Hallux and forefoot philosophy
Hallux valgus, splayfoot, tailor's bunion and hammer toes correction using an own innovative method since 2005:
- No drill wires
- anatomical correction
- no bone removal or shortening in hammer toe surgery
- immediate full load even at maximum misalignment,
- repairs of operations that have not brought the desired result elsewhere.
The story behind it:
Each of the 150 previously known worldwide operations of hallux valgus has at least one disadvantage (the large number is enough to suggest that no method is really faultless):
- Either the toe or the first metatarsal bone gets shorter or the correction is incomplete, or the joint angles are disturbed, therefore the deformity may recur sooner or later.
- Or the correction decreases and the first metatarsal goes up, resulting in overloading of the other metatarsals, possibly also leading to a fracture (march fracture).
- Or the wires emerge out of the toes, which represents a significant disability and an additional portal of entry for germs (infections).
- Or the structure is not sustainable and must be unburdened for weeks in the heel shoe or even plastered.
Mostly, however, the operations have more than one drawback - and a single method, though it is still common in many places, cannot be enough to correct all misalignments.
Hammer toes are still treated almost everywhere using the nearly 100 year old operation method by Hohmann (described in 1922), wherein the joint forming bone portion is removed, i.e. cut away. Actually a mutilating surgery, which, although it sometimes does deliver pretty good results, but which often leads to feeble stub toes and certainly favours the origin and development of hallux valgus (crooked big toe), because the other toes can no longer provide any support to the big toe.
The consequence of this:
After much thought, and countless sketches and experiments since 2003, I have therefore developed new surgical methods, which lead to very good results and it seems that finally all the disadvantages are eliminated:
The new features:
- Foot surgery without wires
- Implants inside the bone for a reliable, safe bunion and hammer toe correction ( with the smallest cuts for smaller misalignments - minimally invasive)
- Full load immediately.
New since 2005: Correction of the intramedullary plate (lying inside the bone) - with a single system (but different implants), depending on the misalignment of the big toe requires:
- Small misalignments to 14 degrees:
Behind the head (subcapital) with the mini plate - 30 mm
- Moderate deformities to 18 degrees:
At the base with the middle plate - 36 mm
- Severe deformities over 19 degrees:
In the metatarsal joint (Lisfranc arthrodesis) with the long plate - 55 mm
THIS METHOD SHOWS PREVIOUSLY UNKNOWN CORRECTION OPTIONS, IMMEDIATE LOAD POSSIBLE
Not all cases of hallux are treated with the same operation type, but the deformity is corrected on site and stabilized with a plate that is located INSIDE THE BONE.
The foot is a very complex part of our body. Sometimes it is even referred to as an "organ". If they work well and properly, we actually do not even notice our feet.
But woe if only the smallest problems occur. We all know how unpleasant a pebble in the shoe, or how horrible pinching or too small shoes can be. You want to do everything possible to free the feet. Each of us knows that "harmless" foot ailments such as corns, blisters caused by bad footwear or even nailbed pus can plague us a lot more than problems elsewhere.
A fortiori, major foot problems cause us all the more complaints of course.
Why the feet are so dominant in case of diseases is due to their exposed location and the small size of their "constituents". The delicate bones with the strong tendons need to withstand many times our body weight in case of acceleration of running or jumping and all the structures are "crammed" in a confined space, so that a problem often pulls in the neighboring units to the disease. The often underestimated biomechanics plays an enormous role in force absorption (absorption of the kinetic energy) and scrolling operations while walking.
In the evolutionary shaping of the foot, a compromise between the small size and robustness was made for optimum performance.
TREATMENT OF FOOT COMPLAINTS
To treat or operate the foot at all, is primarily in the hands of an experienced specialist in orthopedics and orthopedic surgery. Often the support of orthotists and orthopedic shoemakers is necessary.
The common practice in large hospital wards, i.e. to let the younger assistants do the easier forefoot surgeries, unfortunately often backfires because there are no "easy" operations and each foot problem not adequately treated can cause major consequences. For example, deformities of the hallux may occur due to unsuccessful hammertoe surgeries, or heel and midfoot problems and even knee, hip and spine ailment.
INTERNATIONAL SPECIALIZATION - FOOT ON THE SUBJECT
In recent decades, the long practiced U.S. specialization in the topic of the foot (there's even own foot universities that train specialists for foot medicine and foot surgery!) was introduced in Europe, albeit to a much lesser extent. There emerged foot organizations and foot centers that deal with the specialized treatment of foot problems that were not valued enough in large general-orthopedic departments as would be necessary.
These specialists provide continued training to interested doctors in foot medicine.
Following my own interests, I have now worked for over 20 years on the disease and treatment of the foot (in addition to the knee).
In addition to scientific publications and after more than 3000 foot surgeries, I wrote the popular science book "help with foot pain" , which was published in 2006 by the Kneipp Verlag as a patient counselor.
Since I was not always very happy with the methods for treatment of the forefoot problems (very numerously described in the scientific literature) like hallux valgus, hammer toes, splay, I started to develop technical modifications and own new surgical techniques in 2003.
Since these techniques have been perfected after around 5000 operations and can be widely offered, I inaugurated an outpatient center for foot surgery in my practice in Vienna Meidling, the "House of hallux" in October 2007. These new operations allow an immediate loading of the operated foot without protruding wires.
Most patients only have a little swelling and only slight pain occurs after surgery, so outpatient operations, without the need for an inpatient stay in the hospital are possible to offer.
INTERNATIONAL INTEREST AND SEMINARS BY DR: VITEK
The medical interest in my methods of operation is very large. Alone in 2007, I was several times in England (London, Cambridge and Grantham), Spain (Salamanca), Russia (head of the master class for Foot Surgery in Tomsk) and Germany (Munich, Tuttlingen, Germany), to explain my methods in the context of conferences, seminars and workshops and to teach.
In the spring of 2008, I held the first V-tek Foot Surgery Course for foot surgeons at the Sigmund Freud University in Vienna, which was followed by further courses in the Anatomical Institute of the Medical University of Vienna. In the fall of 2008, I gave lectures in Cleveland / Ohio / USA and held an extensive workshop (possibility for foot surgeons to practise the methods on a corpse).
Other workshops and lectures were in December 2008 in Munich and in March 2009 in Going at the Int. Meeting held by the Austrian Society for Foot Surgery. Several publications of these methods have appeared in international journals and more have been filed. Other invitations to lecture and operate abroad led me to many other European countries, USA, Mexico, Argentina and Indonesia in the following years. Professorships in Malta and Mexico followed.
OUR DEVELOPMENT HAS BEEN PROVEN SINCE 2005 INTERNATIONALLY X-FOLD:
- Foot surgery without drill wires- so no entry points for germs, no sacrificing of comfort, immediate movement of the joints for faster recovery, instead of cartilage loss and adhesions due to fixation by wires.
- Anatomic correction of hammer toe instead of bone removal- no wobbly stub toes, no loss of toe length, good kick in walking and running instead of the usual quasi amputation by the Hohmann technique.
- Reliable, safe Hallux correction- with the smallest cuts in case of slight variance.
- Anatomic correction of hallux without loss of length- even in case of massive or even bizarre deformities, no transfer of the ground forces to the small ball head with subsequent pain.
- Possible now thanks to new implants and operation methods- the operating technique depends on the degree of deviation. There are 6 different surgical techniques in hallux and 5 different techniques for the hammer toe - depending on the severity and stage. The implants are made of titanium and are (usually) not removed. Individual approach to the patient and to each foot, instead of "lumping it together" with a single surgical technique.
- Full load immediately possible for all operations - even at maximum corrections.
About Michael Vitek