bunion

Keyhole (Minimally Invasive) Bunion Surgery

Minimally invasive or key-hole Bunion surgery is a technique that reduces the size of the incisions during the surgical procedure.

Currently Dr George Dracopoulos is the only Orthopaedic Surgeon at Orthopaedics SA offering this surgery. Dr Dracopoulos has been doing bunion correction surgery for over 20 years, and has performed several thousand surgeries. He has completed three cadaver workshops on this new method and in 2017 spent time in Sydney learning this technique from a world leader in this field.

Dr Dracopoulos can discuss whether you are an appropriate case for keyhole surgery, and with a wealth of experience guide you regarding the choice between keyhole and open surgery.

Keyhole bunion surgery is a relatively new technique that enables bunion correction through very small incisions.  Keyhole surgery has evolved and is in its third generation and as such has become much more reliable and reproducible.    The surgery involves cutting the bones with a fine, high speed burr through very small incisions.  The bones are repositioned to narrow the foot and realign the big toe.  This allows correction of the bunion with minimal damage to surrounding tissues.  The bones are held with screws, which are designed to stay in place.  Keyhole bunion surgery is usually done with a general anaesthetic, combined with a local ankle block for post-operative pain relief.

Most patients stay one night but it can be day surgery if there is adequate support for the patient at home.  Walking the next day is allowed in a special shoe.  Rest and elevation are required in the first 2 weeks after surgery.    The foot remains bandaged until a 2 week review, at which stage the bandages are reduced but the patient still uses the sandal until 4-6 weeks.  Sensible shoes are worn from 6 weeks on.

The patient can expect to return to work for sedentary duties in 2-3 weeks.  For physical work, 6 weeks or longer may be required depending on the demands of the work.  This will be discussed prior to surgery by the surgeon.

It takes 3-6 months for most swelling to go down, and 12 months before everything really settles.

Studies have suggested equivalent outcomes to open surgery in the longer term but with less disruption of tissues there generally seems to be less pain, swelling and stiffness in the first few months.

It is important to remember that not all bunion surgery is successful whether keyhole or open surgery.  Most keyhole bunion surgery is very successful, but as with any surgery, issues can occur and these will be explained by your surgeon.  Specific issues that may sometimes occur include:

  • Under correction
  • Over correction (big toe too straight)
  • Arthritis leading to pain and stiffness of big toe
  • Prominence of screw head and/or bone requiring removal

Very occasionally a patient may have issues that feel worse than before surgery, and further surgery may be needed, in severe cases even fusion of the big toe.

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