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 Edgware Hospital, Barnet). Outpatient contacts occur at these locations with day case surgery offered at Charing Cross Hospital (local and general anaesthetic), or Edgware Hospital (local anaesthetic) as day case surgery admitted pathway.

All surgery is undertaken at Edgware Community 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:

  1. General Practitioners
  2. Allied Health Professionals
    • Physiotherapists
    • Podiatrists
    • Chiropractors
    • Osteopaths
  3. Hospital Specialists
    • Rheumatology
    • Sports Medicine
    • Orthopaedics
    • Neurology
    • Endocrinology (Diabetic Specialists)

Foot conditions which would benefit from a referral to the community podiatric surgery team:

  1. ASA1,2 and stable ASA3 Patients who present with a foot problem for which Podiatric Surgery would be an appropriate first line treatment.
  2. 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)

Edgware community podiatric surgery service

Hammersmith & Fulham podiatric surgery service (the service is available on Choose and Book)

Merton podiatric surgery service

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

Edgware Community Hospital

Address: Burnt Oak Broadway, Edgware HA8 0AD