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Considering Bunion Surgery

What can be done about a bunion? 

With bunions, there are 44 different surgical techniques to correct the deformity, and there is no consensus amongst surgeons as to which technique is best, so keep in mind that it’s not one size fits all with bunion surgeryDepending on the severity of the bunion, correction occurs with a variety or combination of different methods involving bone shaving, bone cutting to realign and fixate the bone into its anatomically correct position, and/or bone mending by fusing the bone at the joint.

The most common bone correction for bunions regardless of incisional approach is to cut, realign, and fixate the bone into its anatomically correct position.  Recently it’s becoming more and more popular for surgeons to attempt this procedure utilizing a minimally invasive approach by making a small incision to either shave down the prominent bone and/or break the bone to shift it into its correct position, and then fixate the bone with screws through another small incision.  Rather than visualizing the bone directly with the traditional open approach, the surgeon uses tactile senses and real-time intraoperative x-ray to visualize the bone cutting, realignment and stabilization of bony segments.  This approach has become increasingly popular because patients prefer minimal scarring and surgeons prefer to have happy patients.  Having a smaller scar is clearly an advantage of the minimally invasive technique, however it does not create enough room for the surgeon to see what they are doing.  Essentially, the surgeon is cutting and driving screws into the metatarsal blindly and relying on tactile feeling and xrays.

The aesthetic of your foot may look great after this procedure, but the x-rays will tell you different.   Most surgeons will show patients before and after pictures of feet they have operated on but rarely, if ever do surgeons show their patients the before and after x-rays. Next time you consider having foot surgery please ask your surgeon to show you not only before and after pictures but also some x-rays.  I have no doubt that many of you who are looking to correct your bunion, will not want to have minimally invasive bunion surgery once you see some x-rays. Minimally invasive surgery only addresses the aesthetic of your foot externally at the expense of creating an osseous deformity internally. Your feet are not your face, they are the foundation of your body. They are responsible for locomotion, balance, posture, and supporting the weight of your entire body.  Yes, it is important to have pretty feet, but it’s more important to have pretty feet that function properly.

At Gotham Footcare, the doctors favor traditional osteotomies, however, they understand the importance of minimal scarring. The surgeons are trained to create a small hidden opening on the side of the foot rather than the top. They also implement techniques used by plastic surgeons to ensure that the cut heals invisibly. Not only does this allow the surgeons to perform this procedure to the highest standard, but it also promotes minimal scarring which is essentially a better version of minimally invasive. 


Dr. Miguel Cunha Dr. Miguel Cunha, founder of Gotham Footcare and a leading podiatrist in Manhattan, is a highly trained and skilled foot and ankle surgeon with experience treating a wide array of foot and ankle conditions from minor problems to complex reconstructive foot and ankle surgery. Dr. Cunha takes pride in having a genuine interest in each and every one of his patients while providing them the utmost compassion and exceptional care.

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