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BUNION CORRECTION SURGERY

A prominent area near the big toe is called a bunion.  These are more common in women and often run in families.  A bunion is usually painful due to pressure from shoes.  Initial treatment involves shoe modifications or trying various over the counter splints.  If they remain symptomatic, surgery is an option.  Surgical correction involves cutting the bone and holding it in the corrected position with a screw.  In addition the toe is held straight by balancing the supporting tissue of the great toe.  This surgery is common and is generally quite successful.  It is performed on an out-patient basis.  The first night of surgery you should expect bleeding; this is normal.  We see you the following day for a dressing change.  You will have some swelling for six to nine months following surgery.

As with any surgery there are risks, these include infection, bleeding, numbness, and reoccurrence.  We try hard to make your surgical experience as pleasant as possible and have found the following points helpful.

1. We use a re-circulating cold water unit called a “polar pack.”  Mark with Pacific Medical with contact you before the surgery and have you pick this us.  Please bring this will you to surgery as it will be applied during surgery. The polar pack helps greatly with decreasing swelling and decreasing pain.  Turn the polar pack off every two hours for 15 minutes to prevent your foot from becoming too cold. 
2. Elevation will help with pain and swelling.  You need to elevate your foot above your left shoulder constantly for the first 72 hours and then frequently the first 10-14 days. 
3. Please obtain crutches or a rollabout prior to your surgery as you will need these following surgery.  You will be non-weight bearing for the first 10-14 days afterwards.  A list of suppliers is attached.
4. You will be in a bunion shoe after the surgery.  You need to wear this 24 hours a day for the first eight weeks.  After that you can wean into a regular shoe as pain and swelling allows.
5. You will have a follow up appointment the day following surgery for a dressing change.  You will then have an appointment 10-14 days following surgery for x-rays and removal of stitches.  You need to keep your foot dry until this visit.  Your next appointments will be at five weeks from surgery for a clinical check and at eight weeks from surgery for final x-rays.
6. In order to minimize pain after surgery, we generally use regional anesthesia, called a popliteal block,  so that you have no pain for six to eighteen hours after surgery.  During this time your foot and ankle will be numb and will not support you.  In addition, it is important that you begin your pain pills before this block wears off so as to get the pain medication in your system.  Generally we recommend you begin taking the pills the evening of surgery and then set your alarm clock the first night to wake up and take the pills, so that you stay on top of the pain.  Below is a list of commonly used medications and their dosages:

• Norco (hydrocodone/APAP) take 1 pill every 2 hours as  needed for pain
• Oxycodone take 1-3 pills every 2-3 hours as needed for pain
• Darvocet (propoxephene) take 1-2 every 4 hours as needed for pain
• Vistaril (hydroxyzine) take 1 pill every 4 hours as needed to minimize nausea and it also helps to make the pain medication seem more effective
• Phenergan (promethazine) take 1  pill every 4 hours as needed if you develop nausea

                                                                                                                                                                                                                                                                                                                               

If you have any questions or concerns, contact your physician's nurse at 323-2600.

 

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