Background: Foot and ankle disorders are common conditions, but their management in Nepal remains underexplored. This nationwide survey assessed diagnostic and treatment practices and gaps in foot and ankle care among orthopaedic surgeons in Nepal.

Methods: A cross-sectional survey was conducted among orthopaedic surgeons of the Nepal Orthopaedic Association. Of 702 surgeons, 45 were excluded (expired or abroad) ,leaving 657 eligible participants. 262 surgeons responded (39.8%). The survey consisted of demographic information, general practice questions, and condition-specific sections covering plantar fasciitis, Achilles tendinopathy, ankle sprain, flatfoot, cavus foot, and diabetic foot. Data were analyzed descriptively using Microsoft Excel and SPSS version 25.0.

Results: Ankle sprain (96.6%), plantar fasciitis (93.9%), and ankle fractures (88.1%) were the most frequently encountered conditions.Diagnosis was predominantly clinical, supported by X-ray in most cases, while the use of ultrasound or MRI remained limited. The majority favored conservative management, emphasizing physiotherapy, stretching, footwear modification, and NSAIDs. Corticosteroid injection was the most commonly used interventional option for plantar fasciitis (90%), whereas PRP use was minimal. Surgical intervention was reserved for chronic, refractory cases—typically after 6–12 months of failed conservative therapy. The findings reveal significant variability in diagnostic and therapeutic approaches, reflecting both experience-based practice and limitations in subspecialty training and resources.

Conclusion: Foot and ankle conditions are commonly managed by general orthopaedic surgeons in Nepal, predominantly using conservative treatment. Structured subspecialty training, standardized protocols, and improved access to imaging and rehabilitation services are needed.

Keywords: Ankle Sprains; Foot Diseases; Nepal; Orthopedic Surgeons