Minimally Invasive Bunion Surgery Introduction
The London Foot and Ankle Centre was the first in the capital to introduce a new form of minimally invasive bunion surgery and now has 10 years of experience in the approach.
We have completed many hundreds of minimally invasive bunion operations and have applied the minimally invasive approach to the cheilectomy (surgery for stiff big toe) and the calcaneal osteotomy (heel shift).
The minimally invasive approach has many benefits for patients compared with traditional open surgery and is based on using incisions which are smaller than the diameter of a thin pencil. Our minimally invasive bunion surgery takes approximately half an hour.
There is less tissue damaged during surgery and the risk of scarring is much reduced. Therefore recovery from bunion surgery is expected to be more predictable, with a very low risk of infection.
The form of minimally invasive bunion surgery used at the London Foot and Ankle Centre is completely different to another technique also offered in the UK and Europe which involves leaving a titanium wire in the patient’s foot for four weeks after surgery.
Our technique is based on established bunion surgery, adapting new technology to perform the procedure in the most minimally invasive way.
By using established techniques, we are able to maintain the anatomy and the mechanics of the foot and in so doing, expect a more predictable recovery, combined with the benefits of less invasive surgery.
There is no need for a wire to remain in the foot following surgery.
Who Needs Minimally Invasive Bunion Surgery
What are bunions and why do they develop?
The term bunion refers to a swelling on the outside of the big toe joint. This swelling occurs when the big toe leans too much into the second toe. The medical term for this condition is hallux valgus.
As the swelling is prominent, this area is prone to rubbing from shoes, causing inflammation (redness) and pain.
Up to 33 per cent of people will develop bunions at some stage in their lives and incidence is far greater in women than men. High heeled, tight footwear can accelerate the condition, but the primary cause is usually genetic.
Do I need surgery for my bunion?
Many people can have bunions which do not cause any pain. We only recommend surgery if the bunion is causing pain which cannot be alleviated by adapting footwear.
Bunion surgery may also be necessary if the big toe pushes the second toe, causing a painful hammer toe.
How Minimally Invasive Bunion Surgery Works
Traditional bunion surgery involves making a cut of 5cm on the outside of the foot and a smaller incision on the inside of the toe to release the tissues holding the toe.
The incisions used in our minimally invasive surgery are just 3mm – the diameter of the lead in a pencil.
Surgeons use instruments originally developed for head, face and neck surgery, which are very fine and rotate at high speed to make tiny, precise cuts.
The surgeon makes small incisions in four places around the big toe, dividing the ligaments and cutting the bone with minimal damage to the surrounding tissue. These cuts are designed to allow the surgeon to correct the deformity but maintain bone stability in the area.
A wire is then threaded through the incisions and used to lever the big toe back into the correct position. Once the toe is in the correct place, a small screw is implanted to fix it in this position.
The screw is designed to stay within the bone without causing pain or being palpable for the patient in any way. The wire is then removed.
The whole procedure, which takes place under general anaesthetic, takes 15 to 20 minutes.
London Foot and Ankle Centre Consultant Orthopaedic Surgeon David Redfern comments:
“Forefoot mechanics are very sensitive and this technique was developed to respect the precise anatomy of the foot.
“Because it is based on established bunion surgery philosophy, we expect a more predictable recovery and we will not encounter the complications of having a wire sticking out of the foot for the first four weeks after surgery as this is not required.
“This is a technique which will have a very significant impact on the way we perform bunion surgery.
“However, it is very important that this new technique is performed by a specialist foot and ankle surgeon who has extensive experience of all open bunion surgery techniques, which form the basis for this operation.”
How was this procedure developed and what experience do the surgeons have?
This new technique was developed by London Foot and Ankle Centre Surgeon David Redfern, with the French surgeon Dr Joel Vernois. The surgeons were working together at the Sussex Orthopaedic Treatment Centre when they developed the technique, adapting the approach used by Dr Vernois in France, combined with established UK open bunion surgical techniques.
Mr Redfern is currently the most experienced UK surgeon in minimally invasive bunion surgery. Nationally and internationally recognised for his expertise in minimally invasive techniques, Mr Redfern recently presented and led training for surgeons working throughout Europe, at a meeting of the European Foot and Ankle Society.
Minimally Invasive Bunion Surgery Recovery Period
First two weeks
Full weight bearing in special shoe, but keep foot elevated as much as possible
Your foot will be checked by your surgeon and you will continue to weight bear in the special shoe without placing pressure on the front of your foot. Physiotherapy is very important at this stage to mobilise the big toe joint and reduce stiffness.
Weeks four to six
You will start gradually increasing weight bearing in the special shoe which is usually replaced by the patient’s ordinary shoes at the end of week six after surgery.
By six weeks
We would expect you to be walking without a stick or crutches.
By six months
You should be able to resume all normal activities without any pain or discomfort.