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What is
Bunionectomy?
Bunion removal, also called a bunionectomy,
is a procedure in which the doctor removes a
swelling or thickening on your big toe joint
called a bunion. The doctor may also
straighten your toe if necessary.
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Effects of
Bunionectomy
Surgery is recommended to correct the deformity, reconstruct
the bones and joint, and restore normal,
pain-free function. Through bunionectomy, walking
will be more comfortable, your shoes may fit
better, and your toe won't hurt.
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Candidates for
Bunionectomy
Patients who have difficulty walking due to
bunions are advised to undergo this
procedure.
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Your
Consultation
Your Board Certified Surgeon will check for past illnesses
and may have special tests to make sure that
you are well prepared and that you can have
the operation as safely as possible. Many
hospitals now run special pre-admission
clinics that you can visit a few weeks or so
before the operation.
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The Bunionectomy
Procedure
A general anaesthetic will put you to sleep for the whole
operation. Your toe will be straightened by
breaking the bone and moving your toe into a
new position. This is called an osteotomy. A
cut is made over the top of your abnormal
joint. The bony lump on the side of the
joint is then removed. A bone in your foot
is cut and your toe moved into a better
position. The bones may, or may not, be held
with a screw or special staple until they
heal together. The skin wound is then closed
up with stitches. A plaster cast is put on
your foot to hold your big toe in its new
position. You will be in hospital either
just for the day of the operation or for one
more day.
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Recovery
Most people recover completely from the surgery. A plaster
is usually cast on the treated foot which
may be painful for a while after the
surgery. You can be given injections or
tablets to help make the pain tolerable.
Patients are advised to keep the foot
propped up and protected from pressure,
weight, and injury while it heals. Complete
recovery may require 3 to 5 weeks.
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Risks
While it is rare that you can develop an infection in the
area of the operation, should an infection
occur, this can be settled by taking
antibiotics for a few days. Also rarely, a
nerve or a blood vessel can be damaged
during the operation and you might need
another operation to fix the problem. The
bones may not join together firmly. If this
occurs, a further operation may be
necessary.
Other risks for bunion surgery include the following:
·
Numbness over the big toe
·
Wound breakdown
·
Recurrence of deformity
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Frequently Asked
Questions
Q: What is a bunion?
A:
A bunion is a painful deformity of the bones
and joint between the foot and the big toe.
Long-term irritation (chronic
inflammation) caused by poorly fitting
and/or high-heeled shoes,
arthritis, or heredity causes the
joint to thicken and enlarge. This causes
the big toe to angle in toward and over the
second toe, the foot bone (metatarsal) to
angle out toward the other foot, and the
skin to thicken (callus
formation).
Q: What happens during a bunionectomy?
A:
Surgical removal of a bunion is usually done
while the patient is under general
anesthesia (asleep and pain-free) and rarely
requires a hospital stay. An incision is
made along the bones of the big toe into the
foot. The deformed joint and bones are
repaired, and the bones are stabilized with
a pin and/or cast.
Q: Are there alternatives to bunionectomy?
A:
Most people try pads from the chemists or
the chiropodists before seeing an
orthopaedic surgeon. If the pads have not
helped, and your toe is painful, probably
the best plan is to straighten your toe. You
should not have the operation just to make
your feet look better.
Q: What happens after the procedure?
A:
You may go home the same day or you may stay
in the hospital for a day, depending on your
condition. You will limit your walking for 2
or more weeks. You will probably wear a
brace, special shoe, or cast to help support
the toe and foot. Your toe may be painful
for a few months.
Q: What is the purpose of a bunionectomy?
A:
A bunionectomy is performed when
conservative means of addressing the
problem, including properly fitting,
wide-toed shoes, a padded cushion against
the joint, orthotics, and anti-inflammatory
medication, are unsuccessful. As the big toe
moves sideways, it can push the second toe
sideways as well. This can result in extreme
deformity of the foot, and the patient may
complain not only of significant pain, but
of an inability to find shoes that fit.
Q: What causes bunions?
A:
Bunions become more common later in life.
One reason is that with age the foot spreads
and proper alignment is not maintained. In
addition, the constant friction of poorly
fitting shoes against the big toe joint
creates a greater problem over time.
Ignoring the problem in its early stages
leads to a shifting gait that further
aggravates the situation.
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