Bunions 2017-01-29T07:56:20+00:00

The term bunion describes a bump on the inner border of the great toe. It is often associated with a deformity of the great toe called hallux valgus. Commonly, the deformity is not noticed when it causes no pain. When the deformity produces irritation over the bunion, pain at the bunion site, or overlapping of the second on first toe it becomes a problem. Often, adjusting footwear to accommodate the deformity is all that is necessary. Wearing a well fitting shoe can often prevent the deformity from ever becoming symptomatic or causing pain.

When the deformity becomes resistant to simple measures such as shoe wear modifications and anti-inflammatory medication, surgery becomes the best option. We assess your deformity on examination and with X-rays to make the best recommendation for surgery of the bunion and any lesser toe deformities that are painful. We try and use the least invasive approach that allows for correction of the deformity and relieves the pain.

Bunion foot and associated forefoot surgery is performed as outpatient surgery. After you check into the hospital the day surgery personnel will take you back to the day surgery unit where you prepare for surgery. The nursing staff asks lots of questions and examine you in preparation for surgery. The anesthesiologist will visit and discuss your needs for the surgery. If a larger surgery is planned they will often offer a nerve block for your postoperative comfort. Otherwise, we use local anesthetics to numb the forefoot for 12-18 hours after surgery. This will be done in the operating room when you are under anesthesia. The two common anesthetic approaches would be a spinal anesthetic (where your legs go asleep and you have a sedative to be comfortable to your level of choice) or general anesthetic (where you go completely to sleep).  They will discuss the pros and cons of each approach and any special recommendations for you.  After surgery, you will be taken to the recovery room for early recovery and then on to the day surgery unit until you are ready to go home.  Your foot will be in a lite post-op shoe so you can put weight on your heel.  Dr. Bomberg will discuss your surgical findings with you and a significant other after surgery.  A information sheet (available on the website for most procedures) will be provided and specific directions given.  Prescriptions and ice will be provided.  It is good idea to have some crutches for a few days until you are comfortable putting your weight on the heel of the post-op shoe.  Usually, instructions on suggested dates for followup are given and you will need to call the office to confirm a time. In general, we will recheck the foot between 5-10 days post-op. Sutures are usually removed 2-4 weeks after surgery, and any metal pins used for fixation are removed in the office at 4 weeks after surgery. Exercises and wide foot wear is used then. By 6-8 weeks you can start to get back into more normal shoes avoiding pressure on the great toe. Exercise can be resumed at that time although some patients find they can ride a stationary bike sooner.

The two common anesthetic approaches would be a spinal anesthetic (where your legs go asleep and you have a sedative to be comfortable to your level of choice) or general anesthetic (where you go completely to sleep). They will discuss the pros and cons of each approach and any special recommendations for you.

After surgery, you will be taken to the recovery room for early recovery and then on to the day surgery unit until you are ready to go home. Your foot will be in a light post-op shoe so you can put weight on your heel. Dr. Bomberg will discuss your surgical findings with you and a significant other after surgery. An information sheet (available on the website for most procedures) will be provided and specific directions given. Prescriptions and ice will be provided. It is a good idea to have some crutches for a few days until you are comfortable putting your weight on the heel of the post-op shoe.  Usually, instructions on suggested dates for follow-up are given and you will need to call the office to confirm a time. In general, we will recheck the foot between 5-10 days post-op. Sutures are usually removed 2-4 weeks after surgery, and any metal pins used for fixation are removed in the office at 4 weeks after surgery.  Exercises and wide foot wear are used then. By 6-8 weeks you can start to get back into more normal shoes avoiding pressure on the great toe. Exercise can be resumed at that time although some patients find they can ride a stationary bike sooner.

Bunion Deformity

Post Operative Care

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