Correcting a Failed Bunion Repair

What is a failed bunion repair?

Most bunions can be treated without an operation, but sometimes surgical procedures are needed to relieve pain and deformity. Unfortunately, in some cases bunion repairs fail and the bunion returns. Bunions can recur because of medical conditions or non-healing of the bone. Sometimes bunions recur when patients do not follow post-operative instructions.

What is correction of a failed bunion repair?

The goal of correcting a failed bunion repair, using a procedure called revision surgery, is to relieve pain and deformity of the first toe remaining after failed surgery. Sometimes arthritis develops after bunion surgery. This may require a different procedure than the first. It is important to figure out why the first surgery failed to prevent another failure.

What signs indicate surgery may be needed?

Revision surgery is for those with deformity and pain after bunion surgery. The pain may be the same or different from the first surgery. Deformities of bones and joints and their various angles around the first toe will be examined.

When should I avoid surgery?

Revision bunion surgery is not advised with poor blood flow or certain nerve conditions. Bunions should not be revised if they are painless and do not cause problems. No bunion surgery should be performed to make the foot look better. Surgery is avoided if the patient is not able to follow the surgeon’s instructions after the procedure.

General Details of Procedure

Revision surgery may take a little longer to perform because it can be more complicated. Incisions are usually made around the first toe and by the arch of the foot. Keeping off the foot may be needed to have a successful result. Special instructions may include wrapping, protection with boots or braces, and limited activity.

Specific Techniques

There are numerous accepted methods of correcting a bunion. Some are treated with a bone cut of the first toe, while others require a fusion. Hardware in the form of plates and/or screws is often used to maintain corrections or hold fusions solid.

What happens after surgery?

Recovery will take at least as long as the first surgery. After surgery, you will be placed in a brace or shoe. You will have to avoid putting weight on the foot or only put weight on the heel for a period of time determined by your surgeon. Sutures are usually removed two weeks after surgery.

Potential Complications

There are complications that relate to surgery in general. These include risks associated with anesthesia, infection, damage to nerves and blood vessels, and bleeding or blood clots.

Revision surgery is challenging. There is a greater risk of complications. The bone may fail to heal or may heal in a less than optimal position. The nerves closest to incisions may be damaged, creating numbness, burning or pain. There is also a risk that another part of the foot will become irritated. Wound complications, infections, problems with blood flow and prolonged swelling are more likely. Hardware may become bothersome and require removal.

Frequently Asked Questions

My bunion has started to come back but it doesn’t bother me. Do I need surgery?
Generally, no. Bunion surgery is for deformity with pain. If you feel well despite the bunion, surgery is not indicated.
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