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Bunion and Hammertoe Surgery

Sheldon Nadal DPM discusses the symptoms, causes and treatments for bunions and hammertoes. http://www.footcare.net 501-586 Eglinton Avenue East Toronto, ON M4P 1P2 (416) 486-9917 "-Dr. Sheldon Nadal is back with us today. He's from the Bayview-Eglinton podiatry centre. And we're gonna be talking about those wonderful things, bunions and hammertoes. Now bunions are the things that stick out on the side of your foot, right? Oh, and this is Melissa, she's here to help us out. Hi, Melissa. -That's right, Judy, a bunion is a deformity at the big toe joint. This long bone here sticks out and the toe bone goes the opposite way and due to pressure the bump gets bigger. -Now, I mean, I've seen some people with really, really big bumps so that they can't get into shoes. I always thought, or I heard, at one time, that it was tight shoes that made bunions. But that's not true, is it? -Well, tight shoes aggravate bunions, but it's more of a hereditary problem. There usually is a family tendency towards bunions. -Okay, so what do you do once you have a bunion? Do you grin and bear it and get big, fat, wide shoes instead of wearing nice, fancy ones, which doesn't sound like much fun? -Well, you could get big, wide shoes but a lot of people don't want to, they want to get them fixed. So we use a special technique called minimal incision surgery. We work through very small openings in the skin, and because they're so small, there's very little soreness. -So what do you take off when you do the surgery? -Well, what we do is we cut right through this bone here because this bone tends to be crooked. -Uh huh? -So we cut through it right at the neck to make it straighter. And this bump, this joint right over here, tends to be large. So we file it down. Then, we make the toe bone straighter so that it doesn't point the wrong way. -Now we'll see if this really works, it sounds great in practice, I mean, in theory, let's see if it works in practice. Melissa, you had a bunion operation, right? -Yeah. -So let's see the difference between the foot with the bunion and the foot without. -Here's where Melissa had the work done. You can see she's still got a bump on the other side, but this bone is nice and flat and the toe is straight and Melissa is about to have her other foot done. We can see where she still has the bunion over here, and the toe bone is still crooked. -What a difference! Now, I guess it makes a big difference when you're wearing shoes. -Big difference, yeah. -Oh, that's great! Now what's a hammertoe? -A hammertoe is a crooked toe, Judy, and because it's crooked it rubs in the shoe. We've got another example of a hammertoe right here. You can see it's shaped like a hammer and we can use the same technique to make the toe straighter. -Now what causes that? It looks like it's just, you've got a tight ligament or something, or tendon. -Correct. It can be due to tight tendons. -Uh huh. -And if it's a young deformity, you can release the tendon to make the toe straight, but if it's been in that position for a long time, again, you have to remove a little piece of bone so that we can make the toe straighter. Again, it can be done through a small opening, so the patient can walk right away with very little soreness. -So you don't have to go in to hospital or stay overnight or anything like that? -No. -You were walking the next day? -Yeah. Right out of the office, after I had the procedure. -Oh, that's great! And then you don't have to wear those big, fat, ugly shoes! -That's right. Once the foot heals, you can wear whatever is comfortable, usually it's a lot easier to get into shoes. -Okay! Well thank you, you'll be back tomorrow to talk about sports and orthotics and that kinda stuff? -Right. -Okay! Well, we'll see you tomorrow, and speaking of sports injuries..."