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Minimally invasive surgery for pedal digital deformity: an audit of complications using national benchmark indicators
Mark Gilheany1, Omar Baarini2, Dean Samaras2
1East Melbourne Podiatry, Suite 4, Level 2, 182 Victoria Parade, Melbourne, VIC 3002 Australia ; Australasian College of Podiatric Surgeons, PO BOX 248, Collins Street West, Melbourne, VIC 8007 Australia.
Background:
There is increasing global interest and performance of minimally invasive foot surgery (MIS) however, limited evidence is available in relation to complications associated with MIS for digital deformity correction. The aim of this prospective audit is to report the surgical and medical complications following MIS for digital deformity against standardised clinical indicators.
Methods:
A prospective clinical audit of 179 patients who underwent MIS to reduce simple and complex digital deformities was conducted between June 2011 and June 2013. All patients were followed up to a minimum of 12 months post operatively. Data was collected according to a modified version of the Australian Council of Healthcare standards (ACHS) clinical indicator program. The audit was conducted in accordance with the National Research Ethics Service (NRES) guidelines on clinical audit.
Results:
The surgical complications included 1 superficial infection (0.53%) and 2 under-corrected digits (0.67%), which required revision surgery. Two patients who underwent isolated complex digital corrections had pain due to delayed union (0.7%), which resolved by 6 months post-op. No neurovascular compromise and no medical complications were encountered. The results compare favourably to rates reported in the literature for open reduction of digital deformity.
Conclusion:
This audit has illustrated that performing MIS to address simple and complex digital deformity results in low complication rates compared to published standards. MIS procedures were safely performed in a range of clinical settings, on varying degrees of digital deformity and on a wide range of ages and health profiles. Further studies investigating the effectiveness of these techniques are warranted and should evaluate long term patient reported outcome measures, as well as developing treatment algorithms to guide clinical decision making.
Insights
Minimally invasive foot surgery (MIS) for digital deformities shows low complication rates. This prospective audit found MIS procedures to be safe and effective across various patient profiles.
Area of Science:
- Podiatric Surgery
- Orthopedic Surgery
- Minimally Invasive Procedures
Background:
- Growing interest in minimally invasive foot surgery (MIS) for digital deformities.
- Limited evidence exists regarding MIS complication rates for digital deformity correction.
- Need for standardized data on surgical and medical complications.
Purpose of the Study:
- To prospectively audit surgical and medical complications of MIS for digital deformities.
- To compare complication rates against standardized clinical indicators.
- To evaluate the safety and efficacy of MIS in diverse patient populations.
Main Methods:
- Prospective clinical audit of 179 patients undergoing MIS for digital deformities (June 2011-June 2013).
- Minimum 12-month postoperative follow-up for all patients.
- Data collection based on modified Australian Council of Healthcare Standards (ACHS) clinical indicators.
Main Results:
- Low surgical complication rates: 0.53% superficial infection, 0.67% under-correction requiring revision.
- Delayed union causing pain in 0.7% of complex cases, resolving by 6 months.
- No neurovascular compromise or medical complications reported; results favorable compared to open surgery.
Conclusions:
- Minimally invasive surgery for digital deformities demonstrates low complication rates compared to published standards.
- MIS procedures are safe across varied clinical settings, deformity types, and patient demographics.
- Further research on long-term outcomes and treatment algorithms is warranted.
