S3.E39 - MIS Complications with Dr. Brad Abicht

The fastest way to get better at minimally invasive surgery is to study what goes wrong. Dr. Jeff Dikis and Dr. Brad Abicht break down the complications that matter most in MIS bunion and forefoot surgery, from thermal necrosis and periprosthetic fracture to nonunion, screw prominence, and unexpected hardware failure.

Jeff hosts the final episode of MIS Adventures with Brad, a foot and ankle surgeon in La Crosse, Wisconsin, and section chair at Emplify Health by Gundersen, as they walk through real cases instead of textbook theory. This is not a highlight reel. It is a candid, practical conversation about what happens when tiny incisions still lead to big problems.

You’ll discover:

• Why tourniquets can raise the risk of thermal injury in MIS
• How screw placement, length, and orientation can change your complication profile
• When a distal osteotomy is the wrong choice and a Lapidus makes more sense
• How to think about nonunion, varus drift, hardware prominence, and lateral cortex fractures
• Why some complications need revision while others are best watched and allowed to settle

Brad shares the decision-making behind salvage strategies, revision planning, bone grafting, cultures, wound VAC use, and when to back off and let healing unfold. Jeff pushes the conversation with sharp questions about fixation, imaging, vascular concerns, hypermobility, overactivity, and whether MIS head procedures deserve different rules than open bunion surgery.

If you do MIS, are learning MIS, or are deciding when not to do MIS, this episode gives you the complication patterns, practical tips, and hard-earned lessons that can save you from repeating someone else’s mistake. Essential listening for surgeons who want more than perfect post-op X-rays.