Percutaneous round forefoot surgery

Dr. Lopez specializes in percutaneous round forefoot surgery. Find out how to properly prepare for the procedure.

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Non-invasive surgery for the round forefoot: definition and causes of the pathology

Discover the causes that may lead you to consider non-invasive surgery for the round forefoot.

Round forefoot is a forefoot pathology characterized by a forefoot that is convex instead of flat.

Several factors can cause the appearance of a round forefoot. Among the most common, we find:

  • A lack of support under the 1st ray (including the 1st metatarsal and the 1st toe). This defect is common in patients with hallux valgus. In the event of hallux valgus, the big toe loses its supporting role, the entire weight of the body thus rests on the other toes. This results in the appearance of a large corn under the forefoot causing pain.
  • The presence of tendon retractions and toe claws
  • Certain neurological disorders
  • The presence of old fractures
  • Significant excess weight
  • The skeleton as the excess length of the metatrsian bones

Micro-invasive round forefoot surgery: symptoms and diagnosis

Micro-invasive round forefoot surgery is not always the solution. Whatever pathology you suffer from, the surgeon will be able to offer you a suitable and personalized treatment. For each case, Dr. Lopez takes care to seek the diagnosis of the pathology. This diagnosis is based on the symptoms presented by the patient, the clinical examination of the foot and medical imaging when necessary.

The surgeon will particularly look for the presence of other pathologies that could explain the presence of this deformation of the foot: hallux valgus, excess length of the lateral metatarsals, etc. He may also prescribe to the patient a radiological assessment of the foot to look for a morphological abnormality of the forefoot that may explain the symptoms.

In case of round forefoot, the patient complains of several characteristic symptoms such as:

  • Metatarsalgia, pain under the medial metatarsal heads. If it progresses, this pain can become permanent and considerably alter the patient's comfort.
  • Corns and calluses present on the sole of the foot causing pain.

It is important to note that this deformity may remain asymptomatic for some time. The patient is therefore unaware of the presence of this morphological anomaly of the foot.

Minimally invasive surgery for the round forefoot or conservative treatment?

Once the condition has been diagnosed, Dr Lopez will be able to offer you an adapted and tailor-made treatment. First-line treatment is always medical and non surgical. If this fails, minimally invasive round forefoot surgery may be offered and considered.

In case of asymptomatic round forefoot, no treatment is necessary. In the event that the deformation becomes disabling and painful for the patient, Dr. Lopez will offer appropriate treatment.

Medical treatment always constitutes first-line treatment. Several treatments can be implemented such as:

  • A treatment of painkillers to effectively relieve the patient so that he can regain walking comfort.
  • Physiotherapy sessions including stretching of the suro-achilleo-plantar chain.
  • Plantar orthoses to relieve the metatarsal heads.

If medical treatment fails, Dr. Lopez will explain the principles of micro-invasive round forefoot surgery and the postoperative results to expect.

Percutaneous operation of the round forefoot

The aim of percutaneous operation on the round forefoot is to treat both metatarsalgia but also their underlying causes (presence of hallux valgus, etc.).

Dr. Lopez favors the use of the non-invasive round forefoot procedure whenever possible. This surgical technique has many advantages compared to traditional surgery:

  • Shorter recovery time
  • Less visible scars
  • Less severe pain
  • Reduced risk of infection
  • Immediate operation

The minimally invasive round forefoot procedure consists of percutaneous surgery on the lateral metatarsals. The objective is to shorten and elevate the metatarsal heads. Through a short 2mm incision, an osteotomy (bone fracture) is classically performed on the central metatarsals (2nd, 3rd and 4th metatarsals) using a motorized burr.

The surgeon will also carry out hallux valgus surgery if this deformity is present. This significantly reduces the risk of recurrence.

Preparation for non-invasive round forefoot surgery

Before the non-invasive round forefoot operation, an anesthesia consultation is mandatory. The purpose of this consultation is to determine what type of anesthesia will be used during the operation. This is determined by several factors, including the patient's general health as well as the presence of allergies or contraindications.

It is also recommended to stop smoking 2 weeks before the minimally invasive round forefoot operation and 6 weeks afterwards. Smoking increases the risk of post-operative complications such as non-union of osteotomy sites and skin complications.

The use of the percutaneous technique allows the procedure to be performed on an outpatient basis. The patient can thus return home the same day, once the operation is completed.

To ensure that the percutaneous intervention on the round forefoot takes place in the best conditions, the patient will be asked to take a shower the evening before the day of the operation as well as a shower the same morning.

Immediate walking on the operated foot is possible after the operation. This must be done with a forefoot relief shoe that will have been prescribed to you in advance by your surgeon. Remember to bring this shoe with you on the day of the micro-invasive procedure for the round forefoot.

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The informations on the page is provided for information only, it evokes general cases: your situation is specific.

Dr Julien Lopez, orthopedic foot surgeon in Nice welcomes you and advises you for your plantar aproneuritis.

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