2015年4月14日 星期二

Non-surgical (conservative) treatment





No conservative treatment can correct existing bunion deformity.


The practical goal of non-surgical treatment is to minimize bunion pain by wearing wider and softer shoes and to minimize deformity deterioration by wearing bunion-specific protective foot orthotics.

Anti-inflammatory medications can help alleviate bursitis and joint pain temporarily.

Physiotherapy can also provide symptomatic relief, however foot exercises need to be carried out correctly, diligently and possibly permanently to be useful.







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.

2015年4月9日 星期四

何為拇趾外翻?- 拇趾外翻綜合症

拇囊腫是指拇趾旁邊的突起物,是一種普遍的前足部骨骼和軟組織移位而引起的變形現象,醫學上稱為"拇趾外翻綜合症" (如圖2-4)。


拇趾外翻是指大拇趾向外傾斜,之所以被看作綜合症是由於它往往引發一連串足部問題,如前腳掌變寛、爪形趾、足弓下塌、足繭甚至尾趾囊腫等。





圖1. 輕微拇趾外翻 圖2. 中度拇趾外翻 
圖3. 拇趾外翻綜合症 圖4. 足繭







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。

2015年4月4日 星期六

Australian Bunion Patient

This page is going to be dedicated to Bunions. It is incredible the amount of people who suffer from them and who are interested in the journey I am in the process of taking. So as the anesthetic wears off... and, I find a few more brain cells that have gone AWOL, I will post as much info as possible here.
Dr Wu's Surgery in Hong Kong
Dr Wu's Surgery in Hong Kong, you can see the seating is sympathetic to those who need to have their feet elevated. Its a great set up, Rachel, Dr Wu's assistant takes on the spot Xrays. They also have a resident physiotherapist. I was also issued with my special shoes, crutches and instructions on how to use all of these things, pre surgery.
The surgery I chose is non bone cutting/breaking. In Australia, the practice is to cut or break the bones in some way. My Grandmother and my girlfriend did have this surgery and it was not successful for them. So when I heard about Dr Wu and his Syndesmosis Procedure, I jumped at it. I will not attempt to explain it, so I suggest you follow that link to his website which explains not only the procedure but also the condition which we refer to as bunions.
My Feet, Pre Bunion Surgery 2012
#1st month after surgery 2012 
#2nd month after surgery, 2012
My initial enquiries to The Bunion Centre and their response...

"Thank you for your enquiry about our non-bone breaking bunion surgery.   The surgery would take about an hour per foot.  Ambulation from early on after surgery is not a problem.  But unfortunately too much walking is not good for the healing of the surgery and its ultimate result.  There are only two simple requests from Dr. Wu to almost ensure you an excellent result. They  are: 1) Although you will be capable and allowed to walk but the little you walk the better result will be.   If you do have to sometimes walk long distance or time then use crutches. 2)  Stretching exercise of your big toes from day one after surgery and it is very possible and only mild discomfort.

By the way, the recovery process is as follows:

1-3 weeks - wear special shoes, indoor walking , need elevation
1 month after surgery – gentle swimming & stationary cycling could be done
up to 3 months - wear special shoes, limited normal outdoor walking
3-6 months - wear normal shoes with in-soles, limited normal outdoor walking
6 months onwards - all normal activities and resume sports gradually

Third class  room is around US$16,500 for both feet.  For Single room is around US31,000 for both feet, as all the charges is vary according to room charges.

You will stay at Hong Kong Adventist Hospital, their website is www.hkah.org.hk

About a month in advance for booking surgery."
#3rd month after surgery, 2012
#4th month after surgery, 2012
The day after surgery @ The Hong Kong Adventist Hospital 2012
Day after surgery, 2012, The Hong Kong Adventist Hospital have a wonderful approach to their meals, you can basically order what you want, during the day, and it will be cooked and delivered to you. They follow a healthy regime, my choice was to go for as much 'RAW' as possible and high fibre, as I realised that my digest tract needed to work out, even if I couldn't.
The casts, put on by Dr Wu 5 days after surgery at The Bunion Centre. I wore for 3 months. They are slip on and off.
The #1st week after surgery @ Lanson Place Hotel. You can almost see the surgical shoes that I call Moon Boots. The hotel looked after me, propping up my feet on cushions and serving the wine.
Back in Perth/Fremantle, I could not have done with out my hired mobility scooter. The dogs decided it was a fun way to get about as well.
#6th month after surgery, 2013

Contact List:

The Centre for Dr. Wu's Bunion Surgery http://www.bunioncenter.com/

Hong Kong Adventist Hospital http://www.hkah.org.hk/new/eng/index.php

Relevant Posts, to read more just click on the link:
#1 The Journey, Bunion Surgery, Hong Kong
#2 The Journey, Bunions, My Story
Bunions End Of #4th Month
Bunions, 6 Months On, The Xrays
Bunions, Milestones, February 2013 (8.5 months on)
Bunions, 9 Months On
I stayed at The Lanson Place Hotel, short stay accommodation, Just a short walk to Dr Wu's surgery http://hongkong.lansonplace.com/
I loved the Lanson, they were fabulous, bent over backwards for me. But.... unfortunately they do not have room service meals. You can order meals from other restaurants, but I didnt do that. They do have a casual dim sum with drinks in the afternoon. So I would suggest a hotel that where you had a good in room meals service. And please search for accommodation that is clean! I am paranoid about germs!!

My Chiropractor in Perth, Western Australia, Kevin Carlson @ Gentle Chiropractic http://www.gentlechiro.com.au/

My Doctor in Margaret River, Dr Graham Velterop @ The Margaret River Surgery 

My Doctor in Perth, Dr Hendrik Rensburg @ The Hobart Street Medical Clinic

Paul Carroll Shoes, specialising in orthotic shoes @ http://www.paulcarroll.com.au/, I bought Merrell's, Kroten & Betula 

Please feel free to contact me via the contact page on this website.


This looks weird I know, it is a series of anatomical models of feet, used for the study of Medicine. This sits on top of my kitchen cabinet!
The plaster casts of my feet go back 20 years I reckon. My feet have been giving me grief for a loooong time. I think the suggestion at the time was to resolve the pain by giving me an orthotic arch support to go in my shoes.
2 years and 1 month later (looking fabulous :)


Reference link : 
http://www.margaretrivercorrespondent.com/p/bunions.html

2015年4月1日 星期三

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。

2015年3月17日 星期二

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。

2015年3月11日 星期三

Foot: Natures Most Complex Creation



Every day we subject our feet to more physical stresses than any other parts of our body. From daily walking to recreational sports, let alone other extreme activities, our feet are expected to last a lifetime of repeated pounding against the ground and maneuvering all types of terrain. It has to be one of the most complex structures and engineering wonders. A normal foot is made up of 26 specifically shaped bones, versus only four in the leg from hip to ankle. These many bones are connected and moved by more than 100 ligaments, muscles and tendons. Any slight deviation from normal, such as an extra bone (accessory navicula), fused bones (tarsal coalition) or a flat or high arched foot, may render foot function limitations and problems.

Similarly, any surgical alteration of foot structures unnecessarily from the normal form can only risk normal function of the foot. This basic surgical principle is especially true in the correction of bunion deformity.

Therefore, it is essential to understand the true underlying pathology of bunion deformity before an optimal surgical correction, cosmetically and functionally, can be realized.






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.

2015年3月3日 星期二

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.