Nuffield Health Leeds Hospital video

Nuffield Health Leeds Hospital video

You can take a virtual tour in this new Nuffield Health Leeds Hospital video.

You can access / view it to see the excellent facilites at the following link: Nuffield Health Leeds Hospital video

With a rating of ‘outstanding’ from the CQC, an easily accessible city centre location and a full range of diagnostic / treatment facilities it is easy to see why it is a popular choice for private consultations and treatment.

Assessment and treatment of foot and ankle problems is available at weekly clinics: Specialist foot & ankle clinic Leeds Nuffield

You can find more information here about Mark Farndon’s work at Leeds Nuffield: https://www.nuffieldhealth.com/consultants/mr-mark-a-farndon

Easy access to efficient specialist imaging facilities means that additional tests such as ultrasound, CT and MRI scanning are readily available.

For more information, or to book a consultation please phone 0113 388 2189.

 

Morton's neuroma

Investigation and treatment of Morton’s neuroma

The normal foot contains many nerves. The sole of the foot in particular is a very sensitive area due to its dense innervation. The medial and lateral plantar nerves (shown in the diagram below) supply these areas and protect our feet from painful trauma. A Morton’s neuroma occurs when one of the branches to the toes becomes painful and thickened.

 

Morton's neuroma - normal plantar nerve anatomy
Medial and lateral plantar nerves to the sole of the foot (shown in yellow). Morton’s neuroma most commonly affects the nerve supplying the 3rd / 4th toes.

The most common site for this problem is in the lateral branch of the medial plantar nerve that supplies the 3rd and 4th toes. The nerve becomes compressed in the space between the heads of the metatarsal bones and the soft tissue above / below.

Morton's neuroma - sketch of anatomy
Sketch showing thickened Morton’s neuroma between the heads of the metatarsal bones

 

 

 

 

 

 

 

 

 

 

 

 

 

Often the history (description) and examination will allow a foot and ankle specialist to make a diagnosis without the need for further imaging such as ultrasound or MRI scans. A weightbearing xray is essential however to exclude other causes of foot pain. If there is any doubt, then an ultrasound scan (or occasionally an MRI if appropriate) can be helpful. The title image shows an ultrasound picture of a typical neuroma.

There are many other reasons for forefoot pain that can form a differential diagnosis and must be excluded if a neuroma is to be confidently diagnosed. The differential diagnosis for Morton’s neuroma includes:

  • intermetarsal bursitis

  • plantar plate rupture​

  • metatarsophalangeal joint capsulitis

  • metatarsal stress fractures

  • metatarsalgia

  • lumbar radiculopathy

  • tarsal tunnel syndrome

  • Frieberg’s infraction

  • infection

  • tumors (such as synovial sarcoma)

  • painful callosities

  • rheumatoid nodule

  • peripheral neuropathy

Conservative treatment and the help of a good podiatrist can make a big difference to many people with  a painful neuroma.

If this fails to settle the problem, then treatment with an injection can be very helpful. An injection is quick and simple to administer and can be done at the same time as an outpatient appointment.

We have found in Harrogate that about 60% of people who receive an injection in the outpatient clinic for a Morton’s neuroma do not need any additional treatment. We presented these results recently to the SICOT meeting in Rome. See the following links for more information.

SICOT, Rome, 2016: Conservative treatment of intermetatarsal neuroma

American Orthopaedic Foot & Ankle Society: AOFAS Morton’s neuroma information

Surgery is the final option for treatment and in the right circumstances can be a very effective choice, as the following testimonial illustrates:

Outpatient consultation and can be arranged by calling 0113 388 2189 and is available at the following locations:

ankle replacement patient information resources

Ankle replacement patient information resources

For patients with painful ankle arthritis, making the correct choice between treatment options can be difficult.   It is often an intensely personal & individual decision.   Ankle replacement patient information resources may be very helpful.   They should supplement thorough discussions with your clinician.

 

 

Good quality, balanced information about the different surgical treatments is essential.

Adequate time to consider your options and the ability to have all your questions answered before arriving at a decision is essential.

 

The following links may be useful:

Harrogate foot & ankle specialists use the Corin Zenith total ankle replacement. The link below is to the patient information section on the manufacturers website:

Corin Zenith Patient Information

 

The British Orthopaedic Foot & Ankle Society website contains a link to an excellent document prepared on the subject of ankle arthritis by the Royal National Orthopaedic Hospital:

RNOH Total Ankle Replacement Information

 

The American Orthopaedic Foot & Ankle Society website contains links to patient information documents relating to both ankle arthritis and total ankle arthroplasty:

AOFAS Ankle Arthritis Information

AOFAS Total Ankle Replacement Information

 

You can read some patient experiences here:

Arthroscopic Ankle Fusion Testimonial

AP xray 6 weeks after arthroscopic ankle fusion
LAT xray 6 weeks after arthroscopic ankle fusion
Nuffield Health Leeds Hospital video

Leeds Nuffield specialist foot & ankle clinic

Mark Farndon offers regular opportunites for consultation and treatment via a Leeds Nuffield specialist foot & ankle clinic which will now be available weekly from December 2017.

Specialist Foot and Ankle Surgeon Leeds Harrogate Yorkshire

Private consultation and treatment are available in Leeds at the Nuffield Health Leeds Hospital. With an outstanding CQC inspection result, the excellent facilities are easily accessible close to Leeds city centre.

You can find more information here about Mark Farndon’s work at Leeds Nuffield: https://www.nuffieldhealth.com/consultants/mr-mark-a-farndon

Easy access to efficient specialist imaging facilities means that additional tests such as ultrasound, CT and MRI scanning are readily available.

For more information, or to book a consultation please phone 0113 388 2189.

 

bunion (hallux valgus) surgery

Bunion surgery in Leeds & Harrogate

Hallux valgus (bunions) can be extremely painful. A thorough assessment &  discussion of your options, including corrective treatment with bunion surgery in Leeds & Harrogate is available with Mark Farndon privately at the following locations:

Nuffield Health Hospital Leeds (0113 388 2189)

2 Leighton Street, Leeds, LS1 3EB

www.nuffieldhealth.com/consultants/mr-mark-a-farndon

https://www.nuffieldhealth.com/hospitals/leeds

BMI The Duchy Hospital, Harrogate (01423 554411)

Queens Road, Harrogate, HG2 0HF

www.bmihealthcare.co.uk/consultants/Mark-Andrew-Farndon

The Harlow Suite, Harrogate (01423 555430)

Lancaster Park Road, Harrogate, HG2 7SX

NHS treatment is available at Harrogate District Hospital via a referral from your GP.

Weight bearing xrays showing hallux valgus, with increased intermetatarsal angles and uncovering of the sesamoids.

The diagram below shows the normal soft tissue balance around the big toe joint and the imbalanced bone and soft tissues that exist when a bunion is present. A combination of bony and soft tissue surgery is used to achieve correction.

Post-operative xrays showing bilateral (simultaneous) bunion correction using scarf osteotomies to cut and reset the metatarsals. The intermetatarsal angles are corrected to normal range, the sesamoids are reduced beneath the metatarsal heads and the hallux valgus is corrected.

bunion surgery in leeds & harrogate

This surgery is usually undertaken as a day case procedure, under a brief general anaesthetic, with a long acting ankle nerve block to keep the foot comfortable.

After bunion surgery in Leeds & Harrogate undertaken by Mark Farndon, patients are allowed to weight bear in a protective Podalux shoe immediately after surgery, though are advised to elevate the foot / feet as much as possible for the first two weeks to allow wound healing and to let any swelling settle.

ankle replacement surgery in leeds and harrogate

Ankle replacement surgery in Leeds and Harrogate

Mark Farndon is a experienced foot and ankle surgeon specialising in arthroscopic ankle fusion and total ankle replacement surgery in Leeds and Harrogate.

You can read some patient experiences here:

Harrogate & District NHS Foundation Trust are participating in the national Arthritis UK OARS Study, collecting patient outcome data in individuals undergoing total ankle replacement surgery.

OARS study

Read more at http://markfarndon.com/research/harrogate-joins-oars-study/

Mark Farndon and David Lavalette have consistently used the Corin Zenith Total Ankle Replacement with good results.

You can read more about this prosthesis by following this link:

http://www.coringroup.com/patientcaregivers/your_ankle/

You can download a patient information booklet by following this link:

http://www.coringroup.com/document.php?o=229

 

 

 

Pre-op prior to revision syndesmosis reconstruction

Revision syndesmosis reconstruction

After falling several hundred feet whilst climbing near Chamonix, Phil Burgess sustained injuries to his neck, back and ankle. His spinal injuries were treated successfully conservatively with bracing. His ankle injury was treated promptly with surgery in France, though the reconstruction of the ankle joint and syndesmosis was inadequate, necessitating revision syndesmosis reconstruction.

Phil sought a second opinion following his return to the UK, six weeks after the initial accident and surgery. Revision reconstruction of the syndesmosis was advised.

“I suffered a severe dislocation after a major climbing fall in the Alps. My ankle was pinned but unsuccessfully by medics in France and after a period of delay I turned to Mark for a second opinion. He was clear that I needed further immediate revision syndesmosis surgery, explained the action fully and accelerated my procedure to suit my personal circumstances.

The operation has given me the best possible chance of normal ankle use.
Mark kept me fully informed and his admin team were also brilliant in support. I can’t thank Mark and his team enough.”
Removal of metalwork, open reduction of the syndesmosis and repair of the deltoid ligament and stabilisation with a combination of screw and suture button ‘tightrope’ fixation were required.

 

Intra-op XR showing reconstruction of the syndesmosis
Dan Hemingway lisfranc injury

Lisfranc injury in professional athlete

In 2012 I sustained a Lisfranc injury to my left foot resulting in dislocation of the midfoot joints. Mark Farndon performed the operation to fix the bones back in place with plates and screws. So good was the surgery that I was up and about riding and back to the sport I love within 3 months, when other specialists had told me that this injury would end my career.
I found the outpatient care above and beyond, and it’s so refreshing to have a Surgeon that makes you feel so at ease in every consultation leaving me with 100% trust in his knowledge and guidance.
Dan Hemingway (Hemingway Plant Hire)
Kuntscher nail

Knee replacement after previous Kuntscher nail

After sustaining significant tibial and femoral fracture whilst on military service 50 years ago, this gentleman received what was at the time cutting edge orthopaedic fixation and had a Kuntscher nail inserted inside his femur to splint and fix the fracture.

Removing metalwork that has been on or in a bone for some time can be very challenging. An unsucessful attempt was made at least 20 years ago to remove this Kuntscher nail.

This patient subsequently went on to develop severe stiffness and arthritis in the ipsilateral knee.

In 2015, the pain from Mr Eden’s knee arthritis affected his quality of life so profoundly that he was referred for an opinion regarding a knee replacement.

Conventional knee replacement technique usually involves placing a rod temporarily inside the femur to align the knee replacement correctly when it is fitted. This was not possible in Mr Eden’s case due to the Kuntscher nail.

Patient specific instrumentation (PSI) can be very helpful in the context of previous fractures around the knee and requires an MRI scan of the hip, knee and ankle to map the alignment of the limb. This technique cannot be used however if the internal metalwork (in this case the Kuntscher nail as illustrated) extends to within 15cms of the knee joint.

A novel new technology allowing wireless computer aided navigation was used to perform this step of the procedure therefore.

 

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