|
Did you know Dr. Thomas is considered an expert in conservative and surgical management of bunions?
He is one of the nation's highest volume minimal invasive bunion surgeons. After countless hours in cadaver and anatomy labs, teaching and learning at courses in the USA and Europe, and years of practice Dr. Thomas has designed a unique surgical procedure for bunions that achieves improvement in the deformity and a more pleasing cosmetic outcome. The procedure is called the Toeplasty. Not all bunions are the same. Call the office to schedule a consultation with Dr. Thomas to see if your bunion qualifies for this unique, advanced procedure. |
Every bunion is different and Dr Thomas feels doctors that have a ‘one size fits all’ approach to bunions might be doing their patients a disservice. There are over 100 bunion procedures listed in the medical literature.
Here are some factors your doctor must consider when choosing a bunion surgery for you:
Here are some factors your doctor must consider when choosing a bunion surgery for you:
Intermetatarsal Angle
Mobility of 1st Ray
Atavistic Cuneiform
Pronation of hallux (rotation of big toe)
Position of sesamoid bones (underneath the big toe joint)
|
|
Patient activity level and shoe goals
|
|
For those that qualify Dr. Thomas has designed a new procedure that he calls the Toeplasty which involves a combination of small keyhole incisions and a small open incision on the top of the big toe joint that allows for correction of all three planes of the bunion deformity.
While other procedures only deal with part of the problem the Toepalsty can correct the frontal, sagittal, and coronal planes of the bunion deformity. It also allows for decompression of the joint in the case of early arthritis, also called hallux limitus.
Through soft tissue balancing and bone cuts the correction can be achieved in a simple, relatively quick, outpatient procedure with lower recurrence rate and more pleasing cosmetic scars and appearance. This can be done as a local only without anesthesia, under a twilight anesthesia (such as dental procedures or most colonoscopies), or general anesthesia.
Most importantly, the goal is to maintain range of motion of the joint and restore activity as quickly as possible. In many cases the patient can walk the day of surgery in a post op shoe.
Below is a general overview of the Toeplasty procedure. At your consult appointment Dr. Thomas will analyze your foot and x-rays then discuss whether or not you are a candidate for this procedure and specific details including risks and benefits.
With the Toeplasty procedure Dr. Thomas will likely address the big toe joint removing any spurs of bone, removing the bunion ‘bump,’ then a unique soft tissue balancing of tendons and ligaments to help with re-alignment, and finally a minimal invasive wedge cut of the big toe bone to align and secure with a small headless screw or pin (either option sits flush with the bone and isn’t prominent).
Although further progression of the bunion can occur, this is typically if the wrong patient is selected for this advanced procedure. Initial data with recurrence rates is around 2-8% which is much better than the reported traditional bunion surgeries depending on the literature read can be upwards of 40%.
While other procedures only deal with part of the problem the Toepalsty can correct the frontal, sagittal, and coronal planes of the bunion deformity. It also allows for decompression of the joint in the case of early arthritis, also called hallux limitus.
Through soft tissue balancing and bone cuts the correction can be achieved in a simple, relatively quick, outpatient procedure with lower recurrence rate and more pleasing cosmetic scars and appearance. This can be done as a local only without anesthesia, under a twilight anesthesia (such as dental procedures or most colonoscopies), or general anesthesia.
Most importantly, the goal is to maintain range of motion of the joint and restore activity as quickly as possible. In many cases the patient can walk the day of surgery in a post op shoe.
Below is a general overview of the Toeplasty procedure. At your consult appointment Dr. Thomas will analyze your foot and x-rays then discuss whether or not you are a candidate for this procedure and specific details including risks and benefits.
With the Toeplasty procedure Dr. Thomas will likely address the big toe joint removing any spurs of bone, removing the bunion ‘bump,’ then a unique soft tissue balancing of tendons and ligaments to help with re-alignment, and finally a minimal invasive wedge cut of the big toe bone to align and secure with a small headless screw or pin (either option sits flush with the bone and isn’t prominent).
Although further progression of the bunion can occur, this is typically if the wrong patient is selected for this advanced procedure. Initial data with recurrence rates is around 2-8% which is much better than the reported traditional bunion surgeries depending on the literature read can be upwards of 40%.
General overview of the unique procedure designed by Dr Thomas called the Toeplasty:
Through this small incision on the top of the big toe joint the soft issue and bone can be repaired.
Through this small incision on the top of the big toe joint the soft issue and bone can be repaired.
Small incision leaves minimal scar
Removal of excess bone on top and side of big toe joint.
|
|
The bones cuts are made and the soft tissue is balanced
Bone wedge resection through one keyhole incision with one stitch. The toe can be straightened and rotated into position. The toe can also be shortened, the joint space increased, and/or toe elevated or lowered into correct position such as the following:
|
|
The bone is then held in place with a screw or pin which are headless and sit flush with the bone preventing the patient feeling the hardware. This is done through a second small keyhole incision and one stitch.
Again the two small key hole incisions are below, one incision to make the cut with a bur that runs saline through it to prevent causing too much heat to the bone and necrosis such as seen with using a saw for the bone cut. The second incision to place the screw or pin.
Again the two small key hole incisions are below, one incision to make the cut with a bur that runs saline through it to prevent causing too much heat to the bone and necrosis such as seen with using a saw for the bone cut. The second incision to place the screw or pin.
|
|
|
The correction and hardware placement are confirmed with live x-ray with mimicking weight bearing using a sterile plate
|
|
Toeplasty can achieve dramatic results
|
|
Call Dr Thomas’ office today to set up an appointment to see if you are a candidate for the Toeplasty procedure at 614-267-8387.