Podiatric surgeons are podiatrists who have had extensive post-graduate training in the assessment, diagnosis and surgical management of foot and ankle problems.
Find out more in our 'What is a podiatric surgeon?' leaflet.
Podiatric surgery is the surgical treatment of the foot and its associated structures. It is carried out by a podiatric surgeon, usually as a day case procedure and often, but not always under local anaesthetic. Whilst many foot problems respond to non-surgical treatment, some are best treated by podiatric surgery. This is particularly effective for persistently painful conditions or where the foot is being affected by deformity.
Our podiatric surgery department covers three geographical locations (Charing Cross Hospital (Hammersmith & Fulham), Merton and Whittington Hospital (Barnet)). Outpatient contacts occur at these locations with day case surgery offered at Charing Cross Hospital (local and general anaesthetic), or Whittington Hospital (local anaesthetic) as day case surgery admitted pathway.
All surgery is undertaken at Whittington Hospital under local anaesthesia and the focus for this service is forefoot surgery. A full outpatient clinic is managed by the consultant podiatric surgeon and specialist podiatrist. There is a network of support for the service providing pathology (histology, microbiology) and radiology.
Charing Cross Hospital provides forefoot and rear foot (excluding ankle) surgery under both local and general anaesthesia. A full outpatient clinic is managed by the consultant podiatric surgeon and specialist podiatrists. There is a full network of hospital services that support podiatric surgery at this site.
Merton podiatric surgery provides outpatient clinics at the Nelson Health Centre which is supported by a network of community based services such as pathology and radiology.
Referrals are welcomed from the following services and is not mutually exclusive to these groupings:
- General Practitioners
- Allied Health Professionals
- Physiotherapists
- Podiatrists
- Chiropractors
- Osteopaths
- Hospital Specialists
- Rheumatology
- Sports Medicine
- Orthopaedics
- Neurology
- Endocrinology (Diabetic Specialists)
Foot conditions which would benefit from a referral to the community podiatric surgery team:
- ASA1,2 and stable ASA3 Patients who present with a foot problem for which Podiatric Surgery would be an appropriate first line treatment.
- Patients who have received conservative podiatry care with limited or no improvement of symptoms and for which Podiatric Surgery/Injection therapy may be of benefit.
Inclusion
Forefoot conditions:
- Hallux valgus (HAV)
- Reconstructive forefoot surgery (e.g. Rheumatoid foot)
- Revision forefoot surgery (e.g. failed HAV surgery)
- Lesser metatarsal surgery
- Tailor’s bunion
- Metatarsalgia
- Hallux limitus/rigidus (HR)
- Toe deformities – hammer, claw, mallet, dislocated and subungual exostoses.
- Intractable plantar and interdigital corns
- Complex forefoot deformities (e.g. metatarsus adductus)
Mid foot & Rearfoot conditions:
- Acquired adult flatfoot (e.g. Tibialis posterior tendon dysfunction)
- Osteoarthritis of the midfoot joints
- Cavoid foot (high arch)
- Tendinopathy (e.g. Achilles tendonitis, tendinopathy; Peroneal tendinopathy)
- Ankle instability
- Heel bumps
General conditions:
- Benign soft tissue lesions – See CLCH guidelines (e.g. ganglion)
- Nail conditions – recalcitrant ingrown toenails/subungual exostosis.
- Injection therapy
- Morton’s neuroma
- Heel pain recalcitrant
- Trigger point injections
Exclusion
Contra-indications for day case surgery (we defer to BADS guidelines for elective foot surgery):
- Unstable systemic diseases
- Peripheral vascular disease – affecting tissue viability
- Lack of postoperative support/homecare
- Unstable Psychiatric disorders
- Learning disabilities without appropriate support
- Severe or acute anxiety
- Recent or unpredictable drug or alcohol abuse
- Anti-coagulant therapy with INR>3
- High risk of thrombosis
- Currently pregnant or breastfeeding (acceptable if can express for 48 hours)
- MI/CVA/DVT or PE in the last 6/12
- BMI > 30
- Blood pressure > 160/90mmHg
- Paediatric patients (under 16)
- Patient appointments: 020 8732 6813
- Patient enquiries: CLCHT.BarnetPodiatricSurgery@nhs.net
Hammersmith & Fulham podiatric surgery service (the service is available on Choose and Book)
- Patient appointments: 020 3313 5000 (Charing Cross)
- Email (referrals should be sent to): Ichc-tr.imperialreferrals@nhs.net
- Patient enquiries: Ichc-tr.imperialreferrals@nhs.net
Merton podiatric surgery service
- Patient appointments (Single Point of Access): 0333 241 4242
- Email: CLCHT.MERTONSPA@nhs.net
- Patient enquiries: CLCHT.MERTONSPA@nhs.net
| Day | AM | PM |
|---|---|---|
| Monday | No clinic | No clinic |
| Tuesday | Admin | 1pm to 5pm, Outpatients |
| Wednesday | No clinic | No clinic |
| Thursday | No clinic | No clinic |
| Friday | 9am to 12pm, Outpatients | 12.30pm to 6pm, Day Surgery Unit Theatre |
| Day | AM | PM |
|---|---|---|
| Monday | 9am to 1pm, Outpatients | Admin |
| Tuesday | 9am to 12.30pm, Outpatients | 1pm to 5pm, Outpatients |
| Wednesday | 9am to 12.30pm, Outpatients | 1 to 5pm, Outpatients 12.30pm to 5pm, Theatre (Riverside Wing) |
| Thursday | No clinic | No clinic |
| Friday | 9am to 12pm, Outpatients 7.30am to 12.30pm, Theatre (Riverside Wing) |
1pm to 5pm, Outpatients 12.30pm to 5pm, Theatre (Riverside Wing) |
| Day | AM | PM |
|---|---|---|
| Monday | No clinic | No clinic |
| Tuesday | 9am to 12.30pm, Outpatients | 1pm to 5pm, Outpatients |
| Wednesday | Outpatients | Outpatients |
| Thursday | No clinic | No clinic |
| Friday | No clinic | Theatre every 3rd Friday at Charing Cross Hospital in Riverside Wing |
Charing Cross Hospital
Address: Fulham Palace Road, London, W6 8RF
Whittington Hospital
Address: 3rd Floor (Lift A), DTC1 Theatre, Day Treatment Centre, Level 3, Magdala Avenue, London, N19 5NF
Edgware Community Hospital (outpatient appointments only)
Address: Burnt Oak Broadway, Edgware HA8 0AD
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