Minimal incision bunion surgery

June 28, 2006

By PETER REDKO

Minimal incision surgery is now available for treatment of bunions and other foot conditions. With advances in surgical techniques, the incision required to correct problems such as bunions, hammertoes, corns and heel spurs is usually less than one-eighth-inch in length.

Bunions are misaligned big toe joints that can become swollen and tender, causing the first joint of the big toe to slant outward, and the second joint to angle toward the other toes. Bunions tend to be hereditary, but can be aggravated by shoes that are too narrow in the forefoot and toe. Surgery by a podiatric physician is frequently recommended to correct the problem.

It may sound simple, or even elementary, but any tissue that is not cut in surgery doesn't have to heal. Further, it is interesting to note that bones themselves have little or no nerve supply. What does that mean to you? It means that if your foot and ankle surgeon makes a smaller rather than a larger skin incision, and gets right into the bone and remodels and/or repositions that bone, chances are that you will have much less discomfort and can probably return to normal activities much quicker than with traditional techniques.

Some of the advantages of minimal incision foot surgery include:

Since the skin incision is so small, usually requiring only one stitch, scarring is greatly reduced.

Because of the lack of surgical tissue dissection in this type of surgery, post-operative pain may be greatly reduced.

Since minimal invasive surgery causes less trauma to the tissues of the foot, no pins, wires, screws or casts are generally required post operatively.

After the surgery is completed, a gauze and tape bandage is usually applied to the foot, and the patient is given a special post-surgery shoe to wear. Many patients are surprised to find that they can return to work and normal activities in no time at all.

With the use of a small side-cutting burr and fluoroscopy, many bunions are corrected with only small incisions similar to those employed in arthroscopic work commonly used in knee, shoulder and hip surgery.

No two bunions are exactly the same. Therefore, foot and ankle surgeons customize each procedure to achieve the best anatomical correction and restoration of function, with the least amount of trauma. Most of our bunion patients are back in conventional shoes within three weeks. We feel strongly about returning patients to street shoes as early as possible as well as returning them quickly to normal activities.

(Peter Redko is a foot and ankle surgeon at Petaluma Valley Hospital)