Keyhole bunion surgery is offered by Orthopaedics SA as a minimally invasive alternative to open bunion surgery.
The traditional open technique involves an incision about 4-5cm long on the inside of the foot and another about 2cm long between the big and second toes. Through these incisions, an orthopaedic surgeon uses specialised tools to shave off part of the bunion and realign the bones of the big toe.
After the bones are cut, they are held in their new position with bone screws and the surgical incision is closed with stitches. A dressing is then applied to protect the site.
What anaesthetic is used?
Open bunion surgery can be done under local anaesthetic (ankle block) with sedation if required, thereby eliminating the need for full anaesthetic and giving excellent post op pain relief. Alternatively a general anaesthetic can be used in which case a local ankle block is usually used for post-operative pain relief.
Following open bunion surgery, most patients remain in hospital overnight and return home the next morning. Walking unaided is allowed the next day using a special sandal.
Rest and elevation are required for the first 2-3 weeks following open bunion surgery and the foot will remain splinted or bandaged for a total of 6 weeks. The specialised sandal will also be used for walking during this time.
Sensible shoes with a wide toe box and low heel must be worn from six weeks onwards to prevent aggravation by rubbing on the surgery site and promote comfort and healing.
Recovery times
As long as aftercare instructions are followed thoroughly, most people can return to sedentary work following open bunion surgery in 2-3 weeks, however a recovery period of 6 weeks or longer may be recommended for patients who do physical work. Your surgeon will discuss individual recovery times with you before your surgery.
After the surgery, it generally takes 3-6 months for the swelling to go down, and around 12 months for everything to completely settle down.
Rehabilitation
Following open bunion surgery, your orthopaedic surgeon will recommend a variety of exercises to help strengthen the muscles in your foot and to help reduce blood pooling in the calf muscle. These may be different for individual patients and your surgeon will let you know what exercises to do and how often to do them.
Bunion surgery usually reduces pain, especially pain caused by footwear, increasing a patient’s overall comfort and shoe selection. Most open bunion surgery is very successful, but as with any surgery, issues can occur. Your orthopaedic surgeon will explain the full risks of your bunion surgery to you before the procedure.
Specific issues that may sometimes occur include:
· Under correction – the big toe may not be straightened enough, requiring further surgery.
· Over correction – the big toe may appear ‘too straight’.
· Arthritis – this can develop following the correction procedure and lead to pain and stiffness of the big toe.
· Prominence of implant and/or bone – this may require removal with further surgery.
Very occasionally, a patient may have issues that make them feel worse than they did prior to the open bunion correction surgery, and further surgery may be needed. This may include a repeat bunion surgery, further corrective measures or fusion of the joints in the big toe (in severe cases).
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