Forefoot

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

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: