Minimally Invasive Bunion Surgery Provides Reduced Pain, Faster Recovery

Before (left) and after X-rays show how minimally invasive bunion surgery realigns bones to their natural position.

When conservative treatment no longer provides relief of a bunion deformity and pain becomes so severe it affects a person’s lifestyle, patients have turned to two surgeries that require a large incision: open or joint fusion. A North Kansas City Hospital orthopedic surgeon, Angela Walker, DO, offers a minimally invasive technique that realigns the bones to their natural position with three tiny versus one large incision.

Open and Fusion Approaches

In open bunion surgery, cutting the metatarsal bone to displace, correct, stabilize and align its position requires an incision of 4-5 cm, which can be traumatic on surrounding tissue. The Lapidus joint fusion can cause reduced range of motion and arthritis.

“Both leave patients with a longer recovery and larger scars than minimally invasive surgery,” said Dr. Walker, who is with Orthopedic Surgeons Inc. “Plus, we’re not sacrificing any joints. Anytime you fuse a joint in the foot, it causes extra stress on the adjacent joint. No matter how small the adjacent joint, the stress makes patients more prone to arthritis in their foot.”

MIS Approach

Dr. Walker first marks the location for the osteotomy using fluoroscopy for precise visibility. She then makes a small incision and with specialized elevators she clears soft tissue from the bone surface. She then cuts the bone with a minimally invasive burr and slides the metatarsal head laterally, allowing her to correct the bunion deformity. After making two more small incisions, she places two 3.5 mm-diameter screws across the osteotomy to fixate the bone to allow for healing.

Because this newer minimally invasive technique reduces trauma to surrounding tissue, the result is:

• Decreased stiffness, swelling and surgical pain
• Smaller scars and more reliable healing
• Faster recovery
• Higher patient satisfaction

The minimally invasive approach is also advantageous for patients with diabetes, as they can be prone to wound and bone healing complications.

“Most people with diabetes are concerned about foot wounds,” Dr. Walker said. “This technique can easily be done without posing significant risk of infections and wounds in people with diabetes who are well controlled.”

The outpatient surgery is about 30 minutes, and patients are under general anesthesia with local anesthetic at the incision sites. After surgery, patients are allowed heel-weight walking and go home with a postoperative shoe. After about one week on prescription pain medication, they generally only require ibuprofen or acetaminophen. Most patients heal within three months.

Pain Relief

Whether a bunion deformity is minimal or severe, the causes vary. In addition to family history, wearing tight-fitting shoes or high heels puts pressure on the big toe.

“I’m the only female foot and ankle orthopedist in the Northland, and I also understand a woman’s perspective about shoes,” Dr. Walker joked. “If patients are getting to the point where they are unable to wear shoes comfortably and the pain does not allow them to have a normal daily life, it’s time to proceed to surgery,” Dr. Walker said. “I recently saw a female patient about correcting her left bunion. I had corrected her right foot with this technique six weeks prior. I could hardly see the incisions on her right foot, and she wished she had done the surgery sooner. It’s gratifying to have patients come back and say they have no pain.”

Angela Walker, DO

Angela Walker, DO earned her medical degree from Kansas City University. She completed her residency in orthopedic surgery at St. Mary’s Medical Center in Blue Springs and fellowship in foot and ankle surgery at Harbor-University of California Los Angeles Medical Center.