Bunionectomy - Post-Op
• Recurrence of deformity: 10% recurrence rates are historically noted with the correct decision and execution of the surgical procedure key in decreasing recurrence rates.
• Hallux Varus: By moving the first metatarsal in an overcorrected position the first toe can move toward the midline of the body in the direction opposite from the original toe position of the bunion.
• Joint stiffness: All joint surgery can lead to joint stiffness. Aggressive patient motivated first toe range of motion after surgery can decrease joint stiffness.
• Infection: limited to 1-2% of surgical procedure.
• Delayed healing of metatarsal bone: If failure of the surgical fixation or motion at the osteotomy site delayed healing or non healing of the metatarsal bone can occur.
Post operative Visits
The first dressing change generally occurs at the first week after surgerey During this visit your surgeon will evaluate your wound to make sure that there are no early signs of complication including infection. A sterile dressing change and x-rays often times will be taken at this visit. Any surgery involving a joint will experience post operative stiffness and will need to be mobilized aggressively to avoid long term stiffness after surgery.
Range of motion exercises will begin after the first visit with range of motion of the post operative joint occurring 25 minutes per day broken up in 5 minute intervals. You should be experiencing discomfort in the big toe joint if you are performing the range of motion exercises correctly. You will be performing your own home “physical therapy”.
The second post operative visit occurs at week two with the removal of the surgical dressing and steri-strip band aids and removing the sutures. The surgical skin closure is performed with an absorbable suture that needs to be cut at the entrance and exit sites only. This minor procedure entails minimal discomfort. After this visit bathing will be allowed. By removing the dressing and allowing bathing joint range of motion exercises will be performed with greater ease and comfort. Massaging the post surgical tissues will be encouraged at this time to expedite the healing process. A bunion splint or toe spacer will often be dispensed at this visit to help maintain the corrected surgical position.
The third post operative visit occurs at week four with repeat radiographs to determine adequate bone healing and transitions back into supportive well fitting shoes if a “head bunionectomy” was performed or the allowance of limited weight bearing with the use of crutches if a “base bunionectomy” was performed. For base bunionectomy full weight bearing with the use of the CAM walker will be allowed at week six until week eight at which time the transition back into supportive shoes will occur.
Generally one additional post surgical follow up will occur at eight weeks. It is important to understand that activities of normal living will slowly return after your surgery and that at three months some remaining stiffness and swelling will be present but near normal life activities should be performed. At the three month mark it should feel like you are at the “light at the end of the tunnel”
The overall recovery varies between patients and is based on the type of bunion surgery performed. Generally, most patients at three months post surgical correction should feel like there is “light at the end of the tunnel” and they have returned to near normal activity including daily activities and fitness endeavors. There will be some ongoing swelling and joint stiffness that may influence the types of shoes that can be worn at this time but overall recovery is near complete.