Hallux Vagus Deformity

Bunion (also referred to as a Hallux Valgus )
- More common in women
- 70% of pts with hallux valgus have family history
- Risk factors
- – Intrinsic
- – Genetic predisposition
- – Extrinsic
- – Shoes with high heel and narrow toe box
- – Indications
- – When PAIN present despite shoe modification
- – Do not perform for cosmetic reasons alone
- – Intrinsic
Surgical Procedures:

Chevron Osteotomy:
open technique to correct minor deformities. Removable pin inserted.

MICA Chevron Osteotomy:
minimally invasive technique for larger deformities.

Lapidus Fusion:
open technique for moderate to severe deformities with joint instability or flatfoot deformity
Hallux Valgus Correction
Post Operative Instructions
Cast:
- Lapidus: You will have a plaster cast on your ankle and foot for 2 weeks following surgery
- – At 2 weeks you will be placed in an aircast
- – At 6 weeks, you will wean off the boot and begin walking in a regular shoe
- MICA/Chevron: A bunion shoe will be worn from 0 to 6 weeks
- – At 6weeks you will be weaned into a regular shoe
Wound:
- The surgical incision has been closed with sutures
- *IF a pin has been placed, this will be removed at your 4 weeks appointment
- Do not get the cast or wound wet for the first two weeks. When showering place a bag over the cast and secure with tape to your leg to avoid the cast and wound getting wet
- Do not remove the dressing until your 2 week appointment – the first dressing change will occur at your 2 week appointment
- Stitches will be removed at your 2 week appointment
- After the stitches are removed, you may begin to shower after 2-3 days
- Do not immerse the foot in water (bath, hot tub, pool) for 4 weeks
- Do not apply any lotions or creams on the wound for 6 weeks
Weight Bearing:
- You may walk on your heel only for the first 6 weeks while in a walking boot/or bunion shoe . You will be given crutches/walker if needed
- After 6 weeks you may begin fully walking on the foot
Medications:
- You will be given a prescription for pain medication and Aspirin (blood thinner)
- Pain medication should be used regularly for the first 24-48 hours, when required for the first 1 to 2 weeks, followed by Regular Tylenol
- Aspirin should be taken for 14 days (unless you have an allergy to aspirin)
Driving:
- For right foot surgery you are not permitted to drive until you have completely weaned off the aircast or bunion shoe
- For left foot surgery, please contact your insurance company to see if you are permitted to drive
- Driving is not permitted while on narcotics
Work:
- Two weeks off work is recommended for initial recovery
- If you are able to get to work safely, and will be seated for the majority of the day, you may return to work a couple days after surgery. This is assuming you are not taking narcotic pain mediation.
- From 2-6 weeks sedentary duties is recommended
- By 6 weeks you can slowly return to your normal duties
- If your job is physically demanding, return to full duties is usually possible around 8 weeks post operatively
Follow Up:
- You will have your first appointment 2 weeks after surgery in the Fracture Clinic
- Your next appointments will be at 6 weeks, 3 months then 6 months post operatively
Recovery:
- It is normal to experience mild to moderate pain, numbness, or tingling for the first 2 weeks following surgery
- Please come to the emergency department if you are suffering from severe pain
- You will get back to most of your activities by 3 months
- Swelling often remains for 6-12 months
- You are expected to experience a FULL recovery (no pain, no swelling, ability to walk, etc.) in 9-12 months
Physiotherapy:
- Physiotherapy can begin at 6 weeks post operatively(Physiotherapy protocol)