The Bunion

It’s the most common foot issue.  Doctors have been surgically removing them for centuries. Bunions are common and the National Center for Biotechnology Information (NCBI) estimates between 23%-35% of people have them.

A bunion can be painful. Usually, symptoms occur on the sides of the foot, the sole, the big toe and small toe. They have been affecting people for centuries. In 1981, Dr. Basil Helal counted over 150 different procedures to treat bunions.

In the past, people had two options: surgery or non-invasive treatments like wraps and splints. That’s until minimally invasive surgery (MIS) came along.

What is Minimally Invasive Foot Surgery?

Minimally Invasive bunion surgery is a new type of bunion surgery that limits the damage to the foot.

Minimally invasive surgery is your best bet if you want to walk out of the operating room with almost no pain, immediately after surgery. In this procedure, three small incisions are made and closed with a single stitch each. Doctors use small instruments to perform the operation without exposing the surgery site. There is no large cut or rows of stitches.  Minimally invasive foot surgery requires only local anesthetic.  While the surgery site will be numb, you will be awake the entire time and you can drive yourself directly to work when it’s done.

In the past, the field of Podiatric Surgery has had a negative view of the minimally invasive procedure. In the 1970s and 1980s,  doctors were still experimenting and had yet to refine this new method. By the 1990s however, it was the most beneficial procedure available.  Today, MIS boasts thousands of successful operations and thrilled patients who remain active and bunion-free to this day.

Early Attempts at Foot Surgery

Bunions have always been an issue and in 1836, Dr. Gernet was the first to remove them. He removed the bone to get the foot to heal. It was not successful.

As time went on, bunion issues continued and doctors tried to invent new treatments. In 1881, Dr. Reverdin had the first successful procedure for treating bunions. It was a way of removing a piece from the joint to ease the bunion. The procedure is called the Hohmann osteotomy, and it was the first foot surgery with multiple successes.

Still, it wasn’t fool proof. Doctors believed there had to be a better way of treating bunions without causing upheval to patients’ lives.

It wasn’t until they developed the technology in the 1940s, that minimally invasive foot surgery became a reality.

Throughout the 1960s, technology and equipment for MIS was invented and improved. Technology then made a breakthrough, with a machine that allowed surgeons to view a continuous image of what they were doing inside the foot, without exposing the surgery site.

Foot Surgery: The Nineties to Now

In the 1990’s, innovation began to flourish. With the latest technology at hand, different minimally invasive foot procedures began to spring up all over the country.

During this period, intellectual discoveries were made in foot surgery, including:

  • Davis’s Law: Describes how soft tissue replicates itself.
  • Wolff’s LawDescribes how bone heals according to the stresses it is subject to.

As the science developed, so did the different methods of application. First, in 1990, Dr. Bosch and his team developed the SCOT (SubCapital Osteotomy Techniques) procedure. It involved using MIS to remove parts of the joint and stabilize the toe with wire. This new procedure allowed full weight on the foot, with protective gear.

The doctor and his team planned a 7 and 10-year follow-up for their patients to assess the success of the operation. Fast forward to the year 2000.

Dr. Bosch and his team discovered that out of 114 feet, 81% of patients were satisfied, with 95% reporting no pain. There was also a significant reduction in radiographic measurements. They deemed the procedure a great success.

By the year 2005, other doctors began to follow suit. Dr. Magnan and his colleagues applied Bosch’s method to 188 patients with a two-year follow-up. They saw a significant correction in pre and post-op parameters.

In that study, 91% of patients reported satisfaction.

The medical community was catching on. Dr. Giannini and his colleagues developed a procedure called the Modification SERI (Simple, Effective, Rapid, Inexpensive). They made minor modifications to Bosch’s method and reported a 92% fair to excellent satisfaction rate in 54 of their patients.

Today, minimally invasive foot surgery is one of the easiest and least stressful bunion-removal procedures available. Doctors have finally created a means to not only improve a patient’s quality of life but do so in the least invasive way possible.

Related questions about bunions:


  1. How long does it take to walk after bunion surgery?

    After minimally invasive bunion surgery, you will walk right out of the operating room and never be immobilized. After old-fashioned “open-foot” bunion surgery, you might be immobilized for weeks or even months.

  2. Are you put to sleep for bunion surgery?

    You are not put to sleep for minimally invasive bunion surgery. You are put to sleep for the old-fashioned “open-foot” type of bunion surgery.

  3. What happens if you don’t remove bunions?

    If bunions are left untreated, they will progressively get worse and pain will develop. Bunion exercises, bunion correctors and other non-surgical methods might slow the progression and provide temporary bunion pain relief.