Syndesmosis procedure

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Syndesmosis procedure is one of more than 20 bunion operations underway. While most bunion operations involve disconnection and bone shift (osteotomy procedure), the syndesmosis procedure is one of the few surgical techniques using a soft-tissue or non-bone-breaking approach to obtain the same correction. Over 130 different surgical techniques have been described for the correction of one foot condition: bunion abnormalities.

Video Syndesmosis procedure

Destination

Bunion abnormalities (hallux valgus) are actually part of a complex of prominent anatomical mass disorders (bunion), buckling of the big toe (hallux valgus) and the spine (metatarsus primus varus), abandoned sesamoid bone (adverse to foot walking of the important function of the big toe ), the collapse of the metatarsal arch and some other secondary changes that are the domino effect of the varus primus metatarsal. Thus, the correction of the metatarsus primus varus has been the main objective of all bunion operations.

Primus varus deformity

The primus varus deformity is the first metatarsal bone skewed away from the second metatarsal and toward the opposite leg (Figure 1). At that moment bowing, his head protruding out to form a bunion bump and it also widened the forefoot causing the shoes to feel too tight. So when the bunion pain becomes uncontrollable, surgical correction is narrowed the forefoot by repositioning the first metatarsal head back to its normal position. This can be done with osteotomy (soft-breaking), soft tissue (non-osteotomy) or fusion techniques.

What causes metatarsus primus varus deformity?

The first metatarsal bone will lean to one side is because "the medial hood ligament stretches" and due to the weak and incompetent the first metatarsal will lose its support and then gradually shift out of place to form the vascular deformity of the primate metatarsus.

What causes the ligament to fail?

The female estrogen hormone and genetic inheritance are the two main factors behind the weak ligaments of the bunion legs. Bunion deformity was found to be more common in people who wear shoes by a study in Hong Kong and are increasing in Japan because of the shift in shoes to Western styles. Aging, degeneration and trauma have also been linked to weakening of responsible ligaments.

Maps Syndesmosis procedure

Technique

The syndesmosis procedure discusses specifically two fundamental problems of metatarsus deformity of the primus varus that causes bunion deformity. They are inclined and the first metatarsal bone instability. The syndesmosis procedure lifts the first metatarsal bone skewed with a strong binding suture between the metatarsal bone and the second metatarsal bone (Fig 2) and then also uniquely stabilizes by creating a fibrous connecting bridge between these two bones (Fig. 3, 4). The first metatarsal bone can be readily re-adjusted because the first metatarsus definition of its first metatarsal varus deformity is loose and moves abnormally.

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Benefits

1. No fractures (Less postoperative pain and swelling, Fewer possible complications, Technically simpler for surgeons)
2. A single technique can be applied to almost any degree of severity.
3. Both feet can be done at the same time.
4. Load holder is immediately permitted and secure.
5. The instability problem is specifically intended to prevent recurrence.
6. Function restoration has been demonstrated by studies of plantar stress.
7. No special instrument or surgical implant required.

More special warnings

1. Limited travel of no more than 5,000 steps a day for three months
2. No sports or high heels for six months

Possible complications

1. Wound infections
2. Cutaneous nerve injury
3. Cerclage suture breakage
4. The stiffness of the big toe joint
5. A second metatarsal stress fracture (Fig 5)
6. Excessive correction (Figure 6)

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History

Surgical procedure of syndesmosis surgery is derived from the osteodesis procedure first described by Botteri in 1961. Since then it has been studied and reported by Pagella in 1971, Irwin in 1999 and Wu in 2007. Sindesmosis itself is a normal anatomical structure for that purpose. connecting two parallel long bones side by side, such as the tibia and fibula bone. The naming of such syndesmosis procedures to reflect the essence of a technique that creates a mechanism of "syndesmosis" to provide permanent stability to the first metatarsal to prevent recurrence. Both the concept of bone-binding and the syndesmosis-connection concept are unique and revolutionary in the world of bunion surgery dominated by the tradition of osteotomy (breaking bones).

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More options

1. For severe bunion deformity correction (Figure 7)

1. For recurrent correction after osteotomy procedure (Figure 8)

Slow deformity recurrence may occur after osteotomy (ointeotomy) procedures because osteotomy surgery does not specifically stabilize the first metatarsal bone.

For recurrence correction after fusion procedure (Figure 9) Metatarsus primus varus deformity and relapse pain 6 months after a modified Lapidus procedure and may also be corrected again with syndesmosis procedure.

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References

Source of the article : Wikipedia