具數據證實的拇趾外翻手術

過去廿年來，超過1000個不同程度的個案中，吳醫生皆以非截手術方式來矯正，在最近800個個案有完整手術前後X-光照片電子及足部功能掃瞄記錄 (F-scan®)。超過80% 個案可恢復拇趾正常功能，而外觀結果皆以照片形式存檔。功能恢復的臨床效果可從患者術後的正常如跑步、跳舞和穿高跟鞋等活動證明出來。另一方面，功能得到 回復的表現也可從患者術後足繭或痛楚消失中顯示出來。為了把患者的足部功能回復結果客觀地記錄下來，所有本地患者必須作手術前後的功能掃瞄測試 (F-Scan®) 達兩年之久。

正常腳
因為大拇趾承擔8 0%足部向前推動的動力，所 以拇趾在 F-Scan® 的測試中應顯示最大的壓力
(紅色)










拇趾外翻腳 
在拇趾外翻的情況下，拇趾功能受到影響，在 測試中會顯示出低壓力(藍色)，而受力的位置 卻向外轉移至前腳掌底部中間位置 (亦是這部 位常有足繭或痛楚的原因)

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。

拇趾外翻手術的疑問

1. 據說拇趾外翻手術康復過程很痛及復原期長，是否屬實？

是！但通常適用於截骨手術。因吳醫生的韌帶聯合術不須截骨，痛楚較輕及較早通常在手術1-2天後便消失，復原過程也較少不便。


2. 可否雙腳一起進行手術？

可以！這亦是大部份雙足患者的普遍選擇。


3. 手術是否需要移植人工物料？

不用，為一外來物料只是一些可溶性的縫線。

  
4. 有什麼可能的併發症？

可能會出現併發症，但與截骨手術相比，併發症出現機會較低和較輕微。最常見的併發症是於手術附近的拇趾表面的有輕微麻痺，傷口感染、過度矯正、第二及第三蹠骨分離和因患者術後初期過度步行而導致的復發和趾骨勞損等問題，但此類併發症出現的機率約為5%。


5. 醫療保險是否保障拇趾外翻手術？

保險是保障的。因拇趾外翻手術主要是針對治療足部痛楚和功能恢復，外觀亦會跟隨著功能性手術而得以改善。但仍建議先與保險公司查詢為準。


6. 如有需要，手術可否重複再做？

有別於一般截骨手術，韌帶聯合術不會破壞足部正常結構，如有需要，可以再次施行韌帶聯合術，患者亦不會有嚴重的影響。


7. 手術過程需時多久？
  約1小時。


8. 手術可否局部麻醉下進行？

可以！




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。

治療拇趾外翻 韌帶聯合術效佳

【本報訊】長期穿高跟鞋及尖頭鞋，易令拇趾受壓變形外翻，致不少患者舉步維艱。本港三分之一女性患不同程度的拇趾外翻，現時治療方法主要是截骨手術，但術 後患者未必能完全行動自如。香港理工大學聯同一間診療中心研究發現，以非截骨方法治療，重建支撐趾骨的軟組織，創傷性較低，患者術後兩年拇趾活動能力有改 善。

 長期穿著高跟鞋可令拇趾受壓變形

 

受力比例增15%

拇趾外翻是由於拇趾骨移位所致，患者以女性較多，與常穿高跟鞋、遺傳及女性賀爾蒙等因素有關。現時有截骨手術及非截骨的「韌帶聯合術」兩類治療方法。截骨手術需切開骨頭再重整趾骨，或切去部分骨頭。韌帶聯合術是矯正趾骨之間的韌帶，修正變形拇趾。

理大生物醫學工程跨領域學部教授梁錦倫聯同骨科專科醫生吳彥，分析廿七名拇趾外翻患者接受韌帶聯合術後的康復情況。患者術前及術後 兩年進行足底壓力測試，結果顯示患者拇趾承受力改善，即拇趾「受力」比例由原本佔足部總壓力的百分之廿，上升至百分之卅五。

溜冰教練翟小姐早年患嚴重拇趾 外翻，無法穿溜冰鞋，幾乎要放棄事業。她早前接受韌帶聯合術，六個月後康復進展理想，消除拇趾外翻引起的痛楚。

吳彥　骨科專科醫生

參考資料:  http://orientaldaily.on.cc/
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。

新法治趾外翻成功率90%

 

 

高跟鞋是女士的襯衫法寶，但長期穿尖 頭高跟鞋會使前足受壓，有機會令大腳趾外翻，由於大腳趾不能發力，患者步行時只能以腳跟力，像「企鵝」般左搖右擺，容易跌倒；長遠亦使腳掌、腰部及臀部關 節勞損，造成痛症。傳統折骨手術可改善外觀，但未必可恢復活動能力，新的韌帶聯合術則是將趾骨拉回原位，讓身體生出韌帶組織固定骨頭，成功率達九成，有患 者更可重新穿高跟鞋跳舞。

 

骨科專科醫生吳彥表示，大腳趾外翻的成因是由於連接大腳趾的第一蹠骨出現歪斜並偏離其他蹠骨，令拇指向外傾斜，腳掌內側會出 現凸出硬塊，形成「拇囊腫」。九成患者均為女性，多見於四十至五十歲，但由於該症與遺傳因素有關，故亦有八、九歲便大腳趾外翻的個案；女士常穿過窄高跟 鞋，令前足承受額外壓力，亦會加速發病。本港沒有大腳趾外翻的統計數字，美國研究則推算約百分之二人患有此症。

 

步履不穩似企鵝
嚴重的大腳趾外翻，可傾斜至六、七十度，甚至近八十度，患者除感足部疼痛外，步行時大腳趾不能發力將身體向前推，要將力量集中於腳跟及腳掌 外側，並以「八字腳」保持平衡，「患者唔行得快，好似企鵝咁左搖右擺，坐低想起身時要用晒腳力，否則會向前跌。」患者的腳掌、腰、臀關節亦會磨損，引發肌 肉及關節痛。

有患大腳趾外翻二、三十年的八旬長者，大腳趾傾斜約七十度，步履不穩，經常仆倒，接受新的韌帶聯合治療後始能正常步行。

 

傳統術僅改外觀
吳彥解釋，傳統手術將歪斜的第一蹠骨折斷，移正大腳趾後再以螺絲釘固定，雖能改善外觀，但未必可回復足部功能，反而有機會破壞腳掌組織及骨骼結構，步行能力不進反退，亦有復發機會。

新的韌帶聯合術屬低創傷治療，將歪斜的第一蹠骨拉直，並於第一及第二蹠骨之間造出缺口，再讓身體自行生出類似韌帶的組織，令蹠骨不再移位， 「好似比薩斜塔咁，傳統療法係打斷塔身再駁番正，新療法就好似搵鋼纜將成座塔拉番直。」至今有四百多名患者接受新療法，成功率達九成，患者可如常步行、運 動，「有女士甚至可高跟鞋跳舞，十年無翻發。」

吳彥　骨科專科醫生

參考資料: 東方日報 

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。

鄧麗欣拇趾外翻痛到喊 穿高踭鞋劇痛是警號

穿高踭鞋就是會腳痛?不少女士美麗背後默默忍受着痛楚，但其實可能是腳趾外翻的警號。歌手兼演員鄧麗欣（Stephy）原來早於10多歲已患腳外翻，但入行後仍要忍痛穿高踭鞋跳舞表演，結果曾經痛到喊，直至5年前接受「非截骨」拇趾外翻手術，才告別那不能承受的痛。醫生提醒，穿高踭鞋可加劇拇趾外翻的情況，亦可令問題提早出現。

Stephy今日(7日)出席拇趾外翻手術分享會時表示，自10幾歲開始發現拇趾出現外翻情況，直言對生活造成極大困擾：

即使穿平底鞋及球鞋也非常疼痛，但我喜歡做運動，所以仍會忍痛運動，久而久之亦導致腰部疼痛。

她早前接受訪問時說，入行後經常要穿著高跟鞋出騷或者跳舞，曾經試過排舞時痛到喊，亦曾經嘗試物理治療和紮腳趾希望外翻部分「生番入D」，但都沒成效。

她今日分享時說，5年前感到痛楚難耐，在網上搜集有關治療拇趾外翻的資料後，決定嘗試「非截骨拇趾外翻手術」矯正外翻部分，至今也沒有任何後遺症和復發，可自如地穿著高跟鞋在舞台上跳舞，及拍攝武打戲份時也沒有任何疼痛感覺，現時也會將有關經驗介紹給其他朋友。

為Stephy操刀做手術的骨科醫生吳彥表示，拇趾外翻即是大拇趾向外傾斜。他說，女士荷爾蒙容易令韌帶鬆弛，導致出現拇趾外翻問題，有醫學文獻曾指患者9成屬女性，10年前與浸會大學進行的統計亦顯示，超過8成患者有家族歷史。他提醒：女士穿著高跟鞋，令拇趾受壓，有機會加劇外翻情況或令外翻問題提早出現。

現時香港治療拇趾外翻手術一般會使用截骨方式，即是將偏移的第一蹠骨前半斷截斷，並移回正確位置，及鑲上鏍絲，但吳彥指有關方式的復發問題普遍，因此他在35年前提倡非截骨方式的「韌帶聯合術」，先把鬆弛及傾斜的第一蹠骨捆綁在旁邊的第二蹠骨上；再在兩條蹠骨之間，引發身體生出天然如韌帶般的軟組織，來把蹠骨固定及避免復發，至今經他執刀的個案有1800宗。

「韌帶聯合術」會否同樣有復發可能呢？吳彥在過去5年研究55宗個案的復發機會，發現當中所有個案在術後6個月開始恢復正常生活，包括跑跳及穿著高跟鞋，至今也沒有復發的跡象和傾向，有關研究結果的詳細內容稍後將發佈於美國的醫學雜誌。

70多歲的Sally自幼熱愛跳舞，之後在美國一所中學任教，現為副校長。受家族遺傳影響，她早於30年前已發現拇趾外翻，但身材矮小，面對體形較龐大的中學生，無奈忍痛地堅持每天穿著3吋高跟鞋上班，以致外翻問題漸趨惡化：

拇趾與其他腳趾交叉重疊，起初只是腳痛，期後出現膝頭及腰部痛楚，又因為腳趾走路時疼痛難以用力平衡身體，以致行幾步就跌倒。

Sally2004年回港探親期間，腳趾再度疼痛，但任職醫生的女兒向她解釋，腳趾外翻與韌帶有關，並不是骨頭出現問題，因此不建議進行截骨手術。

她在巧合下認識吳彥醫生，並決定嘗試進行「韌帶聯合術」，術後所有痛症消除，至今10多年後也沒有復發，可如常跑步跳舞及穿著高跟鞋，生活質素得以提升。

 

參考資料:  https://topick.hket.com/article/1964796/%E9%84%A7%E9%BA%97%E6%AC%A3%E6%8B%87%E8%B6%BE%E5%A4%96%E7%BF%BB%E7%97%9B%E5%88%B0%E5%96%8A%E3%80%80%E7%A9%BF%E9%AB%98%E8%B8%AD%E9%9E%8B%E5%8A%87%E7%97%9B%E6%98%AF%E8%AD%A6%E8%99%9F?mtc=10027
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。

誰人較易患上拇趾外翻？

誰人較易患上拇趾外翻？

有別於普遍的觀點，高跟鞋並非構成拇趾外翻的主因。反而女性荷爾蒙和遺傳因素的影響比高跟鞋更為明顯和重要。於2008年，香港浸會大學協助本中心為超過1,000名華人女士的調查指出，約有三份之一的女士有著不同程度的拇趾外翻，當中超過80%的拇趾外翻患者具家族遺傳因素，而八成以上都沒有穿高跟鞋的習慣。對比於未有家族史，純粹因經常穿著高跟鞋的患者比例上只低於5%。


總而言之，拇趾外翻基本上是夾雜著女性荷爾蒙及遺傳的因素。

拇趾外翻帶來甚麼困擾?

視乎嚴重程度，拇趾外翻會引起兩種不同的問題。第一種最普遍的問題，便是因拇囊腫或小趾囊腫在穿較窄鞋子而帶來的痛楚，這問題是源於第一蹠骨日漸鬆弛，腳掌變得漸闊而引起的。第二種困擾是由於拇趾是足部向前的主要動力來源，當拇趾功能受損時，患者步姿難免受到影響，從而引發其他如爪形趾、足繭、蹠骨疼痛、小腿或腰背肌肉緊張等問題。

吳醫生建言

對一些喜愛追求時尚及穿高跟鞋，又擔心引起拇趾外翻的女士而言，最佳辦法莫過於求證於家族歷史。如若沒有家族史的話，因穿高跟鞋而患上拇趾外翻的風險較為輕微。相反，如有拇趾外翻基因遺傳的話，高跟鞋或尖頭鞋會令症狀提早出現或加速惡化。

參考資料: http://www.bunioncenter.com/bunion/chi/bunion-basic.html#who-deformity

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。

足部 - 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；都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。

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。

Bunionette and Bunion Deformity

Background:

It may be wrong but easy to blame the obvious. Bunionette is a perfect case in point. Most bunionettes are not at fault for its own pain but the bunion.



What is the bunionette (baby/tailor’s bunion)?

Bunionette is the bony prominence at the base of small toe from the opposite side of the bunion of big toe. The prominence is actually part of the normal anatomy of 5th metatarsal head. While bunion deformity is almost always abnormal, bunionette is mostly normal to the contrary of popular belief.



How would bunion contribute to bunionette pain?

Firstly, bunionette can only be painful in close-toe shoes that are either too narrow for a normal width forefoot or when the forefoot is too wide for regular shoes. Bunion increases the width of forefoot and thus tightness of regular shoes. Thus both bunion and bunionette would rub more against their side of close-toe shoes fighting for room. Therefore, bunionette is another victim of the bunion condition.

Another reason is the outer-side of a bunion foot has to bear abnormally more weight in walking due to function loss on the big toe side of a bunion foot.



Why would poor big toe function contribute to bunionette pain?

The big toe side of foot normally provides most (up to 80%) power for all foot activities. Bunion deformity impairs its function and inadvertently depends more on outer side of foot for walking. This would thus increase the pressure on bunionette against shoes and thus pain.



Should then bunion surgery also resolve bunionette pain?

Yes, an effective bunion surgery will not only narrow the forefoot significantly but also restore function of the big toe side of foot and thus spare bunionette of abnormal crowding and pressure and thus pain



Why do some bunionette pain persist after bunion surgery?

Some bunion surgeries may be able to straighten out the big toe to look better but not really narrow the forefoot to solve the crowding problem in regular shoes.

Even if a bunion surgery can narrow the forefoot but fails to restore big toe function may not help relieve pressure on the bunionette enough in walking for complete pain relieving.



Has syndesmosis procedure been able to help resolve bunionette pain and why?

The non-bone-breaking bunion surgery by syndesmosis procedure has been demonstrated by the Biomedical Engineering Department of Hong Kong Polytechnic University to be able to not only narrow the forefoot effectively but also restore the big toe function. After more than 1,600 syndesmosis procedures there has not been any need for surgery to relief bunionette pain yet in our experience.










Reference information: http://www.bunioncenter.com/bunion/bunionette.html
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.

Body Balance and Bunion Deformity

Background:

During walking body needs to balance itself from one foot during its stance phase to the other foot alternately. The ability to balance properly on one foot relies much on the normal function of big toe.


Why is big toe important for balance?

Big toe is not only the biggest but also more importantly strongest of all toes. We rely on our toes to lean forward and push against the ground for walking and prevent us from falling. Big toe may contribute up to 80% of all power required to do so. If big toe side of foot is weak due to the bunion condition, it may not be strong and reacting quick enough to prevent occasional sudden imbalance and fall. We need healthy big toes to maintain body balance especially for walking fast, on uneven ground and down the stairs or slopes.


How does bunion compromise body balance?

Bunion deformity destructs the power and stability of big toe. Thus bunion sufferers will find walking gradually becomes more difficult and tiring besides pain. Balance during the stance phase of walking will thus become poor and unsteady as bunion deformity worsens. Unexpected sudden falls can become a problem.


How do sufferers compensate for their compromised big toe function and ability to balance?

They will develop gradually more for a compensatory gait by shifting the body center of gravity backwards, away from the unreliable big toe, and walk slower. This altered gait is inefficient and tiring.


Can bunion surgery improve balance?

Absolutely, bunion surgery should be able to improve balance by restoring stability and function of big toes. The improved balance can especially be appreciated by young patients practicing yoga and also reduced falling tendency among elderlies. Syndesmosis procedure can improve balance because its ability to restore proper function of the big toe.







Reference information: http://www.bunioncenter.com/bunion/impaired-balance.html
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.

Metatarsalgia and Bunion Deformity

Background:

Bunion deformity can give rise to not only disabling bunion pain but also elsewhere in the foot, leg and even low back. It is therefore important to understand how and why they can be affected by the bunion problem or more accurately the impaired foot function in order to find a proper solution for them.



What is metatarsalgia?

Metatarsalgia is the pain under mid-metatarsal region of the forefoot just behind the second and third toe joints. It feels like walking on a pebble in the shoes. It is usually associated with thickening calluses in the same area.



Why is there callus and pain under the mid-metatarsal heads area of bunion feet?

The reason is twofold. Firstly and structurally, transverse metatarsal arch of the forefoot collapses due to destabilization/hypermobility of first metatarsal bone of bunion feet and thus increased contact pressure of the mid-metatarsal heads of a flat/collapsed metatarsal arch against the ground in walking. The other reason is the abnormal lateral shift of pressure/force to the mid metatarsal region for walking after gradual loss of the critical big toe function.



Can the non-bone-breaking syndesmosis procedure resolve the metatarsalgia problem for a bunion foot and why?

Syndesmosis procedure has been proven capable of re-aligning and re-stabilizing the first metatarsal consistently to restore the transverse metatarsal arch and also function of the great toe to spare mid metatarsal heads from undue pressure/force in walking.



Are there any clinical evidence that the pressure and force is reduced under the mid metatarsal heads after syndesmosis procedure?

Yes, firstly, any preoperative metatarsalgia has been consistently diminished or disappeared after syndesmosis procedure. secondly, metatarsal calluses have also markedly reduced or disappeared. Thirdly, no additional surgery such as Weil osteotomy (break-n-shift of the 2nd and 3rd metatarsals has been needed. Fourthly, plantar pressure study by F-Scan® has also demonstrated significant and consistent migration of forefoot metatarsal pressure in walking from the painful mid-metatarsal region of bunion feet to under the first metatarsal head where it should normally be.








Reference information:  http://www.bunioncenter.com/bunion/metatarsalgia.html
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.

Low Back Pain and Bunion Deformity

Background:

Low back pain is common in human due to our unique upright posture that exerts more strain and stress in the low back area. As low back spine degenerates with time it will become more sensitive and vulnerable. As bunion feet do not actually damage low back but can irritate it by their compensatory gait.



How can one’s low back pain be connected to bunion foot?

Bunion feet with loss of their all-important great toe function have to compensate by walking more on the outer side of feet. This altered weight-bearing technique would result in a subtle waddling gait from outer side of one foot to the outer side of the other instead of the big toe side of feet which is closer to body’s midline. This swaying of body from side to side can strain the low back and cause pain if walk for long.



How do I know if my low back pain is possibly related to my bunion feet?

Low back pain is a very common condition and more likely caused by aging than bunion feet. A simple way to probably differentiate the two is that bunion related low back pain is usually precipitated by prolonged walking instead of prolonged sitting for the degenerative type of low back pain.



Can bunion surgery alleviate my low back pain?

It is very likely that if any bunion surgery can effectively restore great toe function will also be able to improve the gait and thus reduce irritation and pain in the low back from walking.










Reference information: http://www.bunioncenter.com/bunion/low-back-pain-bunion.html
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.

Leg and Knee Pain

Background:

Without any underlying problems, leg muscles and joints can become painful due simply to overuse/strain at any time and age.



Can leg and knee pain be caused by bunion deformity?

Yes, the altered gait adopted by more severe bunion sufferers from losing their big toe function is less efficient and thus over-working leg muscles causing muscle or joint pain.

Bunion deformity can precipitate and also accentuate any pre-existing flat foot and pronation conditions, which in turn can produce valgus thrust and strain of the knee joint and muscles.



How would I know if bunion surgery may help my leg and knee pain or not?

It will depend on the chosen surgery, whether it can re-stabilize first metatarsal and restore big toe function or not.









Reference information: http://www.bunioncenter.com/bunion/leg-knee-pain.html
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.

Clawed toes and Bunion Deformity

Background:

Clawing deformity can happen usually to the second and third toes of a bunion foot. They can be painful due to rubbing against the top of shoes. Their base (metatarsophalangeal ) joints may also dislocate causing joint pain and metatarsalgia.



What are clawed toes?

As the name suggests that the mid joint of a toe is buckled upwards like a claw in shape. They can become severe and precipitate dislocation of the toe eventually if the bunion problem is not resolved and big toe function is not restored.



Why may the clawing deformity be developed in bunion feet?

Clawing deformity happens due to over-working of the lesser toes when big toe gradually loses its function by the bunion condition and they are also further aggravated by collapsing of the transverse metatarsal arch of bunion feet.



How can clawed toes of bunion feet be corrected?

Since they are caused by poor great toe function and collapsed metatarsal/transverse arch, any bunion surgery that can properly restore function of the great toe and the metatarsal arch will then remove the deforming forces on clawed toes to allow them to return to their normal status in most cases without additional surgery (Fig. 1 & 2).



What is the effect of Dr. Wu’s syndesmosis bunion surgery on clawed toes?

If its clawing deformity is not rigid, then the clawed toe can usually be straightened out on its own without additional surgery after syndesmosis procedure to restore big toe function and transverse metatarsal arch. But if clawing and dislocation have been for a long time and might have become rigid then additional surgery may still be necessary.

Reference information:  http://www.bunioncenter.com/bunion/clawed-toes-bunion-deformity.html
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.

Flat foot and Bunion Deformity

Background:

Foot is made up of 26 uniquely shaped bones that are held together by >100 ligaments and tendons to maintain two (medial longitudinal and transverse metatarsal) reversed suspension-bridge-like springy arches to absorb the tremendous shocks in performing the demanding daily and sports activities. If certain ligaments and tendons are incompetent for whatever reason, then the affected part of foot can collapse and cause function-related problem of foot, such as for flat-foot and bunion conditions.


Flat foot (pronation):

This is probably the most well-known and commonly seen condition of foot caused by incompetent ligaments and tendons that are no longer able to hold up bones to maintain the arch on the inner side of the foot.


Bunion (Hallux valgus) deformity:

This is another well-known foot condition caused by incompetent ligaments. Bunion is formed by the destabilized and displaced first metatarsal bone. Losing its ligament support first metatarsal can be displaced sideway by the stress of weight-bearing activities to form the bunion deformity.


Flat foot and Bunion deformities:

First metatarsal bone forms the distal segment of inner/medial arch of the foot. When it loses its ligament support, it gives way not only in sideway to form bunion deformity but also in upward direction to allows the medial longitudinal arch to collapse and precipitate/accentuate the flat foot condition.


Syndesmosis procedure and flat foot:

Syndesmosis procedure can restore to some extend and particularly stabilize the, static and dynamic, longitudinal and transverse arches of foot by being able to re-align and truly re-stabilize particularly the main culprit, destabilized and displaced first metatarsal bone. Syndesmosis procedure restores the arches statically by restoring the plantar-ward orientation of first metatarsal through the metatarsocuneiform joint configuration when its metatarsus primus varus deformity can be corrected in its entirety without osteotomies. These arches can also be further accentuated dynamically by restoring the windlass mechanism of first ray. These improved arches can be statically assessed by x-ray and photo images (Fig. 1a,b) and also dynamically by plantar pressure scanning of the foot in walking (Fig. 2a,b). Clinically, patients would feel the medial arch and inner side of foot much firmer and stronger for standing and walking. Objectively, the transverse arch is restored by evidence of disappearance or much reduction of preoperative metatarsal calluses.


Osteotomy procedures and flat foot:

While syndesmosis procedure has been shown capable of re-stabilizing first metatarsal to reduce flatness of the medial arch of foot, statically through the metatarsocuneiform joint and also dynamically through the restored windlass effect in walking. However, bone-breaking bunion surgeries would decouple this natural anatomical relationship and surgeons have to instead manipulate the disconnected distal bone fragment to rebuild the arch in a rather tricky if not almost impossible way. Should break-n-shift of the normal first metatarsal bone fail to heal in its pre-calculated position then neither medial and transverse arches nor foot function can be restored, and even postoperative transfer metatarsalgia complication may

Reference information: http://www.bunioncenter.com/bunion/flat-foot.html
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.

拇趾外翻治療概念

非手術治療方式

暫非手術治療方式主要是舒緩拇趾外翻所引起的痛楚，較實際及有效的方式是穿著較為舒適的鞋子,以較平、寛鬆、柔軟鞋面、鞋底較厚或露趾鞋的鞋子來減輕拇趾外翻的痛楚。消炎止痛藥亦可暫時解除痛楚，而物理治療及其運動可作出某程度上的幫助，但不能矯正外翻的問題。把拇趾拉直的輔助工具或有助於輕微的症狀，但沒有證據證實能幫助外翻的問題。處方鞋墊可用來緩和惡化的情況及處理足繭的問題。

手術治療

一直以來，已發展超過150種不同的拇趾外翻手術方式，全球現今流行的方法亦有10種多種。眾多不同的方式可能是由於直到目前為止，仍未有一種最理想的手術方式被醫生一致公認。

拇趾外翻治療的目標

拇趾外翻的最終目標應該是幫助拇趾恢復正常功能、解除患者痛楚及處理因拇趾外翻而引發的連串問題。






參考資料: http://www.bunioncenter.com/bunion/chi/treatment-concept.html
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。

A pertinent analogy: Leaning Tower of Pisa

Bunion deformity is fundamentally formed by the loosened first metatarsal bone that has lost its ligamentous support and thus tilts abnormally to one side.

This scenario is not unlike the Leaning Tower of Pisa which has also lost its external support of a weak foundation. Both first metatarsal bone and the Tower are basically unchanged and normal in shape by themselves.

To upright the Tower by the "break-n-shift" concept as in traditional bone-breaking bunion (hallux vaglus) surgery would not only induce unnecessary damages to the normal and innocent Tower itself, but also fail to address its underlying issue of a weak foundation.

Similarly, the normal and innocent first metatarsal would also be damaged of its function and not stabilized against future recurrence of tilting.

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.

拇趾外翻手術的疑問

 

1. 據說拇趾外翻手術康復過程很痛及復原期長，是否屬實？

是！但通常適用於截骨手術。因吳醫生的韌帶聯合術不須截骨，痛楚較輕及較早通常在手術1-2天後便消失，復原過程也較少不便。



2. 可否雙腳一起進行手術？


可以！這亦是大部份雙足患者的普遍選擇。



3. 手術是否需要移植人工物料？


不用，為一外來物料只是一些可溶性的縫線。



4. 有什麼可能的併發症？


可能會出現併發症，但與截骨手術相比，併發症出現機會較低和較輕微。最常見的併發症是於手術附近的拇趾表面的有輕微麻痺，傷口感染、過度矯正、第二及第三蹠骨分離和因患者術後初期過度步行而導致的復發和趾骨勞損等問題，但此類併發症出現的機率約為5%。



5. 醫療保險是否保障拇趾外翻手術？


保險是保障的。因拇趾外翻手術主要是針對治療足部痛楚和功能恢復，外觀亦會跟隨著功能性手術而得以改善。但仍建議先與保險公司查詢為準。



6. 如有需要，手術可否重複再做？


有別於一般截骨手術，韌帶聯合術不會破壞足部正常結構，如有需要，可以再次施行韌帶聯合術，患者亦不會有嚴重的影響。



7. 手術過程需時多久？


約1小時。



8. 手術可否局部麻醉下進行？


可以！






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。

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

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.

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.

拇趾外翻可藉韌帶聯合術痊癒

不少女性患有拇趾外翻毛病，藝人鄧麗欣亦曾經是患者。她表示，10多歲時已患有腳趾外翻，入行後更經常穿高跟鞋，劇痛難耐，直至五年前接受了非截骨拇趾外翻手術，至今並無翻發。


藝人鄧麗欣表示，她曾受拇趾外翻困擾，在接受非截骨韌帶聯合術後，至今無復發，可如常投入幕前工作。


不需要截骨 可預防復發

骨科醫生吳彥為鄧麗欣操刀，他表示，拇趾外翻術後復發是其中一個比較普遍的問題，傳統上，大多數醫生都會採用多種不同的方式先將第一蹠骨截斷，然後再將它的前段移位，從而改直。不過他說，已有55年歷史的韌帶聯合術，可以利用一般的手術逢線將偏移的第一蹠骨與旁邊堅固的第二蹠骨綁在一起，這便可將第一蹠骨拉直，並非一定需要截斷任何骨頭。
他稱，將第一蹠骨拉直後，韌帶聯合術也會引發兩條蹠骨之間自然生長些韌帶纎維之類的軟組織將它們聯合在一起，從而穩定第一蹠骨，亦可預防術後復發。






 




參考資料:成報
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。

曾受拇趾外翻困擾 鄧麗欣怕痛唔敢做手術

熱愛運動的演員鄧麗欣（Stephy）出席醫學研究學術講座時表示大約在十多歲時已受拇趾外翻困擾：「嗰陣已經覺得痛喺習慣，有時着完高踭鞋都要舒緩返一段時間。」又稱腳患令她經常用錯力，導致身體其他地方都會感到痛楚，例如腰骨，所以不斷尋找可治療的方法：「之前都有聽過截骨手術，但自己好驚痛又覺得好恐怖，所以唔敢做，最後就搵到呢個非截骨手術，其實都考慮咗好耐，因為手術之後都要抖幾個月，要排開晒啲工作。」


問到拇指外翻可有嚇怕男友？她笑言：「咁又冇，又唔係畸型！」更指腳患期間有好多鞋都不能穿，即使是平底鞋、波鞋等，好多鞋都着到「穿隆」。術後超過五年的Stephy如今不再受腳患困擾，無論拍打戲抑或做運動都「活動自如」，準時複診便可，她指希望可以推薦這項手術給身邊受困的朋友。






 



參考資料:東網
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。