ANESTHESIA

Many techniques exist for the administration of anesthesia for foot surgery. The particularities of minimally invasive surgery, which allows for the immediate mobility of the limb requires a good post operation analgesic block to the ankle with the chosen anesthetic. Important elements are the relative easiness of the execution of the block and its safety. The association of a tranquilizer administered before the execution of the block makes it easily accepted in the majority of patients. This actually establishes our standard, in which the validity and conformation of the experience of thousands of cases of satisfied customers.

PERCUTANEOUS SURGICAL TECHNIQUE

The correction of the deformities and the modification of the bones of the forefoot using small saws which are introduced through the 2-3 millimeter incision in the skin. The surgeon “sees” the bones and the saw itself through a radiological instrument, which controls these saws. The important news is due to the absence of screws and wires the fracture is allowed to heal according to the “needs” of the foot. The foot which can walk immediately after the surgery and will be free of medication only after about ten days.

POST OPERATIVE TREATMENT

The surgical treatment can be executed in an outpatient clinic it is not necessary to be admitted to a hospital. The same day as the surgery with the foot wrapped in a bandage and the use of postoperative footwear it is possible to put weight on the foot and walk normally without the use of crutches.

AFTER 2 WEEKS

The patient has the first post-operative check-up. In the course of the visit the medication will be change, the bandage reduced and the post operative footwear will be replaced with a real shoe (e.g. trainers one or two sizes larger).

AFTER A MONTH

A check-up with updated x-rays.

FINAL CONSIDERATIONS

The percutaneous correction of forefoot defects is a technique, which looks to overcome some of the problems encountered with the numerous techniques which have been offered over time for this surgery. In reality it is not a revolutionary idea: the concept of causing fractures in the foot bones to realign them according to a more logical “geometry” came about many years ago. The innovative improvements of the percutaneous technique are evident, the bones are not exposed, the removal of the esostosi from the head of the first metatarsal the fractures are made with a small saw and no internal fixtures of any type are used.
Perhaps the real innovation is that it is not necessary to immobilize every fracture in order for them to heal. The fractures are left free after the realignment so the recovery is according to the real need not predetermined standards. In fact at the end of the surgery the patient is given medication, which is applied by means of a bandage, and each patient is instructed in the correct usage of the bandages in order to administer the medication at home.
There are numerous advantages to this technique such as the use of local anesthetic only to the foot and that it is essentially and outpatient procedure, with the consent or rather the ability to walk immediately after the surgery along with a relatively short recovery time. It is a economical operation in the sense that internal fixations aren’t used and the operation itself is quick which improves the comfort of the patient with less post operative pain, which is truly bearable and easy to tolerate be it either immediate or subsequent. The patient can administer the medications apart from the first at home. The recovery time is relatively brief and complications are extremely rare and any post-operative problems are easily corrected.
All of these considerations make the percutaneous surgical technique the preferred technique of surgeons who perform forefoot surgery. Naturally the apparent simplicity of the execution of this surgery requires a deep understanding of the dynamics and functionality of the foot and its anatomy. Along with particular experience and ability to take care of the problems of weight distribution. Ones treatment however in any surgical procedure should be reserved exclusively for the alterations of the foot that are accompanied by pain and difficulty walking. After this has been clarified to the person concerned and the general the possibilities and limits of the operation apart from the technique used.
Deformity and dislocation of the toes by the big toe pushing against the other toes which over time causes a curvature. Once it gets to the point of the aforementioned deformity (hammer toe) and the toes lateral or dorsal deviation, which creates the loss of the use of the base of the toe with the corresponding metatarsal ending in the complete dislocation of said toe.

POSTURAL RAMIFICATIONS

The first metatarsal moves towards the outer part of the foot and becomes hyper mobile due to the lengthening of its ligaments. With every step the weight raises up and levels out the arch of the foot as it rotates towards the inside of the foot.
The rotation is carried across to the articulated joints of the lower limbs. Muscular and skeletal systems, influencing the posture, which means training various parts of the body along the lines of gravity. Dragging the rotation of the foot and lower limbs as they turn internally, this means the ligaments of the hip are inclined to move in front of the pelvis which in turn modifies the curvature of the spinal column and adds to the curvature of the lumbar. This postural position creates particular incongruences giving life to the clinical manifestations, which are characteristic of patients with bunions.
One can speak about the real and particular “postural syndrome of bunions” which is characterized by the tendency to a Valgus condition of the knees accompanied by pain at the facet of the internal knee cap Rigidity of the hips with limited internal rotation which is accentuated by the lumbar curve along with the presence of degenerative disc disease.
Amongst the causes a strong familiarity surely exists in the development of this pathology. One could ascertain like many patients who have familiar influence and guarantee of the same deformity. Most likely also the use of inappropriate shoes modifies the base.
The use of tight shoes commonly believed to be the main cause of this disease is not necessarily the cause, in fact the contrary. Stretching and pressing the back arch could only slow down the initial symptoms of the disease. Characterized by the widening and fanning out of the back arch, which is caused by the separation of the first metatarsal from the others. At birth the colour of our eyes or the structure of our hands are already determined so is the shape that our feet and toes will assume during the different stages of our lives. Therefore, bunions are a real and true anatomical variant of our feet like flat foot or claw foot.