By Trevor Haynes, DPM | Elite Foot & Ankle, Portland, OR
What Is a Bosch Bunionectomy?
The Bosch Bunionectomy is an advanced, minimally invasive surgical technique designed to correct bunions (hallux valgus) using very small incisions — typically less than one centimeter.
Unlike traditional open bunion surgeries, which require large cuts and extensive dissection, the Bosch technique uses specialized burrs and guidewires to realign the bone with minimal tissue trauma. The result is less pain, smaller scars, and faster recovery.
A Brief History
The procedure was first described by Dr. Karl-Heinz Bosch in the 1980s and has since been refined by foot and ankle surgeons worldwide. It has become one of the most respected percutaneous bunion correction methods in Europe and is now increasingly performed in the United States as minimally invasive surgery (MIS) grows in popularity.
How the Bosch Bunionectomy Works
During the procedure:
- A tiny incision is made along the side of the big toe.
- A low-speed/high-torque bur is used to create a controlled cut (osteotomy) at the metatarsal bone.
- The bone is carefully shifted into a corrected position under real-time X-ray (fluoroscopy).
- The new alignment is stabilized with a pin placed percutaneously under the skin and into the medullary canal of the bone. This wire serves as a buttress to hold the corrected bone in place. This pin is left in place until it is removed in office at six weeks.
- Because the incision is minimal, stitches are rarely required, and soft tissues are left largely intact.
- This technique precisely corrects the bunion deformity while preserving joint motion and minimizing scarring.
Benefits of the Bosch Bunionectomy
Patients often choose this technique for its many advantages:
✅ Tiny incisions (usually 2–3 mm)
✅ Less soft-tissue disruption
✅ Reduced pain and swelling
✅ Faster recovery and return to shoes
✅ Improved cosmetic appearance
✅ Low recurrence rate when performed by a trained MIS foot surgeon
Who Is a Good Candidate?
The Bosch Bunionectomy is best suited for patients with:
- Mild to moderate bunion deformities
- Good bone quality and joint mobility
- No severe arthritis in the big toe joint
If your bunion is rigid or severe, your surgeon may recommend another type of correction — such as a minimally invasive Chevron or Scarf osteotomy, or a Lapidus fusion.
What Recovery Looks Like
Most patients walk the same day in a protective surgical shoe or boot.
Typical recovery milestones include:
- Week 1–2: Controlled weight-bearing in a boot.
- Week 3–4: Stitches (if any) removed; swelling begins to subside
- Week 6–8: Transition to comfortable sneakers or flats
- Month 3+: Return to full activities, exercise, and normal footwear
Your recovery plan may vary depending on your surgeon’s protocol and the severity of the deformity.
Risks and Considerations
As with any surgical procedure, there are potential risks, including:
- Temporary swelling or stiffness
- Delayed bone healing
- Over- or under-correction of alignment
- Rare hardware irritation
Choosing a board-certified foot and ankle surgeon experienced in minimally invasive techniques is key to minimizing these risks and achieving optimal results.
Why Choose Elite Foot & Ankle for Minimally Invasive Bunion Surgery
At Elite Foot & Ankle, our surgeons are well trained in advanced minimally invasive and percutaneous foot surgery, including the Bosch technique. We use state-of-the-art fluoroscopic guidance and fixation methods to ensure precise, safe, and reproducible results. Dr. Haynes is board certified in minimally invasive foot surgery and is the current scientific chair and president elect of the Academy of minimally invasive foot and ankle surgery. He has lectured nationally and internationally on minimally invasive foot surgery and more specifically the Bosch procedure.
Our team emphasizes:
- Patient education
- Personalized surgical planning
- Evidence-based care
- Fast, comfortable recovery protocols
If you’ve been told you need bunion surgery — or if you’ve been avoiding it because of downtime or scarring — a Bosch Bunionectomy may be the ideal solution.
Schedule a Consultation
Ready to take the next step toward pain-free feet?
Call Elite Foot & Ankle at (503) 668-5210 or request an appointment online to find out if minimally invasive bunion correction is right for you.
References
Bosch K, Wanke S, Legenstein R. “The Bosch Percutaneous Osteotomy for Hallux Valgus Correction.” Foot & Ankle Clinics, 2000.
Giannini S, et al. “Percutaneous Hallux Valgus Correction: The Bosch Technique.” Journal of Orthopaedics and Traumatology, 2013.
AOFAS MIS Task Force, Guidelines for Minimally Invasive Foot and Ankle Surgery, 2022.
