Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Computer Assisted Surgery - Elevated 1st & 5th Metatarsals

Discussion in 'USA' started by tiger, Oct 2, 2017.

  1. tiger

    tiger Welcome New Poster

    Members do not see these Ads. Sign Up.
    Greetings. I am brand new here, coming at this from a patient perspective - my medical background as a former Navy Hospital Corpsman Nuclear Medicine Technologist and having had 5 failed / under corrected foot surgeries leaving me with elevated 1st and 5th MTs / metatarsalgia. Yes, my health is excellent, very strong bones that heal well - hoped not to resort to orthotics (not ideal for energy transfer for running and weight training athletes like myself).

    I've been to the best foot and ankle reconstruction surgeons here in Los Angeles and have been told that the procedure is, simplifying here: make a 'game plan' from preoperative xrays and then it is up to surgical skill and experience while in the OR to correctly cut and set the bones properly. Xrays taken afterwards basically ensure that any hardware is installed correctly. Really you would need 3D imaging to verify exact alignment. As a patient by the 3rd under corrected surgery, I was willing to pay out of my pocket to obtain whatever extra imaging was necessary, and or install bone markers if it would better, almost guarantee the desired outcome.

    Recently I searched online for 3D imaging and foot surgery and found Dr Martinus Richter in Germany who happens to be a pioneer in computer assisted surgery using intra-operative CT. I am in communication with him to see if he can fix my foot. Obviously the travel and medical expenses are all mine as insurance will not cover anything. My question is are there no foot surgeons in the USA that use this assistive technology? If none are here in the USA, WHY not? It would seem to be the smarter solution if you can virtually guarantee better outcomes.

    Please see these weblinks below, the last one is a great video how it works, and let me know what you think. I have sent in weightbearing CT scans of each foot (my good one to compare), lots of xrays, and a pedobarograph study... I am hopeful that Dr Richter CAN fix my foot and perhaps use my surgical history and data as a learning case to help bring this technology to the United States. Thanks for your attention on my new forum thread, as a new member here. I have kept my name private so calling me tiger is fine.

    (It won't let me post a link because I have not made 10 posts)

    google this "Computer aided surgery in foot and ankle: applications and perspectives"

    google this "9781849964166-c1.pdf"

    Get the last one, the best one (video in action) off the healthcare Siemens website, choose medical imaging, choose on the left side of the page for C arms, choose information-gallery, choose customer testimonials, choose the 1st one for the Arcadis Orbic 3D
  2. efuller

    efuller MVP

    Not ideal energy transfer happens when you have an elevated first and fifth metatarsals. A correctly made orthotic would create better energy transfer. Why do you think orthotics are not ideal for running and energy transfer?

    You want the loaded alignment to be good. On the operating room table its nearly impossible to load the foot, like it would be weight bearing, and then get the imaging. If someone says they can do that, I'm not sure that I would believe them.
  3. Admin2

    Admin2 Administrator Staff Member

    The original poster is having an error posting. Here is their response:

    1. Thank you for your response. Orthotics would create, in effect, a lever action that is less efficient compared to a direct or straight action. Consider that metatarsal bones are naturally straight so that when you run, the sprung energy translates up into the skeleton without any real ‘blockages’. An orthotic insert to bolster an elevated metatarsal head acts essentially like a lever so that energy transfers to it... and then pushes upon the metatarsal from a more plantar direction... I’ve never had orthotics that worked very well so this is my own logic / theory - that I bounced off a PhD of Physical Therapy ... and he agreed.

    2. Dr Richter does corrective osteotomies by using intraoperative 3D catscans AND intraoperative Pedobarography. That seems to be a very thorough process to be just about as perfect as humanly possible. Check out the last link on the Siemens website how they insert positioning devices in the OR and acquire a scan right there immediately before operating and then computer analysis with verification before final hardware placement and closing CT scan. It seems foolproof. They do not show the pressure scan but he says they also do a computerized foot pressure verification.

    After having had 5 surgeries, I am hopeful that it will become the new Standard of Care for Osteotomy and other foot surgery, given how important correct alignment is to restoring near normal mobility and activity. Now what do you think?
  4. efuller

    efuller MVP

    If you want to learn about energy and levers you should consult a mechanical engineer and not a physical therapist.

    Good Luck with your surgery.

Share This Page