Quintus Varus Correction in Hauts-de-Seine
Foot Surgery
What is quintus varus correction?
Dr Simon Tournemine in Hauts-de-Seine (92)
Quintus varus, also known as a bunionette, is a common deformity affecting the fifth toe. The toe gradually deviates inward, creating a prominent bony enlargement along the outer border of the foot. Pain is primarily caused by repeated friction between this prominence and footwear.
Quintus varus is often described as the equivalent of a hallux valgus affecting the fifth toe.
Quintus varus correction
Specialist in Foot Surgery in Hauts-de-Seine (92)
The objective of surgery is to correct the deformity, restore balanced weight distribution across the forefoot and relieve pain.
The fifth toe is realigned and the bony prominence at the metatarsophalangeal joint is removed.
The procedure is performed using a minimally invasive percutaneous technique under fluoroscopic (X-ray) guidance. A single 3 mm skin incision is sufficient, without opening the joint itself.
The bony prominence is removed using a high-speed burr, after which the fifth metatarsal is osteotomised at the level of the deformity and carefully realigned. No internal implants are required.
The operation takes approximately 15 minutes.
It is performed under either general anaesthesia or regional anaesthesia (where only the leg is anaesthetised). The most appropriate anaesthetic technique will be determined during your preoperative consultation with the anaesthetist.
The procedure is carried out as day-case (outpatient) surgery, allowing you to return home on the same day.
Except in exceptional circumstances, both feet are not operated on simultaneously. An interval of approximately one month between procedures is generally recommended.
Quintus Varus Correction in Rueil-Malmaison
Foot Surgery in Hauts-de-Seine
When should quintus varus correction be performed?
Initial management is conservative.
Treatment includes appropriate footwear, toe orthoses, and regular podiatric care. When symptoms persist despite these measures, surgical correction may be recommended.
Surgery is never indicated for cosmetic reasons alone or as a preventive procedure.
Postoperative care and rehabilitation following quintus varus correction
The procedure is performed as day-case surgery, and patients usually return home on the day of the operation.
A sterile dressing is applied in the operating theatre and must remain in place for two weeks without being removed.
Pain management is carefully monitored to maximise comfort and promote early recovery.
Anticoagulant treatment is prescribed for two weeks to reduce the risk of deep vein thrombosis.
Walking is permitted immediately while wearing a PODONOV forefoot offloading shoe, which should be worn for approximately six weeks.
Following surgery, swelling (oedema) of the foot and toes is expected and represents a normal part of the healing process. Elevating the foot and limiting unnecessary activity during the first postoperative days will help reduce swelling more rapidly.
Physiotherapy should begin early to maintain toe mobility and optimise recovery.
Most patients require approximately three weeks away from work, although this depends on the nature of their occupation. Patients with sedentary office-based work may often return sooner.
Sporting activities are generally resumed after approximately three months.
These recovery times are average estimates and may vary according to individual healing.
Long-term clinical and radiographic follow-up is recommended to monitor healing and identify any potential complications.
Risks and complications of quintus varus correction
Every precaution is taken to optimise healing and minimise complications. Nevertheless, as with any surgical procedure, certain risks remain, although they are uncommon:
- deep vein thrombosis (DVT) and pulmonary embolism, with the risk reduced through anticoagulant treatment for two weeks following surgery;
- worsening of pre-existing medical conditions, such as heart failure or diabetes, with appropriate postoperative monitoring provided by the anaesthetic team;
- infection (risk below 1%). Should infection occur, additional surgery to clean the operative site together with antibiotic treatment may be required;
- postoperative stiffness and reduced toe mobility if rehabilitation is not adequately performed;
- haematoma, caused by postoperative bleeding, which may occasionally require surgical evacuation;
- injury to small sensory nerve branches supplying the foot, potentially resulting in areas of reduced sensation affecting one or more toes;
- recurrence of the deformity, although uncommon. Secondary displacement of the osteotomy may occasionally occur and require further corrective surgery.
Complex Regional Pain Syndrome (CRPS) is a painful inflammatory condition that remains poorly understood. It is treated medically and may persist for several months, or occasionally several years, requiring specialised rehabilitation, additional investigations and, in some cases, dedicated pain management. Both its occurrence and long-term evolution remain unpredictable.
These represent the principal potential complications, although this list is not exhaustive. Rare and exceptional complications may also occur. Not every possible complication can be anticipated in advance. Your surgeon will discuss your individual case and answer any questions during your consultation.
Results of quintus varus correction
Without treatment, quintus varus generally progresses, with increasing deformity and worsening pain. Over time, the deformity may alter the alignment of the neighbouring toes and progressively affect the overall biomechanics of the foot.
The aims of surgery are twofold:
- to relieve pain and restore comfortable walking and footwear;
- to preserve overall foot alignment and limit progression of the deformity over the long term.
Approximately 90% of patients experience significant improvement in both pain and correction of the deformity following surgery.