Podiatric surgery

A Podiatric Surgeon specialises in the surgical and non-surgical treatment of the foot and its related structures.  Podiatric Surgeons are Fellows of the Surgical Faculty of the College of Podiatrists, whose qualification is registered under the Health Professions Council. It takes a minimum of 6 years to qualify as a Podiatric Surgeon

Podiatric Surgeons are not medical doctors or orthopaedic surgeons.  Their training, which is 11 years in duration, is specific to the surgical and non-surgical management of the foot.  Medical management will require liaison with the patients GP or hospital medical colleagues.  You can find out more about Podiatric surgery at the Society of Chiropodist and Podiatrists web site at www.feetforlife.org

Each department is Consultant Lead supported by a team of fully qualified Staff Podiatrists and Nurses who will be involved in providing your care.  We are also a registered training centre for Podiatric Surgeons and part of your treatment, including surgery may be provided by a Surgical Trainee under direct supervision of the consultant.

• Podiatric Surgery at Buxton Hospital was established in November 1991.
• Podiatric Surgery at Chesterfield was established in 1998.
• Podiatric Surgery at Ilkeston Hospital was established in July 1994. 

The service has for a long time enjoyed an excellent reputation both locally and nationally and should be given first consideration when referring anyone with foot problems which may require elective foot surgery.

Podiatric Surgery specialises in the assessment and surgical management of complex foot disorders including forefoot, mid foot and rear foot pathologies.  Surgery is carried out on a Day Case basis utilising either regional local anaesthesia or general anaesthesia.

Podiatric Surgeons are specialists in foot surgery, governed by the HCPC (Health and Care Professionals Council) and registered members of the College of Podiatrists Faculty of Surgery.  The majority of work undertaken is forefoot surgery as this is where the greatest volume of pathology is, there is also however a steady throughput of mid foot and rear foot surgery.

This service prides itself on creating a comfortable surgical experience for all patients and high quality surgical outcomes. Quality of the service is demonstrable by continual clinical audit, patient feedback and transparency of the results. This data can be seen in our regular 6 monthly service reports as well as numerous professional publications.  The variety of audit tools used adds validity to the results produced which demonstrate significant correlations.

When you first attend the department you will be assessed by one of the Staff Podiatrists, Surgical Trainees or Specialist Registrar.  It is important that you bring an accurate list of any medications that you are taking and you should be prepared to give a medical history which will include allergies, medical complaints, previous operations and other hospital admissions.  We may also need to ask about relevant family medical problems.  A treatment plan and/or additional investigations such as x-rays may be arranged and if appropriate you may also see the Consultant Podiatric Surgeon at this time.

If your treatment plan involves surgery you will be provided with information on the nature of the operation in terms of technique, rehabilitation times, common and important complications and limitations. You will have the opportunity to ask questions and you will also be provided with written information sheets and diagrams to take away with you.

You will be offered a date for surgery by post and in order to accept this date you must fully complete and sign the attached questionnaire.  You will then be asked to attend for a pre-operative appointment which is an opportunity for us to check that surgery is still appropriate and for you to ask any further questions.  On the day of surgery and for the next 48 hours you should ensure that you have a responsible adult to look after you.

You will be required to attend for dressing changes and follow-up appointments in the first days and weeks after your surgery. You will be advised of these appointments in due course.  You will need to keep the surgical dressings dry after the operation, which is usually around 2 weeks but can be longer.

Most operations are performed under a local anaesthetic.  This being the case you will be awake; you can eat normally and take your normally prescribed medications on the day of your operation.  The Local anaesthetic is administered via injections around the ankle. Most patients find this to be more comfortable than a dental injection.  Sometimes an injection behind the knee will be offered.

If you feel unable to undergo local anaesthetic treatment or if it is necessary for the type of operation required a General Anaesthetic can be arranged.

Many foot deformities / conditions are treated by Podiatric Surgeons. A list of common procedures undertaken within the department, including specific literature and diagrams is accessible from the links below

In line with the Government requirements, you will have your operation within 18 weeks.

If you are not available to have your operation within this period, you will be discharged back to your GP.

For current waiting times please see latest 6 month report

Stephen Finney has over 20 years' experience in both conservative and surgical management of a wide range of foot ailments, after graduating in Podiatric Medicine in 1989.  He was awarded his Podiatric Surgical Fellowship (F.C.Pod.S) in 1995 and took up his first Consultant post in 1998 in Nottingham.  He has extensive clinical experience having carried out over 8,000 foot operations in the Nottingham, Chesterfield and Kirklees areas, and he has recently taken on a further Consultant post at Ilkeston Community Hospital.

In addition to his clinical duties Stephen is very active in a number of regional and national educational and professional roles including: University Lecturer (Huddersfield); Journal reviewer; National Surgical Examiner of the College of Podiatrists; Executive committee member of the College of Podiatrists and currently Assistant Vice Dean of Faculty of Podiatric Surgery in 2013.  He is also an Advisor to the National institute of Clinical Excellence (NICE), and advisor to RCS AND BOA Commissioning Guidelines for foot and ankle surgery.

Lance Hogg has been a Consultant at Ilkeston Hospital since 2007 and previously in Ellesmere Port and currently in Nottingham.  He is very active in mentoring and tutoring MSc. students and Podiatric Surgical trainees.  He works as a Consultant Podiatric Surgeon full time in the NHS.

Lance obtained his Fellowship in Podiatric Surgery in 1993.  He has been treating patients with foot problems since 1985 and has 16 years' experience at Consultant level in the surgical management of foot pain and deformity.  He trained in Luton, Seattle and San Antonio, Texas. 

Tim Kilmartin has nearly 30 years' experience in the management of foot problems. He established Podiatric Surgery at Ilkeston Hospital in 1994.  Since that time he has performed almost 15,000 foot operations.

Elected the first Dean of the Faculty of Podiatric Surgery, College of Podiatrists, Tim has also served on the Specialty Advisory Board in Podiatric Surgery for the Royal College of Surgeons, Edinburgh.  He was also the external examiner to the Master's degree in the theory of Podiatric Surgery at Glasgow and Edinburgh University and is an Examiner for the Fellowship in Podiatric Surgery.  He is an advisor to the National Institute of Clinical Excellence (NICE) on foot joint replacements.

He has published widely on his work after completing over 70 different research projects on foot surgery.  He is on the Editorial committee of the Journal of Foot and Ankle Research, The Foot and Podiatry Now.

Frank Webb has 27 years of experience in both conservative and surgical management of a wide range of foot ailments since graduating in Podiatric Medicine in 1987.  He was awarded his Podiatric Surgical Fellowship in 1995 and took up his first Consultant post at Hope Hospital in 2003, specialising in the management of the high risk foot. He has held posts at Greenwich NHS Trust and Queen Elizabeth Hospital and since 2011 has been the lead Consultant Podiatric Surgeon at Buxton Hospital.  In this post, he has developed in partnerships with colleagues at Stepping Hill Hospital, a local foot protection service, linking in with their Multi-Disciplinary Foot Team.  

Frank has extensive experience in orthotic and surgical treatment of the sports patient with foot and ankle injuries. He also has specialist interests in Rheumatology and Peripheral Vascular Disease.  In addition to his clinical duties, Frank is active in a number of regional and national educational and professional roles including:  Honorary Lecturer at Salford University, the organising committee of FDUK (Foot in Diabetes UK), the organising committee for DIABETES UK Conference, and the Advisory Board for minimum standards in Rheumatology, supported by Arthritis & Rheumatism Counsel.

He is also a National Surgical Examiner of the College of Podiatrists and is a registered Tutor for the Podiatric Surgical Training Programme.

Podiatric Surgery at Ilkeston Hospital should be the obvious referral choice for the referral of foot surgery problems. The service is accessible in three ways via "Choose and Book”:

1.  View Specialty - Orthopaedics, then Clinic Type - Podiatric Surgery or Foot & Ankle, then directly book into Ilkeston Community Hospital
2. View Specialty - Podiatry, then Clinic Type - Minor Surgery, then directly book into Ilkeston Community Hospital
3. Select Tim Kilmartin as the Named Clinician, then directly book into Ilkeston Community Hospital

Paper referrals are also acceptable however this may slow the referral process slightly.

For all routine referrals, the Consultant Podiatric Surgeon will assess the referral details to ensure that the patient has been directed to the most appropriate branch of the Podiatry service.  The patient will then either have their appointment confirmed by letter or be contacted by phone to advise which route the Consultant has decided would be most suitable for them.

Free parking is available to patients at Ilkeston Hospital.

The podiatric surgery service is now available via choose and book to all GPs who have commissioned the service. (View Mr S Finney under ORTHOPAEDICS foot and ankle also found under Podiatry – podiatric surgery)

The service is accessible in three ways via "Choose and Book”:

1. View Specialty - Orthopaedics, then Clinic Type - Podiatric Surgery or Foot & Ankle, then directly book into Ilkeston Community Hospital
2. View Specialty - Podiatry, then Clinic Type - Minor Surgery, then directly book into Scarsdale
3. Select Stephen Finney as the Named Clinician, then directly book into Scarsdale.

For routine non-choose and book referrals, a letter is sent to the patient inviting them to contact the department to make a convenient appointment.

Free parking is available to patients.

The podiatric surgery service is now available via choose and book to all GPs who have commissioned the service. (Orthopaedics, Orthopaedics / Foot and Ankle, Orthopaedics / Podiatric Surgery or Podiatry) The service is accessible in three ways via "Choose and Book”:

• View Specialty - Orthopaedics, then Clinic Type - Podiatric Surgery or Foot & Ankle, then directly book into Buxton Hospital
• View Specialty - Podiatry, then Clinic Type - Minor Surgery, then directly book into Buxton Hospital
• Select Frank Webb as the Named Clinician, then directly book into Ilkeston Community Hospital

For routine none choose and book referrals, a letter is sent to the patient inviting them to contact the hospital to make a convenient appointment.

Free parking is available to patients.

To assist with Patient referral we have provided a list of patient exclusion criteria

Exclusion Criteria

• Patients with unstable medical conditions,
• Patients with mechanical heart valves,  (Check with SF)
• Patients with a INR>3.0 and pain syndromes (CRPS)
• Children under the age of 16
• Ingrowing toe nails - please refer to our Community Podiatry leaflets 
• Insoles, arch supports, foot splints, cortisone injection, heel pain, metatarsalgia - please refer to our Community Podiatry leaflets
• Numbness, Neuropathic pain please refer to Neurology
• Acute diabetic conditions
• Patients with unstable mental health problems

• Podiatric surgery: information about operations to your foot
• Taking away a bony lump: information about your operation
• Benefits risks and complications associated with podiatric surgery

• Exostosis Removal (bony lump)
• Fixation Irritation - Removal
• Lesser MCJ Arthritis
• Mid Foot Fusion
• Mid Foot Exostosis (bony lump)

• Patient Advice Plaster Cast
• Patient Guide Post Operative Pain
• Post Operative Advice
• Post Operative Rehabilitation Advice Sheet

• Steroid Injection Advice

• Heel Pain Advice
• Mortons Neuroma
• Removal of soft tissue

• Hallux Rigidus - Arthrodesis - Fusion
• Hallux Rigidus - Implant Arthroplasty
• Hallux Rigidus - Limitus - Cheilectomy procedure
• Hallux Rigidus - Limitus - Kessel Bonney procedure
• Hallux Valgus -  Lapidus
• Hallux Valgus - Scarf & Akin Osteotomy procedure
• Hallux Valgus - Silvers plus Akin
• Silvers Bunionectomy

• Crossover toe deformity - Digital Amputation
• Deviated toes - Closing Wedge osteotomy  
• Hammer- Claw- Mallet toe
• Metatarsalgia - Schwartz ostetomy
• Metatarsalgia - Weil osteotomy
• Tailors Bunion 

Find out more about the Podiatric Surgery Service by reading our 6 monthly reports. The information in these report comes from departmental patient satisfaction data.

• Scarsdale and Claycross: October 2013 - March 2014
• Buxton: October 2013 - March 2014
• Ilkeston: September 2013 - April 2014

Buxton Hospital - Harry Hall underwent an operation to remove his big toe...

"I have been under the care of the Podiatric Team led by Mr Frank Webb at Buxton Hospital for the last few years. In order to prevent the spread of infection into my foot and beyond, I underwent an operation to remove my big toe in July 2012. From January 2013 until April 2013 I had intensive treatment with oral and intravenous antibiotics in order to eradicate the bone infection. This has been successful and as such has enabled me to enjoy walking in the peak District where I live albeit not quite as strenuous as I used to”.

"The professional care and skill (the antibiotic treatment I had was a first in this area enabling me to be at home and just making daily visits to the local hospital) were second to none”.

"The podiatric team was absolutely fantastic with their skills, support and care (both in clinic and post operation)”.