Keywords:Minimally invasive surgery, lesser (and greater) toe percutaneous surgery, lesser (and greater) toe surgery, hammer toe, claw toe, lesser toe deformity, MIS, phalanges of the lesser toes. Palabras clave:Cirugía por mínima incisión, cirugía percutánea digital, cirugía digital, dedo en martillo, dedo en garra, deformidad digital, MIS, falanges digitales. ResumenCon este trabajo se pretende dar una actualización y opinión sobre los diferentes procedimientos en cirugía MIS para la corrección de la patología digital mediante la descripción e indicación de las diferentes técnicas, así como la evolución de las mismas. Las técnicas originales en cirugía MIS para la corrección de la patología digital fueron las osteotomías completas; a continuación se adaptaron de la cirugía a campo abierto la artroplastia y la artrodesis por MIS, para más tarde desarrollar las osteotomías incompletas, en las que una parte de la cortical ósea se deja intacta. En sus inicios era indispensable la cirugía sobre tejidos blandos, tenotomías y capsulectomías como parte de la cirugía digital. Hoy en día en las actuaciones digitales, según el grado de deformidad y edad del paciente, se intenta evitar la cirugía sobre tejido blando y corregir la deformidad mediante la actuación en tejido óseo para evitar la deficiencia de movilidad postoperatoria que se produce al realizar tenotomías. AbstractThis study aims to update the various minimally invasive procedures when surgically restoring the normal alignment of the lesser toes and also provides the opinion of the author. This is done through the description and indication of the different MIS techniques and their evolution over time. The first lesser toe MIS procedures were initially performed in a complete osteotomy treatment. Over the years, this alternative was expanded into arthroplasties and arthrodesis surgeries, both commonly used as open methods and finally the minimally invasive correction was practised on partial osteotomies where a portion of the cortical is retained. In the past, lesser toe surgery procedures always involved soft tissue damage, tenotomies and capsular release. Nowadays, based on the type of the deformity and patient age, soft tissue work is avoided and the corrective surgery is preferably done through bone structure treatment strategies instead. This option is carried out to minimise the longer recovery time and mobility impairment associated with tenotomies.

Onychocryptosis is a common pathology treated by podiatry medical services, and in a considerable percentage, surgical procedures are required to achieve a solution. There are multiple surgical approaches for ingrown toenails, both incisional procedures and nonincisional procedures, such as chemical matrixectomies and physical matrixectomies using carbon dioxide laser. This study presents a surgical procedure for onychocryptosis using a physical matrixectomy with a 1064-nm laser applied by means of a 400-μm optical fiber and surgical removal of the posterior cauterized tissue to achieve healing by primary intention. This technique was performed on 30 patients with onychocryptosis affecting the great toe (Mozena stages I and IIa), and all of the patients were followed up postoperatively for 12 months. The patients reported minimal postoperative pain, quicker surgical postoperative healing, rapid return to activities of daily living, and minor postoperative recurrence compared with previous studies using incisional procedures and chemical matrixectomies.