POTENTIAL RISKS OF BUNION SURGERY
By: Corinne Gehegan, DPM
Although there are many benefits of bunion surgery, there are also potential risks that all patients should be aware of when deciding to undergo this elective surgery. Please review the risks below and discuss any concerns with the doctor.
INFECTION: Although this is rare in the case of bunion surgery, a post operative infection can develop. The doctor may request a prophylactic IV dose of an antibiotic prior to making the surgical incision. Post operative infections may require hospitalization and/or additional surgery.
SCAR: It may take up to one year for a scar to fade. Some patients are prone to developing keloid scars. If you tend to form keloid scars, please notify the doctor prior to the surgery.
STIFFNESS/WEAKNESS: Individuals may experience a decrease in motion at the joints where the bunion surgery is performed. This may be due to scar tissue or lack of motion at this area post-operatively. Physical therapy can be quite helpful should the degree of stiffness be greater than expected.
PROLONGED SWELLING: Every patient will develop post operative swelling. The extent of the swelling varies among individuals. Swelling can be minimized by following post operative instructions. Swelling may last from several weeks to several months. In some cases patients will notice some swelling of the foot even years after the surgery.
PROLONGED PAIN: Every patient will experience post operative pain, however, pain tolerance varies among individuals. The doctor will prescribe medication to manage post operative pain. Frequently, the doctor will infiltrate a long acting local anesthetic about the surgical site at the end of the surgery. This allows patients to be comfortable in the recovery area, on the way home, and for a period of time at home. If a patient experiences prolonged pain, a referral to a physical therapist or pain management specialist may be warranted.
NUMBNESS: If this occurs, it is usually temporary and may develop for a variety of reasons. Nerve branches may be affected by swelling and scar tissue. The smallest branches may be cut during the surgical dissection.
SHORTENED TOE: This possibility exists with certain procedures more often than others. It has to do with the amount of bone that needs to be removed or with the particular way the bone needs to be cut in order to reposition the bone.
DEEP VEIN THROMBOSIS (DVT): A DVT is a blood clot that can form in the veins of the legs. If the clot dislodges from the vein it can travel to the lungs and become a pulmonary embolus possibly resulting in death. Several risk factors can lead to the development of a DVT. The doctor can discuss these with you. Prolonged physical immobility is one of these risk factors.
DELAYED HEALING: Certain individuals may be at risk for delayed healing of skin, soft tissue, and bone. Risk factors include, but are not limited to: smoking, diabetes, osteoporosis, auto immune diseases, and certain medications.
NON-UNION: There are a number of different types of bunion procedures. Many involve cutting the bone with a bone saw and subsequently repositioning the bone. The bone is then secured with some form of hardware (screws, plates, wires). The medical term for the bone cut is “osteotomy”. Although not common, there is a possibility that the bone does not heal. This may require use of a bone stimulator or additional surgery.
UNDERCORRECTION/OVERCORRECTION/RECURRENCE: Everything will be done to avoid these situations. The doctor will consider all factors when deciding which type of bunionectomy is appropriate for an individual. This involves a patient’s medical history, age, severity of the bunion based on examination and x-ray analysis, quality of the bone and joints, the type of recuperation the patient can manage, and the patient’s expectations. Unfortunately, there is a chance that the deformity will be undercorrected, overcorrected, or that it may return.
COMPLEX REGIONAL PAIN SYNDROME (CRPS): This is a rare, chronic pain syndrome that usually affects the extremities (arms/hands/legs/feet) and is characterized by intense burning or aching pain along with swelling, skin discoloration, altered skin temperature, and abnormal sweating. The nature of CRPS is not clearly understood. It may result from minor or major trauma including, but not limited to infection, fractures, sprains, and surgery. Early detection and treatment are required for optimal outcomes. This is a rare condition and there is no way of knowing who will develop it.
Article written by Dr. Corinne Gehegan
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