2012年12月12日 星期三

Bunion Breakthrough





1,000 and counting

Hong Kong Adventist Hospital (HKAH) is pleased that Dr Daniel Wu, specialist in Orthopaedic, has performed more than 1,000 of his non-bone-breaking bunion surgery at our hospital. Over 50 of these surgeries were on patients from across the world, including Australia, Canada, China, Dubai, Japan, Indonesia, New Zealand, Singapore, Netherland, Italy, the UK and USA, who came specifically for the procedure.

Congratulations to Dr Wu on his pioneering work and best wishes for his further success.


In 2011, the Biomedical Science Department of the Polytechnic University of Hong Kong verified that Dr Wu’s non-bone-breaking bunion surgery can not only correct bunion deformity but also significantly and consistently improve the all important mechanical functions of patients’ feet. Researchers at the university used the F-scan® to study the pre- and one-year post-operative plantar pressure of 34 consecutive patients who had both their feet corrected.

Dr Wu presented this study at the Hong Kong Orthopaedic Association Annual Congress in December, 2011 and American Academy of Orthopedic Surgeons’ annual meeting in San Francisco in February, 2012. The study is also being prepared for scientific publication to demonstrate that a bunion surgery can finally restore mechanical function of the big toe – the biggest contributor (80%) of all the toes in walking and a major victim of the bunion condition.




Reference: Pulse - Medical News
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.




2012年12月7日 星期五

Foot for Thought (2)





Since females are known to dominate bunion condition over males by the ration of 9:1 and if high heels are not at fault then what is responsible for the gender-related propensity?

To understand the reason, it is necessary to recognize that the bunion condition is caused by over-flexibility of ligaments. What makes female more flexible and even to the point of dislocating their pubic symphysis during pregnancies are female hormones, not high heels.




? A Question to Ponder

Q: If high heels play only a small role in bunion debacles, can they still be worn after surgery with impunity?

A: Unfortunately, the answer may not be quite so simple.
According to websites of American Academy of Orthopedic Surgeons and the British Orthopaedic Association, both advise that patients will have some shoe and activity restrictions after current surgical techniques.
However, not all bunion surgeries are created equal and it is self-explanation by simple x-ray illustration below to compare traditional ‘bone-breaking’ procedures (>95% of all bunion surgeries done around the world) and the minimal-traumatic ‘non-bone-breaking’ syndesmosis procedure which carries no activity or shoe restrictions after surgery.

BY Dr. Daniel WU
Specialist in Orthopaedics








Reference: Pulse - Medical News
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.


2012年12月4日 星期二

Foot for Thought (1)





Everyone would probably agree that feet are mainly functional rather than ornamental. Despite the extreme strains put on our feet in vross-country running and ballet dancing, these common activities are neither medically inadvisable nor proven damaging to our feet.

 
But, why are the devilishly beautiful high-heel shoes always painted as evil instruments for feet? Admittedly, they can be uncomfortable, tiring, bad for knees and back but do they really cause bunion deformities?


After having seen a great number of bunion feet (both women’s and men’s) that are not caused by wearing high-heel shoes, in cooperation with the HK Baptist University, a 2008 survey of over one thousand Chinese women was finally conducted to explore the prevalence and common causes of bunion deformity in Hong Kong.


The findings were 36.5% of surveyed had varying degrees of bunion deformity which was in line with international incidences of 33-50%. Within our bunion sub-group, 88% gave a positive family history and 83% denied much taste for high-heels. Further analysis revealed 74% of bunions were linked to family history alone and only 3% to high heels. In other words, family history could be 25 times as important as high heels in association to bunion development. (“Does Wearing High Heeled Shoes Cause Hallux Valgus? A survey on Chinese Females”, a scientific paper based on our findings has been accepted for publication in Foot and Ankle Online Journal.)

BY Dr. Daniel WU
Specialist in Orthopaedics









Reference: Pulse - Medical News
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your Orthopedist for diagnosis and treatment.


2012年11月26日 星期一

拇趾外翻的問與答


 

1. 如何避免拇趾外翻繼續惡化

儘量避免穿著高跟鞋或尖頭鞋

配戴拇趾外翻專用鞋墊

採用拇趾分離膠或晚間腳套,但效果成疑

經物理治療師指引的足部或腳趾運動

 

 

2. 如我有拇趾外翻家族歷史,有多大機會患上此病症

在拇趾外翻患者中,基因佔著重要的比重,您可能有著拇趾外翻發病基因,但是否發病是完全基於隨機因素,發病與否亦無任何數據可顯示出來。女性荷爾蒙亦是其中關鍵因素,使女性患病的機會比男性多出9

 

 

 

3. 何時需要考慮手術治療

一般來說,當非手術治療未能消除因拇趾外翻所引起的足部、小腿和背部的痛楚;並開始影響日常生活時,便可考慮採取手術來解決。此外,為免形成拇趾關節炎,較活躍或年輕的嚴重患者也應考慮手術來處理

 





 

參考資料: www.bunioncenter.com/

以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的骨科醫生查詢,而不應單倚賴以上提供的資料。

傳統拇趾外翻手術: 截骨移位術


拇趾外翻治療的目標

一直以來,拇趾外翻手術針對修正和穩定第一蹠骨,因它除了是拇趾外翻問題的根源以外,亦是其他足部問題如爪型趾、拇囊炎、尾趾囊腫、腳趾重疊甚至足 弓下塌等症狀的主因,如第一蹠骨問題能有效及正確地解決,患者原則上應可重新享受運動、跳舞和穿高跟鞋等正常活動。

這理想目標能否達成,手術的處理方式乃 其中關鍵所在,手術必須符合病理學的原理。

儘管外觀問題需要處理,但拇趾外翻對功能的影響更值得關注,所以拇趾外翻手術必須以針對功能為大前題。


 

傳統拇趾外翻手術: 截骨移位術


 

一直以來,傳統拇趾外翻手術均以"截骨術""截骨移位術"來進行。現時全球約90%拇趾外翻手術以不同形式的"截骨術"來處理。儘管"截骨術"已被外科醫生廣泛地採用並且有過一些成功的案例,一般患者均對截斷趾骨的手術方式仍有所保留。


American Academy of Orthopedic Surgeons http://www.orthoinfo.aaos.org British Orthopaedic Foot and Ankle Society http://www.bofas.org.uk/ 均提醒患者注意目前外科手術的局限性,因截骨手術仍未能一致地解決患者足部功能如鞋款或活動等限制。似乎截骨手術對患者術後功能恢復仍有不足之處。但事實上,若能配合正確的手術方式,情況未必真的如此。


 






參考資料: www.bunioncenter.com/

以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的骨科醫生查詢,而不應單倚賴以上提供的資料。

2012年11月21日 星期三

個案分享4


特殊拇趾外翻情況 (#1067)這位女患者能於手術後可穿高跟鞋跳舞及拇趾能回復正常功能;是基於韌帶聯合術能把第一蹠骨在非破壞的情形下修正過來

 


 

年輕拇趾外翻個案(#1071)拇趾外翻年輕患者仍可經吳醫生韌帶聯合術處理,唯他們需待到第二蹠骨發育完成才可進行手術。一般女孩和男孩的合適年齡分別為1215

 





參考資料: www.bunioncenter.com

以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的骨科醫生查詢,而不應單倚賴以上提供的資料。

 
 

2012年11月19日 星期一

個案分享3


中度拇趾外翻情況 (#1108)普遍認為,以中度拇趾外翻來說,截骨手術 (Chevron) 比非截骨手術 (McBride)更為有效。但吳醫生的韌帶聯合術不單能在非截骨的情形下改善外觀,還能更有效地恢復拇趾功能,這結果是根據超過三百個拇趾外翻的病例;並於手術前後進行足部的功能掃瞄測試而來。

 
 


嚴重拇趾外翻情況 (#1200)一直以來,當面對不同程度的拇趾外翻問題,需要以不同的截骨手術方式來處理,吳醫生韌帶聯合術由輕微至嚴重個案均可矯正及回復患者功能
 
 
 
 
 
 
 
 
 
 
 
參考資料: www.bunioncenter.com/
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的骨科醫生查詢,而不應單倚賴以上提供的資料。


2012年11月13日 星期二

個案分享2

拇趾外翻及足底骨刺的案例(#1121)
一般認為足底骨刺會影響第一蹠骨的修正,故必須以截骨手術處理,但這理論尚未經證實。然而,吳醫生非截骨手術對此病例仍可解決。

 

 







 

拇趾外翻導致腳趾重疊的案例 (#1186)
拇趾傾斜通常源於第一蹠骨偏離,吳醫生韌帶聯合術已經證實如第一趾骨能正確及有效地修正,並毋須破壞拇趾趾骨 (Akin’s procedure)



 
 
 

 

參考資料: www.bunioncenter.com


以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的骨科醫生查詢,而不應單倚賴以上提供的資料。

 

2012年11月12日 星期一

個案分享1

糖尿病或類風濕關節炎的拇趾外翻案例(#1206)

縱使因糖尿病影響身體復原功能;又或因免疫系統問題(如類風濕關節炎)需服用藥物治療控制新陳代謝的患者,只要患者具有正常的傷口癒合能力,連接第一及第二蹠骨的韌帶仍可建立。這位50歲類風濕關節炎需服用藥物的患者,手術後一年第一蹠骨明顯地被新建韌所修正和固定於正常位置上。


 
 
 
 
 
 
 
 
第一蹠骨過長的拇趾外翻案例(#1177)
有被認為第一蹠骨偏離是由於第一蹠骨比第二蹠骨較長而引起,這位第一蹠骨較長的患者於韌帶聯合手術後3年仍沒有任何復發跡象。
 








參考資料: www.bunioncenter.com


以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的骨科醫生查詢,而不應單倚賴以上提供的資料。