This past month I have had several patients who have had problems after having extensive foot surgery (by other doctors). After you have had multiple surgeries performed on your foot is a bad time to consider the wisdom of having so much work at once on your foot!

My philosophy about foot surgery is to do the most simple single surgery that will solve the problem. As in many things, complexity invites complications.

The problem is that in foot surgery there is an inexorable march to complexity. Inexpensive and easily used pins gave way to screws, plates, expensive expanding metal clips etc. Are the new devices better than the old devices? Well yes – and no. Healing is sometimes slightly quicker – but if there are complications they are much more difficult to remove. And everyone knows – there will be complications! There are cases where new surgical devices allow procedures not previously possible. But there are very few instances of that.

I believe that Podiatrists are particularly susceptible to the creeping surgical complexity.  We work on a small part of the body and feel that we must be at the “cutting edge” (pun intended) of foot surgery.

Interestingly, there is a revival of what is known as “minimal incision surgery” (MIS) which uses no medical devices such as screws, plates, or clips. MIS had very uneven results thirty years ago but with new techniques pioneered mostly by European Orthopedists and a small group of domestic Podiatrists MIS is now showing great results in solving many common foot problems. The “problem” is that since MIS doesn’t use screws, plates or clips the producers of those products do not promote this effective surgical technique.

I do MIS surgery in the office for certain problems and do traditional surgery in outpatient surgery centers for other problems. I have done both types of surgery for over thirty years.

Just remember that if you are considering foot surgery, understand exactly what the doctor will be doing to your foot – and why. Please do not have the doctor do a bunch of extra procedures just because you are getting one painful problem corrected. Consider the possibility that a “deformity” that does not bother you could become a problem if it is operated on.

KISS – Keep It Simple Stupid should really be: KISS – Keep It Simple & Smart.