This relatively new and innovative procedure allows for the correction of a certain category of bunion deformities without bone cutting. Bunion corrections address the angle of the first and second metatarsals and bringing them closer together. Conventional bunion procedures that do this including osteotomy's and or fusions require prolonged immobilization and in some cases non-weight bearing with crutches. 

The tight rope procedure is performed by drilling two 1 mm holes into the second and first metatarsals and then binding them together using a medical fiberwire thereby reducing the intermetatarsal angle with an anchor on each side. This is essentially a soft tissue procedure which requires no cutting/surgical fracturing of bone or fusion of joints to correct the deformity. There are several varieties of bunion deformities and not all can be corrected with this procedure. More severe bunions and those that are hypermobility require more traditional procedures in order to get the best results. However, if your bunion deformity meets the criteria, it is an excellent choice for correction. This can be determined by a podiatric examination and weight-bearing x-rays of the foot.

I perform this procedure at a surgery center or hospital outpatient facility with local anesthesia with a mild sedation. 

Potential complications are those similar to that of traditional bunion surgery corrections except for delayed bone healing and nonunion. Stress fractures of the second metatarsal have been reported.