What is Minimally Invasive Surgery in the Foot and Ankle and for Bunions?

It’s time to finally correct that bunion, so you are considering foot and ankle surgery. You’ve heard of minimally invasive foot surgery for bunions, but are you a candidate? And if so, what is minimally invasive surgery for bunions?

Read more in Bunions: Diagnosis and Treatment.

What is minimally invasive surgery (MIS)?

Minimally invasive surgery in the foot and ankle uses smaller incisions and smaller instruments compared to traditional surgery. 

In MIS, a burr that is 2 mm in diameter is used to create bone cuts (osteotomies) or to remove bony prominences. This method differs from traditional surgery, which uses large incisions and a sagittal saw to create the bone cuts or to remove bony prominences. 

Do you only use minimally invasive surgery for bunions?

No.  Minimally invasive foot and ankle surgery can be used for many conditions. But, not all orthopedic surgeons do all MIS procedures. Further, not all patients are candidates for MIS surgery. Some more commonly performed MIS surgeries include the following:

• Bunion correction
• Exostectomy (removal of a bony bump)
• Hallux rigidus (1st toe arthritis)
• Calcaneal osteotomies for flatfoot or high arched feet
• Bunionette
• Fusions
• Charcot

Who is a candidate for minimally invasive surgery?

The surgeons at Southwest Orthopedic Group and Dr. Stautberg can evaluate your foot to see if you are a candidate for MIS surgery. Many factors determine if MIS is the best option for a patient’s surgery. 

How is minimally invasive surgery done?

First, an x-ray is used to identify the exact point on the bone that needs to be treated. A small incision (appx 1 cm) is made over the bone. Nerves and tendons are moved out of the way to protect them. The burr is introduced into the wound and a bone cut is started. Depending on the exact surgery, either a bone bump is removed, or the bone is cut. Water is used throughout the procedure to keep the burr or bone from becoming too hot. 

Once the bump is removed, another x-ray confirms the procedure is complete. If an osteotomy, or bone cut, is required, the bone is shifted. Then, the bone is fixed with percutaneous screws to hold the bones in place for healing. 

How is this burr different from traditional bunion techniques?

The burr is used to create an ‘osteotomy,’ or a cut in the bones. The burr is low speed and high torque, which lowers the risk of damage to soft tissues, such as tendons and nerves, although the risk is not zero. Additionally, the burr does not generate a lot of heat during the bone cuts, minimizing risk of damage to the bone.

Read more in Bunions: Surgical Treatment and Recovery.

How painful is minimally invasive surgery?

Regardless of the technique, surgery is not pain free. Early research suggests there is decreased pain and swelling after MIS surgery compared to open surgery. 

Read more in Recovering from Bunion Surgery.

Who does minimally invasive bunion surgery?

Orthopedic surgeons who have trained in minimally invasive techniques can perform MIS surgery. 

As MIS bunion surgery is a relatively new technique, not all foot and ankle surgeons perform MIS bunion surgery. Dr. Stautberg has been trained in MIS surgery, and offers this new treatment to his patients. 

Our future posts will discuss specific procedures with MIS. You can also read more at PROstep MIS.

The American Orthopaedic Foot & Ankle Society (AOFAS) has more information about MIS bunion surgery at FootCareMD.

For more questions or to set up an evaluation, contact Dr. Stautberg’s office at 281-977-4870. 

Author

Eugene Stautberg, MD