Hallux valgus is a malposition in which the big toe is angled towards the other toes, at the same time forming a ball (bunion) on the inside of the foot. The condition often causes pain when wearing shoes, swelling and blisters, and over time can change the load on the entire forefoot.

Treatment: For mild symptoms, wide shoes, insoles and physiotherapy may be sufficient. When symptoms persist, surgery is considered.

Operation Method — MIS / MICA: We perform

The fascia is inelastic and does not stretch to accommodate muscle swelling. This leads to increased pressure within the muscle compartment and reduced blood flow, resulting in pain due to oxygen deprivation. This most commonly occurs in the anterior outer compartment of the lower leg. The pain occurs only during activity and typically subsides with rest after exercise.

Treatment: Initial treatment for chronic compartment syndrome involves avoiding pain-provoking activities and engaging in alternative training for a period of 3 months. Training is then gradually resumed with adapted footwear and good shock absorption. If symptoms recur, surgical evaluation is warranted.

Surgery: Surgery for chronic compartment syndrome is performed under general anesthesia. The fascia is released through two small incisions in the skin.

In the ankle, tight posterior conditions can cause posterior impingement or entrapment of structures, leading to sharp, stabbing pain. This condition is common among ballet dancers due to the en pointe position, but it also occurs in gymnasts and football players.

Bone spurs may develop at the back of the joint in a 'ballet ankle.' These can detach and form loose bodies that become trapped. In 10% of the population, there is an accessory bone (os trigonum) at the back of the ankle joint that has not fused with the talus.

Symptoms and Investigation: Pain at the back of the joint when the ankle is extended (plantarflexed). X-rays, MRI, or ultrasound can verify the findings.

Surgery: The procedure is performed under general anesthesia and local nerve block. An arthroscope and surgical instruments are inserted posteriorly through 7 mm portals to access the joint. Bone spurs or loose bone fragments are then removed.

A bursa lies between the heel bone (calcaneus) and the Achilles tendon. This bursa can become inflamed due to chronic friction and tight footwear. Over time, this irritation can lead to bone and cartilage formation at the back of the heel bone, resulting in a bony bump on an already prominent bone. X-rays with oblique views typically show this spur (Haglund's deformity). Initial management involves heel lifts to relieve pressure.

Surgery: In cases of prolonged symptoms and a significant bony bump, surgical removal may be necessary. The procedure is performed under local anesthesia with sedation. A plaster splint is applied and kept on for two weeks, followed by a rehabilitation program. Patients should expect at least eight weeks before resuming normal training.

Achilles tendinopathy actually encompasses several conditions referred to by the same name:

• Inflammation of the tendon sheath, i.e., inflammation of the membrane surrounding the tendon (paratendinitis)
• Damaged tendon tissue (acute tendon tear or chronic wear and tear)

It is not always inflammation of the tendon sheath itself that causes pain; small micro-tears can form in the tendon due to overload. These injuries heal poorly, likely due to relatively poor blood circulation in the area.

Treatment: The initial goal is to promote normal healing of the tendon tissue using eccentric exercise guided by a physiotherapist. Shockwave therapy (ESWT) can supplement the exercise. Foot misalignment (pronation) predisposes to Achilles tendon issues and must be corrected with custom insoles and proper footwear.

A low-dose, ultrasound-guided cortisone injection can be considered for tendon sheath inflammation. Surgery may be necessary if conservative treatments fail.