Orthopaedic Surgery

In our Medical Center is done exclusively visits and specialist advice for any specific surgical options. This surgeries are made in Italy, by noted orthopedic specialists (members of the Italian Society of Foot and Ankle), and in various EU countries by famous colleagues Podiatrists, in public or private hospitals.

Some surgical interventions proposed by such specialists, that are normally found in international literature and on the Web:

For the resolution:
- ingrown nails
- Plantar warts
- Callus and hyperkeratosis

For correction of:
- hallux valgus
- hammer toe

For the removal of:
- Morton's neuroma
- MORBO DI HAGLUND

The interventions of minimum incision

The techniques of minimal incision (TMI) have been developing in last 20 years with the emergence of Podiatry's Activities and of ambulatories
This development is made possible by improvement of surgical instruments and it has provided a valid response to the needs of the patient: avoid confinement and return to his room as soon as possible (no cost and psychological stress.)
The trauma of soft tissues is less than the conventional techniques "in open". Then, the edema and postoperative pain will be less .
In addition, these procedures are performed under local anesthesia, less traumatic and most secure for the patient, that allows an excellent control of pain during surgery, but also in the immediate postoperative period.
There are many diseases of the foot where the TMI are an effective surgical therapy:

• Partial Onychectomy with matrixectomy (ingrown nail)
• Exostectomy for Helomata (removal of hard or soft calluses)
• Subungual Exostosis
• Tenotomy of extensor and flexor of fingers tendons in patients with hammertoes, non - rigid and contracture of the extensor

EXOSTECTOMY

A. HELOMA DURUM (Hard callus)
In clinical podiatrist, the heloma durum is a very common disease.
It’s a hypercheratosic lesion, usually found on the 5th finger, but can also affect the 2nd, 3rd, 4th finger or even the big toe.

B. HELOMA MOLLE (soft callus)
The soft callus are hypercheratosics lesions between fingers.
The friction between the fingers and humidity are factors that can lead the ulceration and infection and consequently a strong pain. The eziologia is usually related to the presence of exostosis below.

Treatment
Surgical treatment is the removal of bony prominence, that it causes irritation of the soft parts, with a radical resolution of the disease.
The minimal incision technique is particularly suitable for this type of pathology and it’s performed under local anesthesia. The duration of the surgery is about 5 minutes
Post-operative care: You can wear normal shoes after 15 days.

C. SUBUNGUAL EXOSTOSIS
The subungual exoxstosis is a disease connected to the presence of a bony prominence of the distal phalanx of the finger. Usually , when there is on the hallux, is because the hallux is rigid, then the proximal phalanx goes down, and the distal phalanx is elevated.

Post-Operative care: post-operative shoe. After 15 days of surgery you can wear normal shoes.

TENOTOMY OF EXTENSOR TENDONS FINGERS

Directions: hammertoes non-rigid, lateral deviation of fingers.
Surgical Procedure
With local anesthesia, the patient must  dorsiflex the fingers, contracting the extensor tendons.
With a knife from 15 is made a medial or lateral incision to the tendon.
Post operative: There are no sutures, the patient applies a compressive bandage for 24-48 h. not stitches are needed, the patient must keep a compression bandage for 24-48 h.
Post Operative shoe, and after 15 days of surgery you can wear normal shoes.