Cressing surgery in the treatment of foot in Spain is the minimally invasive method used by the best Spain. Is to fix the changed position of bones and soft tissues feet Through the minimum incision of a length of 2-3 mm (instead of a large section, usually 6 cm produced in classical open surgery).

What are the main deformations of the stop?

The most common deformation of the foot, which may require percutaneous surgery of the foot are valgus deformation (bursitis thumb feet).

Konskaya foot - accompanied by resistant plantar bending. Active rear bending at an angle of 90 and less degrees is impossible or difficult. In severe cases stop It is impossible to withdraw in a normal position even by passive bending.

Heel foot - characterized by resistant revenge. With severe deformations, the back surface feet Requests the front surface of the lower leg.

Hollow (hard, supinated) foot - accompanied by an increase in the curvature of the longitudinal part of the arch. In severe cases, the patient relies only on the heads of tie bones and the heel borgon, while the average departments feet Do not come into contact with the surface.

Flat (soft, enament) foot - It is characterized by flattening the transverse or longitudinal part of the arch. With longitudinal flatfoot stops, it rests on the surface is not an outer edge, as in the norm, but all the sole. Transverse flatfoot is accompanied by an expansion of the front departments and an increase in the distance between the heads of tie bones.

In practice, when foot treatment in Spain, there is a combination of several types of deformation feet. Along with the state of bones, joints, tendons and ligaments, the magnitude and type of deformation can influence the pathological changes in the overlying departments, especially the ankle joint.

What are the advantages of percutaneous surgery in the treatment of foot in Spain?

1. Conduct operation under local anesthesia.
2. The ability to walk is restored immediately after the operation. The patient enters the operating room and comes out of it alone.
3. Lack of hospitalization period. The operation is carried out outpatient.
4. Reducing postoperative pain due to the fact that soft fabrics Are injured in minimal degree. In 95% of cases, patients do not take painkillers.
5. No need for applying nails and screws for fixing bones.
6. Gypsum in the postoperative period is not required, only gauze bandage and special shoes are used.
7. This method allows you to return to work immediately after the operation.
8. Due to the small incision, the risk of complications is reduced, there is a relatively smaller scar size.
9. Material advantages: The stay in the hospital is only a few hours.

Expressive surgery in the treatment of foot in Spain - Medical Service BCN organizes treatment in Spain, select the best clinics, specialists, accompanied on reception.

Description

In recent years, foot surgery has been highlighted in a separate narrow specialization. It provides a complex approach To stop problems: Prevention, comprehensive diagnostics, choice of type and conduct of surgery, rehabilitation postoperative period. When conservative treatment methods are ineffective, the operation due to modern techniques gives excellent results: allows you to correct the deformation, eliminate the effects of injury, freeing the implanted nervous end and much more.

In our surgical center are performed stop operations Any degree of complexity. Highly qualified specialists under the guidance of an experienced endoscopic surgeon, a phlebologist, the chief doctor of the surgical hospital.

The procedure for providing surgical assistance of foot pathology

Our Surgery Center provides a full range of services for prevention, diagnostics, treatment with further rehabilitation of acquired diseases, injuries or congenital abnormalities of the Stop structure.

Before the operation, the patient passes a comprehensive examination, based on the results of which and on an objective assessment of the state of the limb, the method of operational intervention is selected, optimally suitable for eliminating specific pathology. The possibilities of modern diagnostic equipment, which is equipped with the center, allow all diagnostics on the day of circulation. After receiving the results of research, the doctor appoints an operation for a convenient day for the patient.

Any stope operation Conducted by modern technologies. The use of minimally invasive techniques in practice allows surgical interventions to significantly reducing the risks of postoperative complications. When conducting endoscopic operations, the blood loss is minimal, the patient suffers less from postoperative pains, rehabilitation time is reduced.

Imported anesthetics do not cause side Effects And allow the patient to move the operation well. Our orthopedic and surgeons have extensive experience with modern micro-flames and fixing devices (special brackets, screws), which they, if necessary, stabilize bone fragments. These designs are hypoallergens, non-toxic, are not rejected by the body, do not cause inconvenience when carrying shoes, allow you to abandon traditional drying in postoperative period.

Features of the postoperative period

The duration of stay in the hospital after the operation depends on the state of the patient and the volume of intervention, but usually does not exceed 2 days. Often the patient is discharged on the day of operation for rehabilitation outpatient. Recovery treatment in the postoperative period can also be in NPCC. Complex of physiotherapy techniques + physiotherapy Allow in a short time to restore the function of the operated foot and return to ordinary life. Before the discharge doctor will recommend which orthopedic shoes to wear in your particular case.

Indications for operational intervention in the foot:

• any traumatic damage, up to fractures;
• the consequences of the incorrect bones after the fracture;
• deformation - Taylor, Haglund, hammer-shaped or valgus deformation of the fingers;
• foot structure defects, for example, high heel;
• onychokriptosis (nail rustling);
• any kind of flatfoot - congenital, acquired, richite, traumatic, static, etc.;
• bursitis;
• arthrosis;
• chronic stope pain;
• damage to the bunder apparatus of an ankle, leading to instability (condescending in the field of ankle joint) of the foot;
• heel spurs;
• osteochonropathy - Shinz disease, Keller I and II;
• morton's neurinoma;
• benign tumor;
• lateral amyotrophic sclerosis and others.

* Plusted price is not an offer.

In the article, we describe various types of operations for surgical treatment of valgus deformation, from traditional methods of interference to new percutaneous surgery, less invasive and day hospital.

Term valgus deformation denote deformation of the joints of the plus / phalanx of the first finger of the foot, which is manifested by the inclination of the latter towards other fingers, at least 8 °. The first finger (big) shifts from his normal position and deviates towards the rest of the fingers, sometimes even superimposed on the second and even on the third finger.

The problem is manifested strong poolselocidating in the sole, which in many cases can seriously affect walking. And, in addition, the deformation of the joint over time deteriorates and can achieve such a level that the use of standard shoes becomes problematic.

Surgical intervention - the only treatment in advanced stage

Methods with which the operation can be performed, and, of course, the choice depends on the patient's characteristics and the causes of the disease.

The following parameters affect the choice of operation techniques:

• Patient age. Young patients are recovered faster and completely.
• Physical condition of the patient. The assessment is necessary to choose the type of anesthesia.
• Field of activity and patient expectations Regarding the restoration of the functionality of the leg.
• The size of the degradation of bones, joints and soft tissues: Tenders, cartilage, articular capsules.

Obviously, for evaluations, the doctor will also rely on a number of clinical studies: a general medical examination, a cardiological test, blood test. Certain local tests will also be needed, such as the leg x-ray to assess the degree of deformation. And it will also be necessary will be the opinion of the anesthesiologist for the choice of anesthesia.

The purpose of the operation is the result

Surgical intervention for the treatment of Valgus deformation is intended:

• "Perestroika" of the thumb With a tie and, therefore, a decrease in the Valgus corner.
• Angle decrease Between the first and second tie bones.
• Restoration of functions joints.
• Removal from cones and cornwhich are formed on the side of the head of the first tie bone.

Intervention Methods - Open and Expressive Surgery

Traditional surgery

Typically, traditional surgical approach in the treatment of Valgus deformation It is used in not very young patients or in patients with pronounced violations of the joints.

With this operation, cuts are made, large enough to open access to the surgeon.

Rules of operation:

• Osteotomy (resection) of the tie head in the most suitable form (L-, V-, "Lastochka Tail", etc.) in order to get the best leveling of phalange.
• Osteotomy Falangi to complete the alignment.
• Liberation of semovoid bone from any adek.
• Return of the tendon leading the thumb muscles.
• Return articular capsule and its consolidation with shortened cloth.
• Insert one or more pins, if necessary, to impart stability.

If the victim joint has an arthrotic degeneration, then during surgery surgery will evaluate the state of cartilage. If possible, free the joint from any osteophytes. Otherwise will be fixed in such a way that it is possible to circulate, despite the rigidity.

Mini invasive operation

This form of intervention is carried out. very fast (a few minutes, maximum 10), which obviously requires less time to restore after the operation. Its disadvantage is that the doctor does not have greater freedom of action and cannot affect the surrounding soft tissues.

For this reason, such an intervention is shown only for young or very young patients, because they have great opportunities for recovery.

Percutaneous operation

The procedure is similar to the previous one, but use miniature surgical instruments controlled from outside, under control via x-ray.

This type of operation also allows you to intervene in soft tissues. Also, obviously, in this case, the skill of the surgeon is important. Despite this, it is obvious that the risk of such an operation is very low, but not zero. Recovery here also goes very quickly.

Anesthesia and postoperative recovery

All described operations performed under local anesthesia. Mini invasive and percutaneous interventions are performed on outpatient conditions with returning home in a few hours.

Regardless of the method used, it is very important to correct recovery after surgerywhich starts immediately after surgery using a special rehabilitation gymnasticswhich is done with the help of special shoes, which allows the patient to walk the day after the operation.

Relevance. The need for the correction of deformations of the forefoot is defined as high frequency Meeting of this group of pathologies, as well as the growing requirements of modern patients to the quality of life. According to various authors, about 40% of young women in one or another period of life suffer from problems, lifting the features of the structure of their feet. IN age group Over 60 years old, various in the nature and degree of severity of the deformation of the feet occur about 60% of women. The surgical treatment of deformations of the forefinder stop orthopedists has been engaged in no one century. Hundreds of techniques are proposed, many of which are currently used. With the same form and degree of deformation, the surgeons can be used significantly different from each other. The choice of orthoped techniques of operations can influence various factors: technical and theoretical training of a doctor, belonging to a specific school, tradition medical institution, technical equipment hospital, etc. Such ambiguity of choice says, among other things, the absence of a single approach to solving the problems of deformations of the front department of the STO-POP. This is also evidenced by a large number of unsatisfactory outcomes of operations.

Characteristic tendency B. modern surgery It is the desire to reduce the trauma of operational interventions. The percutaneous surgery of the feet is a sub-injection of orthopedics, most of all meets the principles of minimum invasiveness.

The purpose of the study is to improve the results of the surgical treatment of static deformations of the front footage by introducing and modernizing percutaneous reconstructive operations.

Material and methods.

The foundations of the percutaneous surgery of the foot were laid in the 60s of the last century. Initially, it was about removing the heel spur with a drill and small cutters. Later, percutaneous techniques were developed to perform operations during static deformations of the stop (first of all - during metatarsalgies). Theoretical foundations of percutaneous surgery are based, including those expressed in 60-70, several authors of the provisions that, with properly performed distal osteotomy, the lateral ventilation bones can not fix their fragments. In this case, the head of the tie bones under the influence of early loads find their "perfect" position. In the late 80s and early 90s, the American podiatribist Stephen Isham has developed a detailed technique of percutaneous operations in the Valgus deformation of 1 finger, the disease of the tailor and other pathological states of the stop. To date, Stephen Isham is recognized by the height of the percutaneous surgery of the foot.

Incainting operations in the footsteps are performed through small (up to 1 cm) cuts or skin punctures. To fulfill the standard operation, the following tools are required:

• bEAVER type narrow scalpels having a triangular sharpening and allow access to the bones, forming the space for operation with mills, as well as perform shaden, legame, capsululotomy;
• low-speed pencil type microdel, which gives the opportunity to work at a speed of up to 4000 revolutions per minute, which avoids the bone burn;
• microfrus for performing expootomy, corrective osteotomy (there are several varieties of micrographs, characterized in length, diameter, shape, cutting surface design);
• rashpil and spoons to remove bone chips, burn bone opili;
• electronic optical converter type C-arc (ideally - mini C-arc).

Here is an exemplary list pathological conditions The front of the foot, in the treatment of which percutaneous techniques can be used:

• valgus deformation of the finger of the foot (Hallux Valgus);
• hammer-shaped deformation of the fingers of the foot;
• metatarsalgia;
• morton's disease;
• quintus Varus Supraadductus (Quintus Varus Supraadductus);
• tail disease;
• Hallux Interfalageus HyperExtensus;
• Hallux Valgus Interfalageus;
• clinodactyline;
• inter-fellow exostosis.

As in traditional surgery, with percutaneous operations there is a certain set of surgical actions, the one or another combination of which allows you to solve the plague tasks. At the same time, the approach to treatment should be differentiated and op-recycled not only by the type and degree of expression of deformation, but also complaints of the patient, his wishes, age, quality bone tissue, the state of soft tissues, etc.

Expressive surgical intervention in the Valgus deformation of 1 finger in a significant percentage of cases may consist of the following steps:

• ExpoComatomium head 1 tie bone: Exostosis is removed by affecting it the side surface of the cutter. The bone chips is crushed to the cascaline state removed by extrusion through the wound hole, as well as with the help of a rashpil or spoon.
• The second stage is a distal wedge-shaped osteotomy of 1 ventilation bone on reversal-aisha. This stage is inconsistent. It is performed through the same access as the ek-zoostoxomium in cases where the shortening of 1 tie bone is necessary, as well as in the presence of inclination in the lateral side of its distal articular surface. The size of the wedge removed can be adjusted by the shape and size of the cutter.
• The next permanent stage of operational intervention is the lateral release of 1 of the Plus Snoplanging Sustain. It consists in cutting off the tendon of the leading muscle from the base of the main phalange of 1 finger, as well as in partial lateral capsulotomy.
• Osteotomy base of the main phalange of 1 finger. For the first time, Akin was described many decades ago. It is performed through the puncture of the skin on the tile surface of the base of the first finger. The preservation of the outer cortical layer during the cutting of the cutter significantly increases the stability of phalange fragments after osteotomy. At the same time, in some cases a complete osteotomy is performed. For example, if necessary, eliminate the pronation of 1 finger or achieve its shortening. In the presence of an outdoor deflection due to the deformation, the main phalange of osteotomy is shifted to the average third or can be performed at the level of the distal third phalange with Hallux Valgus Interfalangeus.

The need for intervention in the lateral rays at the Operation on Nallux Valgus is determined by a specific clinical and radiological picture. Even in the absence clinical manifestations In the form of a hammer-shaped deformation of the fingers or hyperkeratoses under the heads of lateral tie bones in cases where the diaphragus is determined on radiographs in the form of a significant predominance of the length of the lateral ventilation bones, the subcontipature osteotomy of one, two or three hanging bones may be required to prevent transition metatarsalgia development.

Percutaneous operations with Hallux Valgus are most effective with light and moderate degrees of deformation (according to our observations - to an angle of 14-15º between 1 and 2 tie bones).

Strain 5 beam. In our work, we are most often encountered with tailor disease. There are 3 main types of structure (or positions) of 5 tie bones that contribute to the development of tailor disease:

• 5 Tweet bone with an increased lateral part of the head in size;
• 5 Tweet bone in the position of excessive dusting;
• 5 Tweet with an increased lateral bend of a diaphyse, leading to the lateral deviation of the head.

The choice of varieties of percutaneous surgical intervention in the tight disease is determined by the embodiment of the structure of 5 tie bones, as well as the presence and degree of deviation of Knutut 5 fingers:

• ExpoToCetomy: puncture of the skin is carried out on the sole-lateral surface of the foot, just proximal than the head of the 5 tie bone. The scalpel is formed by space for work, after which the cutter is eliminated by the protruding part of the head. With the first of the above-described embodiments of the structure of the 5 tie bone of expoceptomy, it can be sufficient to achieve the desired effect.
• Distal linear osteotomy 5 tie bones. Performed with the goal of the medial shift of its head. The osteotomy line should go space towards the distal-lateral to the proximal-medial. After completion of osteotomy, the head is shifted with finger pressure.

Vius and adductrusal deformation 5 fingers. The percutaneous surgical intervention can consist in the tenotomy of the extensor of 5 fingers and medial capsulotomy 5 of the tune-in-flagged joint, as well as the osteotomy of the base of the main phalange.

Metatarsalgia is a collective concept that is not determined by a particular pa-thology. The causes of pain in the forefront may be much, however, we are interested in this work that is interested in metatarsalgia, due to the structure or location of the tie bones.

Select 2 main types of mechanical central metatarsalgies:

• associated with a low location of the heads of one or more central ventilation bones relative to others - static metatarsalgia.
• associated with a greater length of one or more tie bones relative to others - push (or permanent) metatarsalgies.

Both states lead to an increase in pressure on the heads of central hanging bones, which can manifest themselves with pain or hyperkeratoses. In the event that me-Tatarsalgia is not accompanied by deformation of fingers, surgical treatment, as a rule, is to perform percutaneous subcitalized osteotomy of central tie bones. Osteotomy are performed through rear skin punctures at the level of the corresponding plus-palm joints. The number and order of intersected bones are determined as follows: if hyperkeratosis is located under the head of 2 tie bones - 2-3 tall are intersect. In all other cases, osteotomy 2, 3 and 4 tie bones are performed. It is after the subcitalized osteotomy of the central tie bones to achieve the best result, a full-fledged earlier load on the foot, allowing the heads of tie bones to "find" its optimal position.

The deformations of the middle fingers can be combined with a valgus deviation of 1 finger or to be independent pathology. In clinical terms, the problem is no less important than Nallux Valgus. In practice, we often have to deal with the situation when it is the appearance or progression of the deformation of the middle fingers causes the patient to go to the operation in the presence of a long-term coarse rolling strain deformation of 1 finger. Most often, we meet with a group of deformities of middle fingers in the sagthyl plane traditionally united in literature called "hammer-shaped". Within the framework of this general, the concept of involvement in the process of various joints is allocated:

• hammer deformation;
• deformation of the type of neck or cunning;
• hammer-shaped deformation.

Expressive operations for hammer-shaped deformation can be performed on soft and bone tissues.

Operations on soft tissues:

• Extensive tenotomy extensors. The most frequent manipulation with the hammer-shaped deformation of the fingers, performed by almost any form and stage. The exception is the hammer-shaped deformation. The tendons intersect through the rear skin puncture at the level of the Plus-Favaway joints, where there are interspectorate stretching, which prevent significant migration of the proximal ends of the tendons. After some time after the operation, the reinsertion of the ends of crossed tendons occurs.
• Rear capsulotomy of advantage of plus-inflasy joints. As a rule, the need arises in the presence of a finger dislocation, although the elimination of dislocation to the rear of the main phalanx does not have to be the goal of operational intervention. Typically, pain in the field of advantage of the Plus-Falaga joint appears during the development of the displacement and lasts 1.5-2 months. Most often, the patient comes to an operation with already missing pains, due to dislocation in the toll-line inflasy joint, that is, with complaints of pain under the head of the corresponding metallic bone or on top of the finger deformation in the projection of the head of the main phalanx.
• Threadotomy flexors. Ideally, it should be carried out in all cases of tenotomy of the time-sanctifiers in order to preserve the tendonal balance and prevent the progression of the flexing contract of fingers. Nevertheless, a differentiated approach is needed and possible in this issue. For example, in the case of a weakly or moderately pronounced hammer or clawing deformation, in the absence of a fixed contracture of interfalane joints, it is enough to fulfill only the tenotomy of the extensors.

Bone operations:

• Osteotomy the main phalanx. It is performed with a cutter at the level of the proximal or middle third phalanx through the plantar puncture of the skin. Allows you to change the axis of the phalanx, and to shorten it.
• Osteotomy medium phalanx. It can be performed both through the sole and lateral access. Main indications - fixed deformation of the finger or the need for its significant shortening.

We do not stop in this work on more rare deformations of the front feet. Receptions used to eliminate them are similar to those described above.

The process of consolidation after performing percutaneous osteotomy has its own features. Quite often, radiographic signs of the battle appear later than after traditional operations. In the overwhelming majority of cases, it does not appear clinically. The X-ray picture at certain stages can be described as a false joint, or even as a defect. At the same time, consolidation occurs in almost 100% of cases.

A few words about anesthesia and postoperative period. Most often, the operations in the footsteps are performed under the conditions of conductor anesthesia at the level of ankle joint. For anesthesia, we use a mixture of 1-2% lidocaine solution with a narropine or marcain (in equal parts). Lidocaine begins to act faster. The Markain or Naropina action is developing slower, but it lasts up to 8-10 hours after surgery. During this time, the patient begins to go to postoperative shoes with full load on the foot.

When surgery at one foot, as a rule, patients are discharged on the day of operation. In the case of interference on both footsteps - immediately after the operation or the next day.

The first outpatient inspection is made 7 days after the operation. It is removed (if they were imposed) of the seams, the fixing bandage changes. Next, the change of dressings is made twice with an interval of 1 week. 4 weeks after surgery, the patient independently removes the bandage and proceeds to active studies of therapeutic physical education. At the same time, walking in rehabilitation shoes.

Results.

In terms of 6 to 24 months, the results of 102 percutaneous surgical interventions on the forefront stop are analyzed. Operations on one foot were made by 26 patients, at two - 38. The total was operated on 64 patients, of which men were 6. The average age of patients was 48 years old (from 19 to 83). Assessment of treatment results was carried out on the Kitaoka scale, in accordance with which 84% were obtained good and excellent results, satisfactory - 15%. The unsatisfactory result is one, noted at the stage of mastering the method and is due to the technical error. In addition to the assessment on the Kitaoka scale, all feet took pictures before the operation, on the first dressing, after 3 and 6 months after the operation. This made it possible to objectively assess the aesthetic result of the operation, the dynamics of reducing edema, mark the disappearance or preservation of hyperkeratosis. After operations about complex stop deformations, the complete disappearance of the edema was usually observed for two months. After operations, only on the first ray often, swelling in the postoperative period did not develop at all. The need for analgehetics in the postoperative period was determined by the threshold of the sensitivity of each patient, however, as a rule, did not exceed 1-2 x-multiple reception of 400mg ibuprofen or a similar dose of another non-steroidal anti-inflammatory agent during the per-out of 3-5 days after the operation. Many patients did not resort to the admission of painkillers. One superficial and one deep suppuration has been noted after the operation on both feet in a patient of 19 years, which made a serious violation of the regime in the first week after the operation. Surface fitting was stopped by conservative measures, deep - by reducing operation. A good result of reconstructive operations was not lost. After operations at one foot, the return to the usual daily activity in most cases was possible after 1-2 weeks; After operations on two footsteps about the Valgus deformation of the first fingers - in 2-3 weeks; After operations on both feet over complex deformations - after 3-6 weeks after interventions.

Findings.

Based on the analysis of the obtained results, the following advantages and advantages of the method of percutaneous surgery of the front feet of the front stop are possible:

• smaller soreness;
• short rehabilitation time;
• aesthetic advantages (only point scars);.
• less treatment cost;
• lack of necessity in internal locks;
• lack of need for gypsum immobilization or orthosis;
• smaller risk of complications;
• the possibility of repeated (if necessary) operations in the future (incl., in the open method).

The deficiencies of the method include the impossibility of correction of a pronounced vapor deformation of 1 tie bone (more than 15-18º) without the use of internal locks, as well as some other components of deformation (for example, the position of semensoid bones).

In conclusion, it should be noted that percutaneous operations in the footsteps relate to technically complex interventions. Training curve, estimated by various authors, ranges from 30 to 50 operations. Reduce the number of complications and unsatisfactory results associated with the period of learning, you can work on the duct and body material, as well as a combination of traditional and percutaneous techniques with a gradual increase in the number and complexity of the percutaneous components of the operation.

• Finger curvature, including Hallux Valgus and Hallux Varus, hammer-shaped and crossed fingers
• Painful cones ("bones") on the legs arising as the result of Hallux Valgus or Taylor deformation, - respectively, curvature 1 or 5 of the advantage
• Heel spur
• Painful natopes, corn on the fingers and between them
• Arthrosis of the Plyusnefalango Sustav
• Fascia and Ligamethitis
• Morton's disease
• Flatfoot
• Pain in the footsteps, as well as pain in the knees, hips, lower back, the cause of which is flatfoot, etc.

Hallux Valgus treatment

Surgery Hallux Valgus (in the literal translation - "rejected outwards") is one of the most sought-after procedures in orthopedics.

With the rejection of the normal axis of the finger, the outward as a result of carrying close uncomfortable shoes, arthritis, flat-painting, hereditary and acquired reasons, the first plus-inflated joint is starting to write, a bump is formed, which is often rubbed by shoes, is inflamed. Due to the constant injury when wearing shoes and walking, the defect is inclined to progress and does not pass by itself.

In the presence of this problem, orthopedic usually recommend wearing orthopedic shoes. However, aesthetic defect, extreme sickness of "bones", as well as the simplicity and availability of a Hallux Valgus correction operation forces more and more patients to seek help from surgeons.

Benefits of foot surgery in Medsi:

The foot surgery is carried out at the Medica Medical Center minimally, through mini access, with the help of the most modern equipment and tools. Implants, metal structures and endoprostheses are made of inert materials that do not cause allergic reactions or reaction of rejection by the body. Due to the small cuts on the skin and minimal traumatization of the surrounding tissues, the recovery after the operation occurs in a short time. After the operation, additional drying is not required, just carrying orthopedic shoes or stelks.

With the help of minimally invasive and ultra-modern surgical interventions in the footsteps, you can achieve:

• Firefield fixes and its consequences
• Corrections of congenital and acquired (including post-traumatic) deformations of fingers
• Corrections of congenital and acquired (including post-traumatic) foot deformations