Understanding the Potential Risks of Bunion Surgery
Bunion surgery, also known as bunionectomy or hallux valgus correction, is a common procedure used to correct deformities of the big toe joint. While this surgery can provide significant relief for individuals suffering from bunion-related pain and discomfort, like any surgical procedure, it carries certain risks. Understanding these potential risks is essential for individuals considering bunion surgery.
One of the primary risks associated with any surgery is the possibility of infection. Although steps are taken to minimize the risk, such as sterile operating environments and antibiotics, infections can still occur. Symptoms of infection may include redness, swelling, warmth, and discharge at the surgical site. Prompt medical attention is necessary if infection is suspected. Note that we recommend patients scrub the foot with chlorhexidine the night before surgery and the morning of surgery. Prophylactic antibiotics are often given during the surgery via intravenous route to help reduce the risk. Leaving the initial dressing intact and making certain that it does not get wet are also very important.
2. Nerve Damage
During bunion surgery, there is a risk of nerve damage, particularly to the nerves surrounding the big toe joint. This can result in numbness, tingling, or altered sensation in the toes or foot. In most cases, nerve damage is temporary and resolves over time, but in rare instances, it may be permanent. With the Lapidus or Lapiplasty surgery the dorsal medial cutaneous nerve of the foot is often encountered. It is not always possible to retract the nerve and therefore this nerve may have reduced function or sensitivity after surgery.
Some individuals may experience delayed healing after bunion surgery. Factors such as age, overall health, and the extent of the surgical procedure can affect healing time. Delayed healing may result in prolonged pain, swelling, and limited mobility in the foot. Delayed healing can relate to the incision itself, the subcutaneous layers and capsule – soft tissue, and finally bone. Anyone of these layers can be affected by delayed healing. In general the most critical is bone healing because once the bone healing is adequate and stable then protected and/or limited weight-bearing is not necessary.
4. Recurrence
While bunion surgery aims to correct the misalignment of the big toe joint, there is a risk of recurrence. Factors such as genetics, foot structure, improper footwear, and post-operative care can contribute to the recurrence of bunions over time. Additional surgical interventions may be necessary if a bunion returns after initial correction. The more severe the bunion, and the younger the patient is at the onset of the bunion (juvenile bunion) may also make the patient more prone to reoccurrence. Therefore it is critical to make sure that your surgeon that is the most correct the procedure possible in these cases.
5. Stiffness and Reduced Range of Motion
After bunion surgery, some individuals may experience stiffness and reduced range of motion in the affected toe or foot. Physical therapy and exercises may be recommended to improve flexibility and mobility. In severe cases, stiffness may persist despite rehabilitation efforts. The more work that is done directly involving the great toe joint and the first metatarsal phalangeal joint (first MTP joint) and its capsule, the more tendency there will be to have stiffness of the great toe joint here. In some cases such as with the Lapidus or Lapiplasty procedure it is possible to have excellent correction with minimal surgical involvement or dissection of the first MTP joint capsule. These patients seem to have better flexibility postoperatively.
6. Blood Clots
There is a risk of developing blood clots (deep vein thrombosis/DVT) after any surgical procedure, including bunion surgery. Blood clots can be dangerous if they travel to the lungs (pulmonary embolism). To reduce the risk of blood clots, patients may be advised to move their legs regularly after surgery and wear compression stockings. In addition there are a number of other factors that can make patients prone to a DVT. Some examples are estrogen medications and/or supplements, genetic history of bleeding disorders, smoking, the use of the tourniquet during surgery are all examples of risk factors.
7. Allergic Reactions
Rarely, individuals may experience allergic reactions to medications, anesthesia, or materials used during bunion surgery. It is essential to inform your healthcare provider of any known allergies before the procedure to minimize this risk.
8. Unsatisfactory Results
Despite the best efforts of the surgeon, some individuals may be dissatisfied with the results of bunion surgery. This can occur if the desired correction is not achieved, or if complications arise during the healing process. Revision surgery may be considered in such cases.
Reducing Risks and Ensuring Successful Outcomes
While the risks associated with bunion surgery cannot be entirely eliminated, there are steps individuals can take to reduce these risks and improve the likelihood of a successful outcome:
Choose a Qualified Surgeon: Select a board-certified surgeon with experience in bunion surgery. Follow Preoperative Instructions: Adhere to preoperative instructions provided by your surgeon, such as avoiding certain medications and fasting before surgery. Understand the Procedure: Take the time to understand the bunion surgery procedure, including potential risks and expected outcomes. Follow Postoperative Care Guidelines: Follow your surgeon's postoperative care instructions, including medication management, wound care, and rehabilitation exercises. Make sure you get clear postoperative instructions and really plan out your postop help and routine. For example how will you get around and who will help with food. First 48 hours postoperatively, it is critical to have somebody immediately available.
Attend Follow-Up Appointments: Attend scheduled follow-up appointments with your surgeon to monitor healing progress and address any concerns promptly.
By being informed about the potential risks of bunion surgery and taking proactive measures, individuals can help minimize complications and achieve a successful outcome from their surgical procedure. Consulting with a qualified healthcare professional is crucial for personalized advice and guidance regarding bunion surgery and its associated risks.
If you have any questions or would like a consultation please call 425-391-8666 and make an appointment online.
Many foot problems have an inflammatory component. But surprisingly some foot problems have a degenerative aspect also. For example Achilles problems often involve degenerative changes within the tendon itself. The tendon can also have thickening (Achilles tendinosis). Over time this degenerative process changes and calcification of portions of the Achilles tendon can occur. For example near the insertion site of the Achilles tendon at the heel bone or calcaneus.
This is different than a heel spur on the bottom of the foot. This is very common and often happens on both the right side and left side. Sometimes these degenerative changes are quite extensive and the long-term calcification can actually convert to bone-like spurs that need to be surgically removed (Achilles tendon surgery).
If you have Achilles problems or enlargement on the back of your heel and would like to have evaluation, please contact our office at 425-391-8666 or make an appointment online. Our Issaquah Podiatrists would love to see you!
Many foot problems have both mechanical and inflammatory components. The treatment plan should address both of these components. For example plantar fasciitis has a mechanical (biomechanical) component that includes the weight-bearing function of the heel and the foot.
Therefore addressing the biomechanics with prescription orthotics, wearing supportive shoes, and athletic taping will help this. Another mechanical component involves adjacent soft tissue structures such as the attachment of the calf muscle and Achilles on the heel. The constant pull of the calf and Achilles has to be addressed. That is why a night splint can help along with a runner's stretch our also essential parts of the treatment.
If you have heel pain or plantar fasciitis-like symptoms and you would like to have evaluation, please contact our office at 425-391-8666 or make an appointment online. Our Issaquah Podiatrists would be happy to see you.
When considering bunion surgery it’s important to have the bunion evaluated by a foot and ankle physician who performs a significant amount of these procedures. At Issaquah Foot and Ankle Specialists we perform bunion surgeries every single Monday and have performed thousands of procedures. We perform primary and revisional bunion surgeries weekly and have great success rates. There are many different types of bunion surgeries that can be performed from open to minimally invasive. We will help patients decide which is appropriate at this stage of their bunion.
Some patients we see we recommend no bunion procedure should be done at this point. However others are candidates for corrective bunionectomies at this stage. The great thing about our clinic is we have an on-site surgery center which is a huge cost and time savings. IV sedation is performed and a nerve block which eliminates any sort of pain during the operative procedure. If you have a bunion and are considering having surgery or would like to review some other conservative measures make an appointment with our Issaquah Podiatrists today or give us a call at 425-391-8666.
When you think about it, collagen is one of the more ubiquitous proteins in the body. Your skin hair nails tendons and bone all have a significant amount of collagen in them. So if you have a tendon or ligament injury, I often recommend supplemental collagen to help your body get through that injury and supply to building blocks for tendon healing. Some studies also suggest supplemental zinc and arginine. Here at Issaquah Foot and Ankle Specialists, our Issaquah Podiatrists recommend collagen as a supplement.
An ingrown toenail is a lot like a sliver. Slivers may be a piece of wood or possibly metal. They are a foreign body. There is no blood supply and they are a great place for bacteria to hang out. Inherently they are usually “dirty and/or contaminated." Toenails on the other hand are not a foreign body. They also do not have a blood supply and are a place that tends to have a higher bacteria count than other parts of the body and skin.
Therefore when you get inflammation around the toenail and an infection develops, it is hard for your blood supply to bring the antibiotic where it’s needed. Again the toenail really doesn’t have a blood supply and so the bacteria can just “hide" around that area. When this happens with our patients our doctors have to do an I&D. An I&D is also called an incision and drainage. By removing that ingrown toenail or portion of the toenail, you’re basically “removing a sliver. The bacteria no longer have a place to hide and it will heal quite quickly once this is done.
Ankle sprains continue to be the one of the most common injuries in all of Athletics. We see quite a few ankle sprains from pediatrics playing basketball to mature athletes playing tennis. The most common type of ankle sprain continues to be the inversion-type were your foot rolls inward. In addition it continues to be one of the most undertreated injuries in healthcare.
Quite a few people still think ankle sprains or minor injury and they can be treated for home. The previously prescribed treatment regime of “PRICE” which stands for "Protect, Rest, Ice, Compress and Elevate" no longer is appropriate in all cases. Untreated ankle sprains can lead to long-term ankle instability and ankle arthritis. Anybody that has an ankle sprain we stress importance of being evaluated as soon as possible to avoid these long-term complications.
Stress fractures are a common injury we see especially with nice weather and people getting outdoors. We often see patients that have increased activities like running or hiking and have a sudden onset of foot pain and swelling. Stress fracture can occur in the lower extremity especially the metatarsals. The most common are the 2nd metatarsal or the 5th metatarsal.
Just like Chargers All-Pro safety Derwin James who was recently diagnosed with a 5th metatarsal stress fracture. The 5th metatarsal stress fracture can be one of the hardest to heal as this metatarsal is known to have a poor blood supple and receives a lot of force especially with activities like football. Another important part of evaluating for stress fractures is checking the overall foot structure. Certain foot structures are more likely to develop stress fractures. Remember ease into new activities, maintain a good diet and if you have pain and swelling in your feet get to your Podiatrist.
The goal for most patients with bunion surgery is correction of the bunion deformity with the best procedure that provides great long-term outcomes. Bunion surgery can provide predictable consistent results. With proper procedure selection, patients are extremely happy and have great long-term results. There are over 100 different procedures for bunion deformities with the majority focusing on fusions, osteotomies and soft tissue balancing procedures. The most tried and true method continues to be the tarsal metatarsal arthrodesis.
This often allows for more of a triplanar correction as well as stabilization of large bunions and hypermobile foot structures. This procedure, the Lapidus bunionectomy has been around for years and provides clear correction of all 3 cardinal planes. We continue to read literature stating the importance of correcting the frontal plane deformity and realigning the sesamoids for the best long-term outcomes. If you have a bunion and would like to have an opinion as to whether or not you’re candidate for long-term surgical fix please give us a call at 425-391-8666 or make an appointment online.
This is a common question we receive at our practice. The only way to fix your bunion once and for all is surgically. There are many different types of bunion surgeries. Bunion surgeries can be broken down into distal, mid-shaft and proximal procedures. Distal procedures are for smaller bunions and proximal are for larger bunions and people with ligamentous laxity. Mid-shaft procedures are usually reserved for bunion that are neither small nor large.
The best way to avoid reoccurrence is to have the proper procedure selected and follow the post-operative protocol. Bunion surgery can take 6-12 weeks to recover from depending on adjunctive procedures and the bunionectomy performed. If you would like to be evaluated for a bunionectomy and have the procedure explained and recovery explained make an appointment online today or give us a call at 425-391-8666. We have an onsite surgery center that can be a huge time and financial savings.
