Novel Approach for the Surgical Management of Nonunion After Minimally Invasive Bunionectomy Using Bone Harvesting...

Hallux valgus is a common forefoot deformity that can be surgically corrected with minimally invasive bunionectomy, which offers advantages such as smaller incisions, reduced soft tissue trauma, and shorter recovery. Despite these benefits, nonunion remains a challenging complication with limited consensus on optimal management. We report the case of a 42-year-old woman with situs inversus totalis who presented with painful left hallux abducto valgus unresponsive to conservative therapy. She underwent a minimally invasive bunionectomy, but at seven months, she continued to have persistent pain, and radiographic findings confirmed nonunion. Revision surgery was performed using autologous tibial bone grafting, removal of cannulated screws, and fixation with two bioabsorbable screws. Radiographs obtained one month postoperatively demonstrated early bony callus formation, and at three months, robust callus with reduced radiolucency indicating osseous union. Clinically, the patient experienced improved pain, functional recovery, and no hardware-related irritation. This case highlights the potential role of bioabsorbable screw fixation combined with autologous bone grafting as an effective strategy for treating nonunion following minimally invasive bunionectomy, offering the dual benefits of enhanced healing and avoidance of long-term hardware complications.