Bunions can come in many shapes and sizes the more severe the bunion the more the big toe underlapping or overlapping the second toe which cause a hammer toe. With a extremely large bump which is the bunion itself I considered it severe, there are then many procedures for correction. For those bunions we use a closing wedge osteotomy which is cut at the base of the first metatarsal or a Lapiplasty which is a 3-D type correction. The enlargement of the bunion is always removed and the cut in the bone is fixated with special type screw or plates. Bunion correction and procedure that is necessary is determined x-ray finding and physical examination. We used patients complain and hereditary factors for additional understanding of their problems. There can be pain and swelling around the bunion this can be worse in patient that wear narrow shoe's which puts pressure on the bone and joint. Sometimes the area around the joint will can be a fluid-filled sac. Patient’s can try wearing wider shoes or shoe inserts which are a form of a custom made orthotic to relieve Patient's can also present with tailor's bunion, rheumatoid arthritis, bunionette, hammertoe and other symptoms.
When a patient comes into the office with a severe bunion deformity i physically examine the patient At that time we make a drawing on the patient's foot explaining to them the internal structure of the foot and the angle that has caused this severe bunion deformity between the first and second metatarsal. We then take an x-ray; we use digital x-rays and can print these on a piece of paper we review the procedure and write down questions a patient may have. We use also and instructional video that is animated explaining the procedure, so the patient thoroughly understands the procedure. Most severe bunion deformities are hereditary with foot and ankle problem contributing to the problem. They generally occur on both feet with one worse. When surgery is indicated, and we have thoroughly reviewed the procedure and post-surgical care. The surgery is set up through my office we work with your insurance for pre-certification. The surgery is done on an outpatient basis under a Twilight type sleep which is a form of sedation. You are breathing on your own, so it is not a general anesthetic. The foot is numbed when you're sedated so you do not feel the injection. The procedure is performed it takes approximately one hour. X-rays are taken before and after to show the correction and a copy is given to you. Most patients must stay off their foot with no weight bearing for a few weeks so using crutches or a small scooter is beneficial. The patient is given appropriate pain medication and any anti-nausea medication if the patient has had a problem in the past.
I will call the patient that evening to make sure they're doing well to review any instructions or questions with them. Thus, they will have my cell number so that if there are any questions or problems, they can contact me directly. Patients are recommended the stay off their foot an elevated to reduce swelling and inflammation. A patient will normally change their bandage a few days later. The sutures which are within the skin need to be removed within 10 to 14 days this type caused minimal scarring when removed.
The patient is seen within 10 to 14 days after surgery the patient is then given a Cam Walker to slowly start bearing some weight bearing on the foot. This process is slow, but you can slowly increase activities at this point. After surgery Orthotics which are custom-made arch supports are sometimes necessary the key factor with surgery for your bunion is range of motion of the joint so it does not become stiff, I will review this with you and if necessary will use physical therapy. If you have this problem, look forward to seeing you in the office to review treatment options. We have office's in Overland Park and North Kansas City off Barry rd.