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Mini-Tightrope Bunionectomy

A New Procedure for the Correction of the Painful Bunion Deformity

A bunion deformity is manifested by an enlarged bony prominence at the base of the big toe. It is a progressive deformity resulting from an inherited condition of the foot and lower leg and can lead to poor alignment of the great toe joint. Shoe irritation, redness and pain in and around the joint will follow. As the big toe joint prominence enlarges, joint alignment also worsens exacerbating the aching pain. Arthritis may develop as a result of poor joint alignment.
Conservative treatment, to slow the progression of the deformity is available but requires early intervention. Special custom insoles called foot orthoses provide structural support for the foot and will slow the progressive nature of the bunion deformity. Shoe modification in style and shape may also be necessary to conservatively provide space and reduce pressure on the "bump". Although shoegear can exacerbate the deviation of the big toe toward the second toe, tight shoes are not the primary cause of a bunion and associated drifting of the big toe. The underlying deforming forces that create the bunion deformity relate to structural instability of the bony architecture of the foot. Stabilizing the foot with specialist - prescribed orthoses and addressing any muscle imbalance that exists can help to slow the progression of the deformity. Some bunion deformities may have progressed beyond the benefit of conservative management and surgery may be necessary.

Surgical correction of a bunion traditionally involves cutting through the first metatarsal bone (termed osteotomy) and using bone screws to maintain the bone in a corrected position, removing the bunion prominence and straightening the big toe. Protection of the foot in a surgical shoe for a few weeks, while bone heals, is necessary before the patient can safely return to normal shoegear. Crutches and non-weight bearing is sometimes necessary depending upon the severity of the deformity.
There is now a new surgical procedure for the correction of the painful bunion deformity using a device called the "Mini-Tightrope". The Mini-Tightrope bunionectomy eliminates the need to correct the bone deformity by way of osteotomy and screws. The Mini Tightrope employs a strong non-absorbable fiberwire that is suspended between the first and second metatarsal bones, to correct joint misalignment, through a small drill hole in the bone. Advantages to the Mini-Tightrope procedure includes immediate weight bearing, where some corrective procedures may require crutches and non weight bearing. The Mini-Tightrope procedure also helps to prevent recurrence of the deformity that can sometimes be seen with traditional bunionectomy procedures and there is no osteotomy that would demand pins or screws with traditional bone healing concerns. Return to normal activity is more rapid and there is, generally, less post-operative pain. Call for more information.

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