Toe Shortening 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.
Aesthetic Toe Shortening
Excessively long lesser toes are a relatively common deformity and typically pose a cosmetic concern for women more often than men. Commonly referred to as "Craptor toe", when the toe hangs off the edge of an open toed shoe, the most prevalent of excessively long toes is the 2nd digit, which is adjacent to the big toe. Normally, the big toe is roughly equal in the length to the 2nd and possibly 3rd, followed by the 4th and 5th to create what is known as the tip-toe parabola. A small percentage of the population suffers from a disruption of this parabola leading to this unsightly condition, as well as shoe fitting problems.
The aesthetic appearance of the toe often leads to its own array of psychological and social issues. Imagine being ridiculed in school as a teen-ager or being embarrassed to wear open toed sandals. Young females typically become very self-conscious about their feet and tend to shy from social activities that would expose them. But far from being simply a cosmetically displeasing deformity, this condition can result in further deformity and deterioration of the toe. Because the longest toe suffers from repetitive microtrauma in closed shoes, the most common result is a hammertoe contracture of the toe and bending of the tip of the toe with most of the weightbearing occurring at the tip rather than the fatty bottom of the toe. As a result, the nail suffers constant damage and often becomes darkened and thickened from fungal infection. The joints on the dorsum (top) of the toe typically rub and become irritated from the top of the shoe, causing unsightly corns, blisters, scarring, pain and occasionally open wounds.
There is no practical or long term method to manage this problem without surgery, especially if shoe fashion is a priority.
Fortunately, all hope is not lost. Dr. Zeetser is at the forefront of innovative and progressive surgical procedures that can effectively correct this condition using state of art digital implants which usually do need to be removed. Generally the procedure is performed at the level of the toe, but occasionally depending on other structural factors, a more extensive procedure may be required. This is evaluated on a case by case basis. With little to no visible scarring and minimal to no pain, the procedure can be done in an outpatient setting and the patient is ambulatory immediately after. Recovery times are much shorter which let you get active and back into shoes faster. In contrast, the older traditional ways of performing the procedure involve the use of a metal wire protruding from the tip of toe for at least 4 weeks. Not only does this prevent the patient from being able to properly bathe for a prolonged period of time, but there are issues associated with the wires including increased risk of infection, damage to the externally protruding wires by accident and the need to later remove the wires.
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.
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