1.What is a bunion?
Bunion, commonly known as bigfoot, is a common disease of the foot, mainly characterized by deformity and pain. It is characterized by bunion, subluxation of the interphalangeal joint and medial formation of bunions, and difficulty in wearing shoes. After the root of the big toe (actually the first metatarsal) has shifted inward, it makes the area extremely elevated and easy to form friction with shoes, and over time, the skin and subcutaneous related tissues there thicken, become red and swollen, and bursae form, resulting in bunions.
2.Why do you get bunions?
(1) Genetic factors: About half of the patients have genetic factors. The occurrence of foot bunions is mainly caused by certain defects in the bones and ligaments that make up the foot.
(2) Prolonged standing and walking can aggravate ligament damage and contribute to the onset or accelerate the progression of the condition.
(3) often wear pointed shoes or high heels: pointed shoes are triangular in the front, forcing the front of the foot into a narrow triangular area, coupled with the upper for the leather is not flexible, the bunion is forced to turn out, the little toe is turned in. High-heeled shoes make the foot under increased pressure, and the ligaments at the joints are excessively stretched, resulting in bunions. In addition, patients with flat feet are more likely to develop bunions. When the bunion is severe, the second toe can be squeezed to the dorsal side by the bunion, forming a hammer finger.
3.What kind of bunion needs surgery?
Patients with severe bunion deformity, medial bunion formation, or combined interphalangeal joint subluxation, callus formation under the second and third metatarsal heads and hammertoe deformity, with significant pain and difficulty in wearing shoes, which affects daily work life, are recommended to undergo surgery.
4.What is small incision osteotomy and manipulation?
It is a new method of combining Chinese and Western medicine with small incisions and manipulation to treat bunions and other foot deformities, using a minimally invasive technique with local anesthesia and “8” bandages for external fixation. It establishes the advantages of small incision, less damage, less pain, no stitches, post-operative life can take care of itself, fast recovery, orthopedic satisfaction, no recurrence of deformity, no obvious complications, low cost, etc. It solves the problems of traditional surgery, and is also the best method for the treatment of painful corpus callosum (foot pad), painful corns, small toe deformity, heel pain and other foot diseases at present.
5.Does the surgery require hospitalization? How long do I have to be hospitalized?
Hospitalization is mandatory. Although our surgery is a small incision surgery with local anesthesia, you can walk on the ground immediately after the surgery, but because it is easy to bleed about 3 days after the surgery, in order to prevent wound infection, so you need to be hospitalized for one to two weeks to perform wound dressing change, infusion and anti-inflammatory treatment. Patients from overseas need to be hospitalized for more than three weeks due to the inconvenience of visiting the hospital after discharge.
6.Can older people have bunion surgery?
The surgery is a minimally invasive surgery with local anesthesia, which is less traumatic to the body, so it can be tolerated by people in general. Unless there is a combination of serious medical diseases, such as hypertension very high risk group, unstable blood pressure control; diabetes blood sugar fasting >15mmol/L, unstable drug control, etc.. Of course, the recovery of the elderly will be a little slower than that of the young.
7.Is there any recurrence after surgery?
There is a certain recurrence rate after surgery, about 0.3%, but it can be completely avoided as long as the surgery is systematically reviewed.
8.When is the right time for surgery?
Seasonally, spring and autumn are better, because it is fixed for six weeks, which is good for wound healing and air permeability of the foot skin. Of course, these are not absolute, now there is heating and air conditioning, as long as you keep the wound clean and dry, the impact will not be too great.
9.Can children have bunion surgery?
My experience is that it is best to have osteotomy after the age of 18, so that it is less likely to recur.
10.I have already seen the clinic and made an appointment, what should I do next?
There is a recovery process after the bunion surgery, so it is necessary to ask for leave from your office. You will be hospitalized for one week after the surgery, and you should try to control the amount of activity after discharge because the wound has not completely healed. Because it is bony correction, it should be fixed with bandage for 6 weeks, after removing the bandage, walking is no longer a problem, but it will take 3 months for the fracture to heal, and it will take half a year for the fracture to grow solid and run and jump. Therefore, you can decide to take time off work according to your work nature.
11.Do I need someone to accompany me during the hospitalization?
After the operation, you can go down to the floor, and you should be able to take care of yourself in basic life such as going to the toilet. However, you need to take pictures and change medicine after the operation, and excessive walking on the floor will aggravate the bleeding, so it is better to have someone to help you, we have 24-hour nurses in the hospital, if your family is not convenient, you can hire one.
12.What should I prepare if I am notified of the hospitalization time?
When you arrive at the hospital at the time of notification, you should not eat anything in the morning because blood tests will be taken. Remember to bring your medical insurance blue book, hospitalization certificate and outpatient film. Then, the doctor in charge will conduct a consultation, collect information, take gait measurements and sign a pre-operative interview. (Here is a reminder: there is a possibility that the doctor in charge will be in surgery and it may take a long time to complete all the tests, so the patient can go to dinner first after the blood is drawn.)
13.Do I have to be reviewed after bunion surgery?
It is necessary to review. Because it is flexible fixation, you must be changed by a professional doctor. This is very important, especially within one month, you need to instruct the patient to do functional exercises of the bunion joint and perform osteopathic manipulation for correction, etc.
14.What is the specific review time after bunion surgery?
A review is required 2 weeks, 4 weeks, 6 weeks, 3 months, 6 months and 12 months after bunion surgery. The first 4 reviews are especially important.
15.I can hear the bones ringing when I walk 4 weeks after surgery, is it okay?
It is normal for the bone to rattle because the bone scab is not completely connected, so don’t be afraid and try to move as little as possible, usually you can recover in 6 weeks~3 months.
16.6 weeks after surgery, the bandage has been removed, but the foot is still swollen, what should I do?
It may be too much activity, don’t worry, you can apply local medicine such as Furtaline, Qingpeng cream to activate blood and reduce swelling. You can also use warm water to soak your feet, remember not to use warm water too hot, otherwise the swelling will be more powerful, you can add some white vinegar to the water in the ratio of 5:1, the effect will be better.
17, two weeks after surgery, accidentally hit the big toe, what should I do?
If the pain is not obvious, it means that the osteotomy end has not moved, don’t worry, just review it regularly in the clinic.
18.What is the pain of walking with the big toe 5 weeks after surgery?
The pain on the surface of the foot 5 weeks after surgery may be due to the tendon and bruising, and it still needs time to recover, you can use some Furtalin soft gel for external use.
19.What about the callus under the metatarsal head of the second and third foot after surgery?
First of all, it is necessary to wear soft-soled shoes. If the callus is too serious, it may be a collapse of the metatarsal head, which can be solved by surgical elevation. If it is because of arthritis, it should be solved by treating arthritis.
20.How should I perform functional exercises after bunion surgery?
Functional exercise after surgery is very important. There are some exercises in my blog that you can practice against, at least 300 strokes a day, to the extent of mild pain.