Protruding bumps post Bunionectomy

by Lisa
(Florida)

Hi. I am 6 days post Bunionectomy surgery. I had a bunion and tailors bunion removed on my left foot. My doctor did not put any pins to straighten my big toe. I had my initial post op visit to change the dressing. My foot has moderate swelling all over (which I know is normal) and I still see protrusion that looks like the bunions I had prior to the surgery and I am concerned about this. Is this normal and related to the swelling? Or have I experienced a failed procedure?

RESPONSE

Hi Lisa,

Success or failure of a bunion procedure is in the eyes of the beholder. It all depends on what your goals were prior to having this surgery.

If resolution of pain was your only concern, there is a very good chance that will happen even though there still appears to be a bump present.

If, on the other hand, your goal in surgery was strictly cosmetic then you may be in for some disappointment. I would suggest that if after six days, there is a protrusion of the bump, it is probably there for good.

Here is the rub. Your surgeon should have had a discussion with you prior to surgery as to what your expectations were.

Most people who have bunion surgery, do so strictly for the pain. In fact most foot surgeons, but not all, will only operate on a bunion if there is pain involved that has not resolved itself through other conservative means.

Cosmetic surgery for bunions is probably not a smart idea because of the high failure rate and the potential for the bunions to return.

So, in deciding what type of bunion procedure to perform your surgeon has to weigh a lot of factors and the most important factor is resolution of pain.

There are numerous bunion procedures that are performed to correct bunions and they are based on the severity of the bunion.

We as foot surgeons generally measure the angles of the bunion on x-ray to determine the proper procedure, the more severe the bunion, the more aggressive the procedure. Aggressive meaning the first metatarsal bone usually has to be broken and then re-set in order to straighten the toe.

So, for arguments sake, say your x-rays revealed a moderate to severe bunion deformity and a more aggressive procedure would have to be performed. Your surgeon would then discuss the procedure needed to be performed and you could then make a decision as to whether or not you want to go through with the surgery.

Keep in mind, that in many cases when a patient is told the sacrifice they are going to have to make for the next six to eight weeks, in many instances, patients will change their mind and avoid the surgery.

The converse is when a patient, at least by x-ray standards, should have a more involved procedure done but the surgeon, based on conversation with the patient on what the patient would like to achieve through surgery, decides that a simpler procedure might be enough to alleviate the pain although there may still be a bunion protruding.

Hopefully, your surgeon had this conversation with you. Because you have no pins and I assume no internal hardware like screws, staples or implanted pins, I would assume you had a simple bunionectomy performed on both sides of your foot.

Even though the foot does not appear like you would have expected, there is a good chance that after healing has occurred you may very well find that your foot is pain free.

Marc Mitnick DPM
DISCLAIMER