About the Procedure:
A bunionectomy is a generalized term for a group of procedures aimed at correcting a mal-position of the first ray (hallux and first metatarsal) of the foot. The bunionectomy is a procedure where a specific cut (osteotomy) is made in the bone to change the angle, pitch, alignment and/or length to create a more cosmetically pleasing and more functional foot type. The first ray is one of the most important aspects of the foot in reference to walking and running. It is a crucial structure in dynamic gait. Traditionally, a bunionectomy is aimed to correct a specific deformity called a “hallux abducto valgus” but over the years various procedures have been established to address several different types of bunions.
The simplest form of a bunionectomy is when only the bony prominence on the side of the metatarsal is removed and the capsular structures are tightened. This basic approach is used for the less severe type of deformity. A moderate bunion deformity is often corrected with an osteotomy (cut) in the distal aspect of the metatarsal. The most commonly performed osteotomy is the Austin bunionectomy. As a bunion progresses to a more severe deformity a mid-shaft or even base procedure may be required. The more proximal the osteotomy is performed on the bone the more involved the procedure, the larger the incision and the increased likelihood of more hardware used. In older patients where the quality of the joint is the concern a salvage bunionectomy procedure may be performed, more for restoring function rather than for cosmetic gain.
Why a Bunionectomy is performed:
The majority of the time, patients seek intervention for a bunion usually because of one of two main reasons. These reasons are often related to pain on ambulation and with activity or the patient finding the “bunion” displeasing as a physical attribute. Whatever a patient’s motivation to have a bunion corrected a proper exam is paramount.
How to Prepare for your Bunionectomy Procedure:
Before your knowledgeable and talented Union County Orthopaedic Group foot surgeon will address your bunion deformity it is important that you have a comprehensive physical exam with gait analysis. This exam will tell your surgeon more about the mal-position within your foot and will give him or her a better understanding of how your condition formed in the first place. Vital to this pre-surgical evaluation is to obtain new radiographs (x-rays) of your feet to see the actual position of the bones involved, the quality of the joints and the amount of correction needed. This will allow your surgeon a better preparation for your surgery.
What to expect from a Bunionectomy:
A bunionectomy is traditionally an outpatient procedure in which the patient will go to the hospital or surgical center and return home on the same day. Depending on the type of procedure your surgeon performs you will most likely have some type of hardware (plate, pin, screw, staple) that will remain within the foot and based on this hardware you will either be placed in a surgical shoe, post-op cam walker boot or a cast.
As with any surgery you may have some mild pain or discomfort within the first 72 hours post-procedure, which is usually managed with oral medication. Swelling is the most common complaint post-surgery and even if managed properly may take weeks to months to completely resolve. Remember that recuperation takes time, and while you will see improvements daily it will take several weeks following surgery before you return to your normal activities. Your trusted Union County Orthopaedic Group foot surgeon will be there to guide you through the post-operative process.
Your first follow up appointment with your surgeon will usually be within 3 to 7 days of your surgery. At this visit your incision will be examined to ensure there is not evidence of infection and a new clean dressing will be placed on the foot. Often your surgeon will also want to obtain new x-rays that show the degree of correction. This will enable your surgeon to discuss with you before and after and show you the changes in your foot. Your surgeon and his or her staff will discuss with you the importance of elevation of the leg and discuss any and all restrictions. Fourteen days following your surgery your surgeon will likely remove your stitches and place you in a smaller, less bulky dressing. Each visit with your surgeon you will be re-evaluated and instructed accordingly until you can return to your normal, pre-surgical activities.
Results and Outcomes:
Your surgeon’s main and primary goal is to make your foot pain-free and help you return to all your favorite activities. Foot and ankle surgeons are highly trained specialists so they will also help restore proper foot function, create a more efficient first ray and demonstrate a more cosmetically pleasing foot. Remember that there is no one particular criteria that defines a successful surgical outcome; this will be something that you and your surgeon will be able to determine in details specific to your initial deformity and pre-surgical complaint.