Minimally Invasive Bunion & Hammer Toe Surgery
in Singapore

Living with bunions and hammer toes can significantly impact your daily activities, from wearing your favourite shoes to enjoying a simple walk. These common foot deformities often cause persistent pain, limit footwear options, and may affect your overall mobility. Minimally invasive surgery is one option to correct bunions and hammer toes. This approach uses smaller incisions, which may help reduce recovery time and post-operative discomfort compared to traditional methods. Surgery aims to restore foot alignment and function, supporting a return to everyday activities with improved comfort.

Dr Zackary Chua

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (Aus)MMed (SG)MRCS (Glasgow)FRCSEd (Orth)

Minimally Invasive Bunion & Hammer Toe Surgery

Suitability Techniques Process Recovery Benefits Risks Cost FAQ Conclusion

What is Minimally Invasive Bunion & Hammer Toe Surgery?

Minimally invasive bunion and hammer toe surgery is a surgical technique that corrects foot deformities through small incisions, typically measuring just a few millimetres. Unlike traditional open surgery, this approach uses specialised instruments and fluoroscopic (X-ray) guidance to realign bones and correct deformities with minimal tissue disruption.

A bunion (hallux valgus) occurs when the big toe deviates toward the other toes, creating a bony prominence at its base. Hammer toe refers to an abnormal bend in the middle joint of a toe, causing it to curl downward like a hammer. Both conditions can develop simultaneously and often require surgical intervention when non-surgical measures do not provide sufficient relief.

During minimally invasive surgery, the surgeon makes precise bone cuts (osteotomies) to realign the affected joints. This approach addresses both the appearance and functional issues associated with bunions and hammer toes. The procedure typically results in less soft tissue damage, reduced scarring, and potentially faster healing compared to traditional open techniques.

Ideal Candidates

Patients with moderate to severe bunions causing ongoing pain despite non-surgical treatment
Individuals with rigid hammer toes that do not respond to non-surgical treatment
Those experiencing difficulty wearing regular shoes due to foot deformities
Patients with pain that limits daily activities or exercise
Individuals with good overall health and realistic expectations about surgical outcomes
Non-smokers or those willing to quit before surgery, as smoking can affect healing
Those who can comply with post-operative weight-bearing restrictions

Contraindications

Active infection in the foot or systemic infection
Severe peripheral vascular disease or poor circulation
Uncontrolled diabetes with neuropathy
Severe osteoporosis that may compromise bone healing
Certain rheumatoid conditions affecting wound healing
Inability to follow post-operative care instructions
Unrealistic expectations about recovery and functional outcomes

A thorough evaluation by an orthopaedic surgeon is essential to determine if minimally invasive surgery is appropriate for your condition. Your foot structure, severity of the deformity, and overall health will be reviewed to recommend an appropriate treatment plan.

Treatment Techniques & Approaches

Percutaneous Bunion Correction

Percutaneous bunion correction involves making small incisions, typically 3-5mm in length, through which specialised instruments are inserted. The surgeon uses fluoroscopic guidance to visualise the bones while performing precise osteotomies to realign the first metatarsal and address the bunion deformity. This technique may include releasing tight soft tissues and removing the bony prominence. Small screws or pins may be used to maintain the corrected position during healing.

Minimally Invasive Hammer Toe Correction

For hammer toe correction, small incisions are made over the affected toe joints. The surgeon may perform various procedures including tendon releases, joint resections, or fusion of the affected joint. In some cases, a small portion of bone is removed to allow the toe to straighten. Temporary pins may be inserted to maintain alignment during the healing process. Multiple hammer toes can often be addressed during the same surgical session.

Technology & Equipment Used

The surgery utilises specialised burrs and cutting instruments designed for minimally invasive procedures. Fluoroscopic imaging provides real-time visualisation of the bone structures. Low-profile fixation devices, such as small screws or pins, may be used to maintain aligntment. Additional tools, including retractors and guides, help ensure precise bone cuts while protecting surrounding tissues.

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The Treatment Process

Pre-Treatment Preparation

Before surgery, a comprehensive foot examination, including X-rays, will assess the severity of your deformities. Blood tests may be required to ensure you are fit for surgery. Arrange transportation home, as driving will not be possible immediately after surgery. Follow your surgeon’s instructions regarding medications, including stopping anti-inflammatory drugs or blood thinners if advised. On the day of surgery, follow fasting instructions if general anaesthesia will be used, and wear loose, comfortable clothing that can accommodate a post-operative shoe or boot.

During the Procedure

The surgery typically takes 30-90 minutes depending on the complexity and number of deformities being addressed. You will receive either general anaesthesia or regional anaesthesia with sedation. Small incisions are made around the affected areas. Using fluoroscopic guidance, precise bone cuts are made to realign the bones. Any necessary soft tissue releases are performed through the same small incisions. Fixation devices may be inserted to maintain the alignment, after the incisions are closed with sutures and covered with a sterile dressing. A post-operative shoe or boot is fitted before you leave the operating room.

Immediate Post-Treatment

Following surgery, you will be monitored in the recovery area until the anaesthesia wears off. Your foot will be elevated, and ice may be applied to reduce swelling. Pain medication will be provided to manage any discomfort. You will receive post-operative instructions, including weight-bearing restrictions and wound care. Most patients can go home the same day once stable and comfortable. A follow-up appointment is usually scheduled within a week to monitor progress and change dressings.

Recovery & Aftercare

First 24-48 Hours

Keep your foot elevated above heart level as much as possible to minimise swelling. Apply ice packs for 20 minutes at a time, several times daily. Take prescribed pain medications as directed. Keep the surgical dressing dry and intact. Weight may be placed on your heel using the special post-operative shoe, but avoid putting pressure on the forefoot. Monitor for signs of infection, such as increased pain, redness, or discharge. Seek medical advice if you experience severe pain, numbness, or changes in toe colour. Monitor for signs of infection, such as increased pain, redness, or discharge. Seek medical advice if you experience severe pain, numbness, or changes in toe colour.
First Week

Continue elevation and icing to control swelling. Gradually increase your activity level while following weight-bearing instructions. Attend your first follow-up appointment for wound assessment and dressing change. Begin gentle toe exercises as instructed to prevent stiffness. Use the post-operative shoe for all weight-bearing activities. Showering is possible with a waterproof cover over the foot. Most patients can return to desk-based work within a week if the foot can be kept elevated.
Long-term Recovery

Bone healing generally occurs within 6-8 weeks. Transition to normal footwear gradually, starting with wide, comfortable shoes. Physiotherapy may be recommended to restore strength and flexibility. Return to sports and high-impact activities usually takes several months. Follow-up X-rays may be scheduled to monitor your healing progress. Some swelling may persist for a few months but typically decreases over time. Long-term recovery is supported by adherence to post-operative instructions and appropriate footwear.

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Benefits of Minimally Invasive Bunion & Hammer Toe Surgery

Minimally invasive surgery uses smaller incisions, which can reduce tissue disruption and may lead to less post-operative discomfort and swelling. Many patients are able to resume weight-bearing activities and normal footwear sooner than with traditional open surgery. The reduced soft tissue dissection can help preserve blood supply to the bones, supporting the healing process.

The use of real-time imaging allows for precise correction of deformities. Multiple foot deformities can often be addressed in a single procedure, which can simplify recovery compared with staged surgeries.

Preservation of joint structures and surrounding tissues helps maintain stability and support natural foot mechanics. Correcting foot alignment may also relieve strain on other joints, such as the knees, hips, or lower back, which can be affected by altered walking patterns.

Common Side Effects

Swelling and bruising around the surgical sites are expected and typically resolve over several weeks. Mild to moderate pain is common in the first few days but is manageable with prescribed medications. Temporary stiffness in the affected toes may occur but generally improves with gentle exercises and time. Some patients may experience temporary numbness around the incision sites due to small nerve irritation. Small scars are inevitable but usually fade over time.

Rare Complications

Infection may occur and can typically be treated with antibiotics. Delayed bone healing or incomplete bone union may require further assessment or intervention. Recurrence of the deformity is possible but uncommon. Overcorrection or undercorrection of the toe alignment may occasionally require revision surgery. Deep vein thrombosis is rare but mitigated with early mobilisation. Chronic pain or complex regional pain syndrome is very uncommon.

Precautions are taken before, during, and after surgery to help minimise these risks. Adhering to pre- and post-operative instructions plays an important role in supporting recovery and reducing the likelihood of complications. Precautions are taken before, during, and after surgery to help minimise these risks. Adhering to pre- and post-operative instructions plays an important role in supporting recovery and reducing the likelihood of complications.

Cost Considerations

The cost of minimally invasive bunion and hammer toe surgery can vary depending on several factors. The complexity of the deformities and the number of toes requiring correction influence the overall fee. Hospital or surgical facility charges typically cover operating room use, equipment, and related services.

Fees generally include pre-operative assessments, the surgical procedure, immediate post-operative care, and initial follow-up visits. Additional costs may apply for imaging studies, custom orthotics, or extended physiotherapy. The type of anaesthesia and the need for overnight admission, if required, can also affect the total cost. A detailed cost estimate will be provided during your consultation.

Minimally Invasive Bunion & Hammer Toe Surgery

Frequently Asked Questions

How long does minimally invasive bunion and hammer toe surgery take to perform?

The surgery typically takes between 30 to 90 minutes, depending on the severity of the deformities and the number of toes being corrected. If both bunion and multiple hammer toes are addressed simultaneously, the procedure may take closer to 90 minutes. The actual time can vary based on individual anatomy and the complexity of the corrections needed. Your surgeon will provide a more accurate time estimate during your consultation. The procedure duration depends on the severity of the deformities and the number of toes being corrected. When both bunions and multiple hammer toes are addressed at the same time, the procedure may take longer. A consultation will provide guidance on what to expect for your individual case.

When can I return to wearing normal shoes after surgery?

Most patients can transition to normal shoes within 6-8 weeks after surgery, once the bones have healed sufficiently. Initially, you’ll wear a special post-operative shoe or boot for protection. Around week 6, you can gradually start wearing wide, comfortable shoes with good support. High heels and tight-fitting shoes should be avoided for at least 3 months. Full return to all shoe types typically occurs by 4-6 months post-surgery. After surgery, a special post-operative shoe or boot is typically worn to protect the foot. Transitioning to normal footwear usually occurs gradually over several weeks once healing has progressed. Wide, comfortable shoes with good support are recommended initially, while high heels and tight-fitting shoes should be avoided for a few months. A return to a wider range of shoe types may take several months, depending on individual recovery.

Will I need physiotherapy after minimally invasive foot surgery?

While not all patients require formal physiotherapy, but many benefit from a structured exercise programme to restore strength, flexibility, and balance. Simple exercises may be recommended to do at home initially. If additional support is needed, physiotherapy sessions may be advised to assist with recovery. The timing and duration of these exercises will depend on individual progress and recovery.

Can both feet be operated on at the same time?

While surgery on both feet at the same time is possible, it is usually recommended to operate on one foot at a time. This allows you to maintain some mobility during recovery using the non-operated foot. Surgery on both feet simultaneously may require additional support at home and limited weight-bearing initially. Often, the second foot is addressed after recovery from the first procedure, depending on individual needs and recovery progress.

How successful is minimally invasive bunion and hammer toe surgery?

Minimally invasive techniques are designed to correct bunion and hammer toe deformities through smaller incisions. Many patients experience reduced discomfort and improved foot function following the procedure. Recovery and outcomes vary depending on factors such as the severity of the deformities, adherence to post-operative instructions, and appropriate footwear.

What activities should I avoid after surgery?

During the post-operative period, avoid any activities that put pressure on the forefoot. Swimming or soaking the foot should be avoided until surgical wounds have healed. High-impact activities, such as running or jumping should be avoided for at least 3 months. Sports or movements that involve pivoting may also require longer restrictions. Specific guidance will be provided based on your individual recovery progress.

Is minimally invasive surgery suitable for severe bunions?

Minimally invasive techniques can be used for many moderate to severe bunions effectively. Severe deformities or those with advanced joint changes may require traditional open surgery. Suitability depends on factors such as the degree of deviation, joint condition, and bone quality. A consultation and assessment, including examination and imaging, will help determine the most appropriate surgical approach for your situation.

What type of anaesthesia is used for this surgery?

Minimally invasive bunion and hammer toe surgery can be performed under general anaesthesia or regional anaesthesia (ankle block) with sedation. The choice depends on patient preference, medical history, and the planned procedure. Regional anaesthesia numbs the foot while allowing you to remain awake and comfortable, whereas general anaesthesia renders you unconscious during the surgery. Anaesthesia options will be discussed during your pre-operative assessment.

Conclusion

Minimally invasive bunion and hammer toe surgery is a modern surgical approach that corrects foot deformities through smaller incisions. This technique aims to reduce tissue disruption while addressing pain and functional limitations. Recovery and results vary depending on the severity of the deformities, adherence to post-operative care, and individual healing. Careful assessment, appropriate surgical planning, and following post-operative instructions are important to support the healing process and optimise mobility after surgery.

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If you’re considering minimally invasive bunion and hammer toe surgery, our Senior Consultant Orthopaedic Surgeon can help you understand if it’s the right choice for your needs. With considerable experience in minimally invasive foot surgery, we provide personalised care throughout your journey.

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Dr Zackary Chua (蔡克祥医生)

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (AUS)|MMed (Singapore)|MRCS (Glasgow)|FRCSEd (Orth)

A senior consultant orthopaedic surgeon with dual specialisations in Foot & Ankle Surgery and Paediatric Orthopaedics. Backed by his extensive years of training and experience, Dr Chua brings the necessary knowledge and skills to ensure a smooth recovery journey.

Rooted firmly by two fundamental philosophies: “When one’s feet hurt, one hurts all over” and “Children are not little adults”, Dr Chua’s approach to patient care reflects his compassionate care for adults and children.

Singhealth Quality Excellence Award – Silver (2011)
Service From the Heart Award (2021)
Singapore Health Quality Service Award – Gold (2023)
NUS Medicine Dean’s Award for Teaching Excellence (2023)

His active participation in the medical community extends to mentoring, research supervision, and contributions to key professional forums and symposiums, both locally and internationally.