Bunionectomy: aka bunion removal, bunion surgery
What is it?
The bunionectomy is a type of surgical procedure that removes, or excises, a bunion in a patient’s foot. The bunion is an unusual enlargement of the joint which is found at the big toe’s base and is made of bone and soft tissue. A bunion usually results because of irritation and inflammation because the patient wears poorly fitting shoes - usually shoes that are too tight or too narrow.
The surgeon makes an incision over top of the area that is swollen at the big toe’s first joint and remove the enlarged lump. It may be necessary for the surgeon to realign the big toe’s bones. If that is the case, there may be more than one incision. It may be necessary to cut the bone. If the surgeon finds that the surfaces of the joint have been damaged, the surgeon may decide to hold the patient’s bones together with wires, metal plates, or screws. Surgeons have been known to remove an entire joint in if the case is severe and replace it with a replacement joint. If the bones were held in place, the surgeon will remove the pins a few weeks after the surgery. If the case is mild, the surgeon may be able to repair the person’s ligaments and tendons which are causing the big toe to go out of the proper alignment. When the surgery is complete, the incision will be closed with sutures and steri-strips may be applied to make sure that it stays together. The wound will then be wrapped in a compression dressing in order to keep the foot in proper alignment. This will also help to reduce swelling after the operation.
Alternatives to Surgery
If the bunion is caught early enough, surgery can be avoided. If the patient wears the proper shoes; that is one thing that can help them avoid surgery. A good way to find shoes that fit is by trying shoes on during the afternoon. That is when the patient’s feet are likely to be tired and there may be some fluid. It’s not a good idea to go simply by the size. The patient should make sure that the shoes are well fitting and that they have the right amount of arch support. There should also be space in the shoe’s toe box so that the toes have wiggle room.
A doctor may also use injections of medication to reduce the amount of inflammation that is in the joint. This may help to get rid of the irritation and give the joint time to recuperate. Along with wearing proper shoes, this may just be enough to stop the condition from progressing. Some patients also find that applying capsaicin cream to the joint can help the pain. It should be noted that surgery will unavoidable once severe pain accompanies the deformity.
Before the Surgery
It is customary for the physician to require laboratory work prior to surgery to ensure that the patient is healthy enough to endure the anesthesia. Also, pre-operative instructions will be given to the patient that need to be carefully adhered to in order to improve the chances of a successful surgery.
After the Surgery - In the Hospital
The person will be monitored after the surgery, while they are in recovery. The foot of the patient will be checked for excess swelling and bleeding, although a certain amount of swelling is to be expected. The patient will be kept in the recovery area for a few hours to give the patient time to recover from the anaesthesia. When the patient wakes up, they may be given pain medication and fluids through an IV until it’s determined whether or not they can tolerate anything by mouth. They will be monitored for vomiting and nausea, and given juice and crackers. This is to see how well the patient tolerates food. When the hospital staff is satisfied about the person’s recovery, they will need to be driven home, due to anaesthesia and pain medication.
The patient should let their surgeon know if they have any of the following when they go home: fever, chills, increased or constant pain at the site of the surgery, warmth or redness near or around the dressing, the calf above the foot that was operated on is swollen, bloody dressing or the dressing falls off due to becoming wet.
Any of these symptoms can mean that there is infection in the foot and should be checked immediately to prevent further problems.
After the Surgery - At home
Although the patient will be able to resume normal activities anywhere from six to eight weeks post surgery, they should expect to see some swelling for a few months after the surgery. The length of time before patient can bear weight on the foot depends on how bad the deformity was. During the period of recovery, the patient will wear either a boot, a special shoe, or a cast so that the bandage can be accommodated and the foot will have stability.
As it is with all surgeries, there is always the chance of complications. Here are some of the complications that a patient may experience with a bunionectomy:
Reaction to anaesthesia
This is a surgery that doesn’t need to be done. It has become necessary due to patients wearing shoes that are improper for them and paying for it later in life. When people wear shoes that are right for their feet, they can avoid having to have this type of surgery later in life.
Estimated Costs for Bunionectomy Surgery