Minimally invasive quintus varus surgery

Minimally invasive surgery of the quintus varus is a specialty of Dr Lopez. For a consultation, do not hesitate to contact him. The quintus varus (or bunionette) is a pathology of the forefoot characterized by a deformation of the 5th toe. The toe is sometimes deviated above or below the 4th toe, it can also become a toe claw.

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What is a quintus varus?

The forefoot consists of 5 metatarsal bones, each extended by the toes formed by 3 phalanges. The 5th metatarsal is at the outer edge of the foot.

In the case of quintus varus, the toe, which is usually straight and slightly inclined, is deflected inwards. This leads to a bump on the outside of the foot.

This deformation causes severe pain caused by the friction of the shoe, causing inflammation of the foot.

If medical treatment fails, Dr. Julien Lopez will discuss treatment using minimally invasive foot surgery.

Minimally invasive bunionette surgery: cause of onset of the pathology

Minimally invasive bunionette surgery is justified in many cases.

The causes of the appearance of the quintus varus are multiple:

  • Heredity: deformation is usually congenital.
  • Wearing inappropriate footwear: Narrow, high-heeled shoes can be awkward and can compress toes.
  • Pathologies such as hollow feet, inflammatory diseases (rheumatoid arthritis) or neurological disorders (stroke sequelae, etc.).
  • Foot trauma or after a surgical procedure

Symptoms and complications that may lead to non-invasive quintus varus surgery

Before performing the non-invasive surgery of the quintus-varus, Dr. Julien Lopez must proceed with the diagnosis of the pathology. This is done through a clinical examination of the foot. The surgeon also relies on the symptoms described by the patient.

To confirm the diagnosis, Dr. Julien Lopez can request medical imaging exams.

The quintus varus is characterized by:

  • Sharp pain: the pain is intensified during walking due to friction between the outer edge of the foot and the shoe (frequent bursitis and redness).
  • The appearance of corn or soft horns: usually emerge between the 4th and 5th toes because of the friction between the toes.
  • A stiff toe
  • Osteoarthritis
  • A thickening of the skin
  • Wounds caused by rubbing
  • A worsening of the deformation

Non-surgical treatments for quintus varus

Non-surgical treatment is the first-line treatment for a mild to moderate quintus varus.

Several treatments are possible:

Orthopedic soles

Orthopedic soles are custom-made to perfectly match the shape of the patient’s foot. The goal is to relieve pain and reduce pressure on the 5th metatarsal head.

Orthopedic shoes

The irritations accompanying the quintus varus are usually due to poor footwear. It is therefore recommended to wear suitable shoes:

  • Without high heels to keep the foot flat without sliding forward in the shoe.
  • With a wide tip to limit pressure on the toes and avoid friction between the foot and the shoe.
  • Without internal seams to avoid sores from shoe rubbing on the foot. This detail is all the more important for diabetic patients.
  • With a thick sole to cushion the step and limit shocks to the 5th toe. This also helps to stabilize the posture during walking.


Orthoplasty is the realization of a tailor-made device molded directly between the patient’s toes. It reduces friction with the shoe and reduces pressure on the 5th and/or 4th toes.

Percutaneous surgery of the quintus varus

In case of failure of previous treatments, treatment by percutaneous surgery of quintus varus can be considered. Whenever possible and the advance of the deformation allows it, the surgeon prefers as much as possible the use of the percutaneous technique.

The goal is to improve patient comfort by offering a minimally invasive procedure that:

  • Reduces the size of scars
  • Limits the risk of complications and infections
  • Limits tissue aggression
  • Accelerates the recovery process
  • Reduces pain

Non-invasive bunionette surgery aims to make the front foot painless and to realign the 5th toe. Dr Julien Lopez will straighten the toe and file the bone bump at the origin of the pain. To do this, the surgeon cuts the retracted parts with a miniaturized scalpel. He then performs percutaneous osteotomy of the first phalanx and the 5th metatarsus to strengthen the correction and reduce the risk of recurrence.

Surgery is usually short-term. A pin is sometimes left in place for 4 weeks to stabilize the fractures and then removed in consultation (not painful).

Microinvasive surgery of the quintus varus: convalescence

Once the microinvasive surgery of the quintus varus is performed, support is immediately possible on the foot operated.

At the end of the percutaneous surgery of the bunionette, Dr. Julien Lopez uses a dressing to keep until the next consultation appointment (2 to 3 weeks).

Swimming and cycling can resume from 4 weeks after surgery. Other sports activities will be possible after 2 months, depending on the clinical and radiological condition of the patient.

The patient can resume driving from the 3rd week after surgery.

Physiotherapy sessions are not mandatory after microinvasive bunionette surgery. It is up to the surgeon to determine if the patient’s case requires treatment by a physiotherapist. The patient will need to perform self-rehabilitation to accelerate functional recovery and the reduction of swelling.

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The informations on the page is provided for information only, it evokes general cases: your situation is specific.

Dr Julien Lopez, orthopedic foot surgeon in Nice welcomes you and advises you for your plantar aproneuritis.

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