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Simpler Bunion Surgeries Recommended for Advanced Cases

PARK RIDGE, ILL., Sept. 12, 2002 -- A surgical procedure used for treatment of mild-to moderate bunions also can be performed successfully to correct severe bunions, according to new research reported in the Journal of Foot & Ankle Surgery, the official peer-review publication of the American College of Foot and Ankle Surgeons (ACFAS).

The retrospective study evaluated 38 severe bunion cases and showed that outcomes of a simpler surgical procedure are comparable to those of more radical surgeries normally  performed on patients with advanced bunion deformities.  Further, the post-operative recovery period and complication risks are significantly reduced with the simpler surgery.

“Many older patients who have bunion surgery might not be able to function well on crutches, especially if they are not permitted to put weight on the foot, which is normal after surgery to correct a severe bunion,” said John Stienstra, DPM, FACFAS, a podiatric foot and ankle surgeon with the Permanente Medical Group in Hayward, Calif.  “Most older people don’t have the strength to use crutches without putting weight on the surgically treated foot, which requires ten times the energy than using them in a weightbearing manner.  Therefore, the study has significant quality-of-life implications for older patients with severe bunions,” he added.

Stienstra said the simpler procedure, known as a distal chevron osteotomy, enables patients to bear weight and become ambulatory much earlier than more complex bunion procedures, which require casting and long periods on crutches. 

Patients in the study were evaluated according to a standard scoring system that measures pain levels, functional ability and range of motion and stability in the big-toe joint.  Seventy-nine percent of the subjects scored 90 or above and the average result for the entire study population was 93.5.   Further, 95 percent of the patients had no limitation of activities and 84 percent were able to wear fashionable, conventional shoes.

According to Stienstra, wider utilization of the simpler bunion procedure could be helpful in convincing patients to undergo surgery with assurances that the desired correction can be achieved without prolonged activity restrictions.  Also, proper treatment of bunions helps prevent future onset of arthritis.

“The research clearly shows that we can safely use the more patient-friendly procedure for patients with severe bunions as well as for those with mild to moderate cases,” said Stienstra. 

For information on a variety of foot and ankle conditions and to locate a podiatric foot and ankle surgeon in your area, contact ACFAS toll-free at 1-888-THE FEET or at www.acfas.org.

This press release article was provided by the American College of Foot and Ankle Surgeons (ACFAS).


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