Bunion Surgery in Depth

 

 

There are several different types of surgery that can be performed on bunions, and the following articles describe the most commonly used bunion surgery in depth.

 

McBRIDE BUNIONECTOMY

This type of surgery is most often used to treat mild bunions. The enlarged portion of bone is removed from the medial or inner portion of the joint of the big toe and then the surrounding muscles, tendons and bones are realigned.

Post Surgery Care

  • Rest
  • 3-5 days post-op: Elevate the feet regularly
  • 3-5 days post-op: Apply ice regularly
  • 4 weeks post-op: A post-operative shoe must worn until this time
  • 6-12 weeks post-op: Wear wide, roomy shoes
  • 2nd-3rd week post-op: Physical therapy is introduced to prevent stiffness in the foot and joint. Home exercises must be done as well. If these methods are not followed the results may be poorer than expected.
  • 2-3 months post-op: Routine activities may be reintroduced barring complications or difficulties.
  • 6 months + post-op: Some swelling may remain.

CHEVRON BUNIONECTOMY

A chevron bunionectomy is often used to treat mild to moderate bunions. An incision is made above the joint of the big toe and the enlarged portion of bone is removed in such a way that the joint is left undamaged. There are also fewer deformities of the foot left to cause irritation post-surgery, particularly when shoes are worn.

After these steps are taken a cut is made in the first metatarsal to allow the bone to shift into place and the join to realign properly.

Post Surgery Care

  • Rest
  • 3-5 days post-op: Elevate the feet regularly
  • 3-5 days post-op: Apply ice regularly
  • 4 weeks post-op: A post-operative shoe must worn until this time
  • 6-12 weeks post-op: Wear wide, roomy shoes
  • 2nd-3rd week post-op: Physical therapy is introduced to prevent stiffness in the foot and joint and home exercises must be done as well. If these methods are not followed the results may be poorer than expected.
  • 2-3 months post-op: Routine activities may be reintroduced barring complications or difficulties.
  • 6 months + post-op: Some swelling may remain.

CLOSING BASE WEDGE BUNIONECTOMY

This surgical technique is reserved for treating moderate to severe bunions, as it is more invasive and requires a double osteotomy. An incision is made in the big toe and the sesamoidal bone is either removed or realigned. The enlarged portion of bone is removed from the head of the metatarsal and a second wedge of bone is removed from the base of the metatarsal. The bones are then repositioned and stabilized.

Post Surgery Care

  • Rest
  • 3-5 days post-op: Elevate the feet regularly
  • 3-5 days post-op: Apply ice regularly
  • 14 days post-op: A splint must be worn weight-bearing activities must be avoided.
  • 2 to 4 weeks post-op: A below the knee fibreglass cast must be worn and weight-bearing activities must be avoided.
  • Physical therapy is initiated immediately after the cast is removed and home exercises are introduced as well. If these methods are not followed it may result in excessive stiffness and the results may be poorer than expected.
  • 24-30 weeks post-op: Routine activities may be reintroduced barring complications or difficulties.
  • 6 months + post-op: Some swelling may remain.

 

LAPIDUS BUNIONECTOMY

The Lapidus bunionectomy is used to treat moderate to severe bunions or when the big toe and first metatarsal are unusually flexible. An incision is made above the joint in the big toe joint and the enlarged portion of bone is removed from the head of the metatarsal in such a way that the joint is left undamaged and there are few deformities of the foot left to cause irritation post-surgery.

After the bone is removed from the head of the metatarsal the joint at the base of the same toe is also removed, as is the joint surface of the bone it interacts with. The bones are then realigned and screws are inserted to keep the bones in place.

Post Surgery Care

  • Rest
  • 3-5 days post-op: Elevate the feet regularly
  • 3-5 days post-op: Apply ice regularly
  • 14 days post-op: A splint must be worn and weight-bearing activities must be avoided.
  • 6 weeks post-op: A below-the-knee fibreglass cast must be worn and weight-bearing activities must be avoided. After 6 weeks a removable cast will replace the fibreglass cast for an additional 4 weeks.
  • Physical therapy is initiated immediately after the cast is removed and home exercises are introduced as well. If these methods are not followed it may result in excessive stiffness and the results may be poorer than expected.
  • 24-30 weeks post-op: Routine activities may be reintroduced barring complications or difficulties.
  • 6 months + post-op: Some swelling may remain.

Complications Associated with Bunion Surgery

No matter what type of surgery is performed there are risks involved, and complications occur in 10% of all bunion surgeries. These complications include:

  • Infection
  • The bunion returning
  • Nerve damage
  • Joint stiffness
  • Long term pain and discomfort
  • Over correction of the bones in the foot

Your doctor and surgeon will discuss any possible risks and side effects associated with your particular type of surgery before you make any decisions.

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