What Can Go Wrong After a Bunionectomy?

A bunionectomy is a surgical procedure in which the surgeon removes a patient's bunion, a growth of bone and soft tissue at the base of the large toe. Bunions often cause pain, an irregular gait and foot deformities. People with bunions typically have difficulty fitting into shoes. Like any surgery, bunionectomies involve some risks.

Procedure

• According to the Encyclopedia of Surgery, in a bunionectomy, the surgeon makes an incision along the top of patient's large toe over the inflamed area and removes the extra bone matter and the bursa---a sac filled with fluid which might be present next to the bone. The surgeon will then realign the tendons, ligaments and nerves of the toe. If necessary, the surgeon also shortens the bone of the big toe so that it will lie parallel to the other toes. In some cases the doctor may hold the joint together with screws or pins (which can be removed a few weeks later), or perform a joint replacement. The exact technique and level of anesthesia depends on the severity of the individual case.

Risks

• Bunionectomies involve certain risks. As in any surgery, patients might respond negatively to the anesthesia. Nausea and vomiting are common reactions to anesthesia. The surgical site may also become infected. Some patients report that the nerves in their foot have been damaged during surgery, or that they have difficulty managing the pain. In some cases, the bunion returns.

Signs of Trouble

• Although swelling and some pain is normal after a bunionectomy, if you get a fever or chills after the surgery it might mean you have an infection; call your doctor immediately. Other signs that something may have gone wrong include increasing pain, redness around the surgical dressing, dressing that gets wet and falls off or is bloody and swelling in the calf of the operated foot.

Preventing Problems

• To lower the chances of postsurgical problems, talk with both your surgeon and your anesthesiologist before the surgery about your medical profile and what you can do to hasten recovery. Follow their after-care instructions closely. Expect the recovery to take at least six to eight weeks; during that time, don't put your full weight on your foot.

  After you have recovered, talk to your doctor about the types of shoes you should wear to prevent a recurrence of the bunion, since many bunions are caused by tight, ill-fitting shoes.

Alternatives

• According to the Encyclopedia of Surgery, doctors recommend bunionectomies only for patients who have tried less invasive treatments without success. You may be able to function without a bunionectomy by wearing orthopedic shoes or special foot cushions or by getting injections of anti-inflammatory medication every few weeks into the bunion area.