What is percutaneous foot surgery?
Percutaneous foot surgery, also known as MIS surgery (Minimal Incision Surgery), is a novel surgical technique to treat foot pathologies consisting of bone or white tissue alterations.
In practically all cases, loco-regional anesthesia is used (anesthesia is only used from the ankle to the foot), which significantly reduces possible anesthetic complications.
Why is it performed?
The most important pathologies treated by percutaneous foot surgery are bunions and metatarsalgia, that is, pain at the base of the toes.
Some of the most common pathologies treated by percutaneous foot surgery are:
- Toe deformities: claw toes or hammer toes.
- Tailor’s bunion: A deformity similar to a bunion, but affecting the fifth toe.
- Hallux rigidus: It is an arthrosis that affects the big toe. Although in severe hallux valgus that need a great correction is usually operated by open surgery techniques.
- Calcaneal spur: Bone protrusion that occurs in the heel.
- Morton’s neuroma: A thickening of the interdigital nerve in the space between the third and fourth toes.
Other pathologies are candidates for a choice between open or classic surgery and percutaneous or minimally invasive surgery:
- Fifth toe supra, infraductus or mounted or below.
- Subungual osteochondroma: benign tumor above the last phalanx of the fingers that compresses the nail and causes pain.
- Tarsal canal syndrome: Pain in the tarsus towards the fingers with tingling and prickling.
- Tarsal sinus syndrome: Pain in the back of the foot immediately anterior to the ankle.
One of the most important pathologies treated by percutaneous foot surgery is the bunion.
What does it consist of?
Percutaneous foot surgery is performed through minimal incisions, without direct exposure of the surgical planes and minimizing trauma to nearby tissues. The intervention is performed with a radiological control that allows specialists to guide the surgical gestures to be performed.
Thanks to this type of minimally incisive surgery, different foot pathologies can be treated with a minimal skin incision of between two and three millimeters, whereas conventional surgical techniques required large incisions or even the removal of joints in severe cases.
Preparation for percutaneous foot surgery
Before the surgery is performed, the physician will evaluate the patient and depending on the level of severity will ultimately assess whether this technique is the most appropriate to treat the patient’s pathology.
Once it is decided that this technique will be performed, a pre-surgical blood test, chest x-ray and electrocardiogram are usual.
Care after the operation
After the operation, the patient must wear a wide and rigid-soled footwear that reduces the load on the operated foot, so it is not advisable to operate both feet at the same time.
It is an absolutely ambulatory surgery, once the intervention is finished, in the operating room the patient is fitted with a post-surgical shoe with which he/she will be able to walk from that moment on.
The first revision is usually performed in a week to remove the stitches. Regarding the surgical dressing, the patient is instructed how to place the new dressing and will change it daily after personal hygiene for two to three weeks. During this period of time the patient will keep the post-surgical shoe and after one month he/she will use normal shoes progressively.
Alternatives to this treatment
Currently, percutaneous foot surgery is a novel technique for the treatment of foot pathologies. The classic surgical treatment is open surgery.