嶄新非截骨拇指外翻手術

拇指外翻是常見的足患，主要的徵狀是大拇趾向外過度偏斜，而第一蹠骨偏向內側，形成骨狀突出物，從而導致前足變形和增闊﹑足繭﹑痛楚等問題。骨科專科醫生吳彥指出，如未能適當糾正，拇指外翻的情況會愈趨嚴重。早期求醫可利用度身訂造的鞋墊紓緩適，防止進一步惡化；但當足部疼痛導致行走不便時，便應接受外科手術來根治。「創新的微創非截骨韌帶聯合術一方面可以有效恢復足部的正常功能，並改善外觀，另一方面對足部的創傷減至最低，安全性高，是拇趾外翻的治本方法。」

 

拇趾外翻非截骨手術－低痛楚。高安全

現時，全世界超過95%的拇趾外翻手術是以15種不同的截骨移位手術為主。手術會將已傾斜的第一蹠骨先割斷之後移位，從而矯正拇趾外翻的情況。手術後，有可能引致相關的副作用及併發症；而且，蔚改善足部行走功能的成效仍有待證明。故此，吳彥醫生一直提倡對足部損傷較少的非截骨手術，並首創「韌帶聯合術」，不需截斷第一蹠骨及破壞其結構而進行矯正，便可成功令足部恢復正常功能。

吳醫生道：「人的身體會自然產生復修的纖維組織，韌帶聯合術就是建立一個適合的環境，來引發這個正常身體的自然反應，令體內生建的韌帶來將蹠骨固定，所以無需移植人造物料或患者身體組織。由於無需截骨，所以將患者的痛楚大大減低，安全性更高；而且，從過往二十年的臨床病歷證實，新建韌帶的強度足以支持患者運動及穿著高跟鞋等活動，穩定性高，復發機會亦微乎其微。」

首間專療中心　－　提供一站式服務

女性罹患拇趾外翻的情況相當普遍，不但影響外觀，更重要的是導致痛楚及行走不便，患者會下意識改變步行姿態，因而可能導致腿部﹑臀部和背部肌肉抽緊，影響日常生活。因此，吳醫生首創非截骨的韌帶聯合術，並成立全港首間拇趾外翻專療中心，以完善的配套設備對非截骨拇趾外翻手術作出研究﹑教育及治療之用。吳醫生指。中心從診斷病症﹑非手術治療或手術治療﹑手術前後足部功能比較﹑手術後足部功能測試及跟進都鉅細無遺，務求令患者得到全面的治療，並準確評估手術成效，掌握足部功能的復元進程。吳彥

吳彥　骨科專科醫生

參考資料: 東周刊

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。

About after surgery

 

 

 

 

1. Is hospital stay necessary?

It is not absolutely necessary but most people prefer staying overnight for their peace of mind and comfort.

 

2. How much surgical pain is there usually and for how long?

Obviously each individual case can be different to some extent, but most people have moderate pain for no longer than first 24 hours after surgery and it can usually be controlled by oral pain killers. Injection is not usually needed.

 

3. When will I be allowed and able to walk?

Walking is allowed and possible anytime after surgery, although there may be slightly more pain for the first few days.

 

4. Do I need crutches?

They are optional but most people find them useful for their security and comfort for the first week after surgery.

 

5. When can I wet my feet for bathing?

About 10 days when the wound is healed.

 

6. What restrictions do I need to observe?

You need to wear protective footwear for walking and standing for the first 3 months. You should avoid excessive walking to no more than 3-6,000 steps a day.

 

7. Why do I need to restrict my walking initially?

This is to protect the internal stabilizing sutures before the ligament bridge (syndesmosis) is formed.

 

8. Do I need physiotherapy?

It is entirely optional and usually recommended for patients with stiffer big toe joints

 

9. When can I drive again?

Usually in one month's time when normal feeling and reaction return to the operating and operated foot which applies of course usually to the right foot.

 

10. When can I return to unlimited walking, such as hiking?

About 4 months after surgery.

 

11. When can I return to extreme usage of my feet?

All restrictions on activities and shoes are removed 6 months after surgery. Patients can try to return to any sports, jogging, dancing and wearing hi-heels as desired.

 

12. What is the long term recurrence rate?

To our knowledge, there has been no recurrence of loosening and displacement of first metatarsal bone after first 6 months when the syndesmosis bridge has become probably more than 100% strong and safe for all type of activities and shoes. Similarly, there has been little change in the big toe alignment.

 

 

 

 

 

 

 

Reference information: www.bunioncenter.com

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.

 

About the surgery

 

1. Many people talk about bunion surgery being painful and a long recovery, is this true?

Yes, it is the case after certain types of bone-breaking surgery. Since Dr. Wu's syndesmosis procedure does not need to break any bones, its pain is usually much less and for 1-2 days only. Its recovery period is much less incapacitating.

 

2. Can both feet be corrected at same time?

Yes, this is usually the preference by patients with bilateral bunion condition.

 

3. Are there any artificial implant such as screws and pins used?

No, the only foreign material used is the ordinary surgical sutures and they are dissolvable.

 

4. What are the possible complications?

Complications are possible but a lot fewer and milder in comparison to the "break-n-shift" surgeries. The possible complications are numbness around the wound (on top of great toe), wound infection, over-correction, early partial recurrence and stress fracture due to excessive walking and separation between second and third metatarsals. There has been no known late recurrence or transfer metatarsalgia.

 

5. Do medical insurances cover bunion surgeries?

Yes, they do because bunion surgery is considered necessary for pain relief and function improvement of the foot. But it is always advisable to get written approval from your insurance company ahead of surgery.

 

6. Can same surgery be repeated if necessary?

Unlike some bone-breaking bunion surgeries, syndesmosis procedure does not burn any bridges and if necessary it can be repeated without any significant compromises.

 

7. How long does the surgery usually take?

About an hour.

 

8. Can the surgery be done under local anethesia?

Yes.

 

 

 

Reference information: www.bunioncenter.com
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.

 

About the bunion (hallux valgus) condition

1. What can I do to help prevent my bunion from becoming worse?

Wear as little high heels and pointed shoes as possible.

Use bunion-specific foot orthoses for best protection.

Try silicon toe spreader or night splint but their effectiveness is not known.

Physiotherapist instructed foot and toe exercises.

2. If I have a family history of bunion condition, what is the chance of me developing it?

Genes play a strong role in majority bunion patients. You may have inherited bunion genes but their effects are random and there is no statistics yet of their expression among family members. Female hormones (estrogen) can also compound the risk greatly and tilt the gender-balance to 9 times more common among female than male.

3. When may I need to start considering surgical treatment?

Usually when conservative measures fail to control bunion related pain in the foot, leg or low back and the pain begins to interfere with daily activities. To prevent the development of arthritis of the affected big toe joint, surgery should be considered for severe bunion deformity in a relatively young and active person.

 

 

Reference information: www.bunioncenter.com

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.

拇趾外翻矯正 (Part 2)

微創「韌帶聯合術」三個月康復

直至去年底發現最新的微創「韌帶聯合術」﹐毋須截骨或磨骨﹐便可治療翻趾外翻﹐KITTY決定進行手術。

「整個手術療程需時三天﹐第一天入院做手術﹐第二天已可出院。」她笑說﹐手術後麻醉藥一過﹐她便開懷大嚼﹐沒任何不適。「第二天早上﹐我已可自行下床及洗澡﹐當然要避免傷口濕水。」一星期後﹐主診的拇趾外翻創新手術中心主管吳彥醫生再為KITTY度腳訂造鞋套﹐固定雙足﹐「手術後三個月內﹐我穿上鞋套﹐便可照常上班去﹐現在更可到處逛街﹐又可穿回任何靚靚鞋款了!」

行用人體天然再生機制 創傷性低

KITTY並非特殊例子﹐二十歲的黃小姐自小學時代已受拇趾外翻困擾﹐後來接受傳統截骨手術﹐捱了近半年上街不能沒有手杖的日子﹐可過了不久﹐拇趾又再變形。「一年前接受『韌帶聯合術』﹐第二天已可落地行走。」她說﹐三個月的康復期中﹐她如常上學﹐生活不受影響。她喜孜孜補充:「醫生說﹐現在我可隨便跑步﹑跳舞及穿高踭鞋啦!」

吳醫生解釋﹐「韌帶聯合術」的特別之處是能針對拇趾外翻的問題﹐徹底解決﹐「拇趾外翻的成因主要是拇趾韌帶鬆弛﹐引致拇趾骨移位﹑扭曲﹐我們是唯一一個利用人體天然纖維再生機制的治療方法。」他補充﹐「我們先為患者矯正扭曲的拇趾﹐再令拇趾與二趾間纖維再生﹐定趾骨位置﹐數百個案的研究發現﹐新生的纖維韌帶彈性強﹐可承受劇烈的跳舞﹑跑步等運動。病人手術後三個月可正常走動﹐六個月後﹐可全面恢復較劇烈的運動。」
吳彥 骨科專科醫生

參考資料: hk.next.nextmedia.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。

拇趾外翻矯正 (Part 1)

微創手術治拇趾外翻 無痛楚康復快

大學調查發現﹐全港近四成女士患有拇趾外翻﹐可是傳統截骨治療手術﹐康復期長達一年﹐令人卻步。數年前﹐三十多歲的KITTY已察覺拇趾外翻問題﹐且情況日漸惡化﹐腳趾扭曲變形。半年前﹐她接受香港醫生研發﹑首創的微創手術﹐KITTY滿意地說:「手術後一點都不痛﹐不會影響日常生活。」

拇趾外翻手術康復期大不同

	KITTY	KITTY媽媽
接受手術	非截骨韌帶聯合術	傳統截骨手術
術後痛楚程度	只在術後1-2星期有輕微痛楚	痛楚
術後多久能站立/步行	第二天	至場三個月後
徹底康復時間 (可進行劇烈運動)	術後六個月	術後至少一年

傳統手術康復期長達一年

看KITTY的一雙靚腳﹐已很難聯想到她口中:「拇趾骨向外突出﹐好似波子般大﹐而且拇趾已踏在第二隻腳趾上」的昔日情況。

她說﹐「我後來才知道拇趾外翻與遺傳有關﹐我媽媽多年前亦因拇趾外翻嚴重﹐要接受傳統截骨手術。」傳統手術需切斷或磨平突出的拇趾骨﹐並插上螺絲釘固定位置﹐創傷較大﹐「媽媽的傷口碰一碰也痛﹐所以手術後三個月都不能出街。」此手術左右腳須分開進行﹐因此康復期長達一年﹐但﹐真正令KITTY卻步的是──「我媽媽完成手術後不久﹐拇趾便再扭曲﹐回復手術前的模樣。」(續)

吳彥骨科專科醫生
參考資料: 壹周刊

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。

拇趾外翻症狀

醫學上，拇趾外翻稱為"拇趾外翻綜合症"，拇趾外翻是指大拇趾向外傾斜。典型的拇趾外翻問題，通常會引發一連串的前腳掌問題如爪形趾、足弓下塌、拇囊炎、尾趾囊腫和腳趾重疊等問題，而最重的是，拇趾會因傾斜而失效並引發步態的改變和平衡的問題。這些足部結構改變是互相關連及全基於第一蹠骨鬆弛及向內移位所導致的。因拇趾外翻是骨骼鬆弛所引起；這現象會隨著日常足部活動而惡化，故拇趾外翻是一持續性惡化的問題。

拇趾外翻：足部功能問題

拇趾外翻很容易被一般人認為只是外觀問題，然而對患者來說，功能的影響尤為重要。平時步行向前的推動力約有80%來自拇趾，當拇趾向外傾斜時，患者拇趾便難以著力從而影響其功能。因此，拇趾功能失效會帶來患者的步姿改變，甚至有機會演化成腿部肌肉或關節的壓力和痛楚。

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。

拇趾外翻是如何形成的？

一般人對拇趾外翻最常見的誤解是認為它是骨增生所引起，故對正常趾骨作出修改都可能影響手術的效果。實際上拇趾外翻通常只有輕微的骨增生問題，亦甚小機會涉及骨骼變形。在一般典型的拇趾外翻個案中，拇囊腫塊是源於正常的第一蹠骨(連接拇趾骨後面的一條骨)傾斜而使其頂端向外突出而造成 (如圖1)。

 

這傾斜的正常蹠骨使皮膚經常與鞋子磨擦並引起發炎或拇囊腫脹的情況，亦被稱為拇囊炎(如圖2) ，腫脹的情形會使拇囊腫更為明顯及脹大。亦因疼痛的關係，經常被誤以為是痛風症或骨增生的問題。 

因此，重點是要了解絕大部份的拇趾外翻問題是正常的蹠骨鬆弛並移位，基本原因是由於支持第一蹠骨的軟組織失效所引起的，所以拇趾外翻是一種軟組織而非骨骼的問題。

 

 

 

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。

 



大自然奇妙的創造

我們每天都對自己的足部施加比身體其他部位更多的壓力，由每天步行或一般至劇烈運動，我們的雙腳均扮演著一個可以承受各式各樣力量衝擊的角色，正因如此，足部是我們身體最奇妙和複雜的結構之一。

對比只有四條骨骼的腿部，正常足部是由26片特殊形狀和比例的骨骼並以超過100條韌帶、肌肉和筋等組成，在這精密的結構中有任何異常的情況；如骨增生 (附生舟狀骨症)、軟骨連接(跗骨併合)、扁平足、高弓足等會阻礙患者發揮正常的功能，也難以應付日常生活所帶來的壓力。

所以每一個手術，如若對足部結構作出非必要的改動時，都難免會影響足部功能，此理念在治療拇趾外翻問題尤其重要。

手術如欲令患者有效地恢復足部功能，必須先對拇趾外翻的成因作出深入的了解。

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。