Surgery, in general, is a risk that the patient and the doctor take on when considering treatment of your foot problem. At Advanced Podiatry, we avoid surgery unless it is completely necessary. We do this by employing conservative techniques and non-invasive procedures that have a proven record of healing foot problems. In some cases, surgery is absolutely. Unfortunately, complications can arise when undergoing any type of surgery, no matter how minor the procedure. This educational article will focus on the most common complications of a bunion correction procedure.
The first complication to be considered is infection. Any break in the skin can lead to an infection. During foot surgery, the doctor will typically order an antibiotic to prevent any infection before the start of the surgery. The operating room is sterile and the doctors and nurses all wear sterile gowns/masks to prevent any infections from occurring. The most common type of bacteria to infect the foot is staph aureus. This bacteria can cause skin infections which, if left untreated, can penetrate and cause a bone infection.
The infection of bone (osteomyelitis) can be treated with antibiotics but may require stronger IV antibiotics to penetrate to the bone. The IV medication is prescribed for six weeks and then follow up imaging studies (MRI or X-ray) will be ordered to determine if the infection is gone. If the infection does not go away after treatment with IV antibiotics, then surgical removal of the infected bone may be necessary. This type of infection can be serious but the likelihood of it occurring after the procedure is very low. Less than 5% of patients will suffer from this type of complication.
Another complication that can occur is under correction of the bunion, meaning the bunion is still present, but to a lesser degree. The surgeon will do his/her best to fix the deformity but sometimes the “fix” is not enough. In some cases, the anatomy of the patient may not allow for a more drastic correction. In addition, the patient could have boney issues that do not allow for full correction of the problem. In some cases, even if the doctor performs the procedure and everything is straight, the great toe can start to drift back to its deformed state. This can happen because during the healing process it is difficult to keep weight off of the surgical site. Patient’s will often say after surgery that they “had to walk” on their feet in order to fix their lunch or perform different activities of daily life. The problem is that if the bunion correction is being held together by a pin/screw, then there is a risk of the bone moving since the cut bone may not be completely healed.
A bunion can also reoccur if the deforming forces of the foot are not corrected. A pair of custom orthotics are dispensed with every bunion correction we perform because the surgeon knows that if we do not correct the underlying problem that caused the bunion initially, then a bunion may reoccur in a short amount of time. Proper shoe gear and custom orthotics help to slow down the progression of a bunion deformity by holding the foot in its proper position. The more the toe is strained by deforming forces the higher the likelihood of bunion formation.
Finally pain, swelling, and numbness can occur after a bunion surgery. The body is trying to heal itself and pain/swelling it a natural part of that process. Pain is inevitable since the bones are being cut or shaven. Swelling is the body’s way of sending nutrients down to the site of “injury” so that healing can begin. Too much pain and too much swelling can be very uncomfortable and that is why we urge our patients to “be nice to their foot” after surgery. The more the patient ices and elevates their limb the better they will feel. Walking around after bunion surgery will only cause more pain and grief. There can be a lot of inflammation in the area after bunion surgery and this results in compression of the surrounding nerves. This compressed nerve can present itself with either shooting pains or numbness to the inside of the foot. All of these complications are common but also will resolve with time. Swelling, pain, and numbness can last up to a year and that is why we employ RICE (rest, ice, compression, elevation) immediately after surgery.
If you or a loved one are undergoing surgical repair of a bunion know that there are complications. The complications are low in frequency but they can happen. It is important to fully understand the risks of surgery before undergoing any procedure. Please take the time to write down any questions about your upcoming surgery and present them to your surgeon. At Advanced Podiatry, we educate our patients to the highest level regarding their foot problem. Remember, the patient makes the ultimate decision in whether or not to undergo any invasive procedure. Please feel free to call us with any questions you may have. 813-875-0555.