Here we go yet again. Exactly as I have previously state, these advocates of MIS will tell you that if your doctor performs traditional, time-tested and proven procedures in favor of his quick and dirty ones, that it's because your doctor, "lacks the training," is "afraid to inform you that (those) procedures exit," and then Dr. Ozer goes on to even suggests that if may be because your Dr's office is "not clean enough." Quite a psychic insight, don't ya think?
First of all . . We don't really know from Beth's (excuse the use of your name, Beth. I know you want out of this.)description that she has a hammer toe. It may well be that she has a fracture of the great toe which indeed could call for a screw.
But let's see what is done in the MIS-devotee's hands for correction a simple hammer toe. If Dr. Ozer follows general MIS dictums, what he is recommending is essentially this:
After numbing the toe with local anesthesia, the toe is (hopefully)* washed with surgical soap and painted with an antiseptic. Then a puncture incision is made on the toe in the area of the deformity. Next a bit is placed on a rotary drill and the bit is introduced through the hole made in the skin and drilled into the bone below. Of course, to get there, one has to go through what Dr. Ozer ostensibly considers "throw-away tissues" such as sensory nerve, tendon, ligament and joint capsule. Then one blindly cuts the bone (as he can't actually see it through the puncture wound), as he wriggles and wiggles the drill bit around until the bone, admixed with blood turns to a paste-like substance . . as if your bone had been thrown into a blender and a little blood added. Sound tasty? This "bone paste" is then expressed out of the wound by squeezing the toe and when he thinks he has it all out he might flush the area with saline. Of course, any bone paste or bone fragments inadvertantly left behind are potential sources of problems.
* (some I have known actually claim that surgical cleansing of the toe is unnecessary as the blood flow washes out the infectious agents).
Sound difficult to do? . . I don't think so. Sound like it needs a lot of training? . . . I think not. Sound like good surgical technique? . . . Gimme a break!
What Dr. Ozer fails to mention is that only by luck and happenstance has some tissue of importance not been mangled. If that drill happens to contact any of a couple of nerves, it will roll it up and tear it . . and nerve doesn't seem to either forgive or forget such insults. And what of the other tissues that have likely been torn asunder? What the MIS "surgeon" is relying on is that the body can general take a pretty good lickin' and keep on tickin'. Is that good enough for YOU?
On the other hand, traditional procedures really don't take any longer than that, but they do feature complete visualization of the tissues which the surgeon is invading so that those tissues may be identified, handled with care and protected from unnecessary damage. Then, after the bone portion is removed by CAREFUL cutting with APPROPRIATE instrumentaton, the tissues can be carefully repaired. Good surgery is all about appropriate handling of tissues, and THAT is what take training and experience.
Would you go to a watch repair specialist who's technique for removal of a damaged sprocket is to blindly drill into the watch case and grind out the sprocket, then squeeze it out of the hole in liquid form. Or would you prefer one who carefully opens the case, finds the faulty part, carefully removes and replaces it and then skillfully closes the case?
Which method sounds like, "the Dark Ages" to you?
Having see the brutality of this procedure in print, Dr. Ozer is likely to say that he has some special and different non-traumatic technique which I haven't described, (probably because I lack modern training), but don't believe it . . This is IT.
In actuality, the MIS procedure which I have described above is about as simple as one of these procedures gets, and if that's the extent of what these MIS devotees did, I would not be complaining all that much. The real problem is that they have incorporated those and other similarly inappropriate, blind and brutal techniques into surgeries calling for far more skill and much more care than do simple hammer toe procedures . . . as if to say "If one can get away with a little insult, why not try to get away with a BIG one. Ah . . And therein lies the rub.
(How's THAT for a classical ending, thanks to the Bard?)
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