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What is
Bunionectomy?
Bunion removal, 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
This procedure is used when a bunion makes walking painful.
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Your
Consultation
On the ward, you may be checked 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
preadmission clinics, where you visit for an
hour or two, a few weeks or so before the
operation for these checks.
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The Bunionectomy
Procedure
You will have a general anaesthetic, and
will be asleep for the whole operation. Your
toe will be straightened. This is done 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. You will have a plaster cast on
your foot. Your foot may be painful. You
will be given injections or tablets to
control this. The patient is 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
Rarely, you can develop an infection in the
area of the operation which 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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