Клиника Нордвест (Nordwest) — крупная многопрофильная больница во Франкфурте-на-Майне, Германия.
\n\nСпециализация — онкология, неврология, нейрохирургия и ортопедия.
\n\nВ 2019 году Нордвест вошел в ТОП немецких госпиталей по эффективности радиотерапии и успешности лечения рака толстого кишечника.
\n\nЕжегодно в медицинский центр обращаются свыше 25 000 пациентов.
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\n\nСпециализация — онкология, неврология, нейрохирургия и ортопедия.
\n\nВ 2019 году Нордвест вошел в ТОП немецких госпиталей по эффективности радиотерапии и успешности лечения рака толстого кишечника.
\n\nЕжегодно в медицинский центр обращаются свыше 25 000 пациентов.
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pain usually settles over weeks, while swelling may persist for months.","preparation":["Clinical examination, weight-bearing foot X-rays; CT or MRI if needed","Medical and anesthetic assessment; optimization of diabetes and other conditions","Smoking cessation advice","Review of medications with the surgical team","Arrange crutches, walker, protective shoe or cast, and home setup"],"recovery_timeline":[{"phase":"Days 0-14","description":"Rest, elevation and pain control; wound heals until suture removal.","restrictions":["Protected weight-bearing in special shoe","Keep dressing dry","Use crutches if advised"]},{"phase":"Weeks 2-6","description":"Gradual walking in protective footwear; swelling persists.","restrictions":["No driving until cleared","Avoid prolonged standing","No impact activity"]},{"phase":"Weeks 6-12","description":"Transition to normal shoes after X-ray confirms healing; begin mobility exercises.","restrictions":["No running or jumping","Limit high-heeled shoes"]},{"phase":"Months 3-12","description":"Return to full activity; swelling and stiffness gradually resolve.","restrictions":[]}],"rehabilitation_days":{"min":42,"max":90,"unit":"days","qualifier":"Time to walk comfortably in normal shoes; longer after fusion."},"result_longevity":"Often long-lasting after healed osteotomy or fusion, though deformity can recur and adjacent joints may wear over time.","revision_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Reoperation for recurrence, nonunion, hardware removal or persistent pain within about 5 years."},"scars":"Scars are located on the top, side or sole of the foot depending on approach; usually linear and fade over months, though minimally invasive techniques leave smaller incisions.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation addressing all planned foot and toe corrections."},"stages":[{"code":"surgery","label":"Reconstructive foot and toe surgery","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed in one session."}}],"qualifier":"Staged surgery is uncommon in the usual protocol."},"success":{"metric":"Patients satisfied with pain relief and foot function","value":85,"unit":"percent","horizon":"12 months","population":"Adults with painful forefoot deformity or arthritis after failed conservative care","evidence_status":"limited"},"techniques":[{"name":"Corrective osteotomy with soft-tissue realignment (e.g. for bunion)","suits_whom":"Painful hallux valgus or other forefoot deformity with preserved joint cartilage","recovery":"Often protected weight-bearing in a special shoe for several weeks; varies with technique."},{"name":"Joint fusion (arthrodesis)","suits_whom":"Advanced arthritis or rigid severe deformity of toe or midfoot/hindfoot joints","recovery":"Usually a period of restricted weight-bearing while bone heals; longer than for soft-tissue procedures."},{"name":"Lesser-toe correction (e.g. tendon transfer, joint resection or fusion for hammertoe/claw toe)","suits_whom":"Fixed or flexible lesser-toe deformities causing pain or ulceration","recovery":"Usually shorter, with a protective shoe and early walking as directed by the surgeon."},{"name":"Joint replacement or interposition arthroplasty (selected joints)","suits_whom":"Selected patients with arthritis, e.g. of the big toe joint, where motion preservation is desired","recovery":"Varies by implant and joint; protected mobilization followed by gradual return to activity."}],"treatment_conditions":["day_case"],"treatment_duration_hours":{"min":1,"max":3,"unit":"hours","qualifier":"Depends on number of joints and toes corrected and fusion or osteotomy extent."},"initial_assessment_documents":["Weight-bearing foot X-rays, front and side views","Photos of both feet standing, top and back","Foot or ankle MRI/CT report (if available)","Previous foot surgery operative reports (if available)","Recent HbA1c and blood test results"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay about 10-14 days for wound check and suture removal. Follow-up X-rays can be reviewed remotely."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check that the surgeon explains the goals, method, risks, complications and recovery plan","scope":"treatment_type","source":{"url":"https://orthoinfo.aaos.org/en/treatment/patient-guide-to-safe-surgery","host":"orthoinfo.aaos.org","quote":"It is important that you understand the goals of your surgery, how the surgery will be done, any possible risks or complications, and the plan for your recovery.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check that you receive a consent form that clearly outlines the planned surgical procedure","scope":"treatment_type","source":{"url":"https://orthoinfo.aaos.org/en/treatment/patient-guide-to-safe-surgery","host":"orthoinfo.aaos.org","quote":"Your doctor will review, discuss and then ask you to sign a consent form that clearly outlines the planned surgical procedure.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Check that the surgical approach is recommended based on your X-rays and physical exam","scope":"treatment_type","source":{"url":"https://orthoinfo.aaos.org/en/diseases--conditions/bunions/","host":"orthoinfo.aaos.org","quote":"Your surgeon will recommend the best approach and type of bunion surgery that is right for you based on your X-rays and physical exam finings.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Ask about recovery time; a long recovery is common after bunion surgery","scope":"treatment_type","source":{"url":"https://orthoinfo.aaos.org/en/diseases--conditions/bunions/","host":"orthoinfo.aaos.org","quote":"Bunion surgery is typically performed as a same-day procedure with no hospital stay, but a long recovery is common after bunion surgery.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Check that the surgical site is confirmed with you and marked before the operation","scope":"treatment_type","source":{"url":"https://orthoinfo.aaos.org/en/treatment/patient-guide-to-safe-surgery","host":"orthoinfo.aaos.org","quote":"Your doctor will confirm the surgical site with you and then mark the correct area on your skin with a magic marker.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C6","text":"Check that new caregivers introduce themselves and explain their role in your treatment","scope":"treatment_type","source":{"url":"https://orthoinfo.aaos.org/en/treatment/patient-guide-to-safe-surgery","host":"orthoinfo.aaos.org","quote":"Ask new and unfamiliar caregivers to identify themselves and explain their role in your treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An offer of surgery only to change how the feet look is a warning sign","scope":"treatment_type","source":{"url":"https://www.nhs.uk/conditions/bunions/","host":"nhs.uk","quote":"Surgery is not done just to improve how your feet look.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"Surgery offered for a bunion that is not painful is a warning sign","scope":"treatment_type","source":{"url":"https://orthoinfo.aaos.org/en/diseases--conditions/bunions/","host":"orthoinfo.aaos.org","quote":"You should only consider surgery for a bunion that is painful.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"Surgery pushed before nonsurgical treatment has been tried is a warning sign","scope":"treatment_type","source":{"url":"https://orthoinfo.aaos.org/en/diseases--conditions/bunions/","host":"orthoinfo.aaos.org","quote":"If pain continues despite nonsurgical treatment, surgery is performed to correct the bunion and hallux valgus deformity.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Wound infection after surgery","urgency":"contact_clinic","general":false,"source":{"url":"https://roh.nhs.uk/services-information/foot-and-ankle/bunions?highlight=WyJjb3JyZWN0bHkiLCJjb3JyZWN0IiwiY29ycmVjdGlvbiIsImNvcnJlY3Rpb25zIiwiY29ycmVjdGl2ZSIsImNvcnJlY3RlZCIsImNvcnJlY3RzIiwiY29yZWN0aW5nIiwiY29ycmVjdGx5LlwyMDEiXQ==","host":"roh.nhs.uk","quote":"Infections in the wound and minor damage to the nerves of the toe can occur in any foot surgery.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Severe, continuous pain that is debilitating","urgency":"contact_clinic","general":false,"source":{"url":"https://roh.nhs.uk/services-information/foot-and-ankle/bunions?highlight=WyJjb3JyZWN0bHkiLCJjb3JyZWN0IiwiY29ycmVjdGlvbiIsImNvcnJlY3Rpb25zIiwiY29ycmVjdGl2ZSIsImNvcnJlY3RlZCIsImNvcnJlY3RzIiwiY29yZWN0aW5nIiwiY29ycmVjdGx5LlwyMDEiXQ==","host":"roh.nhs.uk","quote":"The main symptom of chronic regional pain syndrome (CRPS) is pain, which can sometimes be severe, continuous and debilitating.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W3","text":"Big toe slowly tilting back toward original position","urgency":"contact_clinic","general":false,"source":{"url":"https://roh.nhs.uk/services-information/foot-and-ankle/bunions?highlight=WyJjb3JyZWN0bHkiLCJjb3JyZWN0IiwiY29ycmVjdGlvbiIsImNvcnJlY3Rpb25zIiwiY29ycmVjdGl2ZSIsImNvcnJlY3RlZCIsImNvcnJlY3RzIiwiY29yZWN0aW5nIiwiY29ycmVjdGx5LlwyMDEiXQ==","host":"roh.nhs.uk","quote":"In some people, the big toe slowly tilts back toward the original position and occasionally this is bad enough to need to have the operation redone.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W4","text":"Pain under ball of foot after surgery","urgency":"contact_clinic","general":false,"source":{"url":"https://roh.nhs.uk/services-information/foot-and-ankle/bunions?highlight=WyJjb3JyZWN0bHkiLCJjb3JyZWN0IiwiY29ycmVjdGlvbiIsImNvcnJlY3Rpb25zIiwiY29ycmVjdGl2ZSIsImNvcnJlY3RlZCIsImNvcnJlY3RzIiwiY29yZWN0aW5nIiwiY29ycmVjdGx5LlwyMDEiXQ==","host":"roh.nhs.uk","quote":"Therefore, if you have pain under the ball of the foot (“metatarsalgia”) it may be worse after bunion surgery and it may also develop for the first time.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Lists medicines to take at home, so the home doctor can continue them","document":"written discharge highlights","source":{"url":"https://orthoinfo.aaos.org/en/treatment/patient-guide-to-safe-surgery","host":"orthoinfo.aaos.org","quote":"The nurse will give you the highlights in writing, including a list of the medications you will need to take.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T2","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your bunion is linked to flat foot or joint stiffening","name":"Orthotic insoles","source":{"url":"https://roh.nhs.uk/services-information/foot-and-ankle/bunions?highlight=WyJjb3JyZWN0bHkiLCJjb3JyZWN0IiwiY29ycmVjdGlvbiIsImNvcnJlY3Rpb25zIiwiY29ycmVjdGl2ZSIsImNvcnJlY3RlZCIsImNvcnJlY3RzIiwiY29yZWN0aW5nIiwiY29ycmVjdGx5LlwyMDEiXQ==","host":"roh.nhs.uk","quote":"If your bunion is associated with a flat foot or some degenerative changes in the big toe joint (pain and stiffening of the joint), insoles (also known as orthoses) may be recommended.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null},{"id":"A2","text":"You prefer a nonsurgical option and can wear wider shoes","name":"Wide-fitting shoes","source":{"url":"https://roh.nhs.uk/services-information/foot-and-ankle/bunions?highlight=WyJjb3JyZWN0bHkiLCJjb3JyZWN0IiwiY29ycmVjdGlvbiIsImNvcnJlY3Rpb25zIiwiY29ycmVjdGl2ZSIsImNvcnJlY3RlZCIsImNvcnJlY3RzIiwiY29yZWN0aW5nIiwiY29ycmVjdGx5LlwyMDEiXQ==","host":"roh.nhs.uk","quote":"Wide-fitting, low-heeled, extra-depth shoes with soft uppers will allow for the extra width of the foot, any under-riding or over-riding of the big toe and the prominence.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null},{"id":"A3","text":"You have pain and stiffness in the joint from arthritis","name":"Corticosteroid injection","source":{"url":"https://roh.nhs.uk/services-information/foot-and-ankle/bunions?highlight=WyJjb3JyZWN0bHkiLCJjb3JyZWN0IiwiY29ycmVjdGlvbiIsImNvcnJlY3Rpb25zIiwiY29ycmVjdGl2ZSIsImNvcnJlY3RlZCIsImNvcnJlY3RzIiwiY29yZWN0aW5nIiwiY29ycmVjdGx5LlwyMDEiXQ==","host":"roh.nhs.uk","quote":"This helps reduce inflammation and may be helpful if you have pain and stiffness in the joint due to arthritis.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"technique_details":{"status":"ok","items":[{"id":"corrective-osteotomy","name":"Corrective osteotomy with soft-tissue realignment (e.g. for bunion)","how_it_works":{"text":"The bone is cut, repositioned, and held with small screws","source":{"url":"https://roh.nhs.uk/services-information/foot-and-ankle/bunions?highlight=WyJjb3JyZWN0bHkiLCJjb3JyZWN0IiwiY29ycmVjdGlvbiIsImNvcnJlY3Rpb25zIiwiY29ycmVjdGl2ZSIsImNvcnJlY3RlZCIsImNvcnJlY3RzIiwiY29yZWN0aW5nIiwiY29ycmVjdGx5LlwyMDEiXQ==","host":"roh.nhs.uk","quote":"The first metatarsal is cut through, repositioned and fixed with one or two screws.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"joint-fusion","name":"Joint fusion 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