A Bunion is a common deformity of the joint and tissues characterized by enlargement of the bone at the base of the toe. One in three women and one in ten men suffer from bunions. It is often said that tight or high-heeled shoes can exacerbate the condition but they are often not the primary cause. There is certainly a genetic predisposition too. A bunion can get worse with time and cause pain and damage to the foot. Treatment in a timely fashion is therefore recommended.
Historically, many treatments and operations have been proposed for the correction of bunion deformities. Some of these have been more popular than others but the surgical correction, in particular, has had a reputation for ongoing pain, forefoot swelling, and scar sensitivity. Modern keyhole surgery has overcome many of these problems and has lessened the risk of recurrence and complications.
MIS (Minimally Invasive ) or Keyhole Bunion surgery is a surgical technique to correct the bunion deformity just by using small key holes. The surgeon uses small tools to effectively remove bunion reducing the scars and recovery time. It is also going by the name of MICA ( Minimally Invasive Chevron-Akin Osteotomy ). It involves very small cuts to access the bone and shift it to a correct position.
Before considering bunion surgery, doctors suggest the patient wear comfortable wide toe box shoes. They also suggest using splints to reposition and straighten the toe. When these techniques do not work then surgery is offered. Surgery often resolves the problem completely by relieving the pain and realigning the bone.
Following are the major advantages of a keyhole bunion surgery:
Surgical procedures usually depend upon the severity of the bunion, age, health, activity level, and connective tissues. Following factors may affect the choice of surgical procedure:
You may need to get a keyhole bunion surgery:
Impingement onto your 2nd toe resulting in a ‘claw toe’ deformity. You need to get surgery before it gets worse. If you notice that bunion is causing trouble for other toes, this may be a time to consider surgery
Here is what you have to do before keyhole bunion surgery:
During the surgery, the following process takes place:
Lastly, the surgeon will close the opening using stitches and a bandage.
Immediately after the surgery, an orthopedic shoe will be placed on your foot. Once you get comfortable, you will be discharged from the hospital. You may feel swelling, redness, and pain in the surgical area. The swelling may increase if you keep your foot down. Putting too much pressure could be painful for the first week.
After the surgery, you have to follow a post-operative course which is as follows:
Forefoot swelling may take 3 months to settle. Wearing proper shoes, elevating the foot when seated and regular physiotherapy will aid this process significantly.
No surgery is risk-free. Most of the keyhole bunion surgeries are successful but rarely, complications can occur. Following are some of the risks that can occur:
However, 95% of the surgeries remain successful, therefore you need not fear the surgical procedure nor the rare complications.
After all the discussion, the question is: is it worth it?
In the opinion of Dr. Gowreeson, the answer is yes, it is better and worth it. Keyhole bunion surgery provides equivalent outcomes to open bunion surgery in the long term. It causes less pain, swelling, and stiffness because it does not include greater disruption of tissues. It is performed by an experienced surgeon allowing many benefits over open surgery. It includes smaller cuts and scars, the smaller the scars the smaller the risk of infection. It allows just as early walking and more rapid recovery than historical bunion corrective surgeries. With all these benefits over open bunion surgery, keyhole or MIS has the edge over open surgery.