Procedures & treatments
The first decision in any case isn't which procedure — it's whether a procedure is needed at all. The practice favors conservative care where it works and surgical precision where it doesn't, with the same standard of judgment applied to both.
Before surgery
Most foot and ankle problems can be managed without surgery, often for years. The practice invests real time in conservative care first — not as a checkbox before the operating room, but because for most patients it is the right answer.
Custom and prefabricated orthotics for forefoot pain, flatfoot, plantar fasciitis, and post-surgical support. Ankle bracing for instability, arthritis, and athletic return-to-play. Choosing the right device is more clinical decision than retail decision.
Image-guided where appropriate, used judiciously rather than reflexively. Best for inflammatory conditions — bursitis, plantar fasciitis, tenosynovitis, selective joint pain. Honest counseling on what an injection can and cannot accomplish is part of every visit.
Joint lubrication injections for arthritis of the ankle and knee. Effectiveness varies by patient and stage of disease; the practice discusses realistic expectations rather than promising outcomes.
Concentrated autologous biologics — including platelet-rich plasma (PRP) and other regenerative agents — used in selected tendon, ligament, and joint conditions where evidence supports the application. Biologics are tools, not cure-alls; patient selection and realistic expectation-setting are what make them work.
For fractures, stress injuries, post-surgical protection, and acute soft-tissue injury. Often overlooked as "low-tech," but choosing the right immobilization for the right duration changes outcomes.
Most foot and ankle conditions improve with structured rehabilitation. The practice works with local physical therapists who understand foot and ankle pathology, and writes specific protocols rather than generic referrals.
Minimally invasive
When surgery is needed, smaller is usually better — provided the smaller approach actually solves the problem. The practice uses minimally invasive techniques where they're appropriate, and standard open techniques where they're not.
Minimally invasive surgery for ankle impingement, cartilage injuries, loose bodies, scar tissue, and selected fractures. Two small incisions, faster recovery than open surgery, suitable for the right indications.
Newer percutaneous techniques for selected bunion deformities, performed through millimeter-scale incisions. Not appropriate for every bunion — moderate to severe deformity often still warrants traditional open correction.
For the rare plantar fasciitis case that fails extended conservative care. Performed through small incisions; faster recovery than open release.
Minimally invasive surgery for selected tendon disorders — peroneal, posterior tibial, Achilles. Useful for diagnosis and limited repair when imaging is equivocal.
Reconstructive
The bulk of foot and ankle surgery is reconstructive — restoring alignment, stability, or function that has been lost to injury, deformity, or disease. The work is precise, the planning is everything, and the outcome is measured in years of use, not weeks of recovery.
Several distinct surgical techniques exist; the right one depends on the severity and pattern of the deformity. The practice tailors the procedure to the bunion, rather than the bunion to a single preferred procedure.
For posterior tibial tendon dysfunction and acquired adult flatfoot. Combines tendon transfer, calcaneal osteotomy, and selective fusion as the deformity requires. A staged approach for the staged disease.
For chronic ankle instability that has failed bracing and rehabilitation. Anatomic repair of the lateral ligaments, with or without augmentation, depending on tissue quality and surgical history.
Acute ruptures, chronic ruptures, insertional tendinopathy with bone spurs, and degenerative tendinosis each require different approaches. The right operation depends on what's actually wrong with the tendon.
Operative fixation of foot and ankle fractures using plates, screws, intramedullary devices, and external fixators as appropriate. Fracture care begins with the X-ray and ends only when the patient is fully back to function.
Correction of rigid hammertoes, claw toes, and lesser metatarsalgia with selective osteotomies, tendon transfers, and joint procedures. Often combined with bunion correction when both deformities coexist.
For focal cartilage defects of the ankle — microfracture, autologous transplantation, and biologic augmentation in selected cases. Best results when the underlying alignment problem is addressed at the same time.
Repurposing a healthy tendon to do the work of a failed one — used in flatfoot, drop foot, complex tendon ruptures, and selected reconstruction cases. A technical specialty within foot and ankle surgery.
End-stage arthritis
When ankle arthritis reaches end-stage, the choice between joint replacement and joint fusion is one of the most important decisions in foot and ankle surgery. The right answer depends on the patient — activity level, deformity, bone quality, expectations — not on a default preference for either operation.
For appropriate candidates, modern total ankle replacement preserves motion that fusion sacrifices. The practice uses current-generation implants and emphasizes deliberate patient selection — not every arthritic ankle is the right ankle for replacement.
The historical gold standard for end-stage ankle arthritis — eliminates pain by eliminating motion at the joint. Still the right answer for the right patient, particularly when bone stock, alignment, or activity level make replacement unwise.
Selective fusion of the subtalar, talonavicular, calcaneocuboid, and midfoot joints for arthritis, deformity, or instability. Performed singly or in combination depending on the case. The goal is the smallest fusion that solves the problem.
For end-stage hallux rigidus where joint-preserving options have been exhausted. Reliably eliminates pain and restores push-off function; trade-off is permanent loss of motion at the big toe joint.
Complex & limb salvage
Some cases sit outside the standard playbook — a deformity that has progressed beyond textbook indications, a previous surgery that didn't deliver, a foot at risk of amputation. These cases benefit from specific surgical experience and, often, from coordinated care across multiple specialties.
Reconstruction of the collapsed Charcot foot or ankle, often in patients with diabetes and neuropathy. Combines deformity correction, fusion, and (where indicated) external fixation. Goal is a stable, plantigrade, ulcer-free limb the patient can stand on.
Reconstructive surgery for the foot or ankle in patients who would otherwise face amputation. Often staged across multiple operations, often coordinated with vascular surgery, infectious disease, and wound care. Not every limb is salvageable, and not every salvageable limb should be salvaged — the judgment matters as much as the surgery.
Ring fixators (Ilizarov-type) and other external devices for complex deformity correction, limb lengthening, fracture stabilization, and Charcot reconstruction. Useful when internal fixation isn't enough or isn't safe.
For failed prior foot and ankle surgery — persistent pain, hardware failure, malunion, nonunion, recurrent deformity. Revision is technically harder than the index procedure and rewards careful planning over surgical heroics.
Surgical realignment of complex deformities — congenital, post-traumatic, or progressive. Techniques range from selective osteotomies to staged reconstruction with external fixation, depending on what the deformity actually requires.
Surgical management of chronic non-healing wounds — debridement, infection control, deformity correction to offload pressure, and coordination with wound care and vascular specialists. Wound care often runs alongside the surgical work it supports.
Beyond the foot & ankle
Foot and ankle is the focus, but the practice also performs selected knee, upper extremity, and elective hand procedures for established patients, sports injuries, and acute trauma.
Minimally invasive surgery for meniscus tears, loose bodies, cartilage injuries, and selected ligament procedures. Patient selection matters — not every painful knee is a knee that benefits from arthroscopy.
Cortisone, hyaluronic acid (viscosupplementation), and biologic agents — including platelet-rich plasma (PRP) — for the appropriate indications. Image-guided where it changes accuracy. Honest counseling on what each agent is and isn't.
Volar plating, percutaneous pinning, and external fixation for displaced wrist fractures that can't be managed in a cast. Approach is matched to the fracture pattern and the patient's hand demands.
Plate-and-screw fixation for selected displaced shoulder fractures in patients with sufficient bone quality and functional demand. Many proximal humerus fractures are best treated nonsurgically; the operation is reserved for those that aren't.
Tension-band wiring or plate fixation for displaced elbow fractures. Restoring the extensor mechanism is the goal; choice of construct depends on fracture pattern and bone quality.
Closed reduction, splinting, percutaneous pinning, and selective open fixation for hand fractures and dislocations. Most are managed without surgery; the goal is alignment that allows early motion.
Splinting protocols for tendon injuries at the fingertip and middle finger joint, with surgical repair for cases that fail nonoperative care or present late.
Open or limited-incision release of the transverse carpal ligament for symptomatic carpal tunnel syndrome that hasn't responded to conservative care. A brief outpatient procedure with a high success rate when the diagnosis is correct.
Decompression of the ulnar nerve at the elbow for cubital tunnel syndrome that has progressed despite splinting and activity modification. Performed in situ or with anterior transposition depending on the case.
Release of the A1 pulley for trigger finger that hasn't resolved with cortisone injection. Brief outpatient procedure under local anesthesia for most cases.
Surgical release of the first dorsal compartment for refractory De Quervain's tenosynovitis. Reserved for cases that fail splinting and injection.
Surgical removal of symptomatic ganglion cysts of the wrist and hand. Aspiration is offered first for most cases; excision when the cyst is recurrent or persistently symptomatic.
Repair and reconstruction of selected sprains, strains, and tendon injuries beyond the foot and ankle. Cases requiring sub-specialty surgery (complex shoulder reconstruction, microsurgery, full-scope hand surgery) are referred to colleagues with that focus.
Don't see it?
The procedures above are the categories the practice uses most. Specific techniques and combinations are tailored to the case. If you're considering a procedure that isn't listed — or you've been told you need surgery and want a second opinion — the office will tell you whether the case is a fit before you make the trip.
Schedule
Most appointments scheduled within one week. Same-week availability for urgent cases and physician referrals.