Richard Zell, MD, is an orthopaedic surgeon who specializes in foot and ankle surgery. While Dr. Zell takes great pride in the positive results that surgery provides, he points out that many times, his patients don’t require surgery.
“The great majority of foot and ankle problems can be managed nonoperatively, and that’s often what people are looking for. Patients come in because they have an issue that’s causing them pain, or they’ve noticed a deformity such as a bunion,” Dr. Zell explains. “We first explore what their diagnosis is and what their options are. We always try interventions such as physical therapy, bracing, immobilization in a walking boot, or possibly a corticosteroid injection. If those interventions aren’t enough, we can talk about surgical options and decide on the best plan together.”
There are many foot and ankle conditions that can be managed with physical therapy, Dr. Zell points out. “Take, for example, plantar fasciitis, which is a common source of heel pain,” he says. “The great majority of patients can be managed with an Achilles tendon and foot stretching program that can be performed at home or with the help of our physical therapy colleagues.”
For patients who do require surgery, there have been advances across several areas of foot and ankle surgery. Two examples include bunion surgery and ankle replacement, Dr. Zell says.
“Most recently, there’s been a push towards performing bunion surgery with smaller incisions and with more precision,” he says. “These new techniques have decreased the risk of the bunion recurring after surgery. Ankle replacement has been around for many years, however the most recent generation of total ankle replacements are performed using patient specific guides. These guides are fabricated prior to surgery using a pre-operative CT scan and they allow the surgeon to optimize the alignment and fit of total ankle replacement components.”
Dr. Zell says one of his favorite things about his job is the variety of patients he gets to help. “I see patients ranging from early teenage years to into their 90s. As a foot and ankle surgeon, I get to take are of a variety of issues including fractures, sports injuries, nerve issues, arthritis, bunions, and flat feet,” he says. “This variety makes our clinic days always interesting.”
