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The orthopedic surgeons at Cedars-Sinai Marina del Rey Hospital evaluate patients with foot and ankle disorders and provide an individualized treatment advice for each patient. They can help you choose from the various conservative and surgical treatment options that are available. The treatment mode that is best for your symptoms and severity of your foot and ankle condition is considered.
The foot and ankle bear the entire weight of our body. Disorders of the foot and ankle occur due to fracture of bones or inflammation of tendons and ligaments due to damage or infection. These disorders commonly affect people who actively participate in sports. An ankle sprain often occurs because of the forced movement from its normal position resulting in tearing of tendons, ligaments, and nerves. Falls from a height and landing on the foot or walking and exercising on an uneven surface can also result in ankle injuries. During all these situations, the whole body weight is taken by the ankle and excessive pressure is exerted on the bones, muscles and the nerves of the ankle resulting in sprain and fractures.
Fracture repair: In this procedure, the surgeon will make an incision in the skin to reach the damaged bone and with the help of screws, plates, wires and other materials the broken bones will be held in place and allowed to heal naturally. More often the open reduction and internal fixation method will be used to repair a fractured bone. In open reduction, the broken ends of the bone are realigned and allowed to heal. During internal fixation, materials such as metal plates, wires and screws are used to hold the displaced bones in place.
Osteotomy: This is a surgical procedure in which the size of the bone is altered by cutting to shorten it, by lengthening it, or by realigning it with adjoining bones and other tissues. It is usually performed as a corrective surgery when the bone has healed in an improper manner following its damage.
Reconstruction of lateral ankle ligament: This surgical procedure is performed when the ankle is unstable and does not resolve upon nonsurgical treatment. The operation is carried out under general or local anesthesia. A large C or J-shaped incision is made and with the help of an arthroscope, the damaged bones and ligaments are repaired. Sometimes, tendons may be used to replace the damaged ligaments.
Ankle fusion: In ankle fusion the surfaces of the bones that have to be merged are prepared so that they can be fused together, and these bones will grow together as a single bone. There are several methods of fusing bones, the ideal method will be chosen according to your ankle problem.
Ankle replacement: This procedure is commonly done when the patient is suffering from arthritis. Through an incision the surgeon will remove the damaged bone and surrounding tissues, reshapes the bone and attaches an artificial joint with a special bone cement or glue. To support and stabilize the ankle bone graft and screws with adjacent bones may be used.
Distraction arthroplasty of the ankle: This procedure is done to restore improper joints. With the help of an external frame around the ankle, screws and wires, the broken bones are aligned in the right position. This frame will pull and hold the damaged joints in place and help in the quick recovery of joint disorders. Unlike other surgical procedures, distraction arthroplasty of the ankle preserves the joints and enables its natural movements.
Depending on the nature of the injury, the symptoms of foot and ankle disorders vary. Following are the common symptoms:
Similar symptoms may also appear in the case of tendonitis and Achilles tendonitis along with the following symptoms.
Physical assessment: The doctor will ask questions regarding your symptoms. The affected region will be physically examined for stiffness, tenderness, swelling, pain, and bone damage.
Lab tests: Blood and urine test will be conducted to identify the level of uric acid, rheumatoid factor indicating the presence or absence of gout or arthritis. Tests will be conducted from the fluid drawn from bone joints to know if there is gout or bacteria infecting the joints.
X-ray: With the help of an X-ray of the affected region, the condition of the bones and joints can be visualized.
Arthrography: This is an imaging procedure where contrast dye is injected into the joint or blood stream to have a clear view with the help of X-ray.
CAT Scan / CT scan: With the help of X-rays and computers the structure of bones, soft tissues, such as muscles, ligaments, and cartilage can be identified better than with a normal X-ray.
Magnetic resonance imaging (MRI) scan: With the help of strong magnetic fields, a contrast dye, and a computer, a clear image of bones, soft tissues such as tendons, muscles, cartilages, and ligaments can be viewed for damages.
Bone scan: In this procedure, radioactive material is injected into the blood stream. These radioactive materials get settled where there is bone damage.
Video fluoroscopy: Using an X-ray and fluorescent contrast material, the internal structure of the ankle and its movements can be visualized in the form of a video.
Age: In elderly people, because of advanced age, the body weight tends to increase, which leads to widening and flattening out of the feet. The muscular padding on the sole of the foot becomes thin and the skin over the foot becomes dry. These conditions pose a high risk for foot and ankle disorders.
Occupational hazards: Individuals performing their jobs at the workplace by standing all day long or walking long distances for a long time will have a high risk for ankle and foot pain.
Pregnancy: During pregnancy, certain hormones that are released in the body may cause the ligaments to relax leading to swelling in the ankle and foot.
Sports activity: Athletes and sports personnel who engage themselves regularly in sports activities will have a high risk for foot and ankle problems due to heavy stress on the feet that can lead to damage of bones, muscles, tendons, and ligaments. Chances of falling and injury are very high when involved in sports.
Obesity: Due to the excessive weight of the body, more stress affects the joints and tissues of the feet, which may lead to foot or ankle injuries increasing the risk of developing tendonitis and plantar fasciitis.
Causes of foot and ankle disorders vary greatly and can range from everyday activities, such as running and jumping, to sports-related injuries that are due to overuse. Ankle sprains and fractures are commonly caused by:
Injury: Damage to bones, ligaments, tendons, and muscles as a result of the injuries from:
Arthritis: When a joint gets affected by arthritis, the cartilage gets damaged and movements of the ankles will suffer.
Birth defects: Flat foot, club foot are some of the defects.
Osteoporosis: The bones become weak and fragile leading to easy fractures.
Acupressure: Applying gentle pressure at specific points on the feet can resolve most of the symptoms of foot and ankle disorders.
Massage: Gentle massaging of the feet makes the blood circulation better and alleviates the pain.
Foot and ankle injuries can be prevented by maintaining good posture and body flexibility. Regular exercise is helpful as it builds strong muscles and bones, and makes your body flexible as well as strong enough to withstand any stress exerted on your foot. Other measures such as stretching and warming up before physical activity, wearing comfortable and suitable shoes that provide good ankle support may be helpful in preventing foot and ankle injury.
For any questions, information or guidance related to foot and ankle problems, consult our specialty-trained orthopedic surgeons at Cedars-Sinai Marina del Rey Hospital.
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