Seeing is believing
We believe this is the most diverse collection of bunion cases for any one single surgical technique. Altogether, these cases illustrate how Syndesmosis Surgery alone has been applied to virtually all levels of severities. Most cases are bilateral surgeries – both feet at the same time. Patient ages range from 15 to 81 years old. Spontaneous improvement of secondary deformities can also be witnessed. Through such a comprehensive collection of cases, we aim to confirm Syndesmosis Surgery’s power of understanding and correcting the root problem.
42 y/o female, no secondary problems. Unable to wear dress shoes or high heels for work without moderate pain. Post-surgery her function scan improved, she returned to high heels without pain, callus or recurrence.
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27 y/o female instructor and competitor had to hang up her skates due to intolerable hallux valgus deformity and bunionette pain. 6-months post-surgery on her moderate deformity, she went back to skating and teaching without any pain. Unexpectedly, her pre-operative tendency to fall while walking stopped completely. No signs of recurrence.
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41 y/o female, mild left and moderate right foot hallux valgus deformities. Compromised foot function scan evident by large metatarsal calluses and clinical pains. Post-surgery function scan normalized, calluses disappeared, and patient returned to high heels with no signs of recurrence.
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Before surgery, this 48 y/o runner could hardly finish half-marathons due to pain from his moderate hallux valgus deformity. 1-year post-surgery he ran his first full marathon and 5 more marathons since, with his time progressively improving with each one. No signs of calluses or recurrence.
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40 y/o female, increasing pain and metatarsalgia. Function scan revealed total loss in big toe power. Patient suffered low back pain caused by an unconscious outerside-to-outerside wobbly walk. Post-surgery normal gait was restored under her big toes and she returned to high-heels for hours at a time.
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29 y/o female, moderate hallux valgus deformity with pain due to frequent high heel wear for work. Post-surgery, patient's deformity, pre-operative calluses or low back pain remedied, even after returning back to frequent high-heels. Pressure scan reveals function restoration the big toes.
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81 y/o female, otherwise extremely healthy who loves walking for exercise, could not walk anymore due to severe plantar callus and ulcer pain under her left foot. Post-surgery, patient healed in 3 months and went back to walking with no more pain.
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67 y/o female, moderate deformity, increasingly painful clawed second toe on left foot. Large metatarsal calluses and abnormal function scan caused by tendency to avoid painful toes while walking. Her hallux valgus, claw toes and pain have not recurred. Function scan improved, but big toes still habitually unused.
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At 16 y/o, the female patient had an arthroscopic joint fusion surgery elsewhere for painful left bunion. Pain recurred. At 19 y/o, she underwent the Syndesmosis Procedure on both feet for mild deformity. She now wears high heels for work and has had no recurrence. Due to the permanent loss of mobility in her left foot rendered by the Lapidus procedure, she still feels discomfort in her left foot when wearing heels.
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60 y/o female, severe deformities, had difficulty walking and presented multiple compensatory secondary foot, leg and back problems. Post-surgery, all secondary problems resolved spontaneously, including all claw toes. Patient still enjoys her high-heels, dancing and unlimited walking without pain.
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59 y/o female, severe deformity, patient had osteotomy procedure 10 years earlier and had persistent pain. She underwent Syndesmosis Procedure on both feet. Function of both big toes returned, shown in function scan. Patient had much reduced calluses and still enjoys unlimited hiking.
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55 y/o female, severe case, painful overlapping toes and metatarsalgia. Had difficulty walking, poor balance and experienced falls. Function scan verified complete loss of big toe function in both feet. Post-Syndesmosis Procedure, spontaneous correction of overlapping toes. Calluses disappeared and normal function restored, as evident in function scan.
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48 y/o female, patient had McBride procedure 25 years earlier for her left foot. Hallux Valgus deformity and pain recurred, metatarsal calluses formed, poor function scan. Patient underwent Syndesmosis Procedure on both feet for severe hallux valgus deformities, no recurrence of pain nor deformity.
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41 y/o female, mild deformity, but primary pain from bunionettes while wearing high heel shoes for her office job. She underwent the Syndesmosis Procedure to narrow the forefoot, restore big toe function and to minimize overloading of the 5th metatarsal head. Pain was gone after procedure.
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A 53 y/o male had a severe left hallux valgus deformity on the same side of his cerebral palsy and spastic thrashing gait. He opted for surgical treatment for his increasing difficulty walking due to severe pain and poor balance/stability of his left foot. 7 months after surgery he returned to independent and unprotected walking, albeit with his usual spastic gait, but without pain or fear of falling.
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A 53 y/o female underwent procedure for her right foot 9 years earlier and continued to experience pain and thick metatarsal calluses. After a bilateral Syndesmosis Procedure, her calluses reduced, and she was able to wear high-heel shoes again without pain. Functional improvement was also evident by her F-Scan studies. No signs at all of deformity recurrence for 6 years after surgery.
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A 36 y/o female suffered recurrence of hallux valgus deformity and pain after a simple procedure for removal of the a bony bump 10 years earlier. However, 14 years after a bilateral Syndesmosis Procedure there was still no pain or sign of recurrence.
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A 68 y/o female complained more about her painful claw toe than her bunion. It was rigid and required PIP joint soft tissue release and pinning for one month. We expect the usually consistent functional result of the forefoot after the Syndesmosis Procedure, as well as, the prevention of her claw toe deformity and pain from recurring.
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A 61 y/o female had severe hallux valgus deformities and flexible second claw toes on both feet. One year after a bilateral Syndesmosis Procedure, her photos showed the spontaneous correction of her claw toes without surgery. Her F-Scan study expectedly revealed a remarkably improved pressure pattern of her feet in walking. The associated metatarsal calluses and metatarsalgia disappeared also, as predicted.
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This 29 y/o female wanted to be able to jog without pain and calluses. She was able to return to running without pain 6 months after her bilateral Syndesmosis Procedure. 8 years later, there were still no signs of any recurrence.
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A 26 y/o female with a moderate hallux valgus deformity had to stay away from high heels to help minimize pain. 4 years after a bilateral Syndesmosis Procedure, there was no more pain experienced, despite her wear of high-heels. The reason for the spontaneous bunionette pain relief was due to a true forefoot narrowing effect of the surgery and also its normal function restoration, shown in her F-Scan study.
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A 40 y/o male had no pain, but severe hammer toe pain in jogging (see first photos). Examination revealed a hypermobile first metatarsal. X-ray revealed a moderate MPV deformity and laterally displaced sesamoids. Function study by F-Scan revealed the abnormal lateral transfer of metatarsal loading. One year after surgery, his x-ray showed a narrowed first intermetatarsal space and F-Scan revealed satisfactory medialization of metatarsal loading. 7 years later, he still had no signs of any hammer toe recurrence.
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A 35 y/o female had relatively mild-looking bunions, but experienced severe pain and dysfunction of her feet. Upon examination, she did not have widened forefeet as usually expected in such deformities. However, x-rays revealed the important underlying MPV deformity and also the dysfunctional dislocation of lateral sesamoids. F-scan study confirmed severe loss of big toe function in walking. However, 7 years after a bilateral bilateral Syndesmosis Procedure, she had no more pain in hiking, playing badminton & ping-pong, nor any calluses and recurrence.
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The x-rays of a 54 y/o female showed complete dislocation of lateral sesamoid in both affected feet. It signified severe dysfunction of big toes that correlated with her calluses, metatarsalgia and difficulties in walking. Three years after a bilateral Syndesmosis Procedure, she still had no more pain. She felt her feet much sturdier and stronger than before, although her big toes were still very weak in her F-scan study and needed more exercises to help further strengthen their muscles.
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A 47 y/o female had intolerable pain, metatarsalgia and worsening flat feet. Even her leg muscles and low back became painful when she walked for too long. After undergoing a bilateral Syndesmosis Procedure she felt her arches came back due to realigned and re-stabilized first metatarsals, and the restored windlass effect of the big toes. Disappearance of her metatarsal calluses and metatarsalgia was a testament to adequate restoration of biomechanical function of the forefoot, which normalized her gait and thus also relieved her leg and low back pain from long walks.
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A 31 y/o female with severe bilateral pain, metatarsalgia and low back pain. She also felt herself losing her balance and stumbling often. However, 4 years after surgery she was still extremely pleased with her feet, despite a mild residual hallux valgus deformity due to the metatarsus adductus condition of her feet.
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This case demonstrated how the hammer toe deformity of the lesser toes can be caused functionally by hallux valgus deformity and thus they can also be resolved by removing its root cause. But, this would only happen if biomechanical function of the foot can be adequately restored. A 62 y/o female had a painful hammer toe on her right foot. Her 3-year postoperative photo and x-ray showed its spontaneous resolution, although a hammer toe was developing in her left, untreated foot.
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A 58 y/o female previously underwent an osteotomy procedure at age 16. Her feet never felt normal and her shoes were still restricted. She had increasing symptoms of metatarsalgia and Morton’s neuroma despite wearing her foot orthotics. Her 2-year post-op F-scan study showed significantly improved medialization of metatarsal loading in walking. She had no more metatarsalgia but still mild Morton’s neuroma symptoms that did not need further treatment.
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Five years after having Chevron and Akin osteotomy procedures on her left foot, a 58 y/o female underwent a bilateral Syndesmosis Procedure to salvage her recurring, painful hallux valgus deformity on her left foot and also to correct her right untreated foot. Five years after surgery, her F-Scan showed significant medialization of metatarsal loading back to under the first metatarsal in walking. 7 year later, she was still found enjoying unrestricted activities and shoes without any sign of recurrence.
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A 54 y/o female continued having severe metatarsalgia in walking 3 years after a mid-shaft osteotomy procedure (break-n-shift surgery). Six years after undergoing a bilateral Syndesmosis Procedure to salvage her failed left foot surgery and also correct her untreated, right affected foot, she was still enjoying her unrestricted activities and shoes without calluses, pain or recurrence.
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