New ‘tightrope’ procedure moves bunion back in place
By Lara Krupicka
Naperville resident Diane Frame suffered from a dibilitating bunion, until she received a "mini-tightrope" procedure that put the bone back in place. | Submitted
Take care of feet
The following foot-care tips are meant for runners, but are helpful to anyone who is active:
Cross-training is better: alternate running with rest, swimming, weights and biking.
Avoid cotton athletic socks. Choose synthetic materials instead.
Shop for shoes in the afternoon when feet swell more. Allow 1/2 to 1 inch of space between longest toe and end of shoe.
Trim toenails straight across to avoid in-grown nails.
When not running, wear supportive shoes. Don’t go barefoot.
If you have pain in your feet that worsens during a run, or if your foot or leg goes numb, don’t ignore it.
A bunion on Diane Frame’s left foot bothered her for several years. It became so painful it was difficult for her to wear shoes.
Thanks to the mini-tightrope, a procedure designed by Dr. George Holmes, the 61-year-old Naperville woman is back to walking comfortably.
“I can wear regular shoes,” Frame says. “I have no problem with anything I want to do now.”
A bunion develops from the big toe pressing continually against other toes. This pressure forces the main joint of the big toe outward. Over time this joint becomes enlarged and sometimes painful. This hard bump is called a bunion.
“Bunions are a phenomena of Western culture,”says Holmes, a Lisle resident and surgeon at Midwest Orthopaedics at Rush. “In cultures where they don’t wear closed-toe shoes, the incidence of bunions is very low.”
Too-small shoes, a genetic predisposition and stress on the foot are primary causes of bunions.
Holmes recommends avoiding pointed-toe shoes. Comfortable shoes like Birckenstocks, Easy Spirits and Rockports provide good support and protection for feet, and help prevent conditions like bunions. Holmes also suggests women wear heels sparingly, about three to four hours per day if they must, to reduce the risk of foot problems.
Typical treatments for bunions include pain relievers, wider shoes and special shoe inserts. But once the bunion reaches a certain point, surgery becomes necessary. For Frame, Holmes’ procedure worked perfectly.
Instead of the traditional bunionectomy or osteotomy, which involve breaking or removal of bones from the big toe, Holmes created the mini-tightrope procedure. In a mini-tightrope, buttons are attached along the outside edge of the big toe between the bunion and the base, and to the opposite side of another toe bone, above the base. String is then tightened between the buttons, drawing the angled joint of the bunion back in line.
Holmes touts the lack of complications from the procedure.
“If the mini-tightrope fails, the bone goes back into the exact position as before,” he said.
Frame was surprised at the results.
“The recovery went very easily,” she said. “I didn’t have much pain at all. It was much less than Dr. Holmes described.”
Recovery from the mini-tightrope typically takes six weeks. For two weeks, patients must stay off the foot. Then they graduate to a walking boot.
“The worst part was the inconvenience of having to keep my foot elevated and protected,” Frame said. “I went in every week for them to change my bandage. It was very reassuring to get feedback and ask questions.”
While this outpatient procedure may appear an ideal option, not every bunion patient is a candidate for it. Patients with diabetes, arthritis or lupus may not fit the profile, along with those whose bunions have progressed too far or aren’t sufficiently severe.
“It’s been an eye-opener to see this come from concept to fruition,” says Holmes of his procedure. “It offers patients a way to avoid pain from breaking bones. Patients appreciate the concept of just putting the bone back in the position where it was before the bunion.”
That’s a tightrope patients like Frame walk in comfort.