Bunion Keyhole Surgery in Singapore: What You Need to Know

You have experienced a bunion (hallux valgus) for years, to the point that it affects the way you stand, walk, and choose footwear. Keyhole bunion surgery is one of the options your orthopaedic surgeon may discuss with you. Here's what the procedure involves, what recovery looks like, and what it costs in Singapore.

What is bunion keyhole surgery?

Keyhole bunion surgery is a minimally invasive procedure that uses small or keyhole incisions to reshape, straighten, and secure your toe joint. During the operation, the surgeon inserts specialised instruments through these small cuts. 

The surgeon safely cuts the affected metatarsal bone (five long bones in the midfoot) and shifts the toe joint back into its proper position to correct the deformity. To complete the procedure, they use tiny screws or pins to stabilise the newly realigned bone to restore normal foot alignment.

When should you consider bunion keyhole surgery?

You may consider having this minimally invasive bunion surgery when you have these symptoms or conditions:

• Difficulty in walking

• Difficulty in standing for long periods

• Visible toe joint misalignment

• Severe and persistent pain in your toe joint

• Your big toe is bent and looks like a claw

• Your bunion gets bigger, starts to hurt, and swells but doesn't get better with medicine

Differences between keyhole and traditional bunion surgeries

The differences between traditional open bunion surgery and the keyhole approach lie in how your orthopaedic surgeon accesses the metatarsal bone. 

During a traditional open bunion surgery, the surgeon makes a single, large incision (around 4 to 6 cm long) along the side or top of your foot to fully expose the bone and correct the deformity.

Common traditional bunion surgeries include:

• Osteotomy: which involves cutting and realigning the bone to improve its shape and position.

• Soft tissue procedures for bunions: which correct tight or loose tendons and ligaments around the big toe joint to help realign the toe and reduce pressure.

• Arthrodesis (joint fusion): which permanently joins two bones in the joint using metal plates, pins, and screws to correct its alignment. The procedure is usually reserved for severe bunions or bunions with arthritis.

On the other hand, keyhole bunion surgery uses several small incisions, usually about 2 to 4 mm, and specialised instruments to realign the bone with minimal disruption to the surrounding tissues. 

This minimally invasive bunion surgery approach usually causes less soft tissue trauma, scarring, and post-operative stiffness than open surgery.

If you are unsure which type of bunion surgery is right for you, consider a consultation with an orthopaedic specialist who may diagnose your condition and provide recommendations on the appropriate surgery for you. Schedule an appointment at Thomson Medical today

How is a bunion keyhole surgery like? 

Before undergoing the procedure, knowing what to expect from the bunion keyhole surgery process may help you to prepare better for the surgery.

How do you prepare for the surgery?

Before performing bunion keyhole surgery, your doctor may advise you to:

• Follow fasting instructions:

  • You may need to avoid food for 8-10 hours before surgery to help lower the risk of stomach contents entering the lungs while you are under anaesthesia. 

• Discuss the medicines you take, if any:

  • You may need to temporarily stop or adjust certain medicines before surgery, particularly those that may affect bleeding, anaesthesia, or recovery. 

What are the procedures during the surgery?

During the procedure, your surgeon will typically take the following steps:

• Administer anaesthesia (general or regional anaesthesia).

• Make a small incision and cut the metatarsal bone.

• Move the metatarsal bone to make the bump less noticeable.

• Use screws to hold the sections of the metatarsal bone in place.

• Adjust the affected toe into a more natural, straighter position by taking a wedge out of the toe bone.

• Insert a screw to hold the realigned toe bone in place.

• Trim the protruding bone on the side of the big toe joint to reduce the bunion bump.

What to expect after the surgery?

Minimally invasive orthopaedic procedures are typically performed on an outpatient basis, allowing most patients to return home on the same day as their surgery. While this approach generally supports a smoother healing process compared to traditional open surgery, complete bone fusion and swelling reduction still require time to heal properly.

• Post-operative care:
  • You’ll be discharged wearing a protective post-operative shoe and surgical dressings.
  • Immediate walking is permitted but should be restricted to short distances only to encourage healing.
• After two weeks:
  • You may increase your activity as the bone begins to stabilise.
  • Doctors will typically remove your stitches during your scheduled follow-up clinical review.
• After three weeks:
  • You can begin transitioning from the post-operative shoe to spacious, comfortable trainers around three to four weeks.
  • You may do low-impact exercises, such as using a stationary bike, beginning between four and six weeks, subjected to your doctor’s approval.
  • Returning to work or resuming high-impact exercises, such as running, depends on every individual and only after your doctor’s approval.

Keyhole bunion surgery costs in Singapore

Keyhole bunion surgery costs in Singapore may vary based on your condition and whether you choose a public or private hospital. You may expect keyhole bunion surgery costs to be around SGD 4,000-18,400 in public hospitals and up to around SGD 30,400 in private hospitals.

Bunion surgery is generally covered by insurance, and there are several schemes in Singapore that may help offset the total cost. These include MediSave, MediShield Life and Integrated Shield Plans.

The level of coverage offered by each scheme depends on your eligibility, the procedure being performed, and your insurance arrangements.

• MediSave:

  • According to the CPF website, there is a claim limit of up to SGD 1,920 for bunion keyhole surgery.

• MediShield Life:

  • MediShield Life covers a portion of the surgical and hospitalisation costs for bunion surgery with claim limits up to SGD 1,920 for bunion keyhole surgery.

• Integrated shield plan:

  • You may use integrated shield plans (IPs), which are private insurance providers that sit on top of your national medical insurance and offer additional coverage beyond what is provided.

  • However, you will still need to pay some money out of pocket as a co-payment.

Please note that these are estimated costs based on the information available at the time of writing, and they may have changed since then. These costs may also vary depending on the required treatment, hospital, and location of care.

Bunion surgery is generally claimable from insurance for several medical indications. If you are considering treatment, please contact our medical concierge team at Thomson Medical, who will discuss your specific situation with you, provide personalised cost guidance, and assist with electronic filing.

Risks of bunion keyhole surgery

While this minimally invasive bunion surgery offers several advantages, it still carries some risks. These risks include:

• Infection

• Nerve injury

• Under or over-correction of the bunion

• Blood clots

• Stiffness

• Recurrence of the bunion

• Ongoing pain

• Anaesthetic problems, such as nausea, vomiting, and dizziness

What helps with bunion keyhole surgery recovery?

To support faster recovery, there are a few tips that you could try, such as:

• Manage pain and swelling:
  • Keep your foot elevated above chest level to help reduce swelling.
  • Take pain relief medication recommended by your doctor to ease discomfort.
• Wound care:
  • Keep your bandages and wound area dry when bathing by using a waterproof cover.
  • Wearing your post-operative shoe as your doctor advises.
• Light physical activities:
  • Moving your big toes gently, but only if your doctor approves.
  • Avoid long walks in the first few weeks.
  • Avoid heavy activities such as running until your doctor approves.

If you are still considering bunion keyhole surgery for your bunion treatment, you may consult with our orthopaedic specialists to help with your treatment plans. Schedule an appointment at Thomson Medical today.

FAQ

What are the advantages of bunion keyhole surgery?

What age is recommended to have bunion keyhole surgery?

There is no specific age, but you may consider this surgical correction when the bunion causes significant discomfort and negatively impacts your daily life.

What happens if a bunion is left untreated?

The deformity may progress and lead to chronic pain, difficulty walking, and potential development of other foot problems.

Should I have bunion keyhole surgery on both feet at the same time?

Though this bunion treatment can be performed on both feet at the same time (bilateral surgery), it is best to consult with your doctor to decide on whether you should have the bilateral surgery.

When should I expect to return to work after the surgery?

Return-to-work timelines after minimally invasive techniques depend on the physical demands of your job. If you work in an office and have sedentary duties, you can usually return within a few days to two weeks. If your job involves manual labour, heavy lifting, or long periods of standing, you will usually need to wait six to eight weeks before returning to work.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised advice based on your unique conditions, schedule an appointment with Thomson Medical today.