09/29/2015    Ed Cohen, DPM

Standard of Care for Bunion Hardware (R. Alex Dellinger, DPM

There are some podiatrists doing great surgery on
bunions using either limited fixation or non-
fixation.The trend in medicine is toward
minimally invasive surgery and this movement in
podiatry began 40 years ago and has really seen
some state-of-the-art advancements which give
better functional and cosmetic results.

Advantages of minimally invasive foot surgery are
that it is a safer technique when working with
the higher risk and geriatric patients who are
not good candidates for traditional surgery.

This movement which began in the United States by
the AAFAS has now spread all over the world
mostly with orthopedists and to some extent
podiatrists. It has really been popular in Europe
,Mexico and South America and has been seeing a
lot of growth in Asia and Africa.

Unfortunately, these procedures which don't use
fixation have not been taught in American
podiatry schools and to a very limited extent in
residencies. The movement has caught the
attention of some influential traditional
surgeons and is gradually opening up to the idea
of minimally invasive foot surgery by reducing
the amount of hardware placed in the foot and by
using smaller incisions on the foot.

Some of the most authoritative books on this
subject have been written by international
orthopedists and a few of these experts have done
their PhD work on MIS foot surgery. I think it is
a good idea for those who have an interest in
atraumatic foot surgery to attend some these
international cadaver meetings hosted by the
AAFAS to see if it is something they might
consider incorporating in their practice.

Ed Cohen, DPM, Gulfport, MS

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