Minimally invasive hallux valgus surgery
Dr. Lopez uses minimally invasive hallux valgus surgery to limit possible post-operative complications and pain. Click here to know more.
Most of the time, we talk about percutaneous surgery or minimally invasive surgery of the foot with hallux valgus. By abuse of language, we can also speak of laser surgery. The minimally invasive surgical technique allows the surgeon to reach his target through mini centimeter incisions. This procedure is performed using long, thin instruments coupled with an intraoperative imaging system.
Minimally invasive hallux valgus operation: operation and steps
The minimally invasive hallux valgus operation is most often performed under local anesthesia. Some patients may benefit from general anesthesia in the event of an operation on both feet, for example. The procedure is usually performed as an outpatient surgery: you arrive and leave the clinic on the same day. The operation takes 30 minutes.
Because of its many advantages, minimally invasive surgery can be used for many known interventions and in all disciplines such as gynecology, urology, digestive surgery, cardiology, orthopedic surgery...
For all minimally invasive hallux valgus surgeries, the surgeon makes incisions of a few millimeters, just large enough to work and make the necessary bone corrections.
It is important to differentiate between minimally invasive surgery and percutaneous surgery. Not all stages of surgery can be performed percutaneously. This is why we talk about minimally invasive surgery, which, combined with percutaneous, introduces the concept of mixed surgery. In minimally invasive surgery, the procedures are the same as for conventional surgery, except that the incisions are smaller.
The stages of micro surgery for hallux valgus
1) The surgeon begins by making a first incision on the inside of the foot, at the level of the big toe (hallux).
2) The first step is to shave the bone hump using a miniaturized saw. The goal here is to make the onion completely disappear.
3) The surgeon then performs an osteotomy. The metatarsal bone is thus cut and the two bone fragments are moved to correct the deviation and allow perfect alignment of your toe. A fracture of the first phalanx is often done to have ideal alignment.
4) The last step of the operation is to keep the foot in a good position with a special bandage. Usually screws are placed to keep the fractures in the correct position.
Important: Regarding screws: Patients often ask whether it is necessary to keep the screws? If the screws are inconvenient? If it is necessary to install the screws?
In practice, screwless hallux valgus surgery is possible. The fractures are then only maintained by the dressing. There will then be a possible movement at the level of the fractures, and, a fracture that moves is a fracture that hurts. This is why Dr. Lopez uses screws in all of his hallux valgus surgeries. On the one hand, it stabilizes fractures and decreases pain. On the other hand, screws decrease the risk of displaced fractures. The screws are completely buried inside the bone. We don't feel them and they won’t bother you. These screws can be removed after 6 months.
The benefits of minimally invasive hallux valgus surgery
The discovery and use of micro-invasive hallux valgus surgery has revolutionized the management of hallux valgus. This surgery has many advantages, both for the surgeon and for the patient.
Significantly reduce the duration of the operation and the time spent in hospital
The reduced size of the incisions and the different stages of the surgery considerably reduce the duration of the operation. Instead of spending several days in the hospital, minimally invasive hallux valgus surgery is performed as an outpatient surgery which gives you the option of leaving the clinic during the day. Minimally invasive hallux valgus surgery takes only 15 to 30 minutes.
Limit the size of scars and pain
Traditional surgery requires the surgeon to make incisions long enough to access bone and tissue. These large incisions can lead to certain complications such as: significant surgical bleeding, severe pain, unsightly scars, increased risk of infection, etc.
Thanks to the small incisions of non-invasive hallux valgus surgery, the tissues are less attacked by the surgery, which reduces post-operative pain, faster recovery, reduced immobilization, lower risk of infection and a decrease in the size of scars.
When should hallux valgus surgery be performed using non-invasive surgery?
In the presence of hallux valgus, non-invasive surgery can be offered in virtually all cases. It is never too late to manage a hallux valgus. On the other hand, a premature and rapid assumption of responsibility considerably facilitates the work of the surgeon.
If you have doubts and don't know when to see a doctor, pain is a great indicator. As soon as you have pain or discomfort in the forefoot, it is important to see you quickly. Indeed, a hallux valgus will always progress spontaneously towards self-aggravation. The earlier the hallux valgus is managed, the easier it will be to operate. Conversely, an advanced hallux valgus can lead to the appearance of other pathologies and deformities such as claw toes or lateral rays.
Premature management of hallux valgus makes it easier to operate hallux valgus with non-invasive surgery. The greater the deformity, the more difficult it will be to perform this surgical technique. Other more painful and more invasive techniques can be considered such as traditional surgery for example.
After the operation
With regard to remission, pain is increasingly better managed thanks to the development of many techniques. Locoregional anesthesia, for example, in most cases results in almost painless recovery. This process provides anesthesia for the foot for 12 hours after the operation, that is to say during the most painful postoperative phase.