Bunion correction surgery is done as an outpatient. It can be done with a general anesthetic or an ankle block. If both feet have bunions they can be corrected at the same time, or they can be done singly. Most people choose to have both sides corrected at the same setting so they only have one anesthetic, and only one recovery period. I routinely allow you to walk with all of your weight on the operated foot, so it is possible to have both sides done and still be able to get around. Some patients have other forefoot problems, such as hammertoes or Morton’s Neuroma that can also be treated at the same time.
There are several different types of bunion corrections that can be done. You will have a scar about 2 inches long on the inside of the foot by the bunion. With some corrections there may also be a small scar between the great and second toes, or over the inside of the midfoot.
Occasionally a wire may be used to hold the position of the toe but that is not common.
Day of Surgery
At the end of the surgical procedure the wound is covered and the foot is wrapped with a dressing that is securely taped into place.
That dressing gives support to the foot, and in particular the great toe, acting like a cast to hold it securely. That dressing should be left in place until I change it at the first post-operative office visit.
You will be given a post-operative shoe at the surgery center, and you may put all of your weight on the foot if you have that shoe on. You must not walk on the operated foot unless you are wearing the post-operative shoe. Some people sleep with the shoe on for the first few days after surgery because it gives them a sense of more security, but you do not have to keep it on unless you are walking. If the dressing gets wet or there is a problem with it, please call the office so I can remove it myself.
Dealing with post-operative pain will be your major concern for the first few days. Try to keep your foot elevated to prevent swelling.
The first post-operative visit is usually 7 – 10 days after surgery. I will remove the dressings, wash your foot, and take out the skin stitches.
At the first post-operative visit I will make a molded silicone spacer for you to wear between the great and second toes, to support the great toe and help maintain the alignment. That can be taken off for bathing, but it is best if you can wear it at all times for the next 3 weeks. You will continue to use the post-operative shoe until 4 weeks have passed after the surgery. You may bathe the foot and keep a clean sock on it, using the spacer between the great and second toes. You should not sit in a hot tub until 2 weeks after surgery. If your surgery was on the right side you should not drive until 4 weeks after surgery.
The second post-operative visit is usually at the 4 week point. If all is going well I will allow you to begin wearing whatever shoe feels comfortable on the operated foot. You may stop using the spacer at that point. You may walk as much as feels comfortable, but should not do anything more vigorous for another 4 weeks. You may drive when you can wear a regular shoe.
The next visit is usually the final one, and it will be after an additional 4 – 6 weeks.
Most patients have swelling about the great toe that lasts for about 4 months after surgery. With the initial swelling and pain from surgery the great toe motion is limited. As that resolves the motion normalizes.
The goal of the surgery is to leave you with a painless foot that will allow normal activities and unrestricted shoewear. You should be able to regain full strength and power in the foot. Some patients have mild restriction of motion by the great toe, but it would be rare to cause any limitations. Some patients will have some mild soreness still. Some will notice discomfort when the weather changes.
Complications can occur with any surgery.
Specific risks of this surgery include the possibility of the bone not healing, or non-union, stiffness of the great toe, and recurrence of hallux valgus.