The Austin bunionectomy is one of the most common bunion correction procedures which we routinely perform at The Foot & Ankle Institute. A bunion patient has a first metatarsal which is pointing inward and creating a bump on the inner part of the foot, just proximal to the big toe. The problem is the first metatarsal is deviating inward (medially) and hence the big toe (hallux) is pointing outward (laterally). Depending on the severity of the deformity, sometimes the hallux will overlap or under lap the second toe. Bunion pain is different for everyone, but it likely includes discomfort at the "bump", big toe pain, achiness of the arch and generalized discomfort of the smaller toes.
We will perform your surgery at a hospital or surgi-center and, depending on your health and age; you may be required to have preoperative blood work and testing. Generally the surgery is performed on an outpatient basis, meaning you will be able to go home the same day as your surgery. An anesthesiologist will meet with you before your surgery and review your health history to determine the best method of anesthesia for your particular case. Many times they will decide to use MAC anesthesia for this type surgery. This is a mild sedative which allows us to inject the local anesthetic into the surgical site without you feeling pain. Only after we have determined the area to be anesthetized (numb) will we begin surgery.
Through a skin incision on the top of the big toe joint, we will make two cuts into the first metatarsal which allows us to reposition the bump closer to the rest of the metatarsals. When the "bump" is moved laterally (towards the little toe), the hallux will move medially and the bunion deformity is corrected. Generally we will hold the cut bone together with screws or pins, but sometimes this will vary depending on surgeon preference and bone density (hardness). The rest of the remaining bump will be shaved off so that the shape of the foot is anatomical and no longer has a protrusion of bone. The soft tissue and skin will be closed with sutures and a soft dressing is applied to the foot before you are taken to the recovery room.
In the recovery room you will be given a surgical shoe to wear on the foot during your convalescence and sometimes crutches are dispensed to help keep weight off of the foot during your recovery. Sutures are usually removed two weeks after surgery and this is followed by a gradual return to wearing a soft sneaker or shoe. Depending on the severity of your deformity and the amount of surgical correction needed, physical therapy may be prescribed as part of your recovery.