Welcome to CITYFOOTCARE.COM,
Lawrence Silverbergthe Internet home of Drs. Emanuel Sergi and Lawrence Silverberg, the most compassionate and skilled foot doctors in the New York City Metro area and the country.

Dr. Silverberg is Board Certified by the American Board of Podiatric Surgery. Our office is conveniently located in Midtown Manhattan near Grand Central Station.

We take great pride in providing excellent medical care along with great bedside manner and take the extra time to explain your problems and the treatment options in detail.

At City Footcare we treat all problems related to the foot and ankle. We use state of the art diagnostic and therapeutic equipment.

The doctors believes in patient education, and patient participation in their care. We take pride in spending time with our patients and listening to them. Our patients never feel rushed. We also take the time to explain patients problems in detail and spell out explicit treatment plans.

When your problem requires surgery, you can rest assured that you are in the hands of a competent and highly trained surgeon. Drs. Sergi and Silverberg have been called the best foot surgeons in NYC and the best bunion surgeons in NYC. The doctors perform all foot and ankle surgery including traditional open surgery, minimally invasive surgery, laser surgery, radio frequency surgery and extra-corporeal shock wave therapy. Drs. Sergi and Silverberg are experts in all aspects of foot surgery. They are very detail oriented from start to finish. A good surgical outcome starts prior to entering the operating room. After expertly diagnosing patients’ conditions, they plan out the procedures with great skill. In the operating room they are skillful and precise. they also take into consideration aesthetics with incision planning and plastic surgery type suturing techniques.

They is hospital and surgery center affiliated.

To resolve all of your foot and ankle problems, simply look around this site and make an appointment with Drs. Sergi and Silverberg today. Your feet will be glad you did!

Please see the medical DISCLAIMER on the ‘about this blog page‘.

Case Study: severe bunion surgery opening base wedge osteotomy

I am going to start posting quick case studies of interesting foot surgery and other foot problems as they come in. These posts will be shorter than my more education posts and just present the complaint, physical findings, diagnosis and treatment.

The first case study is a severe bunion. This is one of the largest bunions I’ve operated on in my ten years of practice (since 2000).

This patient had severe pain in both of her feet with bunions. The right bunion was bad but the left bunion was really severe.

Here are preoperative pictures. (Click any picture make larger.)

imageimageimage

You can clearly see the great toe is under the second toe and how large her bunion is.

Below are the pre-operative x-rays:

image

You can clearly see the large bunion with the first metatarsal severely angulated.

I decided to do an opening base wedge osteotomy (inserting bone graft to move the metatarsal) . Her first metatarsal was a bit short and if I had done a closing osteotomy (taking out bone to move the metatarsal) it would have shortened it even more, so I didn’t do the closing wedge surgery. After I did the base wedge osteotomy I released the soft tissue contractures at the great toe joint.  Then I removed the bump of bone at the first metatarsal joint. Then I did an Akin osteotomy in the toe bone because the first toe was still turned toward the second toe. Then I corrected for the extra skin after moving the bones. After all of these procedures the correction was amazing.  There was a new foot!  See below.

I called the patient the night of surgery and again the next day and she reported that she had little to no pain even with all the work that I did!

I did surgery two days ago so I don’t have and long term postoperative pictures yet but I did have one of the OR nurses take a picture while still on the operating table at the end of the surgery. I also have immediate postoperative fluoroscopy pictures.

Below are the before and after pictures of this bunion surgery: I will add more long term pictures in the future.

imageimage

imageimage

Come back in the future to see pictures of the healing process. I will update below…

© Copyright 2010
Best Podiatrist NYC
Lawrence Silverberg, DPM
City Footcare, PC
20 E 46th Street
New York, NY 10017
212-871-0800
www.cityfootcare.com
cityfootcare@gmail.com
Specializing in foot surgery, bunion surgery, hammertoe surgery, cosmetic foot surgery, general podiatric surgery.
One Response to Case Study: severe bunion surgery opening base wedge osteotomy
  1. TF
    December 25, 2010 | 10:52 pm

    Dr. Silverberg, Holy cow my celebrity bunion looks bigger than I remember it- I still can’t believe that’s my foot in the after picture.The transformation is truly amazing. You made my day yesterday taking that bandage off. Thanks again for your consistent attention and care and see you at the follow-up. All my best, TF

Leave a Reply

Wanting to leave an <em>phasis on your comment?

Trackback URL http://www.bestpodiatristnyc.com/case-study-severe-bunion-surgery-opening-base-wedge-osteotomy/trackback/