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.
1. Infection
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.
Dr. Timothy Young
Foot & Ankle Surgeon
Issaquah's Top Podiatrist
