The revival of "new" minimally invasive bunion surgery (MIBS) is made possible as a laparoscopic-like fluoroscopically guided procedure using new instrumentation, advanced osseous realignment techniques and procedure-specific orthopedic hardware. Bunions of all severities can be treated with MIBS with a functional walking recovery in a small surgical shoe. Realignment occurs through a subcapital osteotomy with metatarsal head shifts that are stabilized by a single or dual metatarsal MIBS screw(s) that span a resultant osseous defect. Bone healing occurs by callus deposition, a process of "first metatarsal regeneration," resulting in a new straight realigned first metatarsal segment. New MIBS is rapidly evolving with widespread use and we are currently on the fifth & sixth generational update, highlighting a 1-screw construct. Surgeons are rapidly flocking to learn and incorporate this modern procedure in their daily practice.

Hallux valgus recurrence after traditional open bunion surgery is a notable concern. New minimally invasive bunion surgery (MIBS) offers a promising new revision option for those with recurrent hallux valgus. This innovative approach signifies a noteworthy departure from traditional open surgical methods by minimizing tissue damage, allowing immediate weight bearing, and providing improved patient satisfaction outcomes. This article provides is insights into this emerging method, case examples, and key surgical treatment pearls for treating the recurrent bunion with MIBS. As more surgeons gain MIBS experience, this approach will likely become the gold standard revision method for revisions.

Minimally invasive surgery is gaining tremendous popularity in reconstructive foot and ankle surgery, as well as with trauma. Minimally invasive approaches have demonstrated equivalent to outcomes to traditional open incisional approaches with the added benefit of less risk for wound healing complications and surgical site infections. Advances in orthopedic hardware and surgical techniques are allowing minimal incision surgery for trauma to become more widespread. While there is a steeper learning curve to become proficient, minimally invasive surgery is likely to become the standard for most foot and ankle trauma cases.

Minimally invasive surgery (MIS) continues to develop as a viable alternative to traditional open surgery for various foot and ankle pathologies. The neuropathic foot is one area where MIS can be very beneficial to surgeons and their patients. Improving wound healing and decreasing the surgical footprint and thus reducing complications associated with soft tissue in this population is advantageous. Further research is necessary; however, the early successful outcomes in neuroarthropathy reconstruction via MIS are encouraging.

New minimally invasive bunion surgery for hallux valgus (HV) has received attention in the last few years. A rapid growth in knowledge and techniques has been seen, with many publications, books, and experienced surgeons worldwide. Several variational advancements have emerged with the most common as a percutaneous subcapital osteotomy first metatarsal with long scaffolding minimally invasive (MI) screw placement. MI techniques are a great advancement in the treatment of all HV severities. Supportive literature has demonstrated that MI can achieve equal to better results compared to traditional open surgery, for metrics such as satisfaction, pain, and time to full recovery.

Complex forefoot deformities are challenging to treat and are labor intensive for the surgeon and the patient. New minimally invasive surgery (MIS) shows great potential and in some instances outperforms traditional open surgery. Another advantage MIS has is that it is technically easier to perform (once proficient) and produces less pain and recovery for the patient. This article takes the reader through MIS preoperative planning, soft tissue considerations, the different osteotomy configuration options, rationale, transverse plane correction, sagittal plane correction, revision MIS surgery of malunions, metatarsus adductus correction, hybrid MIS correction, and postoperative bandaging and management.

Hammer toe deformity is a highly prevalent lesser toe deformity and accounts for a high proportion of appointments to foot and ankle clinics. Its etiology is due to extrinsic and intrinsic muscular imbalance, attenuation and subsequent rupture of the plantar plate, and neuromuscular disorders. This leads to marked flexion of the proximal interphalangeal joint and extension of the metatarsophalangeal joint. Effective diagnosis requires robust clinical examination and radiographic imaging or MRI. This article discusses the anatomy, etiology, and management of hammer toe deformity using percutaneous surgical techniques, as well as a treatment algorithm.

Lapidus is a common procedure in our armamentarium for the treatment of hallux valgus deformity. This study presents to the reader that it can be performed percutaneously. It is a technically difficult procedure to perform that requires didactic and cadaveric percutaneous training.

A variety of osteotomies on the calcaneus have been described in the past to adapt the shape of the calcaneus to specific needs. Newer osteotomy and fixation methods allow the procedure to be as minimally invasive as possible. Recent data suggest that the minimally invasive surgery (MIS) techniques allow for fewer complications, particularly with regard to wound healing. The calcaneus can be cut and shifted in all planes, shortened, and rotated with MIS. Calcaneal MIS has become a major component of foot and ankle surgery.

This article will discuss the risk and benefits of percutaneous arthrodesis of various joints in the foot. This will focus on the surgical indications, the approach, as well as tips and pearls to enhance the outcomes of the procedures. Lastly, it will discuss post-surgical protocol and the postoperative complications that are particular to the percutaneous approach.

The journey through the history of minimally invasive surgery in foot and ankle procedures reveals a remarkable narrative of innovation and progress. Minimally invasive surgery has been adopted in various foot and ankle procedures including elective and trauma surgery. Most notably, the transformative impact of minimally invasive bunion surgery, spanning 3 generations of techniques, showcases a relentless pursuit of precision and efficiency. The incorporation of beveled screws in the latest generation stands as a testament to the ongoing biomechanical and research-driven advancements that contribute to the ultimate stability and success of minimally invasive procedures.

Over the last 5 years, minimally invasive surgery (MIS) has seen a significant surge, propelled by advancements in surgical equipment, implants, methodologies, and comprehensive education. The introduction of specialized hardware and advanced bone-cutting burrs has contributed to a reduction in complications. Evidence from peer-reviewed studies suggests that the outcomes of MIS are often on par with, and at times surpass, those of traditional surgical methods. In the context of MIS, certain complications are specifically linked to the use of burrs and hardware, the types of deformities being addressed, and the tools utilized. This article aims to discuss these complications associated with MIS.

Ultrasound is a high-resolution, real-time imaging modality that is frequently used for image-guided procedures. Due to the highly complex anatomy of the foot and ankle, ultrasound should be considered a first-line imaging modality for injections and procedures in this region.

Weight-bearing computed tomography (WBCT) was introduced in 2012 for foot and ankle applications as a breakthrough technology that enables full weight-bearing, three-dimensional imaging unaffected by x-ray beam projections or foot orientation. The literature describing the use of WBCT in the treatment of foot and ankle disorders is growing, and this article provides an overview of what can be measured with WBCT.

In the past few years, advances in clinical imaging in the realm of foot and ankle have been consequential and game changing. Improvements in the hardware aspects, together with the development of computer-assisted interpretation and intervention tools, have led to a noticeable improvement in the quality of health care for foot and ankle patients. Focusing on the mainstay imaging tools, including radiographs, computed tomography scans, and ultrasound, in this review study, the authors explored the literature for reports on the new achievements in improving the quality, accuracy, accessibility, and affordability of clinical imaging in foot and ankle.

The increase in competitive sports practice among children and lack of ionizing radiation have resulted in a higher demand for MRI examinations. MRI of the children skeleton has some particularities that can lead orthopedists, pediatricians, and radiologists to diagnostic errors. The foot and ankle have several bones with abundant radiolucent and high signal intensity cartilage in several ossification centers, apophysis and physis, that can make this interpretation even harder. The present revision aims to show, how to differentiate between normal developmental findings and anatomic variants from pathologic conditions, whether mechanical, inflammatory, infectious, or neoplastic.

High-resolution ultrasound (US) can be used to assess soft tissue abnormalities in the foot and ankle. Compared to MRI, it has lower cost, is widely available, allows portability and dynamic assessment. US is an excellent method to evaluate foot and ankle tendon injuries, ligament tears, plantar fascia, peripheral nerves, and the different causes of metatarsalgia.