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What is the consensus of syndesmosis surgery(Dr. Wu) for bunions? Are there any surgeons that perform this in Oz?

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I have never done one because I think the underlying philosophy behind it is flawed.

From what I understand, a fibrous union is formed holding the first and second metatarsals together at the neck and head level. More of a precursor to a tight rope procedure or older procedures that tied the first and second heads and or capsules together.

Why is it flawed? Does the first ray not move independently from the second?

Steve

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DrSArbes
Fellow American College of Foot & Ankle Surgeons
Board Certified Foot & Ankle Surgery, ABPS
Adjunct Professor OCPM
Green Bay, Wisconsin, USA

I regard bunion condition is primarily a problem of first metatarsal destabilization. Bunion surgery is to realign and restabilize the loosened first metatarsal. First metatarsal moves in a combined horizontal and sagittal plane. Horizontal plane hypermobility produces metatarsus primus varus. Sagittal plane hypermobility collapses both the medial longitudinal and transverse metatarsal arches and thus pronation. Syndesmosis procedure is trying to reproduce the function of natural syndesmosis between the first and second metatarsals. The newly and naturally formed connecting bridge works as a leash which restricts horizontal movement completely to prevent metatarsus orimus varus recurrence and reduces sagittal movement to stablilize first metatarsal but not completely like Lapidus procedure. Stability is good, not only for cosmetic effect but much more for the proper function of first ray which is all that matters for the foot.

Yiang