Osteotomy and Ligament or Tendon Repair (Bunion Surgery)
Osteotomy and ligament or tendon repair is a type of bunion surgery. A bunion is a bony bump (growth) at the base of your big toe. This growth can form when your big toe pushes against your next toe. A bunion can cause pain, swelling, redness, and other symptoms. During this surgery, bone is removed from your toe. Nearby tendons and ligaments are made shorter or longer as needed. This allows your big toe to line up (align) properly.
Preparing for surgery
Follow any instructions from your healthcare provider.
Tell your surgeon about any medicines you are taking. You may need to stop taking all or some of these before the procedure. This includes:
All prescription medicines
Over-the-counter medicines, such as aspirin or ibuprofen
Herbs, vitamins, and other supplements
Follow any directions you are given for not eating or drinking before surgery.
The day of surgery
The surgery takes about 60 minutes. You will likely go home the same day.
Before the surgery begins
An IV (intravenous) line is put into a vein in your arm or hand. This line gives you fluids and medicines.
You may be given medicine to help you relax (sedation). To keep you free of pain during the surgery, you may have medicine to block the nerves in your foot. Or, you will be given general anesthesia. This puts you into a deep sleep.
During the surgery
A cut (incision) is made on your foot to expose the bunion bump, and the tendons and ligaments around it. The tendons and ligaments that are tight are cut (released).
The bunion bump is removed with a bone saw. Your big toe bone or the main bone in your foot is shortened and realigned. A pin, screw, or plate (or a combination of these) is used to hold your toe and foot bones together.
The nearby tendons and ligaments may be tightened. If there is extra tissue, it is removed and the ends are stitched (sutured) together. The incision in your skin is then closed with sutures. Your foot is bandaged.
After the surgery
You’ll be taken to a recovery room. You may have medicines to manage pain. You may wear a brace, surgical shoe, or cast to protect your foot while it heals. The surgeon will tell you when you can go home. Have an adult family member or friend drive you.
Recovering at home
Once home, follow any instructions you are given. During your recovery:
You may go home with bandages holding your toe in the corrected position. Keeping the toe in this corrected position is critical for proper healing. Do not disturb the dressing unless the surgeon tells you to do so. Follow your healthcare provider's instructions about caring for the bandage.
Take pain medicine exactly as directed.
To prevent swelling, sit or lie with your leg raised on one or more pillows. Do this for the first 2 days.
Follow your surgeon's instructions about putting weight on your foot after the surgery. You may need to use a walker, cane, or crutches for a time.
You may wear a brace, surgical shoe, or cast for up to a month or longer. Care for this as instructed. Keep it dry by wrapping it in plastic bags when bathing.
Avoid sports and other activities until your surgeon says it’s OK.
Care for your incision as instructed.
Don't drive until your surgeon says it’s OK.
Call your surgeon if you have any of the following:
Chest pain or trouble breathing
Fever of 100.4°F (38°C) or higher, or as directed by your surgeon
Pain that isn’t helped by medicine or rest
Increased swelling not helped by raising or icing your foot
Signs of infection at any incision site, such as increased redness or swelling, warmth, more pain, or bad-smelling drainage
Bleeding through the bandages
Symptoms of poor circulation, such as toes that look blue or pale instead of pinkish
Numbness that doesn’t go away
Any other signs or symptoms indicated by your surgeon
Keep all follow-up appointments with your surgeon. These are to check that you are healing well from the surgery. You may have X-rays to check how the bone is healing. Physical therapy, foot exercises, and other treatments may be discussed at follow-up visits. Full recovery can take up to 6 months. Follow-up visits to your healthcare provider are sometimes necessary for a year.
Risks and possible complications include:
Sensitivity at the incision site for months after the surgery
Foot pain that doesn’t go away after surgery
Numbness in the foot
Only partial relief of symptoms, or no relief of symptoms
Return of the bunion
Risks of anesthesia (the anesthesiologist will discuss these with you)
Poor wound healing
Breakage of screws or pins
A lot of scarring
December 24, 2017
Hallux valgus deformity (bunion). UpToDate
Fraser, Marianne, MSN, RN,Joseph, Thomas N., MD