Minimally invasive bunion surgery can reduce pain and improve function in patients with bunions. In this video, I will be describing the Arthrex MIS bunion correction procedure.
Video Transcript:
Before we start the procedure, we delineate the metatarsal. Then a small stab incision is made and the elevator is used to create a working window. This is to ensure that no soft tissues are injured as we introduce a burr. The burr is then introduced under fluoroscopic guidance and what I gauge is to make it more perpendicular to the long axis of the second metatarsal. The burr tip is advanced from the medial to the lateral cortex and under fluoroscopic guidance, the osteotomy is made both dorsal and plantar.
Then we translate and rotate. As you can see in the video, as we translate and rotate, those two little circles are called sesamoids, and we want to reduce these.
After this reduction is achieved, the next step is to achieve stable fixation, which is created by using 2 parallel screws and guide wires from the proximal first metatarsal into the capital fragment. Once those are in place, we proceed to make a stab incision and then drill all the way to but not through the metatarsal surface, and then place our screws.
Once the screws are placed, we check fluoroscopically to ensure the placement is appropriate. Then we take off any overhanging bone to create a nice, flush surface.
The post-operative healing protocol is pretty straight-forward. It is 2 weeks heel weight bearing in a post-operative shoe or a controlled ankle motion boot. At week 2 you are weight bearing as tolerated. At 4 weeks, we transition you into athletic shoes.
