More than 40 years performing foot surgery
Minimally invasive or percutaneous foot surgery
Nowadays, advances in medicine allow for more effective treatments with fewer side effects. Modern surgery similarly tends to use techniques that allow faster recovery without discomfort and with fewer complications. Within these surgical techniques, there has been a great development for the correction of foot deformities, in particular for the treatment of the hallux valgus or bunion and claw toes.
Minimally invasive surgery, also known as MIS surgery (Minimal Incision Surgery), is an alternative technique to traditional surgery, which offers the patient excellent results with a quick recovery.
The philosophy of minimally invasive techniques is to perform millimeter corrections with minimal tissue damage. Successful performance of these techniques requires the surgeon to be highly experienced in these techniques.
These surgical techniques allow corrections to be made through incisions of just a few millimeters, with minimal trauma to the tissues, which translates into a comfortable postoperative period, with hardly any discomfort and fewer complications. Percutaneous surgery must be performed under radiological control with a fluoroscope that allows accurate orientation during the surgical procedure. It also requires specific instrumentation for these procedures.
Percutaneous or minimally invasive foot surgery may be a treatment option in patients who have already undergone one or more foot surgeries, patients who are not suitable for traditional surgery due to age or associated diseases.
These minimally invasive techniques are mainly used for the correction of bunions and claw toes. However, itis also used for the correction of other toe deformities, hallux rigidus, tailor’s bunion, plantar fasciitis, metatarsalgia, heel spurs, Haglund’s deformity, among others.
Another advantage of minimally invasive surgery is that there is no age limit for it to be performed. In addition, the vast majority of patients who undergo these procedures do not require strong analgesics during the postoperative period; only a small minority require occasional analgesics.
Minimally invasive surgical (MIS) techniques are unfamiliar to many orthopedic surgeons. This may be the reason why many of the papers published on these techniques do not meet the levels of evidence required for acceptance by the medical community. However, in recent years several scientific articles have been published demonstrating that these techniques are a surgical option and that in no case are traditional techniques superior to minimally invasive foot surgery.
On the contrary, these techniques are widely used and advocated by many university schools of podiatric medicine in the USA, as well as by the American and European academy of minimally invasive foot surgery.
Minimally invasive or percutaneous surgery is performed under local anesthesia and is completely ambulatory. Generally, for bunion surgery, an ankle block is performed to anesthetize the entire foot. However, to correct a claw toe, it is sufficient to perform a local locking of the toe. Local anesthesia is very safe and significantly reduces possible anesthetic complications.
Foot corrections are performed through incisions of a few millimeters with mini-scalpels and motorized drills specially designed for bone, tendon and ligament corrections. Laser, however, is not used in this type of surgery. Percutaneous surgery is in some ways similar to arthroscopy using an optic, with the difference that percutaneous surgery requires special real-time radiology equipment called a fluoroscope, which allows precise visualization of the surgical gestures.
At Clínica San Román, after bunion and/or claw toe surgery, patients must wear a special bandage and a post-surgical shoe to protect the foot and allow immediate ambulation without assistance.
Special bandage from Clínica San Román:
Clínica San Román’s special bandage for bunion surgery should not get wet or be manipulated. In case of any problem with your bandage such as humidity, pressure or simply a loose bandage, you should contact Clínica San Román 24 hours a day at the telephone numbers provided. Finally, the patient can shower as normal thanks to a special boot that seals the ankle and prevents water from entering.
During the first days after surgery, the patient can walk with full foot support and perform daily activities relatively normally. Avoid prolonged standing and flexing the toes.
The patient must follow the medication guidelines prescribed by the physician to reduce possible inflammation and discomfort that may occur. In case of need, the patient will be able to communicate with his physician 24 hours a day during the entire post-operative period.
From the third or fourth day, the patient should feel a significant improvement of pain and inflammation that allows him to increase his daily activity always gradually. The patient should always walk with the post-surgical footwear and remove it when at rest. Normally, if pain appears, it is likely that you have done more activity than indicated. Rest with the foot elevated and if necessary, take the analgesic/anti-inflammatory medication prescribed by your doctor.
The first check-up is usually performed one week after surgery. In this consultation a dressing change, suture removal and radiographic control are performed.
Subsequent check-ups with dressing changes and radiographic control if required are performed every two weeks at the clinic by the doctor who operated on you. Subsequent check-ups may be spaced out depending on the evolution until final discharge.
For our patients who live far from the area or even outside Spain, we perform a special post-operative procedure that only requires them to come to the clinic twice, on the day of surgery and seven days after. For this reason our national and international patients only need to be in Alicante for one week.
The most frequently asked questions that our bunion and claw toe surgery patients ask us are the following:
When will I be able to work and carry out my usual activities?
Thanks to our post-surgical footwear, from the third day you can gradually start your daily activities, always taking care of the foot to avoid inflammation. The start of their work activity will logically depend on their level of activity. For example, an office job can be done from practically the first day.
When will I be able to wear normal shoes again?
Normally after 40 days, the patient who has undergone bunion surgery with osteotomy must change the post-surgical shoe for a more comfortable one until the inflammation subsides completely and he/she can wear his/her usual shoe.
Patients who undergo bunion resection without osteotomy can wear a comfortable shoe two weeks after surgery.
High-heeled shoes with narrow or excessively flat toes should be avoided as much as possible.
For more information you can contact us by phone (+34) 965 92 11 56, using the contact form or our online chat to resolve any questions.
