Post-Surgery Instructions to follow after SURGERY TO CORRECT HALLUX VALGUS (BUNION)/METATARSALGIA
The “percutaneous correction of acquired defects of the forefoot” is considered “Mini-Invasive”, since the corrections of the bone segments are carried out with small, cutaneous (keyhole) incisions, through which surgical instruments are inserted to improve foot movement. To allow the bone heads to be moved and repositioned, corrective surgery can involve opening the joints, bone section or other surgical procedures. For this reason, the foot will require some time to settle and heal after surgery.
PAIN
The operation is carried out under local anaesthetic, the effect of which usually lasts for some time. Your foot may remain “asleep” for several hours and therefore you will have no pain. This state can last for more than a day and the day after the operation, the patient may still continue to feel a sensation of numbness and heaviness in the limb.
Approximately 30% of our patients do not need to take any analgesic drugs. However, if you do suffer any pain caused by the operation, just take paracetamol (e.g. TACHIPIRINA, EFFERALGAN in Italy, or other analgesics available to the patient) following a dosage of 1000 mg (1 gr) every 6 hours, 4 times a day. In some cases, it might be necessary to take an anti-inflammatory (Ibuprofen, Naproxen, etc). For any doubts or problems, we recommend consulting your own GP or our team. It is important to remember you should never exceed the recommended doses of analgesic drugs. However, it is also wrong to wait too long before taking them, particularly when the pain is very bad, or to take them in insufficient doses.
Ice can also be of help due to its analgesic and anti-oedematigenous effects and should be applied for approximately 20 minutes each time and never in direct contact with the skin.
Lying down with your leg raised helps reduce discomfort.
BANDAGING
Following surgery, the specific medication must be kept dry and must not be changed in any way until the first post-operational check-up, which will be fixed on a case by case basis, and the date will be indicated in your discharge document.
BLEEDING
Despite “Mini-Invasive” surgery, your foot could bleed and your bandaging might become soiled. However, this is not at all serious, and actually occurs quite frequently. It is not a problem so there is absolutely nothing to worry about. Our advice is to lie down and keep the leg slightly raised for at least 1 hour. The bleeding will stop quickly and spontaneously, especially if you sit, or lie down with your foot raised and ideally with a bag of ice on your foot.
DARK TOES OR BLISTERS
There is no need to worry if your toes darken. They will regain their normal colour within a few weeks after the operation. If blisters form (phlyctens), just cover them with some gauze without bursting them, and they will reabsorb by themselves.
SWELLING
It is normal for the foot to swell. If the operation was complex and involved several toes, the swelling will be greater and will last longer, even several months. In order to reduce the swelling, sit, or lie down with your leg raised and move your foot up and down for a few minutes.
CLICKING
In the first few days after surgery, it is absolutely normal to hear clicking caused by the surgical fractures.
CONVALESCENCE
The period of convalescence varies from person to person (from one to six months) depending on the complexity of the operation and the number of fractures. Some months might pass before your foot takes on its definitive shape, even though you will be able to walk immediately. During this period of time, you will be able to move and walk by placing your operated foot (wearing the orthopaedic footwear suggested) on the ground. However, you must always take care not to tire or overload your foot. If this should happen, you will need to rest it, by lying down and taking care to raise your foot.
Many patients instinctively tend to protect the foot, which has been operated, by shifting their weight, while walking, on to the external edge of the foot. This can cause swelling and pain in the foot, the ankle and, as a chain effect, problems which can extend to the knee, hip and lumbar region. The limb, which was not operated, can also suffer from this altered distribution of the load. It is, therefore, very important to make an effort to walk, right from the start, by placing weight on the whole foot, pending the removal of the bandaging at your first check-up. You will then be able to wear a more comfortable shoe, which will allow the recovery of the normal rhythm of steps (heel and toe).
PRACTICAL ADVICE:
- On leaving the operating theatre, you will have to remain lying down and rest for at least 30 minutes, before sitting up on the bed;
- If there are no noticeable problems (dizziness or other problems), you can put on the orthopaedic shoe and take your first few steps (before you stand up, always call for a nurse to help you) gradually increasing the amount you walk in the hours following your operation;
- In the following days, you need to take care not to spend too long standing or sitting, to prevent the foot from swelling excessively.
- Be careful not to get your bandage wet;
- For any doubts, we recommend you speak to your GP or the team which carried out your operation.