Dr Troilo, what can you tell us about bunions in general?
Despite its masculine gender, the bunion or “hallux valgus” affects more women than men in a ratio of 8 to 1. It is the tenth most searched disease on networks and web search engines, affecting approximately 35% of people. the population. It develops as a bump on the metatarsal where the big toe begins, which grows and becomes swollen, painful and often infected. This is generally aggravated by the use of fashionable footwear, with a narrow last and/or high heels, although its origin is mostly genetic.
Should the bunion always be operated on?
Many times silicone inserts and a wider, low-heeled shoe improve symptoms, however, the ultimate solution is surgery. Letting time pass only aggravates the problem.
In the past, when the patient did not present pain or complications, the bunion was not operated on. This was due to the bloody surgical techniques, often with placement of plaster, pins or other immobilizers and prolonged rest. At present, the possibility of leaving the sanatorium on foot, the latest generation analgesics and the early return to work, added to less invasive techniques, have overcome this indication, adding the aesthetic aspect to it.
What is bunion surgery like?
There are several cutting-edge procedures and it is the surgeon who must choose one of them according to each patient, the type of pathology, its associations (hammertoes, claws, etc.) and the person’s expectations. The operation consists of making small cuts in the bone that allow its position and orientation to be changed. Many years ago only exostectomies were performed, those that are commonly called “filing the bone”. This brought about an almost certain recurrence (that the bunion comes out again) or an incomplete correction. Nowadays, MIS or percutaneous surgery and the mixed surgery that we use in BAP, added to the use of plasma rich in tissue growth factors, allow safer, faster and less bloody procedures. This allows the patient to retire in the day and walk. Despite these advantages, it must be taken into account that, as a dear professor used to say, “surgical techniques are for patients, not for surgeons”. In this way, the choice of surgery is for the absolute good of the person who receives it. Each patient is different and each bunion has its “personality” for which the surgery is personalized.
Can it be operated with lasers?
I must clarify here that despite the advances in surgery, the use of laser does not exist in traumatology. Therefore, said promotion and that which refers to the use of “magical” healing splints or accessories fall within the chapter of medicine referred to as “quackery and quackery”, being only a hoax.
Is it necessary to be a specialist to perform these interventions?
Years ago, foot surgeries were performed by general traumatologists or even general surgeons. At present it is highly specialized, finding experts in it. Here experience is essential. Most foot surgeries require a steep learning curve, years of practice and improvement in the country and abroad. Therefore, the “secret” of a good surgery and its speedy recovery lies in several factors: A trained team, a patient who cooperates with the post-operative indications and is confident in his recovery, and the correct choice of the surgical technique on the part of the patient. of the surgeon. There are more than three hundred procedures to operate on a bunion. Experience and medical knowledge is essential for choosing the most appropriate, according to the characteristics of each one.
Can fashion shoes or heels be worn after surgery?
A myth of bunion surgery is about the limitations that remain after it. There is no sustainable limitation in time in a successful operation. The use of high heels, for example, has the same recommendations as in non-operated people. Use for many hours is discouraged and exercises are recommended to lengthen the posterior muscles of the leg and the Achilles tendon that are retracted with the constant use of high heels. This causes pain, cramps and plantar fasciitis (pain in the inner arch of the foot and/or heel).
In short, if you have bunions, claw toes or other deforming pathologies of the foot that affect it functionally or aesthetically, the medical recommendation will be surgery. The methods currently used are minimally invasive, with correct management of postoperative pain and recovery according to them.
Dr Fernando G Troilo
MN: 91,741 MP: 39,771
@buenosairespie
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by CEDOC