Bunion Surgery Melbourne
Bunion Surgery or Metatarsal Osteotomy – A Patient’s Guide:
Mr Troy Keith MBBS (Hons), FRACS (Orth), FAOrthA
Orthopaedic Foot and Ankle Surgeon
What is a bunion?
A bunion is not a ‘bump’ on the bone.
It’s caused by a bend or angulation of the big toe.
The bunion itself can be painful.
It commonly causes painful symptoms by placing additional pressure within your shoe on your foot and toes or by squashing up against the second toe causing it to rub on your shoe.
Bunion Surgery Melbourne
Is surgery the only way to treat bunions?
No – Surgery is recommended if your bunion symptoms do not settle or improve with wider fitting shoes or orthotics. Orthotics or insoles are worn in your normal shoes and these may help bunions potentially caused by a flat foot or fallen arch.
Bunion splints or braces may treat early and mild bunions, although their effects may be short-lived.
Arch supports or insoles may sometimes help, but these will often require you to wear a wider or broader shoe to help fit the insole along with your bunion. ‘Corn plasters’ or ‘pads’ may also help to relieve local pressure symptoms.
More severe bunions can only be corrected by surgery. Surgery should only be undertaken if the symptoms are significant and appropriate non-operative management has been considered.
What happens during Bunion surgery?
The surgery is usually performed either as a day-case (go home the same day), or with an overnight stay in hospital.
The surgery is usually done under a general anaesthetic along with a local anaesthetic block to numb your foot.
The “ block” provides pain relief after your surgery for approximately 8 -12 hrs.
A small incision is made at the side of your big toe and the soft tissues are released and an ‘osteotomy’ or bone cut is performed to straighten your bunion. The osteotomy allows for your big toe to be shifted into a straighter position. Two very small screws are then used to hold the straightened toe in place.
A second bone cut may be done as well, a procedure known as an ‘Akin’. This helps to straighten the toe further.
What can you expect after the operation
After the operation, you will wake up with your foot bandaged in a special post-operative shoe. The post-operative shoe will need to be worn for six weeks to protect your foot whilst it is healing. The shoe should be worn at all times, even in bed at night.
Your foot will be sore after the local anaesthetic wears off, but pain relief medication will usually control this. To minimise swelling, it’s VERY IMPORTANT keep your foot elevated after the operation. Mr Keith will discuss with you the options available to help reduce the swelling.
When your foot is lowered it will throb and swell, so please keep it elevated when possible. With time, the period you can keep your foot down will increase. Two or three weeks after the operation you should be able to keep your foot down most of the time.
What happens after you’re discharged?
Please keep your bandage on and avoid getting your foot wet. IMPORTANTLY, please keep your foot elevated as it helps to reduce the swelling and control your discomfort.
When lying down elevate your foot on a pillow and when sitting down elevate it on a chair. When your foot is lowered down it will throb and swell. This is normal and can continue up two to three weeks following your surgery.
You will be discharged from hospital with pain relief tablets. Please take these regularly in the days following surgery. You may only require pain relief in the evening before bed.
When do I see Mr Keith?
You will be booked in for a follow up appointment to see Mr Keith approximately two weeks after your surgery. Your bandage will come off and Mr Keith will instruct you how to start exercising your toe to help increase movement, strength and flexibility.
Failure to undertake these exercises increases the risk of developing a stiff toe after surgery.
When can I go back to wearing a normal shoe?
On average, expect to spend about six weeks in the postoperative shoe. At your six week review with Mr Keith, you will may be able to wear an open toed sandal, preferably with adjustable straps or loose fitting supportive shoe. Your foot may remain swollen for up to six months after the operation.
It will normally be three to four months after your surgery before you can wear a shoe for a working day, and it is usually three to six months from the operation before you can hope to resume recreational walking or light sporting activities.
If you are slower than these outlined recovery times do not panic, they are only averages, but let Mr Keith know when you attend your follow up appointment.
Bunion Surgery Melbourne – Risks & Complications
Although the operation mostly produces good results, complications may occur. Although great care is taken with the operation and aftercare, a small number of people (up to 10%) may have less than perfect results due to problems such as:
- Infection or wound related problems
- Stiffness of the big toe
- Recurrence of the bunion
- The screws become prominent and require removal at a later date
- Weight transfer to the second toe (a callus under the second toe forms)
- Over-correction of the bunion, so that big toe points inwards
- Non-healing of the bone
- Sensitisation and pain in the foot due to damage to the small nerves or blood vessels in the foot
- General complications of any surgery such as thrombosis (a blood clot) and anaesthetic problems
Mr Keith will ensure to take great care with your operation and aftercare.
Most problems can be treated by medication, therapy and on occasion further surgery, but even allowing for this, sometimes a poor result ensues. For this reason, we do not advise surgery for cosmetic reasons.
The level of symptoms before surgery must be worth the risk of these possible complications.
You can reduce the risk of complications by preparing yourself and your foot, as described in our handout ‘Preparing for Foot Surgery’.
If you are at particular risk of complication, this will be discussed with you. If you have any general or specific worries, you should share your concerns with Mr Keith, who will explain the potential complications to you in further detail.
How do I know if I have a complication after surgery?
Some problems such as recurrence of the bunion, become obvious with time.
It is important that you notify Mr Keith if your pain increases after you go home, particularly if the pain does not settle with elevation and regular pain relief, as this may be a sign of early infection.
When your foot is lowered down it will throb and swell. This is normal and can continue up two weeks following your surgery
Similarly, if your leg or foot swells, which does not settle when the foot is elevated above heart level, you should contact Mr Keith.
Bunion Surgery Melbourne
A Message from Mr Keith
These guidelines are intended to help you understand your treatment and prepare for your operation.
I understand the level of detail may cause concern or worry for some patients.
If you do have further questions, please don’t hesitate to ask me at your consultation or contact a member of my team.
We will happily address your concerns.
It is important for me that you feel comfortable and satisfied you have all the information you need before your surgery day.
Mr Troy Keith – Orthopaedic Foot & Ankle Surgeon.
Bunion Surgery Melbourne
Mr Keith consults in a number of locations in Melbourne in relation to surgical and non-surgical treatment options for Bunions. He has more than 17 years surgical experience and seven years of specialist training.