Many surgeons who are unfamiliar with minimally invasive bunion surgical (MIS) procedure erroneously believe that minimally invasive bunion surgeries are prone to recurrence.

This is not true. Like traditional surgery, if the proper technique is used on the appropriate patient, for the appropriate deformity, there is no reason to think that bunions will reoccur when performed with MIS.

As with traditional surgery, it is important to reduce the intermetatarsal angle, and/or the proximal articular set angle. This is usually accomplished with an appropriate osteotomy. Like traditional surgery, if you simply remove the bump and do not take the various angulational deformities into account, you will get recurrence. If the proper procedure is used and followed up with appropriate orthotics to address the biomechanical problems, there is no reason to expect a higher rate of recurrence than you will get with traditional surgery.

Below is an example of a 62 year old lady who was in to see me recently for an annual check up. I performed the right bunion in January 2007 and the left bunion surgery in January 2009. 

BEFORE         (LEFT)              AFTER                         BEFORE             (RIGHT)     AFTER                                    


In both cases, I performed a modified Wilson osteotomy, which is very similar to the Austin osteotomy, except that with the Wilson procedure, the apex of the osteotomy is proximal, whereas with the Austin, the apex of the osteotomy is distal.

This lovely lady was seen in November 2015. I am attaching the pre-op x-rays, the immediate post-op x-rays , the 1 year post-op x-rays and 8 years/6 years post-op x-rays. 

PRE-OP X-RAYS                                                                                                                 Left foot                                                                                               Right foot                                                            

IMMEDIATE POST-OP X-RAYS                                                                                         Left foot                                                                                              Right foot                                                           

1 YEAR POST OP X-RAYS                                                                                                 Left foot                                                                                              Right foot                                                             

6 YEARS POST OP X-RAYS (Left)       8 YEARS POST-OP X-RAYS (Right)             

Sheldon Nadal D.P.M 

Vice president Academy of Minimally Invasive Foot & Ankle Surgery.