Minimally Invasive (MIS) Bunionectomy — What to Expect, Benefits, and Recovery

Minimally Invasive (MIS) Bunionectomy — What to Expect, Benefits, and Recovery

Introduction
Bunions (hallux valgus) are a common foot deformity where the big toe drifts toward the second toe and a bony bump forms at the base of the big toe. Minimally invasive (MIS) bunionectomy techniques have grown in popularity because they aim to correct the deformity through smaller incisions, less soft-tissue disruption, and potentially faster recovery compared with traditional open surgery.

What is MIS bunionectomy?
MIS bunionectomy refers to a group of surgical techniques that use tiny incisions (often 2–5 mm), specialized instruments, and fluoroscopic guidance (real-time X-ray) to cut and realign the bone and soft tissues causing the bunion. Procedures range from percutaneous osteotomies (bone cuts) to chevron or scarf-style corrections adapted for percutaneous approaches. Fixation may be with screws or a small plate depending on the technique.

Benefits of MIS over traditional open surgery
- Smaller incisions and less visible scarring
- Reduced soft-tissue trauma and swelling
- Less postoperative pain
- Faster return to walking and normal shoes in many cases
- Shorter surgical time in experienced hands
- Lower risk of wound-healing complications

Who is a good candidate?
- Patients with mild-to-moderate and even severe bunion deformities can be candidates for MIS techniques. 
- Those seeking smaller scars and quicker recovery.
- Patients without active infection, severe osteoporosis, or uncontrolled vascular/medical conditions that complicate healing.
-A consultation with a foot and ankle surgeon will determine candidacy based on X-rays, medical history, and activity goals.

The MIS bunionectomy procedure (typical steps)
1. Anesthesia: local with sedation or regional/general anesthesia.
2. Small percutaneous incisions made over the bunion and at sites for bone cuts.
3. Bone osteotomy performed under fluoroscopy to realign the first metatarsal and correct the angle.
4. Soft-tissue balancing (capsular release or tendon work) performed percutaneously if needed.
5. Fixation with small screws or internal hardware as indicated.
6. Dressing and a protective postoperative boot or specialized shoe placed.

Recovery timeline (general guide)
- Immediate: weightbearing as tolerated in a protective boot is often allowed the day of or soon after surgery, depending on fixation and surgeon preference.
- 2 weeks: wound check and dressing change; stitches may be removed if used.
- 6 weeks: transition from boot to stable shoe; many return to light activities.
- 8–12 weeks: most swelling decreases; increased activity and return to regular footwear possible.
- 3–6 months: continued improvement in comfort, swelling, and foot function; full healing and remodeling may take up to 12 months.

Risks and possible complications
- Infection, nerve irritation or numbness (transient or permanent)
- Incomplete correction or recurrence of the bunion
- Stiffness of the big toe joint
- Nonunion or delayed union of the osteotomy (rare)
- Hardware irritation requiring removal
- Overcorrection (hallux valgus to hallux varus)
Discuss risk mitigation and expectations with your surgeon.

Comparing outcomes
Several studies show MIS bunionectomy can produce similar radiographic correction and clinical outcomes to open techniques, with benefits in early pain and return to activity in experienced hands. Outcomes depend heavily on surgeon experience, appropriate patient selection, and proper postoperative care.

Preparing for surgery and what to bring up with your surgeon
- Bring a list of medications, including blood thinners.
- Ask about anesthesia type, expected weightbearing status, pain control, and physical therapy needs.
- Clarify the surgeon’s experience with MIS techniques and complication rates.
- Plan ahead for mobility aids and a supportive shoe/boot for early recovery.

Alternatives
- Conservative care: footwear modification, orthotics, padding, NSAIDs, and activity changes.
- Open bunionectomy: well-established for moderate-to-severe deformities or when soft-tissue exposure is needed.

Conclusion
MIS bunionectomy is an effective option for many patients with bunion deformities, offering smaller scars, less early pain, and a faster return to activity when performed by an experienced surgeon. Discuss your individual case, expectations, and risks with a foot and ankle specialist to choose the approach best suited to your deformity and lifestyle.

Book an appontment today at www.azchoicefa.com