Posted by editor on Monday, December 6th, 2010
A Bunion is a deformity of the 1st metatarsal that is characterized by the big toe pointing towards the 2nd toe and is often associated with what appears to be a bump on the side of the big toe joint. Bunions are predominately genetic( familial) in origin and progressive by nature . Sometimes there is pain in the joint or over the metatarsal and frequently the bunion will cause other problems in the foot; such as pain in the ball of the foot or contractures and hammering (curling) of the small toes. Not all bunions require surgical management but many do. There are over a hundred different procedures to correct bunions.Most of the procedures require a cutting into the bone (osteotomy) to realign the big toe joint. The osteotomies are used in conjunction with soft tissue(tendon) balancing procedures and the location of the osteotomy distal (towards the tip of the toe) or proximal (towards the heel) are dependent on the degree and location of the bunion deformity. Each of the osteotomy procedures has potential complications including malunion( poor alignment),shortening,elevation of the 1st metatarsal and angulation of the joint cartilage.
The Mini-TightRope ( Osteotomy sparing) procedure for Bunions was developed because of the determination that many bunions are a result essentially of an acquired soft tissue angular deformity and malalignment( poor position). The TightRope has been very effective in correcting the angular deformity associated with Bunions while eliminating the problems associated with osteotomies(cutting of the bone). See animation of the procedure Mini-TightRope Bunion Procedure and Mini TightRope FT .Dr. Geldwert and Dr. Lai have been performing the Mini TightRope for 2 1/2 years with promising results. As with any procedure there are some inherent complications. The most frequent complications that we have experienced are stress fractures of the 2nd metatarsal,knot/fiberware failure or prominence of the button.Sometimes we will combine the mini TightRope procedure with other procedures depending on the type of bunion deformity. We have found that the complications associated with the mini TightRope are less profound than the potential complications of shortening,dorsiflexion,malunion,transfer metatarsalgia (pressure on an adjacent bone) and avascular necrosis that can be seen with Bunion Correction utilizing osteotomies. The typical Mini- TightRope Bunion recovery allows for immediate weight bearing in a stiff soled shoe. Our overall success rate for bunion surgery via osteotomy is over 95%; however we are looking toward the minitightrope procedure to lessen the profound complications that can occur with osteotomies. If you would like to know more about the Mini TightRope procedure or other bunion corrective procedures call The Center For Podiatric Care and Sports Medicine at 212-996-1900 or 914 328-3400.