such as touch, pressure, and temperature to the brain. Thanks to these nerves, we take steps, maintain our balance, and feel the ground beneath us. Any damage or dysfunction occurring in the nerves can affect these fundamental functions and make daily life more difficult.

Common Foot and Ankle Nerve Problems That May Require Surgery

The main nerve problems in the foot and ankle region that may require surgical intervention are as follows:

• Tarsal Tunnel Syndrome: Occurs as a result of compression of the tibial nerve or its branches as they pass through the tarsal tunnel located on the inner side of the ankle. It causes pain, burning, numbness, and tingling in the foot and toes.
• Morton’s Neuroma: Thickening of the interdigital nerve leading to the toes, usually between the third and fourth toes, resulting from chronic compression and irritation. It causes burning-type pain, especially aggravated when wearing shoes, and numbness in the toes.
• Other Nerve Compression Syndromes:
  
  • Anterior Tarsal Tunnel Syndrome: Compression of the deep peroneal nerve on the front surface of the ankle.
  • Peroneal Nerve Compressions: Compression of the peroneal nerve (its superficial or deep branches), which extends from the outer side of the calf to the foot, at various levels.
  • Sural Nerve Compression: Compression of the sural nerve on the outer-back part of the ankle or in the foot.
• Traumatic Nerve Injuries: Cutting or piercing injuries, fractures, dislocations, or crush-type traumas can cause cuts, ruptures, or stretch damage to nerves. These conditions may require emergency or planned surgical repair.
• Nerve Tumors: Benign (such as schwannoma, neurofibroma) or, rarely, malignant tumors arising from the nerve sheath can compress the nerve or disrupt its own structure.

Symptoms of Foot and Ankle Nerve Problems

The symptoms of nerve problems vary depending on the nerve affected and the type of problem, but generally include the following:

• Pain: May be burning, stabbing, electric shock-like, aching, or cramp-like. It usually increases at night or with certain activities.
• Numbness (Hypoesthesia/Anesthesia): Loss of sensation in the distribution area of the affected nerve.
• Tingling (Paresthesia): Abnormal sensations such as pins-and-needles or a numb, tingling feeling.
• Muscle Weakness: Loss of strength in the muscles innervated by the nerve, difficulty walking, inability to move the toes.
• Muscle Wasting (Atrophy): Thinning of the muscles in long-standing nerve damage.
• Sensory Changes: Difficulty distinguishing hot from cold, excessive sensitivity to touch (allodynia).
• Symptoms Changing with Footwear Choice or Position: In some nerve compressions, tight shoes or certain foot positions increase the complaints.

Diagnostic Methods for Foot and Ankle Nerve Problems

Accurate diagnosis is the first and most important step toward effective surgical treatment. Prof. Dr. Murat Bozkurt performs a comprehensive evaluation during the diagnostic process at his clinic in Ankara:

• Detailed Patient History (Anamnesis) and Symptom Analysis: The onset, character, and severity of the complaints, aggravating and relieving factors, history of trauma, and accompanying conditions are carefully questioned.
• Comprehensive Neurological and Orthopedic Examination:
  
  • Sensory Examination: Light touch, pinprick, and hot-cold tests are performed along the course of the affected nerve.
  • Motor Examination: Muscle strength and reflexes are evaluated.
  • Provocative Tests: Special tests are applied, such as the Tinel sign (triggering symptoms by lightly tapping over the compression point), nerve stretch tests, and the Mulder compression test for Morton’s neuroma.
• Electrodiagnostic Tests (EMG and Nerve Conduction Studies): These tests, which measure how well nerves conduct electrical signals, are highly valuable in determining the location, type, and severity of nerve damage. They are frequently used to confirm nerve compressions and to distinguish them from other nerve disorders.
• Imaging Methods:
  
  • X-ray: Taken to rule out bony abnormalities, fractures, or bone spurs (osteophytes) that may compress the nerve.
  • Ultrasonography (USG): High-resolution ultrasound can dynamically visualize nerves, possible compression points, cysts, ganglia, and neuromas. It is very useful in experienced hands.
  • Magnetic Resonance Imaging (MRI): Superior for showing soft tissues, nerves, possible tumors, cysts, inflammation, and the details of traumatic nerve damage. It plays an important role in surgical planning.

Foot and Ankle Nerve Surgery: When and Why?

Not every nerve problem requires surgery. Prof. Dr. Murat Bozkurt first evaluates conservative treatment options:

• Conservative Treatment Options:

  • Rest, activity modification.
  • Anti-inflammatory drugs, neuropathic pain medications.
  • Choosing appropriate footwear, custom insoles (orthotics).
  • Physical therapy and rehabilitation (nerve gliding exercises, muscle strengthening).
  • Injections (corticosteroid and local anesthetic injections; for both diagnostic and therapeutic purposes).

• Criteria for Deciding on Surgical Treatment:

  • Persistence or worsening of complaints despite at least 3–6 months of regular conservative treatment.
  • Presence of neurological deficits such as progressive muscle weakness, atrophy, or significant sensory loss.
  • Unbearable pain that impairs quality of life.
  • A clear cause of compression identified by imaging that can be surgically corrected (for example, tumor, ganglion cyst, severe compression).
  • Acute traumatic nerve lacerations.

Foot and Ankle Nerve Surgery Methods: Prof. Dr. Murat Bozkurt’s Approach

In the foot and ankle nerve surgeries he performs in Ankara, Prof. Dr. Murat Bozkurt selects the most suitable technique based on the type of problem and the patient’s individual condition:

• Decompression (Release) Surgery for Nerve Compressions: The most commonly applied method. The goal is to relieve the compressed nerve by clearing away the compressive connective tissue, cysts, or bone spurs around it (for example, tarsal tunnel release for Tarsal Tunnel Syndrome).
• Neuroma Excision (Morton’s Neuroma, etc.): Surgical removal of the thickened, painful neuroma. Frequently performed for Morton’s neuroma. Because the nerve is removed, permanent numbness may occur between the toes, but this is generally more acceptable than the pain.
• Repair and Grafting in Traumatic Nerve Injuries:
  
  • Direct Nerve Repair (Neurorrhaphy): Suturing the cut ends of the nerve together under a microscope using very fine suture materials. Results are better when performed early.
  • Nerve Graft (Autogenous or Allogeneic): When there is a gap between the nerve ends or direct repair is not suitable, a segment of nerve taken from elsewhere in the body (usually the sural nerve from the leg) is used as a bridge (autograft). Processed cadaveric nerves (allograft) can also be used.
• Nerve Transfers: A procedure in which a nearby, functioning but less critical nerve or branch is redirected to the damaged nerve in order to restore function to a nerve that cannot be repaired or has low healing potential.
• Surgical Treatment of Nerve Tumors: Removal of benign or malignant nerve-derived tumors with as little damage to the nerve as possible. Sometimes part of the nerve must be removed along with the tumor, in which case a nerve graft may be needed.

Prof. Dr. Murat Bozkurt’s surgical principles are based on selecting a patient-specific surgical technique founded on an accurate and detailed diagnosis, using anatomy-respecting, precise, and where possible microscopic surgical techniques, and planning appropriate postoperative rehabilitation.

What Are the Benefits of Foot and Ankle Nerve Surgery?

The main benefits that can be achieved after successful nerve surgery are as follows:

• Significant reduction or complete resolution of pain.
• Improvement in abnormal sensations such as numbness and tingling.
• Increase in muscle strength and recovery of function.
• Halting of progressive nerve damage.
• A significant improvement in quality of life.

Risks and Complications of Foot and Ankle Nerve Surgery

As with any surgical procedure, foot and ankle nerve surgery also carries certain risks and potential complications:

• Infection.
• Bleeding (hematoma).
• Wound healing problems.
• Deep vein thrombosis (DVT) and pulmonary embolism (rare).
• Anesthesia-related complications.
• Specific Risks:
  
  • Symptoms not fully resolving or recurring.
  • Additional nerve damage occurring during surgery (very rare).
  • Permanent loss of sensation (especially after neuroma excision).
  • Formation of painful scar tissue or a new (symptomatic) neuroma.
  • Development of Complex Regional Pain Syndrome (CRPS) (rare but difficult to manage).

Prof. Dr. Murat Bozkurt informs his patients in detail about possible risks and complications before surgery and takes all necessary precautions to minimize these risks.

Recovery Process and Expectations After Foot and Ankle Nerve Surgery

The recovery process varies depending on the type of surgery performed, the patient’s general health status, and the severity of the nerve damage:

• Early Postoperative Period: Rest and elevation of the operated area are generally recommended. Medications are given for pain control. In some cases, a splint, cast, or special boot may be required.
• Wound Care and Sutures: Dressings are changed regularly, and sutures are usually removed within 2–3 weeks.
• Weight-Bearing: Depending on the surgical procedure, partial or complete non-weight-bearing may be recommended for a period.
• The Nature of Nerve Healing: Nerve healing is a slow process (on average 1 mm per day, or 2.5 cm per month). Therefore, full functional recovery can take months, and sometimes even 1–2 years. Patience and realistic expectations are important.
• Physical Therapy and Rehabilitation: An essential part of the recovery process. Special exercise programs are applied to maintain joint range of motion, strengthen muscles, provide sensory re-education, and restore a normal walking pattern.

Foot and Ankle Nerve Surgery in Ankara: You Are in Safe Hands with Prof. Dr. Murat Bozkurt

Ankara is a healthcare center where complex and specialized treatments such as foot and ankle nerve problems are successfully performed. In such delicate surgeries, the surgeon’s experience and expertise directly affect the success of the treatment. Prof. Dr. Murat Bozkurt inspires confidence in his patients in Ankara through his deep knowledge in the surgical treatment of foot and ankle nerve pathologies, his command of modern diagnostic and treatment methods, and his meticulous surgical approach. He offers a wide range of services, from interpreting advanced electrodiagnostic tests to performing precise nerve repairs under the microscope.

Contact and Appointment Call:

Don’t let nerve problems in your foot and ankle diminish your quality of life. With the expertise of Prof. Dr. Murat Bozkurt in Ankara, you can regain your health through accurate diagnosis and effective surgical treatment options. For detailed information and appointments, take a step toward expert help by calling 0312 502 70 74.