Minimally Invasive Bunion Surgeon
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MIS: Minimal Invasive Surgery for Bunions
Already know about bunions scroll down to MIS Bunion Surgery information below. 
What are Bunions?
Bunions are a condition describing a noticeable bump at the great toe. They can occur at any age from birth through adulthood, but are more commonly a problem after the older we get.

Did I inherit this from my parent(s)?
Yes...and No. You do inherit the type of feet your parent have, however, acquired bunions take time to develop through the years. Shoe gear, trauma, weight gain, and pregnancy are just a few of the additional causes of bunions.

How does a bunion form?
The formation of a bunion occurs with a capsule, tendon imbalance which can involve the entire foot. The joint looses range of motion and stiffens. Inflammation and the development of arthritis can easily occur and worsen the longer you have the bunion. Over time the metatarsal bone protrudes to the inside and the big toe shifts towards the 2nd toe or over/under laps the second toe.
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How do shoes affect bunions?
The true cause of a bunion is abnormal mechanics of the toe joint. Shoes may accelerate or worsen the formation of the bunion and lead to more pain. If the bump rubs on the shoe there can be pressure on the nerve under the skin leading to sharp pain and inflammation of the area.
This explains why wearing wider, larger or more accommodating shoes helps to relieve the pain of bunions.

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Deciding to Treat Your Bunion?
Many factors to consider including but not limited to: level of pain, cosmetic appearance, big toe joint damage, gait changes and other pain such as knee hip or back, emotional concerns, can’t fit in your shoes.
  • Level of Pain: Not all bunions hurt, however sometimes minimal bunions cause life altering pain. This typically depends on how much arthritis has developed in the joint.
  • Cosmetic Appearance: As the bump becomes larger the it becomes more unsightly and in some cases disfiguring. Mostly limits shoes can wear and can include embarrassment at the pool or beach.
  • Physical Joint Damage: As the joint jams even less motion occurs and development of arthritis worsens. If this develops it can lead to having a joint fusion or replacement instead of the MIS procedure.
  • Many cases can be cited where the only obstruction for a 70 year old person to perform physical exercise is a bunion, yet they cannot undergo correction because of a medical condition prohibiting them from elective surgery. Therefore, it is important to weigh the total lifestyle impact of bunions before it's too late.​
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Fun Facts from UFAI
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Should You Treat a Bunion Conservatively or Surgically?
Depends! The following are some items to consider in making this important decision.
- Wear wider shoes or better fitting shoes. Have you shoe modified to accommodate your bunion?
- Place a pad over the prominent bump.
- Decrease your level of activity.
- Get prescription orthotics (inserts) to return the joint back to normal function.
- Take pain medications (prescription or over-the-counter).
- Have the joint injected with cortisone if extremely inflamed and painful.
- Do nothing about it.
If the above measures don't help you then,
Consider having the bunion surgically corrected.

Have you been avoiding bunion surgery because your only option is the traditional surgery with significant pain and being off your foot and work for up to 3 months? If so see Dr. Thomas to see if you’re a candidate for MIS bunion surgery.

Non Surgical Bunion Treatment

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Non Surgical Bunion Treatments are not designed to fix the deformity and are meant simply to provide symptom relief or slow the progression of the deformity. These options include:

- Prefabricated or Custom Orthotics
- Splints and Toe Bracing
- Padding and Shoe Modifications
- Physical Therapy and Home Exercises
- Anti Inflammatory Oral and Topical Medications
- Injections into the Big Toe Joint (including corticosteroid, PRP, etc...)
- MLS Cold Laser Therapy (anti- inflammatory)
- Wider Shoes or Orthopedic Shoes

​What about laser or chiropractics manipulation?
Technology is constantly advancing. However, don't be fooled! Laser cannot be used to reduce a bunion because bone is involved in the process of correcting a bunion. Current laser technology is not capable of cutting bone without damage to the bone itself. A bunion can be temporarily reduced by manipulation but only corrected by cutting and moving bone. Save your money and time. There are MLS cold laser options approved by FDA for joint inflammation which can relieve bunion pain but is only temporarily and cannot correct the deformity.


As a patient contemplating bunion surgery you are no given the task of the selecting the right surgeon.
Bunion surgery is considered highly successful and proven for the reduction of pain and disfigurement. Thus many insurance companies cover this procedure.
NOT ALL SURGEONS USE THE SAME TECHNIQUES OR HAVE THE SAME LEVEL OF TRAINING AND EXPERIENCE


How to pick a Bunion Surgeon

​Corrective bunion surgery is not a one size fits all procedure. The human foot is a complex mechanism supported by 26 bones, 33 joints, and over 100 unique muscles, tendons and ligaments. Estimated more than 150,000 bunion procedures done annually in the United States, unfortunately many of these are revisional surgeries. Dr. Thomas performs many revisional surgeries sent to him from other providers.

Although a bunion looks like a localized problem, it involves the entire foot, ankle, and calf. Choosing the wrong bunion surgeon could set you up for future pain, arthritis, and a recurring bunion. Fortunately, there many high-quality bunion surgeons who can provide individualized treatment for the best possible surgical outcome. If you’re not a candidate for MIS bunion surgery Dr. Thomas will advise the correct procedure for you. How do you find a good bunion surgeon? Consider these tips while doing your research.

Note: If you meet a doctor that performs just one type of bunion surgery, you might want to look elsewhere.

Where to Start
The internet is a great resource that enables you to obtain a lot of information quickly. However you can’t always trust websites and physician reviews online. The hospital websites are a good source for which doctors are credentialed or not.

Ask your social network. You might be surprised by how many of your friends, family members, and coworkers have had foot surgery.

Call your local surgery center or hospital and ask for their foot and ankle surgeons on staff.

You could also get a recommendation from your primary care physician. Depending on your insurance coverage, you may not be able to see certain specialists without your doctor’s referral. You will want to check with your insurance carrier.

Make sure you only seek out board-certified surgeons. A surgeon certified by the American Board of Foot and Ankle Surgery has been recognized for his or her expertise in the field. An orthopedic surgeon may be certified by the American Board of Orthopedic Surgery but recommend they are affiliated with the AOFAS (American Orthopedic Foot & Ankle Society) as they're typically focused mostly on the foot and Ankle. .

Your bunion surgeon should be taking these factors into consideration before presenting you with a surgical plan.
  1. How severe is your bunion?
  2. Do bunions run in your family?
  3. What type of shoes do you wear, and what type of work do you do?
  4. What is the shape of your feet? Do you have flat feet or high arches?
  5. Do you have any other pain or abnormalities? Severe bunions often lead to big toe arthritis, which can be addressed at the time of your surgery if your surgeon is well trained.
  6. How loose is the first metatarsal? Bunions form when the metatarsal loosens and shifts out of alignment at its base. Your surgeon will need to stabilize it to prevent the bunion from coming back.
  7. Is the big toe misaligned as well? In some cases, the toe needs to be straightened for the bunion to be corrected.

Questions for a Bunion Surgeon
How many bunion surgeries, and what types, have you performed?You will want your bunion surgeon to have plenty of experience, as well as expertise on various bunion surgery techniques. If your surgeon uses the same procedure for all patients, he or she is not going to provide you with the individualized attention that your unique condition needs. There are still bunion surgeons who only do a small amount of these procedures a year.

How often do your patients need a revision of your work?A bunion surgery might fail for several reasons. The bunion may be under- or over-corrected. A failed surgery may result in complications such as delayed bone union, malunion, or nonunion, a trapped nerve, stiffness in the joint, or excessive shortening of the first metatarsal. Or, the bunion may return, having never been truly corrected in the first place. Or the patient may not follow the set post op protocol and end up with a poor result.

Will you be using hardware, like screws or plates?Surgical hardware can give the foot more stability, greater bone fixation, and generally patients can walk sooner in their recovery. Many older surgeons who have not been trained in new techniques will not use screws or plates to correct bunions and simply “shave off the bump” which always worsens and leads to more stiffness in the joint long term.

Will other areas of my foot be addressed in the surgery?Bunions have structural causes which must be addressed in surgery, or else the bunion will return. Make sure your surgeon takes a whole-foot approach.

Other Considerations
Don’t get discouraged by a busy practice. A busy surgeon is one who has a great reputation and is highly sought-after. Dr. Thomas at times can have longer than average waits but patients report outcomes are more important than wait times. Also if you’re surgeon is truly doing these cases they’re likely highly qualified and taking Hospital call for foot & Ankle Surgery and the office day commonly gets disrupted by this issue for emergencies at the hospital.

Does your surgeon and their staff provide courteous and compassionate care? You should feel good about working with this practice over the long run. Communication should be good and the surgeon available at all times. If the surgeons bedside manner is poor pre operatively it won’t be any better post operatively.

Try to ignore patient complaints about cost: a good surgical outcome is an investment in your future free of pain. Instead, focus on the surgeons whose patients are happy with their outcomes. Don’t be afraid to travel if able. Commonly the best surgeons often live in larger cities, and are happy to work with out-of-towners. Larger city hospitals require more difficult certification and maintenance of surgical privileges and typically attract the best surgeons. Dr. Thomas has operated on patients from many states throughout the USA as far as Alaska!

Don’t rely entirely on advertising and for websites with physician reviews. Did you know there is a growing problem with review sites not being completed by patients but by competing doctors and other people in the community who’ve never seen the doctor they’re writing about. There is no way to prevent this issue. Additionally word of mouth should be the best advertisement, rely on others you know and trust for their recommendations.

How soon can I walk after bunion surgery?
If you’re a candidate for Dr. Thomas’ MIS Bunion Surgery you will walk the day of the surgery. Major improvement in quality of life and post op recovery being able to ambulated and work on range of motion this quickly after surgery.
Minimally Invasive Surgery (MIS) Bunion Procedure
Did you know Dr. Thomas has worked to develop the minimally invasive bunion surgery for over 8 years? He has traveled to numerous states to operate and do cadaver labs and even Europe to further this technique. Great to bring this surgery option to Ohio. 
M​inimal injury and pain:
Is a surgical technique done under minimal injury and steps are taken to ensure the post-operative pain is minimized. The majority of Dr. Thomas’ patients stop taking oral opioids within 48-72 hours after surgery and some simply take OTC Tylenol or Ibuprofen.

History of MIS Bunion Surgery

Technique Guide Paper from American Orthopaedic Foot & Ankle Society

Can Dr. Thomas perform a bunion surgery without metallic implants?
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Yes, thanks to OssioFiberTM implants. 

Reasons to use biointegrative screws and implants:
- Patient does not want implantable hardware long-term as the Ossio Fiber products absorb into bone and give stability. 
- Patient has an allergy to metals such as Nickel or had hardware complications in previous surgeries  *this has been revolutionary for Dr. Thomas' patients. 
- Almost eliminates risk for return to surgery for hardware removal. 
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Dr. Thomas inserting a biointegrative screw in 2021
See below bointegrative diagram and x-rays  from Dr. Thomas 
Pre Op Right Foot Bunion
Painful and difficult to fit in shoes. Patient unable to do activities of daily living without pain.
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Not Actual X-ray
OssioFiber Screws superimposed for demonstration purposes only to show location of implanted screws. Implants cannot be seen on x-rays, only the shadow of the screws track.
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Post Op Right Foot Bunion Resolved
OssioFiber Screws are biointegrative meaning they grow into bone as bone cuts heal. 
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Post Operative MIS Bunion Surgery
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Post Operative MIS Bunion Surgery
- Minimal dressing
- Ambulation in post op shoe
- RICE (rest, ice, compression, elevation)
- Antibiotics (pevent infection), DVT (blood clot) prevention medication, pain control
​- Follow up appointments and early return to activity, work. 

Post Op Instructions

Post Op Instructions.pdf
File Size: 863 kb
File Type: pdf
Download File

Dr. Thomas is Accessible
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614-267-8387     ohiofootandanklesurgeon@gmail.com     IG @ohiofootandanklesurgeon

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2019 Copyright www.ohiobunion.com, Dr. Randall C. Thomas Jr. DPM FACFAS at the Clintonville Dublin Southwest Foot and Ankle Group Columbus Ohio.

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The information shared on this website should not be considered personal treatment recommendations. This site is intended to be an interactive resume of Dr. Thomas and should be used for information purposes only. This site cannot replace the individual doctor-patient relationship you have with your physician. Some of the content on this website may be provided by a third party and is posted here as a reference not necessarily reflecting the opinion of Dr. Thomas. The purpose of this website is educational and informative regarding Podiatric Medicine and Surgery. The information is the opinion of Dr. Thomas and not the group practice or hospital system. Medical information may be out of date and contain omissions. Any patient information will be protected and confidential in compliance with HIPPA. Outcomes presented here are not guaranteed. Dr. Thomas reserves the right to disregard any direct contact or requests. If you need personal or immediate assistance contact your primary care physician or 911. Under no circumstances will the website author, Dr. Thomas, or Clintonville Dublin Southwest Foot and Ankle Group be liable for any direct or indirect damages arising in connection to the use of this site. Patient education and Blogs are not a substitute for personalized medical advice in person with a physician. Remember according to Dr. Thomas "an educated patient is a great patient,” this website is offered as a public service for information on bunion surgeries from a board certified foot surgeon. Policy for dealing with any personal information that you might disclose to us while visiting this website includes any information you submit or provide will be treated as strictly confidential and HIPPA compliant. Do not collect or use any personal information on visitors to our website, through the use of third party cookies or other software or hardware techniques. Google Analytics are separate from the website in which this information is used for statistical and website development purposes only. It is the policy not to sell or pass on any personal information that you may have provided to us unless we have your express consent to do so. An exception to this is where we may be required by law to disclose certain information.
  • Home
  • Dr Thomas
  • MIS BUNION
  • Before & After
  • MICA
  • MiniBunion
  • Joint Replacement
  • LAPIPLASTY
  • FAQs
  • Media
  • Insurances Accepted
  • Surgery Consult
  • Virtual Consult