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Foot surgery

Minimally invasive surgical procedures are being used more and more. Minimally invasive (percutaneous) surgical procedures have also become established in the field of foot surgery. While the basic principles correspond to those of conventional operations, minimally invasive operations on the foot are only performed using small stab incisions a few mm in size. The smaller surgical approaches can reduce the risk of wound healing disorders and infections. Furthermore, the scars are hardly visible cosmetically in minimally invasive surgical procedures.

Main focus

  • Hallux valgus
  • Clamp toes
  • Hammer toes
  • Claw toes
  • Tailor bale
  • Metatarsalgia (splayfoot)

Development

In contrast to minimally invasive techniques in other locations in Germany, minimally invasive foot operations are not yet widespread. These techniques were developed and promoted in Spain in particular. For some years now, however, the minimally invasive techniques of foot surgery have been increasingly used in German centers and are part of the training concepts of the German foot societies.

Implementation

The surgical method allows multiple malpositions to be operated on the foot at the same time. Although the operation is only performed through stab incisions, the procedures should be performed in a hospital. Whether the OP then

performed on an outpatient or inpatient basis depends on the extent of the deformities to be corrected. In most cases, regional anesthesia (numbing) of the foot is sufficient. Targeted stab incisions are used to remove bonesusing special reamers. The bone axis is also corrected using special milling tools (osteotomies). This is done under X-ray control in the operating room. The introduction of metal implants (wire, screw, plate) is not necessary for most of the corrections. Accordingly, there is no need for a second intervention to remove the implants. Larger corrections, however, can make it necessary to insert screwsor wires even with minimally invasive surgical techniques.

Side effects

The small stab incisions in the skin must not hide the fact that the basic principle involved here is the same operation as with the open procedure. This is expressed in the fact that even after minimally invasive operations there is a tendency for the foot to swell. Although this tends to be lesspronounced than with open techniques, it is nevertheless observed.

Aftercare

Correct follow-up treatment is an essential part of the surgical procedure. A special reducing bandage is applied inthe operating room to keep the foot and toes in the corrected position. In addition, a special shoe is adapted. Full weight bearing is allowed immediately in this shoe. Depending on individual needs, crutches can also be used for a few days. The first dressing change takes place after a week. The threads are pulled and a special splint is put on, which keeps the foot and toes in the correct position. Overall, this splint must be worn day and night for a total of 6 weeks after the operation. For a further 6 weeks, the splint should then only be worn at night. During all this time, a full load on the foot is permitted and desirable.

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