Mini TightRope Bunionectomy

A bunionectomy is a surgical procedure to remove the bony bump on the inner side of the foot at the base of your big toe. Traditionally, a bunionectomy involves breaking or cutting the bone (osteotomy), resetting it in the correct position and using a screw or pin for fixation.  The Mini TightRope bunionectomy is a less invasive surgical procedure to correct painful foot deformities caused by bunions. The Mini TightRope method uses a strong non-absorbable fiberwire suture to bind the first and second metatarsals together without cutting bone or using bone screws.

A bunion, also known as Hallux valgus, is a bony protuberance on the inner side of the foot at the base of your big toe, known as the metatarsophalangeal joint. This joint thickens and enlarges causing the tendons to tighten and the big toe to shift towards the second toe resulting in a painful bunion.

Causes

Bunions are often caused from genetics and tend to run in families. Wearing too tight, narrow-toed, or high-heeled shoes may lead to the development of bunions. Bunions are more common in women than men possibly due to footwear that women often wear. Bunions may also be associated with inflammatory or degenerative arthritis and neuromuscular conditions such as cerebral palsy.

Symptoms

People with bunions experience pain when wearing shoes. A bony bump can be seen at the base of the big toe. Corns or calluses may develop where the first and second toes overlap. The skin around the bunion may become swollen or inflamed. The big toe turns in towards the second toe often overlapping and causing pressure. You may also have restricted movement of your big toe.

Diagnosis

A doctor can diagnose a bunion by your medical history, a physical examination and x-ray of your foot.

Treatment Options

Nonsurgical treatments include:

footwear modification,

padding and taping,

using shoe inserts,

taking medications,

and physical therapy to relieve the pain and pressure of a bunion.

You may need surgery if conservative treatment doesn't provide relief from your symptoms. A bunionectomy is a surgical procedure to remove the bony bump and to correct the alignment of big toe. The surgery is aimed at relieving the pain and realigning the bone thereby correcting the deformity.

Traditionally, a bunionectomy involves removing the bony prominence and straightening the big toe by cutting through the first metatarsal bone and repositioning it in a corrected position using bone screws. This procedure can lead to a long recovery period and several potential complications associated with the osteotomy.

Unlike traditional bunion surgery, the TightRope method uses a fiberwire device to correct the bone deformity without the need for an osteotomy or bone cutting.

Mini-TightRope bunionectomy

Mini-TightRope bunionectomy is a surgical technique for the correction of painful bunions. The goal of the surgery is to relieve your foot pain and allow unrestricted shoe wear and early return to normal activities.

In this surgery, tiny holes are drilled through the first and second metatarsal bones in the foot instead of cutting the bone for realignment as in traditional bunionectomy. A strong non-absorbable fiberwire is then threaded between the two bones and tightened to correct the position and alignment of the big toe.

Advantages

Advantages of Mini-TightRope bunionectomy include:

Allows for a greater selection and use of less strong pain medications

Can be used in conjunction with other procedures if needed

Faster healing time

More rapid return to normal activity

Less postoperative pain

Prevents shortening of the great toe associated with osteotomy

Risks and Complications

Earlier an infrequent but unique complication associated with the Mini-TightRope bunionectomy procedure was a stress fracture of the 2nd metatarsal. In a study presented at the AOFAS 2012 meeting the use of a small buttress plate has eliminated this potential complication.

Other complications that can occur with any bunionectomy include:

Wound infection

Complications with anaesthesia

Incisional numbness

Recurrence of the bunion

Post Operative Care

Following Mini TightRope bunionectomy surgery some doctors allow patients to walk immediately with a post-operative shoe whereas other doctors may instruct you to protect the foot for two weeks with the use of crutches. The stitches are removed after two to three weeks and most patients usually return to regular shoe wear in about 3 months.

Mini TightRope bunionectomy is a less invasive surgical option for patients with painful bunions that offers less post operative pain, less complications and a quicker recovery than traditional bunion surgery.