Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Minimally invasive foot surgery (MIS) — performing osseous correction through small stab incisions using burrs, wire-guided osteotomies, and percutaneous fixation techniques — has undergone a renaissance in the past decade with the development of standardized techniques, dedicated instrumentation, and fluoroscopic guidance. Contemporary MIS bunion and hammertoe correction produces outcomes equivalent to open techniques with significantly reduced soft tissue trauma, post-operative swelling, and recovery time for selected patients.

MIS Bunion Correction (MICA Technique)

The MICA (Minimally Invasive Chevron Akin) technique — the current gold standard MIS bunion procedure — performs a percutaneous first metatarsal chevron osteotomy and Akin (proximal phalanx) osteotomy through two 3–5mm stab incisions, using a dedicated Shannon burr under continuous fluoroscopic guidance. The osteotomy cuts are stabilized with 2–3 headless compression screws placed percutaneously. MICA produces correction equivalent to the open chevron procedure for mild-to-moderate bunion deformity (IMA <16 degrees) with: less post-operative swelling, earlier return to normal footwear (typically 4–6 weeks vs. 6–8 weeks for open surgery), and equivalent radiographic correction at 1 year. The procedure is performed in ambulatory surgery or in-office OR settings under ankle block anesthesia with sedation.

Percutaneous Hammertoe Correction

Percutaneous flexor tenotomy — transecting the flexor digitorum longus tendon through a 2mm stab incision at the plantar PIP joint crease — corrects flexible hammertoe deformity without open surgical exposure. The procedure takes less than 5 minutes per toe under digital block anesthesia and allows immediate weight-bearing in a surgical sandal. Percutaneous PIP arthroplasty using a small burr removes the proximal phalangeal head for rigid hammertoe correction through a 3mm dorsal stab incision, avoiding the plantar scar and prolonged recovery of the open approach. Dr. Biernacki at Balance Foot & Ankle offers MIS bunion correction and percutaneous hammertoe techniques as appropriate for patient anatomy and deformity severity. Call (810) 206-1402 at our Bloomfield Hills or Howell office to discuss whether MIS techniques are appropriate for your condition.

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Frequently Asked Questions

Can bunions be corrected without surgery?

Bunion correctors and orthotics cannot reverse a bunion, but they can significantly reduce pain, slow progression, and improve function. Surgery is the only way to permanently correct the deformity — but conservative care often manages symptoms effectively for years.

How long does bunion surgery recovery take?

Recovery varies by procedure. Most patients are in a surgical boot for 4–6 weeks, return to regular shoes at 8–12 weeks, and are fully recovered with normal footwear at 3–6 months. Minimally invasive techniques often have faster recovery.

Do bunions come back after surgery?

Recurrence rates are low with modern surgical techniques (5–10%). Risk is reduced by wearing appropriate footwear after surgery and using custom orthotics to correct the underlying biomechanics that caused the bunion.

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Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Township offices.

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Minimally Invasive Foot Surgery (MIS) in Michigan

Minimally invasive techniques allow bunion correction, hammertoe repair, and other foot procedures through tiny incisions with less pain and faster recovery. Our podiatric surgeons offer MIS options when appropriate for your specific condition.

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Clinical References

1. Giannini S, Faldini C, Nanni M, et al. A minimally invasive technique for surgical treatment of hallux valgus: simple, effective, rapid, inexpensive (SERI). Int Orthop. 2013;37(9):1805-1813.
2. Vernois J, Redfern DJ. Percutaneous surgery for severe hallux valgus. Foot Ankle Clin. 2016;21(3):479-493.
3. Lam P, Lee M, Xing J, Di Nallo M. Percutaneous surgery for mild to moderate hallux valgus. Foot Ankle Clin. 2016;21(3):459-477.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.