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Home > Centers of Excellence > Orthopedic > Exostectomy 

What is Exostectomy?

Exostectomy is the process of getting rid of bony bumps on the bones. These bones can differ in size, location and number, depending on the person. Any bone can be affected and the long bones (legs, arms, fingers, toes), pelvis, and shoulder blades are the common ones, while the face and skull are normally unchanged.

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Effects of Exostectomy

Exostoses occasionally develop near nerves or tendons and press on them. The removal of exostoses is necessary so that they would not damage the structure laying over them.

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Candidates for Exostectomy

Surgery is recommended if an exostosis is painful, pressing on a vital structure, cosmetically unappealing, or if easily bumped.

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Your Consultation

The doctor will perform a physical examination, as well as an evaluation of your gait, examination of your feet and a neurological examination.  It is also possible that the doctor may want to inspect your shoes. Signs of extreme wear in specific parts of a shoe can give beneficial clues to problems in the way you walk and poor bone alignment. Depending on the outcome of your physical examination, you may be required to have foot X-rays or other diagnostic tests.

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The Exostectomy Procedure

There are numerous procedures and techniques for foot and ankle surgery. Each patient is unique, each possessing a distinctive problem. Treatment will depend on the specific condition of the patient.

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Recovery

Rest is recommended for the injured ankle, usually from 2 to 4 weeks. To prevent weight-bearing, the use of splints or crutches may be needed. It is also suggested that you elevate the foot when sitting or lying down. Then you can gradually return to your normal activities.

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Risks

Probable complications are proneness to repeated injury and degenerative arthritic changes in the ankle joint and cartilage in later life. It is also possible that there may be injury or pressure on nearby nerves, ligaments, tendons, blood vessels or connective tissue. There is also the risk of disability serious enough to reduce an athlete's competitive ability if the exostosis is left untreated. Since mild exostosis is not promptly noticeable, coaches and other athletes often attribute the deterioration in performance to emotional causes or a loss of competitive drive in the athlete, rather than awareness that it is brought about by a physical disability such as exostosis.

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Frequently Asked Questions

Q: What is an exostosis?

A: An exostosis is the creation of new bone on the surface of a bone. Exostosis can produce chronic pain, extending from mild to debilitatingly severe, depending on its location and size.

Q: What causes exostosis?

A: One of the causes of exostosis is recurring ankle or foot injury, even mild injury. Another factor is the involvement in sports that need "pushing off" or "springing" from a position with the foot bent upward.

Q: What are the symptoms of exostosis?

A: The following are some signs and symptoms of exostosis:

          Loss of "push" or "drive" (the ability to push off quickly and forcefully in running).

          Inability to run, cut or jump at full speed.

          Low level of ankle pain with activity. Occasionally, no pain exists.

          No tenderness or pressure with a physical examination. Sometimes pain and tenderness in the ankle and top of the heel bone can be identified only by special examination from a trained medical professional.

          Variation in ankle-bone contours. This starts as a small irregular bump that develops to a large calcified spur (1 cm or more in length). In the worst cases, the exostosis may break away and emerge on the X-ray as a calcified foreign body.

          "Locking" if the tendon catches on the exostosis during exercise.

Q: How can I prevent exostosis?

A: To prevent exostosis, you can get involved in vigorous muscle strengthening and conditioning prior to regular involvement in sports. You can also allocate full healing time after an ankle or foot injury before returning to any sport that makes you push off and run. It is also helpful to warm up sufficiently before competition or workouts.

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