title: Minimally invasive surgery for pedal digital deformity: an audit of complications using national benchmark indicators.
abstract: BACKGROUND
  There is increasing global interest and performance of minimally invasive foot surgery (MIS) however, limited evidence is available in relation to complications associated with MIS for digital deformity correction. The aim of this prospective audit is to report the surgical and medical complications following MIS for digital deformity against standardised clinical indicators.
  
  
  METHODS
  A prospective clinical audit of 179 patients who underwent MIS to reduce simple and complex digital deformities was conducted between June 2011 and June 2013. All patients were followed up to a minimum of 12 months post operatively. Data was collected according to a modified version of the Australian Council of Healthcare standards (ACHS) clinical indicator program. The audit was conducted in accordance with the National Research Ethics Service (NRES) guidelines on clinical audit.
  
  
  RESULTS
  The surgical complications included 1 superficial infection (0.53%) and 2 under-corrected digits (0.67%), which required revision surgery. Two patients who underwent isolated complex digital corrections had pain due to delayed union (0.7%), which resolved by 6 months post-op. No neurovascular compromise and no medical complications were encountered. The results compare favourably to rates reported in the literature for open reduction of digital deformity.
  
  
  CONCLUSIONS
  This audit has illustrated that performing MIS to address simple and complex digital deformity results in low complication rates compared to published standards. MIS procedures were safely performed in a range of clinical settings, on varying degrees of digital deformity and on a wide range of ages and health profiles. Further studies investigating the effectiveness of these techniques are warranted and should evaluate long term patient reported outcome measures, as well as developing treatment algorithms to guide clinical decision making.
authors.affiliation: East Melbourne Podiatry, Suite 4, Level 2, 182 Victoria Parade, Melbourne, VIC 3002 Australia ; Australasian College of Podiatric Surgeons, PO BOX 248, Collins Street West, Melbourne, VIC 8007 Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Gilheany
authors.affiliation: Australasian College of Podiatric Surgeons, PO BOX 248, Collins Street West, Melbourne, VIC 8007 Australia.
authors.forename: Omar
authors.initials: O
authors.lastname: Baarini
authors.affiliation: Australasian College of Podiatric Surgeons, PO BOX 248, Collins Street West, Melbourne, VIC 8007 Australia.
authors.forename: Dean
authors.initials: D
authors.lastname: Samaras
keywords: Clinical audit; Complications; Hammertoe; Minimally invasive surgery; Percutaneous