Minimally Invasive Bunion Surgery

How is the Bunion corrected minimally invasive?

The operation performed is called the “Minimally Invasive Chevron Akin (MICA)


Why do you need this operation?

Before being offered this operation, you should have tried other measures such as using wide-box shoe-wear, padding the swelling and maybe trying forefoot insoles.

This operation is offered to you if you continue to have symptoms despite trying the above measures and after you have been examined and counselled.

What does the operation involve?

The operation is done as a day case, but come prepared in case you need to stay overnight.

The operation is performed with general anaesthetic and nerve block (which means numbing the nerves of the foot).

The operation involves two small incisions on the medial side of the big toe. One is used to shave the bunion with a special burr and to perform a cut in the bone with another burr. Through the same incision, the bone is displaced to correct the deformity.

Through the second incision screws are introduced to fix the translated bone. Further stab incisions may be needed to do a percutaneous Akin osteotomy.

The operation is done under x-ray guidance.

You will use crutches if needed as well as a surgical shoe “the off-loading shoe”.

Your post-operative period

  • You must keep your foot raised for the first two weeks and if needed afterwards.
  • You can put your full weight on your foot using the surgical shoe for the first 6 weeks.
  • There is no plaster needed following this operation.
  • Use crutches if needed.
  • Exercise big toe movements at two weeks
  • The swelling may last for a few months going on and off and finally fading away.

Your follow-up

  • At two weeks, the dressing is reduced and the stitches are removed
  • At 6 weeks, you have a follow-up with x-rays
  • Off work for 2 to six weeks depending on your job
  • No driving for six weeks.

What are the possible complications?

  • Infection
  • Sensitive or painful scar
  • Big toe permanent numbness
  • Joint stiffness
  • Under-correction or Over-correction
  • Failure of bone healing (non-union)
  • Recurrence of the deformity
  • Avascular Necrosis of metatarsal head
  • Clots in the leg (DVT)
  • Clots in the lung (PE)
  • Chronic Regional Pain Syndrome

Smoking, diabetes, rheumatoid arthritis or being on steroids or blood thinning medication increases possible risks significantly.

Is this technique better than the open technique?

The gold standard surgical correction of the bunion deformity is the Scarf & Akin osteotomies. The minimally invasive technique is suitable for a group of patients where it can have the benefit of less scarring. The recovery period is the same following both techniques and there is no evidence in the current literature to suggest that this technique is better or worse than the open correction.

For information on the open surgical correction click here.

Patient Testimonies

Dear Mr Shalaby, Thank you for bringing my foot back to what it was, and for inspiring so many of my artworks. I wish you all the best in the future, and I hope you can continue to inspire hope in others, as you did in me.
Mr A J, 15 years old – Revision of EHL tendon repair
Dear Mr Shalaby Last year you operated on my ankle. It was badly broken and the joint was damaged. I was in doubt what the outcome of the Joint replacement would be. However I thought you would like to know that the operation was great success and I am walking now very well without a stick. I would like to thank you for all your professional care.  
Mr J G, 64 years old – Advanced post-traumatic Ankle Arthritis
Dear Mr Shalaby I cannot thank you enough for sorting out the severe deformities of my toes and the pain I was experiencing in the ball of the foot. The operation gave me my life back.  
Mrs E J, 55 years old – Rheumatoid Forefoot deformities
Dear Mr Shalaby My grateful thanks for your excellent professional care. My husband and I are very impressed with all the care and of course the results. Thank you.  
Mrs M M, 62 years old – Severe flat foot deformity
Dear Mr Shalaby Just a brief word to thank you for the excellent job you did on my ankle. After suffering years with my ankle pain, I can now say I have had no pain since the day of the operation and my overall walking ability has improved significantly.  
Mrs M G, 58 years old – Ankle fusion for congenital Dysplastic Ankle
Dear Mr Shalaby After the ankle ligament surgery, you performed I am back to all the sports I wanted to do and I can finally trust my ankle again. I am also writing to tell you that I have just manged to climb Mount Kilimanjaro. I greatly appreciate you help.  
Mr J A, 34 years old – Lateral ligament repair for Ankle Instability
Dear Mr Shalaby Just to let you know that last week I completed the 97-mile West Highland Way Walk with a group of friends. So again, many many thanks.
Mrs S M, 30 years old – Bilateral Bunion Correction