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Surgeons
rethink approach to minimal incision foot
and ankle surgery
Newswise — Many patients who undergo foot and ankle surgery are
recovering faster and with smaller surgical
scars, thanks to new minimal incision
techniques and tools. At the same time, foot
and ankle surgeons are questioning whether
smaller is always better.
"In the 70s and 80s, there was a trend towards small incisions for
the sake of small incisions," says Lawrence
Ford, DPM, FACFAS.
He will be presenting a lecture on small incisions Thursday at the
66th Annual Scientific Conference of the
American College of Foot and Ankle Surgeons
(ACFAS). "Surgeons are now recognizing that
the incision has to match the procedure and
the patient."
Minimal incisions provide several potential benefits for patients,
including smaller scars, faster tissue and
bone healing, and fewer complications such
as pain, bleeding and infections.
These techniques can also reduce complications for high risk
patients, such as those with circulatory
problems caused by smoking, diabetes or
other conditions.
The disadvantage of minimal incision procedures is loss of visual
exposure, or the surgeon's ability to see
the injured tissues or bones with the naked
eye.
The foot is a compact body part, filled with 26 bones, 30 joints,
and more than 100 muscles, ligaments and
tendons.
"Depending on the patient and the procedure, a wider exposure may
be preferable to a small opening that is
made just for the sake of a small scar,"
says Ford. "More surgeons are embracing an
approach that matches the incision size to
the individual patient and condition being
treated."
Ford gives the example of a patient who
falls off of a ladder and shatters his or
her heel bone, requiring an operation.
For some patients, a small incision technique may be appropriate.
It would allow the surgeon, guided by miniature cameras and scopes,
to insert metal plates and screws to secure
the bones in the correct position without
compromising the surrounding delicate soft
tissues. Healthy blood flow is important for
bone healing.
A few, small incisions would disrupt fewer veins and arteries.
But Ford points out that every patient's injury or condition
is different, so in some cases a larger
incision can make repairing a complicated
injury easier.
Small incisions can be especially beneficial
for repair of Achilles tendons, which suffer
from sub prime blood circulation and can
develop wound complications.
Jones fractures, an injury to the bone on the outside of the foot
that attaches to the little toe, also
benefit from small incision procedures
because part of this bone receives less
blood.
Arthroscopic surgery for joint pain has been performed through
small incisions for many years now, and is
considered standard of care for certain
problems.
For more information on foot and ankle conditions, and to locate a
local foot and ankle surgeon, visit the
ACFAS consumer Web site,
http://FootPhysicians.com.
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