Beyond the bunion: trends in minimally invasive techniques in foot and ankle surgery

ABSTRACT: Minimally invasive surgery (MIS) has revolutionized foot and ankle care by emphasizing delicate tissue handling, reduced postoperative pain, and faster recovery through small incisions and precise instrumentation. The evolution of MIS spans 4 distinct historical "seasons," from its early development in the mid-20th century to its global resurgence in the 2010s, driven by improved techniques, education, and international collaboration. Today, MIS extends beyond hallux valgus correction to include complex procedures such as first metatarsophalangeal joint, subtalar joint, tibiotalar joint, and tibiotalocalcaneal arthrodesis, with evidence demonstrating comparable or superior outcomes to open approaches. This review details the history of MIS in foot and ankle orthopedics and how this paradigm shift continues to redefine standards and improves outcomes in foot and ankle surgery.