Bunion Correction Surgery

Correction of a bunion involves cutting the bones and realigning the deviated first toe. The most important goal of any bunion surgery is to reduce the chronic toe joint dislocation and restore it to a more normal anatomy. Many patients are concerned about removing the bunion prominence. This happens naturally when the deformity is corrected. Simple bump removal has an unacceptably high rate of failure.

The surgery is usually performed on an outpatient basis.

Pre-operative Care

The surgical center will inform you when to arrive and how to prepare for surgery. The day of surgery you will receive regional anesthesia known as a Popliteal nerve block. This is a procedure performed by the anesthesiologist prior to surgery. You will be given medication to induce “twilight sleep”, placed on your stomach, and a small needle will be used to inject Novocain-like medication around the nerve in the back of your leg. This gives complete pain relief that lasts for 12 to 36 hours. Patients report extraordinary satisfaction with this type of anesthesia.

Operative Care

During surgery you will be put into a very relaxed state by the medication delivered through the I.V. Time passes quickly while you sleep. A tourniquet will be placed around your calf but, you will not feel the pressure because of the nerve block. Incisions are made along the inside of your foot. The ligaments are rebalanced and the bone is cut and secured with screws, wires and occasionally plates. In unusual cases a fusion is performed. X-Rays taken during the surgery confirm the correction of the toe dislocation and the correction of alignment. Other procedures such as hammer or crossover toes, mid-foot arthritis, or bunionettes may be corrected simultaneously during this surgery when indicated. The wounds are closed with stitches.

Immediate Post-Operative Care

Once your anesthesiologist is satisfied that have recovered you will be permitted to leave the surgical center. During this recovery time your family member may take your prescription to the nearest pharmacy. You will be given crutches. Take your narcotic pain control medications before falling asleep or as you feel the “numbing” effect wearing off. Remember, post operative pain is much easier to control with prevention. Schedule your first post-operative appointment for 2 to 7 days after surgery.

To schedule surgery, please contact Kathi at contact_us@anklefootmd.com or at 952-920-4333 ext. 5, four weeks in advance to best ensure your desired surgery date. If you have questions after surgery, please contact our office and ask for my medical assistant.

Post-Operative Course – Bunion Correction
This timeline is a general guideline. Your post-operative course may vary.

Elevation	23 hours / day for 3 days. Remember that swelling may last over 4 months and early elevation prevents more problems.
Motion	Move your ankle and lesser toes when the block resolves. This will decrease pain and swelling, and improve healing. Begin great toe up and down motion after the first dressing change.
Walking	Heel and outside of the foot only for 2 weeks. Once the wound has healed most of our bunion surgery patients can weight bear as tolerated. In all but the rarely required fusion surgery, we use the most stable types of surgery to allow this rapid return to function. **
Bathing	Keep dressing clean and dry.
Dressing	Keep dry and intact. The first dressing change is a few days after surgery. Stitches are removed at 2 weeks and an aftercare brace is used. Patients are encouraged to wear tennis shoes as soon as swelling permits.
Pain Control	Expect to use strong narcotics for the first 3-5 days. Wean off as soon as you are comfortable using Tylenol or Motrin.
Work	Return depends on specific demands. It is safe to return to sedentary work at 10 days post-op. Return to heavy labor will take at least 8 weeks.
Driving	Patients with left foot surgery may drive an automatic transmission. Patients with right foot surgery must wait until healing is adequate and they feel safe.

Routine Clinic Visits

2-7 days	Return for a dressing change. Begin active motion of the toe up and down for best results.
2 weeks	Check XR and confirm incision is healed. Remove dressings, and begin wearing a tennis shoe when swelling permits.
6 weeks	Check XR to confirm healing. Gradually, resume normal activity if bones are healed. **
3 months	Return if you have pain, other concerns, or per Dr.Silverman’s instructions. Minimal feelings of discomfort may linger, your overall comfort level improves over a year.
Other Issues	Hardware removal in less than 50% of patients and is recommended only if it is bothersome.
**************	If at any time during your post-operative period you notice any drainage or foul odor from your incision, a temperature of more than 100.4 degrees and/or increased swelling or tenderness, you should contact our office.

** No weight bearing is permitted in bunions that require midfoot fusion.

The information contained in Anklefootmd.com is intended to provide only general education about foot and ankle problems. It should NOT be regarded as diagnostic, treatment or any other type of specific medical advice to anyone. Individuals should always consult a licensed and qualified health care provider for evaluation, diagnosis and treatment recommendations regarding their specific ankle and foot or other medical problems. If you think you may have a medical emergency or a major medical problem, call your doctor or 911 immediately. The information contained herein is subject to change without notice.