Bear wrote:
-------------------------------
I am 39 years old and over the past year, my bunions have progressed to the painful point of capsulitis on the second toe (of both feet). I play Aussie Rules Football and need surgery during the offseason (now thru April) on both of my feet. I have seen 2 podiatrists. One recommends a Chevron bunionectomy, with the use of an absorbable pin, no cast (just a boot) and doing the other foot at about 6-8 weeks. The other surgeon recommends a Green-Watermann trilateral osteotomy, with the use of a metal pin (may or may not be removed at 8 weeks) and a lower leg plaster cast for 2 weeks. And then doing the other foot at about 6-8 weeks as well. What is the difference between these 2 procedures and the surgeons preference on pins/casts?? I know surgery is an art form, but I am looking for some confidence in approaches. Am i too optimistic to think I will be out on the "footy" field wearing cleats this spring?
Thanks...Bear.
======================
DISCLAIMER:
THE FOLLOWING IS OFFERED AS GENERAL INFORMATION ONLY, AND MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER'S PROBLEM. IT IS NOT BASED ON ACTUAL KNOWLEDGE OR EXAMINATION OF THE QUESTIONER AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION. ONLY THROUGH HANDS ON PHYSICAL CONTACT WITH PATIENTS CAN ACCURATE MEDICAL ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER SHOULD CONTACT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS FORTHCOMING HEREIN.
==========================
Sounds to me as if you're talking apples and oranges, Bear. A Green-Waterman osteotomy is employed for hallux limitus .. a condition where there is restriction (usually painful) of the normal dorsifectory (upward) range of the great toe joint. This technique utilizes an osteotomy, which decreases the elevatus (upward angulation) of the first metatarsal, and changes the effective functional surface of the joint to a lower plane. This generally provides a greater dorsiflectory range for the great toe.
A Chevron osteotomy is employed for a bunion deformity (hallux valgus) where there is abnormal metatarsus primus varus (angulation of the 1st metatarsal toward the mid-line of the body.
In other words . . I do not see these procedures as interchangable. Perhaps you were somewhat mistaken regarding your diagnosis of "bunion."
As far as having the procedure done in the near future and playing football in the spring . . Unless you are getting pretty good bucks for that and have a first rate sports medicine physical therapist at your disposal, I think you'd be pushing it.
|
