On Wednesday November 07, 2012, I flew to the city of New Orleans, Louisiana, for the fall Minimally Invasive Foot Surgery seminar held at the Louisiana State University Medical School.

As a member of the board of trustees of the Academy Of Ambulatory Foot And Ankle Surgery, I attended the business meeting on Wednesday night.   The conference began early Thursday morning and ended Saturday afternoon.

I picked up several tips on foot surgery including the correction of contracted toes or hammer toes, removing bone spurs, treating heel pain and arch pain due to plantar fasciitis as well as treating arthritis at the first metatarsal phalangeal joint or big toe joint.

On Thursday afternoon, November 08, 2012, I had the honour of giving a lecture to my colleagues who came from all over the United States, Canada, Europe and Australia, on how to perform bunion surgery.

I explained how I treat bunions, in the office with local anesthetic.

I do this through very small openings in the skin which results in much less soft tissue trauma.  In most cases this means very little pain and swelling postoperatively for the patient.  I then use an adhesive tape dressing to help hold the foot in its corrected position. The procedure I described is the Plon-Arnold modification of the Wilson bunionectomy.  Doctors Abram Plon and Marvin Arnold are two pioneers of minimally invasive foot surgery and taught me much of what I know about the procedures.

On Saturday, November 10^th, I had the opportunity to demonstrate several of the surgical procedures I use to treat bunions, hammer toes, tailors bunions or bunionettes and dropped metatarsals, in the cadaver lab at the Louisiana State University Medical School.   I also was able to pick up some tips from some of the other instructors.

In the evenings, I visited the French Quarter with some of my colleagues and listened to some New Orleans-style jazz on Bourbon Street.   I heard a very entertaining fellow named Steamboat Willie and purchased two of his CDs. I will be very happy to play them for you if you come to my Toronto foot clinic to have treatment for bunions, hammer toes,heel spur pain, plantar fasciitis, and arch pain, or any other foot problems that you may have.  Please call our podiatry office at 416-486-9917 to set up a private consultation.  I will examine your feet, take a careful history, answer your questions, and explain the ways I can help you. 

Bottom picture:I am on the left standing beside my colleagues from Spain at the L.S.U. lab.

My favourite television show, as a boy, was Star Trek, the original series.  It featured the adventures of Captain James T. Kirk, played by my favourite actor, Canadian, William Shatner, as he visited strange new worlds on board the Starship  Enterprise.  

One of his trusty companions was helmsman Sulu, played by George Takei.

It turns out that, in real life, George had bunion surgery years ago, and it was unsuccessful.

Although there can be no guarantees with any foot surgery, one of the keys to successful bunion surgery is to adequately treat the problem in the first place.  It is not enough to just remove the bump.  The first metatarsal, which sits behind the great toe, must be made as straight as possible during the surgery, or the deformity may reoccur.  Podiatrists do this by performing what is called an osteotomy.  An osteotomy is when we cut through a bone to make it straighter,  in this case, the first metatarsal.  If this is not performed, in most cases, the deformity is destined to come back.

Postoperative orthotics can help to improve the mechanics following surgery but will not be enough if the deformity is not treated adequately in the first place.

In my Toronto podiatry office, I perform osteotomies for bunions, painlessly with local anesthetic.  I then keep the foot taped for six weeks to reduce the possibility of a loss of correction.

If you suffer from bunions, make sure the foot surgeon plans to do an adequate bunion procedure.  You should ask him or her if and how they plan to improve the position of the first metatarsal.  In most cases, removing the bump and releasing soft tissue contractures is not enough.  The bone must be made straighter.

If you, a friend or a relative suffer from bunions please call my foot clinic at 416-486-9917 to make an appointment for a private consultation where I will evaluate your bunion and tell you what is involved and the best way of treating it.

Don’t end up like Mr. Sulu with feet that are Lost in Space. 

(Foot photo from The Howard Stern Show)

I believe it is essential for the modern podiatrist to attend medical conferences on a regular basis in order to stay current so that I can provide the most up to date care for my patients in my Toronto podiatry clinic. The Chicago conference was the third meeting I have been to in 2012. I previously attnede a seminar in Pittsbugh in February and a surgical conference in Barcelona Spain in January 2012.

I had the pleasure of attending several lectures on wound care, bunion surgery and laser treatments for toe nail fungus. Most of the laser companies were represented, including CoolBreeze laser (made by CoolTouch or Cool Touch), Cutera Genesis laser (Cutera),  Pinpointe or Pinpoint laser (Cynosure),  ClearSense laser or Clear Sense (Sciton),  Q-clear Q-switched laser (Light Age)  and the Fox diode laser. I discussed protocols with the company reps and other podiatrists and compared them to how I treat fungal nails using my long pulsed laser in my Toronto podiatry office.

I learned about the latest in digital X-ray technology including Reina 20/20 P-DR (20/20 Imaging), Simon Marathon (SimonDR), iCR3600 (iCRco) and ScanX (AllPro Imaging).

While I was there, I ordered some inexpensive soft insoles to provide  cushioning for patients who do not need custom orthotics, as well as some surgical instruments for use when I perform minimally invasive surgery to treat bunions (hallux valgus) hammer toes (crooked or contracted toes), bone spurs, corns and calluses (osteotomies) with local anesthetic in my office.

I also ordered some textbooks on antibiotics, diseases of toe nails and a textbook called Minimally Invasive Surgery of the Foot and Ankle for which I had the honour of writing a  chapter called "The modified Wilson osteotomy for the correction of hallux valgus" which is a technique  I use for treating bunions in my office with local anaesthetic. This type of foot surgery involves specialized instruments and reduces soft tissue trauma which can mean less pain and swelling and quicker return to normal activities following foot surgery.

For more information on minimally invasive foot surgery and laser treatment for thick yellow fungal toenails , or onychomycosis, please call my office today at 416-486-9917. My friendly staff will be happy to answer your questions and arrange a private consultation with me.

All work and no play makes Sheldon a dull boy, so I managed to go out for dinner and I caught the Chicago production of Jersey Boys, one of my all time favourite musicals about the life and times of Frankie Valli and the Four Seasons. After the show, I said hello to Joseph Leo Bwarie who plays Frankie Valli. I told him that I liked the show so much even after seeing it twice in Toronto that I couldn't turn down a chance to see it again  in Chicago. He was very personable and asked me lf I remembered which cast I saw in Toronto. I told him that I remembered him and several others of the Chicago cast from Toronto. I picked up an Jersey Boys poster autographed by the cast. I will get it framed and put it up in my Toronto podiatry office beside my Beatles and Elvis posters. If the show comes to your area, see it. You will enjoy it.