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  • Why are bunion surgeries so different???

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    Old 12-01-2005, 11:04 AM   #1
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    Why are bunion surgeries so different???

    I see that some of you can't bear weight at all for a month or two and are in plaster casts. My doctor said I'll only be on crutches for a week or less and just wear a removable boot for 6 weeks. I'm having an Austin bunion surgery with screw.

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    Old 12-01-2005, 12:51 PM   #2
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    Re: Why are bunion surgeries so different???

    Hi Jennifer, I think it all depends on what type of bunionectomy you have done. I had Mitchell osteotomies done 3 months apart about 13 years ago. I had 3 days in the hospital for each (boy, how times have changed), the bone was cut completely and repositioned but I don't have any pins or screws. I had a splint (like a tongue depressor) with a bandage for a week and then a VERY short cast with walking boot for 4 weeks. I was never nwb. The first metatarsal now has arthritis in the joint but it doesn't bother me. The problem was that the first metatarsal ended up being too short. This surgery, I had the second metatarsal shortened. I think (according to my doc) that this osteotomy is normally done at the distal end (close to toes) of the 2nd met as the pain is NORMALLY under the ball area of foot. For some reason, I didn't have that. All of my pain was midfoot and the extra long met was causing problems with the tmt joint. So My doc did the incision at the proximal end (more at the midfoot although it looks 3-4 inches long) and cleaned up the joint and then shortened the 2nd met and put in a plate and 4 screws. They sure look huge on xray. Some people have this shortening done at the same time as a bunionectomy but it is usually at the other (distal) end of the bone. I think I read that when it is done at the distal end (it may be a weil osteotomy) some doctors will allow a surgical shoe. Since mine was more in the midfoot I have the 6 weeks nwb issue. I think the internet has an endless resource for types of bunionectomies and post op conditions.

    Last edited by sorefootsophie; 12-01-2005 at 12:54 PM.

    Old 12-01-2005, 03:45 PM   #3
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    Re: Why are bunion surgeries so different???

    I am also amazed at that same thing and questioned it on a previous post.

    I had a Chevron Bunionectomy on 9/16, had an absorbable screw and stitches and my Tailors bunion shaved. Was in a weight bearing air boot for 5 weeks and then sloooooooowly took the next week, to go between boot and shoe for so many hours. By week 7 I was in a larger size tennis shoe and began PT shortly after that. Just this week, number 10+, I was able to get into a size 7.5 tennis shoe w the insert removed. I am hoping in a few months maybe to be in my reg size 7.

    Recoveries are different as well. As are experiences with opposite feet. I only hope my LT foot surgery on 12/15 will go as well or better. Will let you know. He is planning the same surgery and plan.

    Old 12-02-2005, 11:35 AM   #4
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    Re: Why are bunion surgeries so different???

    It is interesting that there are so many bunionectomies. I just had mine 2 weeks ago. I was weightbearing from the beginning and given a wooden shoe. I had a Keller bunionectomy with no pins or screws. I have pins in 2nd and 3rd toe as they needed straightened. I told the doctor that I can't walk in the shoe and asked for a cam walker. Much easier to walk in that because it allows a more natural gait. I will never use a shoe again if/when I get my other foot done! I must admit that even though I was told I could bear weight from the beginning, it did take 4 days before I could step on it! I used crutches then. After that each day got a little better. Did anyone have dissolvable sutures instead of the ones that need to be removed after 2 weeks? Mine are dissolvable. I haven't seen my foot since my one week post op. I guess I'm in the same bandage till 12/27 when I go back to the doctors.

    Old 12-02-2005, 12:12 PM   #5
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    Re: Why are bunion surgeries so different???

    Part of it is because some are not "just" bunion surgeries (which are bad enough in themselves!) With my recent surgery, for example, it was not done primarily to remove bunion - my 1st metarsal had splayed out so much, and was shortened (from previous bunion surgery in 1980), along with a too-long 2nd metatarsal, so that my "big-toe joint" wasn't bearing the weight as it should have been - 2nd and 3rd metatarsals were bearing weight instead, causing painful stress fractures in 2nd metatarsal, as well as severe metatarsalgia throughout 2nd, 3rd, & 4th metatarsals. The bunion was big, but wasn't really causing much pain, and was not the primary reason for the surgery I just had... The foot had to be fixed mechanically so it would bear weight properly, and to do that, my pod had to cut and re-align both the first and 2nd metatarsals (shortened the 2nd one) and add pins to (hopefully!) keep everything in place so the 1st metatarsal will function as the weight-bearing joint/bone that it *should* be. My doc also had to additional straightening of the 1st metatarsal, with an additional pin, and shave off the bunion (comparatively the most minor part of my surgery), as well as remove some cartilage that was damaged by arthritis... SOOoooo... with lots of bones being cut, and more invasive stuff being done, there's more the foot to be need for non-weight bearing, so it can heal properly.

    When I had surgery at 19 and 20, it was bunionectomies with Chevron osteotomy, so the 1st metatarsal was cut then too, but in a less destructive way (can't think of a better word) and not moved nearly as much as this time, so I was able to be weight-bearing, with a walking-cast, by the end of the first week. I WISH it was that way this time too! Unfortunately, that surgery was not a permanent "fix" as the 1st metatarsal still splayed out again - 20 years later though, so it did work for a good long while.

    There are SOoo many different procedures, each for different problems (not all bunions are "simple bunions" - many have other, more complex problems going on as well), as well as different doctors, who all have their own way of doing things, and all have different recommendations for recovery (WB vs. NWB, how long - 2 wks. vs. 8 wks - pins removed or not, etc. etc. etc.) there ends up being all kinds of different recoveries.


    Old 12-03-2005, 05:43 PM   #6
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    Re: Why are bunion surgeries so different???

    Hi Everyone! I Had A Bunionectomy On My Left Foot On Sep 16, 2005 As I Posted On This Board Before I Never Had Any Pain Or Swelling And I Went Into A Wedge Show Two Weeks After Surgery Than One Week After That I Went Into A Flat Surgical Shoe And A Week And A Half I Went Into My Nb Motion Control Rollbar Athletic Shoes With The Orthodic With No Problems . After Reading The Posts On The Board I Feel Very Fortunate That I Had No Significant Problems With The Surgery. I Even Spent Yesterday In New York City Going To Radio City For The Show And Walked For One And A Half Hours In Nyc With No Problems With My Left Foot. I Had A Great Surgeon Who Is A Podiatrist And I Feel Very Fortunate That My Surgery Went So Well. I Have A Slight Scar But I Dont Mind It. I Will Not Have Surgery On My Right Foot (which Is Not As Bad As The Left One Was) Until It Actually Hurst Which It Doesnt!!!! As I Know Now What Complications May Delelope. Good Luck To You All!!!

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