Complication Rates During Early Adoption of Fourth-Generation Minimally Invasive Bunion Surgery: A Retrospective Review.

Abstract

Fourth-generation minimally invasive bunion surgery (MIBS) has gained popularity given its minimal soft tissue disruption, small incisions, and potential for expedited recovery. Although early outcomes have been encouraging, limited data exists regarding complication rates during the initial learning curve phase of this most recent technique evolution. To evaluate postoperative complications associated with early adoption of fourth-generation MIBS. Retrospective review. 72 fourth-generation MIBS procedures (67 patients) performed by three surgeons during their initial experience with the operative technique were reviewed. Patient demographics, radiographic measurements, and postoperative complications were collected and analyzed. 53 (88.9%) procedures were completed without notable postoperative complications. Hardware failure occurred in 6 (8.3%) procedures. Reoperation, surgical site dehiscence, and postoperative infection each occurred in 5 (6.9%) procedures. Deformity recurrence, postoperative first metatarsal fracture, and first metatarsophalangeal joint stiffness each occurred in 2 (2.8%) procedures. Symptomatic nonunion, sesamoiditis, and intraoperative metatarsal fracture each occurred in 1 (1.4%) procedure. No instances of paresthesia, avascular necrosis, or hallux varus were observed. These findings offer important insights into the outcomes of fourth-generation MIBS during initial procedure implementation. Postoperative complication rates during early adoption of fourth-generation MIBS appear acceptable and comparable to those reported for other bunion correction techniques. Understanding the complication profile during this phase can help guide technique refinement, enhance patient selection, and promote successful outcomes in hallux valgus correction. IV.