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Old 28.04.2018, 23:03
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Orthopedic surgeon -- how to find a good one?

Hello, I would appreciate any advice/recommendation on the course of action.
I have a rare foot condition (Freiberg's infraction of the third metatarsal) that made walking fast or long painful. I have been hoping that it will stabilize or go away (happens sometimes) but the latest visit for an RX shows that it progressed a lot. The orthopedist in Malley was literally very excited by the news and told me I would need a prosthesis for the bone head. She told me that the surgery is easy, 6 week after that I will stay home (no crutches though) and then 6 weeks of physio. No name of the prosthesis or any other info was given.
As the condition is very rare, I could not find much info on the web. I was not very comfortable with the surgery and went to another orthopedic surgeon (in Zurich) for the second opinion. The guy hinted to me that many doctors like to do prostheses because the companies making the prostheses pay them, advised me against the radical surgery (kind of agree about it). He found that the other toes were also affected (toe arthritis), affected by the redistribution of the pressure. The guy showed me on the RX image how he would cut/fix the bones here and there (now on 3 toes) and suggested a surgery with him, no prosthesis... When I asked him later to email me a written conclusion, he did not reply.
Here I am, have two different opinions, no information how to choose between them. Both of the doctors above are associated with Hirslanden, so they are supposed to be good.
I am going to see a third orthopedist in Montreux in a couple of weeks, he was recommended by the friend of a friend, but overall I do not see any strategy how to make an informed choice. My situation is not acute, so I can wait. Any recommendations/advice would be greatly appreciated. I live close to Lausanne, but am willing to travel Thank you! Kutuzov
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Old 29.04.2018, 13:16
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Re: Orthopedic surgeon -- how to find a good one?

How were you referred to the first two doctors? My orthopedic surgeon is also with Hirslanden group and was recommended by my GP. I don't have anything like what you have, but so far I've found my doctor's approach to be avoiding surgery if possible.

It sounds like in your case some sort of surgery is needed but the question is how drastic and whether or not you'd need a prosthesis?

Hopefully some more folks will chime in now that it's daylight and you can get further recommendations.
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Old 29.04.2018, 13:36
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Re: Orthopedic surgeon -- how to find a good one?

Try looking up "Freiberg's disease". There appears to be quite a lot of information.
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Old 29.04.2018, 18:34
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Re: Orthopedic surgeon -- how to find a good one?

Some input.

A quick Google should give you some reading as was recommended by HA above.

freiberg infraction treatment

https://www.google.ch/search?q=freib...w=1566&bih=982

There is an ortho doctor (professor Xavier Crevoisier) at the CHUV in Lausanne that I would recommend (he did some work on one of my feet a few years ago. He works ONLY from the ankle down - so ankles and feet! He would be the person. You would probably need a referral to see him.

Link to his bio and details: http://www.chuv.ch/fr/otr/otr-home/l...er-crevoisier/
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Old 30.04.2018, 00:35
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Re: Orthopedic surgeon -- how to find a good one?

Balgrist in Zurich is another very good orthopedic clinic, and has divisions to cover different anatomic areas, e.g. their foot & ankle department website lists 4 surgeons.

However, for something esoteric and potentially tricky, one key question to ask is simply "how many of these does your clinic treat per year?". Another is to try to find recent publications on the subject and look if any of the research was done in Switzerland, or anywhere else you'd be able to go for treatment.
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Old 30.04.2018, 21:07
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Re: Orthopedic surgeon -- how to find a good one?

Dear all, thank you so much. Will try to follow your recommendations and certainly will try first to get to the doctor in CHUV.

I did google and I think I've read through majority of information I could find. There are different options and suggestions for surgical treatment, but from what I understood, there is no widely accepted way to deal with various stages of the infraction, due to both small sample and age differences (many cases mentioned are for young people, and unfortunately I am not exactly in this category).

To my first doctor I got by referral. The second guy in Zurich I found through some database of orthopedic society and their recommendation. My insurance in principal allows to go w/out a referral, but so far I haven't received the bill for my visit in Zurich, so have no idea how insurance will look at it when they receive it.

Again, thanks a lot to everyone replied. For me of course the main subject is what to do with my foot, but overall it is kind of weird that it is still impossible to find and classify information on the doctors and their quality... On my side, I'll keep posted if I manage to learn something valuable related to the orthopedic surgeons and algorithms of identifying the "better" ones or doctors in general.
Kutuzov
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Old 27.09.2018, 18:48
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Re: Orthopedic surgeon -- how to find a good one?

Hi Everyone! Went to see an orthopedic surgeon today in Loerrach about my shoulder. Great friendly, knowledgeable, speaks English. Office is just a 2 minute walk from Loerrach Hauptbahnhof. I paid private/cash----- 57.64 Euros
Dr.Joerg Bosch
Palmstrasse 36
Loerrach
2nd floor
He has a partner, Dr.Wolfgang Scharek
-- wait time was about an hour so bring a good book - - - office located in a medical building called Aerztehaus:-)
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Old 27.09.2018, 19:10
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Re: Orthopedic surgeon -- how to find a good one?

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Hi Everyone! Went to see an orthopedic surgeon today in Loerrach about my shoulder. Great friendly, knowledgeable, speaks English. Office is just a 2 minute walk from Loerrach Hauptbahnhof. I paid private/cash----- 57.64 Euros
Why would you go to Germany instead of Switzerland?
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Old 27.09.2018, 20:01
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Re: Orthopedic surgeon -- how to find a good one?

So sorry to hear about your foot problems. Unfortunately, I’ve been there and the various doctors only wanted to operate, which I did not want.


Surgical option:
The last time when it got bad, I was referred to the Schulthess Klinik in Zürich. The assistant doctor was stumped and the Oberarzt was an ass but they seem to have some experience with your particular issue: https://www.schulthess-klinik.ch/de/...rsale-2-und-3/.


Non-surgical option:
The assistant doctor referred me to https://www.spiraldynamik.com/ in Zürich, which offers non-surgical therapies. I was skeptical, especially of all the blah blah on the website but I had an excellent foot specialist there (she isn’t there anymore) who taught me various ways of dealing with my feet (massage, strengthening exercises, walking and structural issues etc). It was a long process, mostly on my own applying what I’d learned, but my feet are pain-free now - without surgery.


Referral:
I went to Dr. Speck for a second opinion on my shoulder on a Friday. On Monday he operated and on Tuesday I was pain-free for the first time in months. So, I can certainly recommend him, but it would be way out of your way. https://swissklinik.ch/aerzte-team/

Hope you find a solution! It’s not fun when every step hurts.
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Old 27.09.2018, 21:26
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Re: Orthopedic surgeon -- how to find a good one?

Quote:
View Post
Hi Everyone! Went to see an orthopedic surgeon today in Loerrach about my shoulder. Great friendly, knowledgeable, speaks English. Office is just a 2 minute walk from Loerrach Hauptbahnhof. I paid private/cash----- 57.64 Euros
Dr.Joerg Bosch
Palmstrasse 36
Loerrach
2nd floor
He has a partner, Dr.Wolfgang Scharek
-- wait time was about an hour so bring a good book - - - office located in a medical building called Aerztehaus:-)



When you have orthopedic problem, money is not everything...


PS. I've had 3 very invasive procedures
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Old 29.09.2018, 10:06
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Re: Orthopedic surgeon -- how to find a good one?

No money isn't everything ---just wanted to post what I paid. Have no clue how much an appointment would cost in Switzerland.
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Old 21.08.2019, 15:27
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Re: Orthopedic surgeon -- how to find a good one?

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Dear all, thank you so much. Will try to follow your recommendations and certainly will try first to get to the doctor in CHUV.

I did google and I think I've read through majority of information I could find. There are different options and suggestions for surgical treatment, but from what I understood, there is no widely accepted way to deal with various stages of the infraction, due to both small sample and age differences (many cases mentioned are for young people, and unfortunately I am not exactly in this category).

To my first doctor I got by referral. The second guy in Zurich I found through some database of orthopedic society and their recommendation. My insurance in principal allows to go w/out a referral, but so far I haven't received the bill for my visit in Zurich, so have no idea how insurance will look at it when they receive it.

Again, thanks a lot to everyone replied. For me of course the main subject is what to do with my foot, but overall it is kind of weird that it is still impossible to find and classify information on the doctors and their quality... On my side, I'll keep posted if I manage to learn something valuable related to the orthopedic surgeons and algorithms of identifying the "better" ones or doctors in general.
Kutuzov
Hi Kutuzov,

My wife was diagnosed with this when we were living in the UK. We actually turned up at a&e as her foot was painful and we didn’t know why. The surgeon decided to operate and debride the bone which had become jagged as the cartilage had disappeared.

The other option offered was to remove part of the bone which would make the toe go floppy as she wouldn’t have the ability to control it. This would have been better however for her if she wanted to wear high heels.

We chose the former, my wife still gets some pain so we will likely get it looked at again sooner or later. She wears heels occasionally but she can’t do so for long.

Unfortunately Fribourgs is rare and so when they see a case Dr’s get excited. I think my wife was only the 2nd case our surgeon had seen in his career. Because of the rarity of cases techniques for dealing with it are likely to be subject to change and so probably all the specialists are right in their treatment plan, it’s really just up to you to decide how you want to proceed.

My advice, go with whoever made you feel most at ease, personally I tend to research things and many doctors don’t like it when people do.

As such we tend to go with the doctors that are more than happy to be asked questions and for us to read up on things.
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Old 21.08.2019, 22:34
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Re: Orthopedic surgeon -- how to find a good one?

I think you're answering a very old thread. Hopefully by now the OP's question has been answered.
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