Bunion Pain Surgeon
5400 Balboa Boulevard, Suite 325
Encino, California 91316
(on the east side of Balboa Blvd, just south of the 101 freeway)
Telephone: (818) 907-6100
Fax: (866) 513-4995
Dr. Vladimir Zeetser is a board certified podiatric physician and surgeon specializing in reconstructive foot and ankle surgery. He is certified by the American Board of Podiatric Surgery both in Foot Surgery and Reconstructive Rearfoot and Ankle Surgery. His training includes advanced wound management and limb salvage and he has consistently achieved unparalleled results in healing problematic wounds. As an innovator and trendsetter in his field, he has been progressive in expanding aesthetic foot surgery and associated procedures to improve his patients' self-image while achieving among the highest functional outcomes and levels of patient satisfaction. Apparently unconventional in his practice approach, Dr. Zeetser believes that surgery should be minimally painful with a convenient and tolerable recovery, while producing the maximum results. He believes that the aesthetic result of any procedure is not a secondary consideration, but is just as important as the primary condition being corrected.
Feel free to explore this internet destination to become acquainted with the information and services available. Dr. Zeetser treats all aspects of foot and ankle structural disorders, including lower extremity muscular, neurological, vascular and skin conditions. During your consultation, Dr. Zeetser always performs a thorough evaluation, explains his findings in detail and creates a treatment plan tailored to your specific needs. With all of your options presented in an understandable manner, you participate equally in the decision making for the treatment of your complaint.
Advanced Modified Mini-TightRope Bunion Surgery
The treatment of hallux valgus deformity includes the assessment of the hallux valgus angle, the intermetatarsal angle and the contribution of an interphalageus deformity. Additionally, there must be an assessment of the presence or absence of arthritic involvement of both the first metatarsocuneiform joint and the first metatarsophalangeal joint. Other considerations are the orientation of the distal metatarsal articular angle and the orientation and stability of the first metatarsocuneiform joint.
Various methods have been described to correct the intermetatarsal angle. Soft tissue correction can be achieved by suturing the lateral capsule of the first metatarsal to the medial capsule of the second metatarsal, incorporating the intervening, previously released adductor tendon. A loss of reduction can occur due to the forces that oppose the suture repair as well as the possibility that poor tissue quality can contribute to a loss of reduction.
In the presence of more rigid deformities the intermetatarsal angle is reduced by using a distal or proximal osteotomy of the first metatarsal. Such osteotomies can be tec hnically challenging. A rather daunting list of consequences and potential complications include delayed union, malunion, nonunion, excessive shortening of the first metatarsal, avascular necrosis, hardware failure and prolonged protected ambulation.
The Mini TightRope is useful as an alternative and adjunct method for reduction of the intermetatarsal angle. A FiberWire® and button construct is placed across (distally or proximally) the first and second metatarsals. As the FiberWire is tightened, the intermetatarsal angle is reduced to a normal angle (less than 9-11°) The suture tied over the lateral button maintains a secure reduction of the intermetatarsal angle. Used alone or in conjunction with the distal soft tissue intermetatarsal repair, this technique affords a greater degree of strength and security than can be achieved with the soft tissue repair alone. Additionally, the Mini TightRope System provides a more technically straightforward method of reducing and maintaining the intermetatarsal angle than with conventional osteotomies while avoiding the complications associated with osteotomies.
Aesthetic Bunion Correction
These are not merely unsightly bumps on the side of the foot. Bunions are the quiet joint killers. Although typically painful with redness and inflammation, this condition can have no symptoms for many years. During this time, the damage is being done as one of the most important joints in the foot becomes deteriorated and worn away. The cartilaginous joint surface that you are born with cannot be effectively replaced and technology to achieve this is still some time away. In the meantime, the cartilage is progressively eroded as the deformity continues to grow and pain usually follows. However, often the most disturbing aspect of this problem is the aesthetic appearance of the foot and inability to wear the desired shoes. Conservative treatment often includes wearing silicone bunion shields, wide unfashionable shoes and occasionally injections of anti-inflammatory medication. Unfortunately, since this is a fixed structural deformity, conservative care can only go so far and surgery is generally recommended. Most bunions become painful and irritate the foot inside shoes at some point and being proactive at preventing further deterioration is usually the best decision. When taking this into consideration, an aesthetic result is of major importance. Conventional bunion surgery has been performed for decades. Previously, little attention has been focused on the cosmetic result, consideration for the patient's ease of recovery and post-operative pain. Using the state of art in fixation, aesthetic incision placement and modifications of time tested surgical techniques, Dr. Zeetser has been successfully performing these procedures and changing people's lives one foot at a time. Patient's typically can ambulate the same day. All fixation is hidden and does not usually need to be removed. Gone are the days of railroad track incision scars on the top of the big toe joint, having wires or pins protruding through the skin. Casts are almost never necessary and pain is minimal to none. Contrary to popular belief and what people may tell you, bunion surgery does not have to be painful and debilitating. Compare your result to the typical bunion surgery horror story!
Bunion Deformity (Hallux Abductovalgus)
A bunion deformity is a misaligned big toe joint that can become swollen and tender, causing the big toe to deviate towards the second toe and a bump or bunion to form on inside (medial aspect) of the big toe joint. As time progresses, the angle between the first and second metatarsal bones increases and the bunion becomes larger. Initially, it may be without symptoms, however because of the deviation at the joint, arthritis may develop and destroy the joint and cause pain. Bunions are generally thought to be hereditary, but their development can be exacerbated and hastened by tight fitting or narrow shoes, flat foot and hypermobility deformity. It becomes very difficult to wear shoes comfortably and depending on the patient's age, can lead to skin breakdown and wounds. Conservative therapy is typically only temporary and thus surgery is frequently performed to correct the problem.
Tailor's Bunion or Bunionette
This is the equivalent to a bunion but is present on the outside of the foot at the fifth metatarsal bone. Causes and treatments are generally the same as for a bunion deformity.
Heel Pain, Plantar Fasciitis and Heel Spur Syndrome
This general category results in pain to the inside (medial aspect) of the heel which can occur suddenly or have a gradual onset. It occurs from excessive tension on the plantar fascia, the tendon attaching on the bottom of the heel bone, which results in microtearing and inflammation. With time and continued stress, the muscle pulls at its attachment to the heel bone and eventually produces a calcified spur visible on x-ray.
Typically described by patients as a very painful sensation upon arising in the morning and trying to make the first step of the day. After anywhere between 10-30 minutes, the pain subsides and the day progresses with a dull aching constant pain. Upon relaxing and being seated the pain tends to go away and then when the patient arises again to start walking the cycle starts all over again with very painful first step. Conservative treatment typically consists of injections, anti-inflammatory medications, stretching exercises, orthotics and sometimes physical therapy. For the 5-10% of patients that do not completely improve with conservative care, additional options remain. Prior to considering open surgery, a successful treatment called Extracorporeal Shock Wave Therapy (ESWT), first introduced as Ossatron, has been used for decades safely to procedure up to 92% success rates with one treatment.
When to Call a Doctor
Please seek immediate medical care if you experience:
- Persistent pain in your feet or ankles.
- Red, hot, swollen joints in the foot with severe pain and limping.
- Pain, redness or other noticeable change to your toenails.
- Pain, redness or other skin condition including severe cracking, scaling, or peeling.
- Blisters and/or sores on the feet or ankles.
- Signs of bacterial infection including: increased pain, redness, heat, red streaks extending from the affected area, discharge of pus.
- Fever of 100°F (37.78°C) or higher with no other cause.
- Symptoms that do not improve after two weeks of treatment with a non-prescription product.
Any of the above AND you are diabetic, have poor circulation, are taking Coumadin (or other anticoagulants) or have any other systemic condition that places you at increased risk for lower extremity complications.
Disclaimer - The content on this site is for informational purposes only. You are encouraged to perform your own research into common foot problems and treatments available. It is not intended for the purpose of self-diagnosis or treatment recommendations. Only a personalized consultation can appropriately address your specific concern. - Dr. Zeetser