We’ve applied the same surgery consecutively for 35 years to correct more than 2,000 bunions of all severities and for patients of all ages. There has been no need to cut bones or fuse joints. Almost all other bunion surgeries have done otherwise.
Traditionally, surgeons use a bunion severity scale to determine their choice of surgical treatment. A bunion deformity is graded as mild, moderate, severe or extreme depending on the degree in displacement of affected bones. But underneath, they share the same pathology, and hypothetically, should be corrected by the same surgery, only with rare exceptions. The Syndesmosis Procedure is perhaps the only surgery that does not discriminate since it equally addresses their common pathology.
Many bunion feet eventually develop secondary problems such as painful calluses, flexible clawed toes, bunionettes and even knee or back pain, all due to the primary bunion deformity itself. Therefore, holding to the same principle, if the bunion deformity can be truly corrected, then these problems will be free from their cause and resolve automatically without additional surgeries. Following the Syndesmosis Procedure, we’ve regularly observed the disappearance of these secondary problems.
We have also applied the same Syndesmosis Procedure principle to salvage a number of recurrent bunion feet after bone-breaking (osteotomy) and even joint-fusion (Lapidus) procedures.
To us, surgical success is a foot capable of returning to unrestricted activities and shoes without pain or recurrence.
Full-function recovery as told by our patients
The very definition of ‘success’ is subjective, and it can also have different meanings to surgeons and patients. While surgeons may be satisfied by the straightness of the big toe, patients are also interested in the full-function recovery of their feet.
In our opinion, if a patient still has pain after 6 weeks, the surgery was not so successful. If a patient is still not able to run or wear high heels after 6 months, the surgery was not so successful. If bunion recurs, even after 10 years, the surgery was not so successful.
We believe the highest standard of success is usually told by patients themselves. That’s why our most powerful evidence is found in the compelling stories directly from our patients.
Function versus Appearance
Often bunion surgery outcome reports are focused on the angle measurements of the bones in isolation and not enough on the correlation between the foot’s functional results and their bone re-alignment.
We regard the improvement of a foot’s appearance as a cosmetic result that is simply a by-product of the Syndesmosis Procedure. The Procedure’s quantifiable success lies in its ability to restore function that is verifiable with an objective test method. After all, the human foot is primarily for function, not for show.
Is there a way to measure foot function?
Being able to walk is not a true evaluation of the foot’s functional ability. To be objective and comparable, there are several computerized devices to assess the real-time pressure distribution of a foot against the ground while walking. The distribution pattern can also be quantified to demonstrate any true functional improvement after a particular bunion surgery.
We’ve used F-Scan® for more than 10 years to verify the function outcomes after the Syndesmosis Procedure. The biomedical engineering department of Hong Kong’s Polytechnic University has analysed our results, confirming the Syndesmosis Procedure could significantly and consistently improve the function of big toe and the foot.
Normal Foot F-Scan
The inner foot carries most of the body weight and contributes up to 80% of the power required for normal walking. A function scan of a normal gait shows the most force under the big toe side of foot.
Bunion Foot Scan F-Scan
In the case of bunion deformity, function and power are significantly diminished under the big toe. Weight-bearing force is typically shifted laterally to the region under the second and third metatarsal heads. This lateral weight transfer is also accentuated by the collapse of the metatarsal arch in bunion feet.