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BUNIONS |
Expected
Outcome for Bunion Surgery
AIM:
To eliminate pain, stiffness and malalignment of the big toe.
HOW:
Bone which is limiting joint motion and/or protruding from
the joint is removed and the big toe joint is realigned.
Arthritis
If the joint is very arthritic, the base of the big toe is
removed and a pin (K wire) is inserted through the big toe
and into the first metatarsal bone. This allows for a fibrous
joint to form in place of the arthritic one. The pin is removed
(with minimal pain) in the office. No anaesthetic is required.
This procedure allows for immediate weight bearing after surgery.
Little or no arthritis
Usually a bone cut is made to allow for realignment of the
metatarsal bone. Tight soft tissues are released on the inside
of the joint and loose soft tissues on the outside of the
joint are tightened. A combination of bone and soft tissue
procedures allow the big toe to be properly aligned. A screw
or pin is used under the skin to hold the bone in its new
position. Occasionally these are removed under local anaesthetic
in the office but this is not done before three months after
surgery. The majority of these procedures allow for immediate
weight bearing after surgery. However, in cases of very large
bunions or juvenile bunions a period of six weeks of non weight
bearing using crutches may be needed.
WHERE:
All of these procedures may be performed as Day Surgery. This
may be in the Podiatrist's office operating room or in a Hospital
or a Day Surgery Centre.
ANAESTHESIA:
A specialist Anaesthetist is used for the administration of
anaesthesia and intravenous antibiotics to prevent infection.
Intravenous sedation in combination with local anaesthetic
block is used in the vast majority of bunionectomy procedures.
The advantage of this type of anaesthesia over general anaesthesia
is that your recovery is usually more rapid. You will go off
for a "light sleep" for most of the procedure. Often patients
are partially aware of the last few minutes in the operating
room. However as this type of anaesthesia has calming and
amnesic effects, very few patients can recall any of this.
You will be required to fast for 8 hours before the surgery
and a responsible adult must accompany you home and be available
for the first 24 hours after surgery.
POST OPERATIVE CARE:
Arthritic
Bunions
A post operative shoe is provided and used for 3 weeks. The
dressing is changed from 3 to 7 days after surgery. Sterile
dressings are then dispensed with after a further 2 weeks.
The foot is kept dry for 2 weeks after surgery. At this point
in time a compression bandage is used. The patient is then
asked to obtain a lace up sneaker which is a half to a full
size larger than normal. The toe is splinted and the modified
foot wear is used for 6 to 8 weeks after surgery. Usually
at 10 to 12 weeks after surgery normal foot wear can be used.
Non
Arthritic Bunions
A post operative sandal is used for 5 to 6 weeks after surgery.
The dressing is changed at 3 to 7 days after surgery and again
at 2 weeks after that. Depending on the procedure performed
the foot must be kept dry for 2weeks and sometimes for up
to 6 weeks. The same type of splint and modified foot wear
as previously mentioned is used post operatively. Return to
normal foot wear occurs at 10 to 12 weeks after surgery.
Click
here for a pre and post operative view of this condition
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