Beware of Minimal Invasive Bunion Surgery - Walking a Tight Rope

We here at AFAS are hoping you had an opportunity to enjoy some live music over the weekend.  If not, we’re sure that you’ve had the radio on lately to listen to some music. You may have heard some advertisement about a ‘new’ minimally invasive procedure to correct bunion deformity along with your music.  Let’s talk a little bit about bunions and this particular procedure before you decide to get your bunion fixed by that means.

Bunions are a complicated problem.  There are many factors that effect if you will get one and how quickly it will progress to pain or discomfort.  As foot specialists, podiatrists learn that there are many different angles of motion that are affected.  Your podiatrist needs to assess many facets of your deformity before discussing procedures that will correct the deformity and stop it from reoccurring.  The ‘tight rope’ procedure attempts to correct one of these angles.  There are bones behind each of your toes that are known as metatarsals.   One of the angles that must be corrected during bunion surgery is the Inter-Metatarsal (IM) angle, or the angle between the first and second metatarsals. The IM angle between your 1^st and 2^nd metatarsals must be addressed with almost all bunion procedures, but is only one of the components of this multi-faceted problem.

Because this procedure relies on the 2^nd metatarsal to hold the 1^st in better alignment, weak bones or patients with osteoporosis may not be candidates for this type of surgery.  The technique was first used to hold the smaller of your leg bones to the larger in order to heal.  Unlike that procedure, a quick x-ray of the foot shows the 1^st metatarsal much larger than the 2^nd.  The bone holding the deforming tensions is the smaller 2^nd.  This fact should make it no surprise that a common complication with this tight rope procedure is fracture of the 2^nd metatarsal.  While the tight rope procedure may allow you to walk soon after surgery, a broken 2^nd metatarsal will quickly put you in a non-weight bearing cast and may require another surgical procedure.  Both these things will keep you off your feet for some time.  Not every patient has this type of complication, but it is a significant one if you’re choosing this procedure because you won’t have to stay off your feet.  Please discuss this procedure along with others and consider the risks, alternatives and complications of all.  We feel that the better informed you are the better outcome you will have!

Until next time, keep those feet happy and healthy Austin!