I would advise waiting also. Even of the surgery has not been able to achieve the desired outcomes, nothing can be done right now. I wouldn't have anyone touch the toe until complete healing has occured. Further trauma (more surgery) could cause other issues.

I would discuss your concerns regarding outcomes and what he suggests in dealing with these issues. The CT won't make any difference. Evaluation of this problem is mainly clinical. Lmk how you go after the consult.

Yes, just read your other post and replied. Hopefully chat soon.

Hi, I know how debilitating this problem can be. I can assess and see if anything further can be done. If you can contact my prac manager Maree, she can help you to make an appointment at [email protected] If you speak with Maree, please send through to her all your reports, so I can have a read before the appointment.

Thanks Philip, really appreciate the comment. Cheers Oz

Hi, the cost will vary greatly. Will depend on the surgeon and the country you are in. Hospital and anaesthetic costs need to also be factored in.

Thank you, Im happy you liked it. The second excision is another adventitial bursa.

I see, I thought the second is sth else as the location is not on the side. Do you also have some video or pictures of the excision of the intermetatarsal bursa?

@44moka22 I don't have a video of an intermetatarsal bursal excision. I know these are reported often with a neuroma. Interestingly, when I excise a neuroma, I rarely see the intermetatarsal bursa.

Can replace with sports tape

Hi Scott, yes it was performed under local in my office. I have a room I use specifically for procedures.

Hi, I usually keep patients in a cam boot or a post operative shoe for 3 weeks, and then get them into a sneaker.

Good to hear the right foot has healed.

Thank you for the very nice comment.

muchas gracias

Hi, continue taping as you have been in the corrected position. As the tissue heals and swelling goes down, the deviation most often reduces. This can take several weeks. Hopefully you'll be able to consult with your surgeon soon and have him assess progression of healing.

@DrOzanAmir Thank you so much!! This helps me tremendously! He did reply last night and said this. "I would would work on massaging the incision sites, and passively flexing the toe down, by holding at the base of the toe (not the tip) and flex the toe down for 15-20 seconds, 4-5 times. Will help stretch the soft tissue and allow the toe to sit better aligned. " Do you feel this will help as well? I will do what he said, plus I'll constitute to tape it down. He didn't mention how many times a day to do this 4-5 times. If you have any other suggestions, I would love to hear them. I have been post-op since May 31, 2024.

@scorson74 it's still early days. The massage and holding the toe down is a very good thing to do. If the stretch is not causing pain, you can repeat a few times a day.

@@DrOzanAmir Thank you a million for your help and responses! I will continue to head your advice!! Have a wonderful day!

@DrOzanAmir Hello again! I'm still very concerned that my 5th toe is not moving, going down or purchasing the ground. My Dr said the way he did it, it will eventually go down. It is rigid and stiff as a board, sticking to my 4th toe as it did when I had the pins taken out on July 9th. I still tape my toe down but had to give it a break because it became bruised on the top. My 4th toe also had a k wire, but that is not rigid like my 5th toe. I'm so upset and don't know if it will go down without a tendon release surgery. I'm your opinion, what are your thoughts since I'm 4 weeks out from wire removal and no improvement at all. I don't see my foot Dr until a week from this Tuesday (Aug. 20, 2024). I can't even wear a shoe with sides or any top to it as it would rub and squeeze my toes together. I trust your opinion, and you have been so great at answering my questions.

Hi Sharon, There shouldn't be a need for taping post surgery. However, some patients like the mild compression from the tape. I would check with your surgeon before trying this taping technique. I used kinesio tape (rock tape) and sport tape (5cm width).

Hi, this is actually an 'open' technique, though the incision is small.

What advise were you given regarding the recovery time?

Thanks for the nice reply. Hope you get to consult with a podiatric surgeon in the near future.

@@DrOzanAmir Absolutely. I didn't know about this surgery. A wonderful option to avoid my soft corn coming back over and over. Thank you so much again for your video.

Putting clips on skin causes unnecessary trauma.

Hi, there is always a risk of complications, however with an isolated tenotomy (1 toe) I have not seen a complication arise that has prevented returning back to sports. When multiple tenotomies are performed on several toes, swelling can be excessive, nerve damage is a greater risk and also muscle weakness in the toes.

@@DrOzanAmir thank you! So you suggest not doing 4 toes at once? What if you just do 2 toes at a time? I wasn’t sure it cause you to lose the ability to use your toes at all when you walk and run? Thus, limiting you in sports if you’ve been an athlete your whole life.

@AAD2120 it is difficult for me to comment without examining your problem. There are several factors that can affect outcomes. It maybe OK doing all 4 toes but you need to be aware of the associated risks. If you are unsure of the advise given by your surgeon, it is a good idea to get a second opinion. Have another surgeon examine you thoroughly and compare the advise given.

Hi, yes this technique also allows lengthening of the soleus. I have not seen permanent loss in strength, only temporary. Specific exercises can be given post surgery to help build strength back up again.

@@DrOzanAmir thank you doctor.

Thank you for the very nice message. I hope you have an uneventful recovery when it comes time for your surgery.

Hi, it will depend on the type of bunion procedure you are having performed and if you have any issues that may delay healing. For the Chevron bunionectomy patients are back in a jogging shoe around 3 weeks after surgery, however the bone won't be fully healed until week 7 and the surrounding soft tissue till week 12. There is continued healing even for 12 months after surgery.

Thank you Dr Amir

Hi, No, the patient was under general anaesthetic.

The plantar fibroma can reoccur, which I have seen. Usually the module is smaller than prior to surgery. I have not seen a callus form on the skin after excision.

This is so good to hear. I hope the taping continues to help and you become pain free.

🙂

Gets bigger, damages the skin, leads to risk on infection. You can even see the corns are leading to abnormal biomechanics

@yousef_afc9363 thank you for the clear response.

I know :)

Hello, The idea of this procedure is to increase dorsiflexion at the ankle due to a tight gastrocnemius muscle If the heel is off the ground and this is responsible for the slight limp, this procedure should help. See this article attached. It should answer a few things. www.ncbi.nlm.nih.gov/pmc/articles/PMC8955202/

@@DrOzanAmir Yes hoping this procedure and few months of rehab can help me in improving my walking posture and reduce my limp . Thank you for the response . It clears my mind off . Would you please share your email id where i can ask few more question regarding the foot drop ?

@ArjuneS-sk7tp hope the procedure goes well. It can be difficult to answer questions without examining you properly. For this reason I ask people to consult with their specialist who has had the opportunity to perform a thorough clinical assessment.

@@DrOzanAmir Appreciate it , thank you !!

Yes it is. I recently added a vid and titled it as the Winograd kzfaq.info/get/bejne/eLl7opqIxLXJYX0.htmlsi=TqgHz2D4QFt9mviK

I am fairly conservative and keep patients in a protective shoe and limited activity for 3-4 weeks. This is followed by wearing a stable jogger and an ankle brace for another 3-4 weeks. Start with walking short distances and slowly increasing actvity. May take 12 weeks before full activity is recommended.

If the fracture went through the joint (intra-articular fracture), this can result in stiffness. If swelling is still present, this can also contribute to the joint being stiff. To know if the tendon was affected by the injury or the wound that occured, best to speak with your Dr. He/she may suggest an ultrasound to assess this.

@@DrOzanAmir thank you Dr. Ozan🙏😀 thankfully the broken bone was a little far from the joint. permission to ask Dr. If there is a problem with the tendon, it can cause stiffness in the fingers, as I experienced, my thumb is very stiff, it can only be moved downwards 10% and not upwards. sometimes my fingers feel cramped when I press on the soles of my feet...

Hi, in this video, I didn't demonstrate the injection technique, but in a previous video, I go through the hallux block. I've attached the link. kzfaq.info/get/bejne/ldpdpJpzkpe6pZ8.html Hope this helps.

Hi, Yes these can heal. I would also encourage that you see a podiatrist, especially if the infection is still present after 3 courses of antibiotics.

I have an upcoming appointment. Wondering what is the best way to help my toe heal. Do I keep it dry at all times y/n?, wrapped up y/n? Vaseline y/n? Wear socks y/n?

@mondoburley keep it covered, keep dry (can wash with saline) and apply Betadine until your appointment. Your Dr will advise if antibiotics are required.

Hi, You're correct, the primary problem is related to pressure under the met heads. All practitioners would accept this. The heloma durum, that are highly sensitive (far more painful than they should be), I've noticed appear in chronic smokers. This is the reason I focused on smoking.

Hi, yes it does. Takes several months for full regrowth

This patient didn't have recurrence, but the rate is relatively high. A wide excision decreases the recurrence rate. Agree, there are other methods - padding, strapping, orthotics and cortisone injections etc. I wouldn't recommend or perform this procedure unless conservative care failed and the person was still in considerable pain.

Thanks always Ian.

Hi, I use various mixes, usually containing local anaesthetic and saline or dextrose and saline. In this vid I used ropivacaine and saline (50/50).

@@DrOzanAmir thanks

Hello. No lower back issues. For anything deeper than the subcutaneous level, I would advise ultrasound. In this video, the injection was just below the skin. Eg: Hydrodissection for tarsal tunnel syndrome, I would use ultrasound (or a nerve stimulator as described by @Dr Ian Reilly).

Hi Scott, it was performed at a day surgery hospital (under general anaesthetic)