What is a bunion?
Bunions are primarily a hereditary condition. They can
affect anyone. A bunion occurs due to a mechanical instability
in the foot, which results in a malalignment of the
bones with the big toe drifting toward the second toe.
As this progresses, we begin to notice a large bump
behind the inside of the big toe. As you walk more and
more, the symptoms become worse. As the bunion deformity
increases in severity it can cause many other associated
foot problems, such as hammertoes, painful calluses
on the bottom of the foot and arch pain. top
Do lasers get rid of bunions?
This much-publicized technique is severely limited because
lasers are only used to cut soft tissue in bunion surgery,
not to cut the bone. Making precise bone cuts is the
most critical part of a successful bunionectomy. top
What's unique about our approach
to bunion correction?
We feel that in order to effectively correct the bunion,
all of the adaptive changes must be addressed to ensure
appropriate function and reduce recurrence. Our technique
includes surgical engineering to realign the bone for
proper function, using a surgical screw for the most
stable fixation. The proper use of the surgical screw
enables us to reduce many of the potential hazards of
bunion surgery. top
Do bunions ever come back?
No surgeon can guarantee perfect results. Unfortunately,
if the wrong procedure is performed, the recurrence
rate can be very high. Many of the new micro-surgeries
also known as lunch-time surgery, and laser techniques
have a high recurrence because they generally cannot
accurately realign the bones. top
When should I have my bunions
corrected?
If you have any of the following problems, your feet
should be evaluated.
- Calluses on the inside of the big toe
- Pain around the big toe when wearing certain shoes
- Painful calluses on the bottom of your feet
- The big toe pushing on the second toe
- Difficulty wearing shoes top
Results
of the bio-engineered Tri-Correctional Bunionectomy:
In the past, bunion sufferers have been subjected
to an array of surgical procedures with mixed results.
Pain, long-term disability, hospitalization and casting
were the standards of care. Now the podiatrists at
Encino-Tarzana Regional Medical Center and Medstar
foot and ankle center, have pioneered a procedure
which changes the traditional way in which bunions
are approached. This bio-engineering technique realigns
the bones and maintains the correction so securely
with generally minimal discomfort, that our results
have been impressive. top
| Traditional
Bunionectomy: |
|
Tri-Correctional
Bunionectomy: |
| Often
done under general anesthesia. |
|
Performed
under a local anesthesia on an outpatient basis. |
| Many
times requires a full-leg cast or steel rods which
protrude from the toe (This is for severe bunions.) |
|
Requires
a surgical screw beneath the skin. |
| Often
minimal walking for as much as four months. |
|
Most
patients walk immediately after surgery without
crutches. |
| Patients
cannot wear shoe for prolonged periods of time. |
|
Most
patients usually return to shoes within two weeks.
|
 |
What
happens if I have arthritis in my joint?
The nature of a bunion is a malaligned joint, it’s
not just a bump. As the joint continues to function
out of alignment, the bunion deformity gets worse.
Some bunion deformities worsen more rapidly than others,
but they all get worse with time.
Special doctors called rheumatologists treat the many
varieties. Generally, patients with bunions, have
osteoarthritis, or a wearing down of the joint. The
longer the joint is crooked and the longer the joint
is malaligned, the greater the chance for the person
to develop arthritis of the big toe joint.
Below:
The
joint on the left is arthritic. Cartilage should be
intact, not worn out, and shiny & white like the
joint on the right.
 |
 |
That is why the surgical engineering behind the Tri-Correctional
Bunionectomy is so important. The procedure is designed
to restore proper alignment and function. Traditionally,
arthritic joints were destroyed, fused or implants
where used. These are not good alternatives for an
active person who puts great demand on their feet.
Why destroy a joint if you can save it? Using surgical
engineering, we are usually able to get the big toe
joint to bend again, saving many such arthritic joints.
top
Excellence in surgical engineering.
The foot is a highly mechanical apparatus. What’s
surprising is how important this joint really is.
Try walking without bending your big toe, it’s
like trying to drive a car with a flat tire. This
is why so many people with big toe problems have knee
and back pain as well.
Since the force on the big toe joint is horizontal,
bending torque moment occurs when you walk. Bending
torque moment measures the point of application of
weight-bearing forces times the length of the lever
arm (length of bone) to the osteotomy (bone cut).
The application of Tri-Correctional Bunionectomy (at
1/2x) minimizes the bending torque moment. The illustration
below shows the placement of the Tri-Correctional
osteotomy (bone cut) as compared to other traditional
osteotomies:
As
the osteotomies are moved farther away from the big
toe joint, the bending torque moment becomes higher.
Higher bending torque moment creates more stress in
the area of the bone cut, which can prolong recovery
time. Other bone surgeries are done similarly, but there
is an advantage in performing surgery at the end of
the bone to minimize torque, which is our "secret"
ingredient in the Tri-Correctional Bunionectomy.
 |
Not
only do we minimize torque at the
endof the bone, but the quality of the bone used is
better closer to the joint. The better the quality
of bone, the faster the bone heals. Our goal in creating
the Tri-Correctional Bunionectomy was to minimize
torque so that we can get you back to your activities
as quickly as possible.
The effects of bending torque moment are similar to
bending of a pencil whose point is placed on the edge
of a table. Applying a force near the tip of the pencil
will not generally result in breaking the pencil,
because bending torque moment is minimized. But, if
one applies the same force near the eraser, the pencil
will break much more readily. top
What is my foot going to
look like at the end of surgery?
While the Tri-Correctional Bunionectomy is performed
to repair your painful joint, it is also used to repair
unsightly feet. Many people with bunions are afraid
to show their feet because they are embarrassed by
their appearance. The Tri-Correctional procedure has
helped many people return to a life of open-toed shoes.
During the procedure, sutures are closed with what
is called a subcuticular stitch, with no ‘Frakenstein’
holes on either side of the incision. The incision
is made on the side of the foot, as opposed to the
top, because it scars less as the incision rubs against
the shoe. Seri-Strips are used to support the skin
as it heals, to prevent unattractive scarring, and
to get the incision to heal as quickly as possible.
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OUR
OUTCOMES SPEAK FOR THEMSELVES
Most of our patients experience minimum discomfort.
This new bioengineering procedure, the Tri-Correctional
Bunionectomy, is done on an outpatient basis. Traditionally,
bunionectomies were done in hospitals where patients
stayed overnight, usually due to post-operative pain
and the inability to walk. In a recent study, nearly
80 percent of our patients stated that their discomfort
was markedly less than they had anticipated, and required
minimal medications for pain. Additionally, the surgical
engineering approach stabilizes the bone allowing
our patients to walk the same day as their surgery.
The majority of our patients are in shoes
after two to three weeks.
With
traditional bunion surgery, a return to shoes has
often been delayed by pain, swelling, and the inability
to walk because of pins or bone instability. The use
of a surgical screw significantly reduces pain and
swelling. Security of the bone realignment usually
allows for immediate weight bearing and ambulation
(walking), without the need for full-leg casting.
Patients are generally ready to begin wearing shoes
in ten days after surgery.
Traditionally, pins and wires have been used to hold
the alignment of the bones. The pins stuck out of
the foot and prolonged the return to shoes by as much
as a month or longer. The surgical screw we use is
placed beneath the skin and is much more stable than
pins. To ensure the best possible results, patients
enter a program of vigorous rehabilitation to help
with the healing process and increase the flexibility
of the corrected joint. Now there is no need to be
afraid of bunion correction any longer.
Of course no two people are the same. We would be
happy to discuss your unique foot condition.
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