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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