Minimal incision bunion surgery has tremendous benefits over traditional bunionectomy. There have been great advances in techniques and hardware, which has allowed for small incisions, the ability to walk right after surgery, decreased pain, shorter time of surgery and anesthesia used.

 

This is all possible due to the decreased amount of soft tissue trauma from a smaller incision. But the proper patient selection and having a surgeon trained in such techniques is very important.

 

  • Minimal incision can mean a variety of options and is often a vague description. The purpose of this blog is to clarify and demystify some of the misconceptions surrounding minimal incision bunionectomy.
  • Minimal incision surgery in our practice does not mean shaving of the medial prominence. These surgeries which were done in the past had below satisfactory results and many of these patients ended up needing surgical correction/fusion later on due to the progressive nature of bunion deformities.

 

Our technique at Laser Foot Surgery Centers we use is done with a 2-3 mm incision through which an osteotomy(bone cut) is made. This is done with a specialized osteotomy tool. This very specific osteotomy is superior to traditional methods because it not only reduces the bunion deformity but also provides a rotational component which is one of the main reasons that bunions form in the first place. This type of osteotomy is done at the neck of the metatarsal, therefore, it prevents violating the joint capsule and therefore decreases the joint stiffness that most people feel with traditional bunionectomy.

 

What does the current literature say?

This surgery has been performed since the 1940s. The initial concept for minimal incision bunion surgery goes back to the Kramer osteotomy, in which one used a K-wire to stabilize the metatarsal head. Bosch and Colleagues then in 1990 modified this technique.

  • I Magnan and coworkers in 2005 performed118 consecutive percutaneous distal osteotomies (in 82 patients). Ninety-one percent of 91% of the patients were satisfied with the procedure
  • In 2013 Gianni then coined the term SERI (simple, effective, rapid, inexpensive) in which he performed 1,000 feet with hallux valgus. There was a minimal complication, no nonunion, no deep wound infections even with the 2.0mm k-wire present.

Conclusion

  • The Minimal Incision bunionectomy is an excellent choice for the right patient. As with any surgery, it is important to have a face to face consultation to see if you are a candidate for a minimally invasive bunionectomy.
  • Aside from excellent cosmesis, the Patient has less pain, faster recovery, less joint stiffness, a walking recovery and decreased trauma to soft tissue.
  • It is best performed by a skilled surgeon who has been trained in minimal incision/minimally invasive bunionectomy. As there is a learning curve and these surgeries require meticulous surgical technique.
Before and After Bunion Surgery

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