The foot and ankle are supplied by many nerves and supported by tendons. Injuries to these structures are usually caused by penetrating wounds, which can lead to various problems and abnormalities.
Nerve injuries can lead to the lack of sensation in the foot and cause nerve cells to regenerate into the surrounding tissue to form a painful growth called neuroma. Injury to the motor nerves can lead to clawing of the toes due to imbalance of muscular forces.
Nerve repair includes preparation of the injured nerve stumps and joining of the nerve ends without tension. If repair can cause tension in the nerve, a nerve section from another part of the body is removed and used as a graft to join the two ends. It is usually performed as a microscopic surgery.
A neuroma can be prevented by timely nerve repair and nerve grafting procedures. Once neuroma has formed, it may be treated conservatively with medicines, steroid injections, nerve stimulation or mechanical desensitization. Surgical treatment may include excision of the neuroma and embedding the nerve stump in a non-irritable region. Following repair, three weeks of immobilization is necessary to allow the repaired nerves to heal completely.