Surgical Services

27 de mayo de 2022

More than 40 years performing foot surgery

Minimally invasive or percutaneous foot surgery

Nowadays, advances in medicine allow more effective treatments to be applied 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, especially for the treatment of hallux valgus and claw toes.

Minimally invasive surgery, also known as MIS (Minimal Incision Surgery), is an alternative technique to traditional surgery, which offers the patient excellent results with a rapid recovery.

The philosophy of minimally invasive techniques is to perform millimetric corrections with minimal tissue damage. In order to perform these techniques successfully, the surgeon must be highly experienced in these techniques.

These surgical techniques allow corrections to be made through incisions of just a few millimetres, with minimal trauma to the tissues, resulting in a comfortable postoperative period, with hardly any discomfort and fewer complications. Percutaneous surgery must be performed under radiological control with a fluoroscope that allows exact orientation during the surgical procedure. It also requires specific instrumentation for these procedures.

Percutaneous or minimally invasive foot surgery can be a treatment option for patients who have already undergone one or more foot surgeries, patients who are not suitable for traditional surgery due to their age or associated diseases.

These minimally invasive techniques are mainly used for the correction of bunions and claw toes. However, it is also used for the correction of other toe deformities, hallux rigidus, tailor’s bunion, plantar fasciitis, metatarsalgia, heel spurs, Haglund’s deformity and 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 painkillers during the post-operative period; only a small minority require occasional painkillers.

Clínica San Román estudio del pie por Israel San Román

Minimally invasive surgical (MIS) techniques are unfamiliar to many orthopaedic 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 anaesthesia and is completely ambulatory. Generally, for bunion surgery, an ankle block is performed to anaesthetise the entire foot. However, to correct a claw toe, a local toe block is sufficient. Local anaesthesia is very safe and significantly reduces possible anaesthetic complications.

Clínica San Román pies huesos

Foot corrections are performed through incisions of a few millimetres with mini-scalpels and motorised drills specially designed for bone, tendon and ligament corrections. Lasers, however, are not used in this type of surgery. Percutaneous surgery is in some ways similar to arthroscopy, which uses an optic, with the difference that percutaneous surgery requires special real-time radiology equipment called a fluoroscope, which allows the surgical gestures to be visualised with precision.

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:

The special San Roman Clinic bandage for bunion surgery must not get wet or be manipulated. In the event of any problems with your bandage, such as moisture, 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 few days after surgery, the patient can walk with full foot support and carry out daily activities relatively normally. Prolonged standing and flexing the toes should be avoided.

The patient must follow the medication guidelines prescribed by the doctor to reduce any possible inflammation and discomfort that may occur. If necessary, the patient will be able to communicate with their doctor 24 hours a day throughout the post-operative period.

zapato postquirurgico cirugia minima invasiva juanetes 6

From the third or fourth day, the patient should feel a significant improvement in pain and inflammation that allows them to gradually increase their daily activity. The patient should always walk with the post-surgical footwear and remove it when resting. Normally, if pain occurs, 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 normally performed one week after surgery. At this check-up, the bandage is changed, sutures are removed and an X-ray is taken.

Subsequent check-ups with dressing changes and radiographic control, if required, are carried out every two weeks at the clinic by the doctor who operated on you. Subsequent check-ups can be spaced out depending on the evolution of the patient until final discharge.

For our patients who live far from the area or even outside Spain, we carry out a special post-operative procedure that only requires them to come to the clinic twice, on the day of surgery and seven days afterwards. For this reason, our national and international patients only need to be in Alicante for one week.

The most frequent questions 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 onwards you can gradually start your daily activities, always taking care of the foot to avoid inflammation. The start of your work activity will logically depend on the degree 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 operated on for bunions with osteotomy must change the post-surgical shoe for a more comfortable one until the inflammation subsides completely and they can wear their normal shoes.

Patients who undergo bunion resection without osteotomy can wear a comfortable shoe two weeks after surgery.

High heels and narrow or excessively flat shoes should be avoided as far as possible.

For more information you can contact us by telephone (+34) 965 92 11 56, by using the contact form or our online chat to resolve any doubts.