Minimally Invasive Foot Surgery (MIFS) uses the latest advanced technology to treat foot and ankle pain caused by a variety of conditions. Special surgical instruments, devices and advanced imaging techniques are used to visualize and perform the surgery through small incisions. The aim of MIFS is to minimize damage to the muscles and surrounding structures enabling faster recovery and less pain.
The benefits of MIFS over the traditional open foot surgery include:
- Small surgery scars
- Less risk of infection
- Minimal blood loss during the surgery
- Minimal post-operative pain
- Quicker recovery
- Shortens the hospital stay
- Quicker return to work and normal activities
Some of the foot and ankle conditions treated using MIFS technique include:
- Bunions
- Hammer toes
- Metatarsalgia
- Big toe arthritis
- Flat feet
- Ankle Arthritis
- Achilles Tendon Rupture
- Toe Deformities
Procedure
Minimally invasive foot surgery is performed through very small incisions. Through these small incisions, segmental tubular retractors and dilators are inserted to retract muscles away from the operative area and provide access to the affected area of the foot. This minimizes the damage to the muscles and soft tissues and lessens blood loss during the surgery. An endoscope, a thin telescope-like instrument with a video camera on the end is inserted through one of the tiny incisions to provide images of the operation field on the monitor in the operating room. Special tiny surgical instruments are passed through the working channel of the endoscope to perform the surgery. Sometimes surgical microscopes may also be used to magnify the visual field. Once the surgery is complete, the tissues fall back in place, as the various instruments are removed. The incision is then closed and covered with surgical tape.
Bunions
A bunion is an enlargement of bone in the joint at the base of the big toe. Bunions are most often inherited. Tight shoes do not cause bunions, but they can aggravate them. There are several types of bunions and surgical treatments for each. (See Bunions)
Hammertoes
A muscle imbalance or abnormal bone length can make one or more small toes buckle under, causing their joints to contract. This in turn, causes the tendons to shorten. Corns (build-ups of dead skin cells where shoes press and rub) often form on the contracted joint, and may become irritated and infected.
Flexible Hammertoes
When hammertoes are flexible, you can straighten the buckled joint with your hand. Flexible hammertoes may progress to rigid hammertoes over time. Corns, irritation, and pain are common symptoms. Function is often limited as well.
Rigid Hammertoes
A rigid hammertoe is fixed; you can no longer straighten the buckled joint with your hand. Corns, irritation, pain, and loss of function may be more severe for rigid hammertoes than for flexible ones.
Curled Fifth Toe
The little toe may curl inward underneath its neighbor so that the nail faces outward. With this inherited problem, the fat pad on the bottom of the toe (normally used for walking) loses contact with the ground. Corns and pain may result.
Second Metatarsal Plantar Callus
When the second metatarsal bone is longer or lower than the others, it hits the ground first - and with more force than it is equipped to handle at every step. As a result, the skin under this bone thickens. Like a rock in your shoe, the callus causes irritation and pain. The treatment for this is an osteotomy. The second metatarsal bone is cut, and the end of the bone is then "lifted" and aligned with the other bones.
Heel Spurs
A heel spur is a bony overgrowth on your heel bone (see Plantar Fascitis). It may be stimulated by muscles that pull from the heel bone along the bottom of the foot. High-arched feet are especially apt to have too-tight muscles here. Heel spurs may cause pain when the foot bears weight. They can be treated first with an injection, anti-inflammatory medication, as well as arch supports if indicated. If this fails, they can then be treated with surgical excision and a plantar release. The band of tight muscles is released to relieve the abnormal stress. The bone spur is surgically removed.
Neuromas
When a nerve is pinched between two metatarsal bones (usually the third and forth metatarsals), enlargement of the nerve may occur. Abnormal bone structure contributes to the cause, but too-tight shoes can aggravate the condition. You may experience sharp pain in your toes that may become severe enough to keep you from walking.
Excision: A small portion of the nerve is removed. As a result of this, a small area is usually permanently numbed, but this is preferable to pain.
You can usually bear weight right away, but you must return to have your dressing changed. Keep your incision dry until the stitches are removed.
High-Arched Feet (Pes Cavus)
The shape of your foot often determines the kinds of foot problems you will have. Your feet may have unusually high arches due to an imbalance of muscles and nerves, which is usually inherited. Too high arches can cause various problems - tired or aching feet; and calluses. High arches are not usually investigated with surgery but most often treated with arch supports.
Flat Feet
Flat feet can be hereditary and are caused by a muscle imbalance. Feet with low, relaxed arches may bring on such problems as hammertoes and bunions; arch, foot, and leg fatigue; calf pain; and an overly tight heel cord (which makes the foot even flatter). Loose joints move to freely, causing pain and instability. Flat feet are also usually treated with arch supports.
Orthotics
Orthotics are prescribed, custom made arch supports. They fit inside most shoes. A podiatrist may prescribe them to help correct such problems as high arches and flat feet. Also, following some foot surgeries, orthotics can help support the correction that was achieved.
To be fitted with orthotics, the podiatrist will first take an impression of your feet. Orthotics are then fashioned from leather, plastic, or other materials. Their fit is checked at an office visit and adjustments can be made as they are worn.
Surgery
If your bunions or hammertoes are bad enough, they may need surgical correction. This is a gratifying operation that can provide both pain relief and improved appearance.
Risks
All surgery carries risks. Make sure you understand the risks and alternatives prior to surgery.
Post operative Care
These tips facilitte faster recovery without complications,
Pain: To help relieve pain and reduce swelling in the first 24 to 48 hours after surgery, apply an ice pack to the affected area and elevate the foot above heart level, as recommended. Pain is usually most severe the second and third days after surgery. Walking again may also be painful.
Bathing: You will need to keep your foot dry. Getting the stitches wet can lead to infection, so be sure to keep your foot outside the shower or bath.
Weight-Bearing: Bearing weight and walking can stimulate circulation and promote healing. But overtaxing a healthy foot can detract from the results of your surgery.
Shoes: a wide surgical shoe to wear on the affected foot may be necessary.. A surgical shoe stabilizes and protects the foot as it heals.
Returning to Work: timing of return to work depends on the type of surgery and the activities the job requires. Returning to a desk job is usually faster than returning to a job that requires a lot of walking.