The Austin Bunionectomy is a common procedure done to correct a bunion deformity. The first step of this procedure is to remove the “bump” or excessive bone from the side of the first metatarsal head. The next step is to perform a “V-shaped” cut, called an osteotomy, through the metatarsal head to re position the bone. The head of the metatarsal is shifted toward the second toe, thereby reducing the bunion deformity and straightening the big toe. The V-shaped cut adds a level of stability to help support healing. Because the bone is cut and re positioned, it is necessary to fixate the osteotomy. There are various forms of internal fixation available, but today most foot surgeons prefer to use stainless steel screws. The screws are typically left in the bone permanently unless they become painful or cause irritation. Bunion surgery is typically performed at the hospital under a twilight or general anesthesia.
What to expect with your surgery
The day of the surgery
Your podiatric surgeon will visit with you and answer any additional questions you may have prior to your surgery. You will also meet with the anesthesiologist to discuss what type of anesthesia you will have for the surgery. A nurse will typically start an IV, so the anesthesiologist can administer any necessary medication during the procedure. If this is the only procedure being done on your foot, the surgery takes approximately 1 hour. Your doctor will numb your foot before and/or after the surgery and will give you a prescription for a pain-relieving medication. You will also be given detailed instructions on how to care for your foot.
Most of the pain and inflammation from the surgery will be during week 1. It is very important to wear your surgical shoe at all times and to elevate and rest your foot as much as possible. You will leave your bandages on your foot and you should not get your foot wet. When you return to the office for your first appointment, your doctor will take x-rays and change the dressing. Sutures are not typically taken out at this point.
There is usually less pain and inflammation during this week. You will continue to wear your surgical shoe and keep your foot dry. Activity may generally be increased slightly depending on how much inflammation is present. At the second week appointment, your doctor will usually take out your sutures and you will likely be able to get your foot wet again.
You will continue to wear an ace wrap, a foam spacer (between your first and second toes) and a surgical shoe during this time. Activity can usually be increased slightly to tolerance.
Your doctor will usually take an x-ray at this time to ensure that the bone is healing normally. If things are progressing as expected, many people may get back into a walking shoe at week 4. Bone healing will continue throughout the next month.
Week 8 and longer
Most of the bone healing is usually done at week 8. Your body will continue to “remodel” the bone where the osteotomy was performed. Although the majority of patients may begin to get back to their regular activities at this point, some may have swelling and/or pain that may persist longer. Activity should be increased as tolerated.