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Bunionectomy

Welcome

At Mater Health Services we understand that being in hospital can be a very stressful experience. This booklet aims to alleviate some of your concerns in keeping with our Mission to offer compassionate, quality care that promotes dignity while responding to patients’ needs. It explains briefly the events that may occur during your visit and the things to expect when you are discharged from the hospital.

It is, however, only a guideline as each person may require differing treatments.

If you have any questions about your treatment please ask your doctor or nurse.

Our pastoral care team offers a caring support network to all patients. The dedicated members of this team will visit you during your stay and are available at your request to discuss any anxieties or problems that you may have.

Bunionectomy

A bunion is a local painful swelling at the base of the big toe. Due to new bone formation, the joint has become enlarged, misaligning the toe. It is associated frequently with inflammation or degenerative joint disease.

The big toe may bend sideways overlapping the second toe causing it to curl up. Pain or discomfort may develop due to the pressure of a shoe. It might also be difficult to find shoes that fit due to the widening of the foot.

A bunionectomy is the surgical procedure where the lump on the joint is removed. Straightening of the toe may be done at the same time if needed.

Expected length of hospital stay

The day following your surgery you will be transferred anytime from 7 am to the Transit Lounge then discharged at the pre-arranged time.

After your operation

  • You will stay in the recovery room within the theatre suite after the operation while you waken from the anaesthetic. You will be transferred on your bed to your room in the Day Procedure Unit.
  • You will have a dressing over your wound. It may be necessary for you to have a drain in situ to remove excess fluid from the site of your operation.
  • Your nurse will take frequent observations of your vital signs (e.g. temperature, pulse, blood pressure) and wound (colour, warmth, sensation and pulses) for several hours after the surgery. As you become fully recovered, these become less frequent but remain regular until you leave hospital.
  • Immediately following your surgery, you will be resting in bed. When you feel well enough you will be assisted the first time you get out of bed.

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The following exercises help prevent complications suchas chest infections and blood clots in your legs. You should do these every hour that you are awake while resting in bed.

Breathing exercises: take five long and slow deep breaths. Each breath should be deeper than the previous breath. Think about getting the air to the very bottom of your lungs.

Circulation exercises: firmly move your ankles up and down to stretch and contract your calf muscles.

  • You will be instructed on how much weight-bearing you can do according to your doctor’s orders. Usually you will be able to walk with weight through your heel but only when wearing a surgical shoe. This will be provided to you.
  • About four hours after you return to the ward, your nurse will assist you to have a wash.
  • You may have small amounts of water or ice to suck, then progress from fluids to a normal diet as tolerated.
  • If you have pain or nausea, please tell your nurse as there are medications which can be given to relieve this. It is important to be comfortable.
  • The drip (IV) is necessary to maintain your fluid intake. This will be removed when you are tolerating adequate amounts of oral fluids.

In preparation of going home

  • Your nurse will discuss your follow-up appointment and any discharge arrangements that have been made with you.
  • Discharge information will be given to you and your nurse will discuss this with you. If you have any questions, please do not hesitate to ask.
  • A full assessment will be made prior to transferring you to the Transit Lounge in preparation for discharge to ascertain your condition is safe for you to go home.
  • You will be transferred to the Transit Lounge anytime from 7 am, the morning following your surgery. This is where you will wait for your transportation home. Those picking you up will find the Transit Lounge:
    • on the fourth floor of Mater Hospital Brisbane
    • just inside the ambulance entrance
    • opposite the waiting area for the Emergency Department
  • It is still recommended to perform deep breathing, coughing and leg exercises while you are resting in bed.
  • You will recommence your normal medications.
  • Please tell the nursing staff if you have any pain so that they may give you medication to help relieve it.

Discharge advice following bunionectomy

What to expect

Recovery from your bunionectomy takes place in the 23 Hour Unit as well as in your home.

  • Your foot will be protected in a brace, special shoe or a cast to help support the toe and foot. In the early weeks of recovery it is important to keep your foot raised above knee level to minimise the risk of bleeding, swelling, clots or stiffness.
  • Weight-bearing on your heel is normally allowed. Crutches are not usually needed. Excessive standing and walking should be avoided during the first six to eight weeks.

What you can do

  • Take your medication. Maintain your pain and anti-inflammatory medications as prescribed.
  • Eat well by maintaining a high-calorie, high-protein diet for optimal wound healing (fish, poultry, and lean meat, cottage cheese, tofu, yoghurt, protein-enriched whole grain cereals, lentils, milk). Include foods that provide calcium, phosphorous, iron and Vitamin C and D at 100% of recommended daily allowances (milk, mineral water, non-fat yoghurt, sardines, almonds, frozen yoghurt, oysters).
  • Weight bear as directed by your doctor. Take frequent rest period and elevate your foot.
  • Care for your wound. Observe for signs of redness, excess swelling or drainage; follow your doctor’s instructions regarding dressing and wound care. You will be wearing a special shoe, boot or cast for the six to eight week recovery period to provide stability to the foot and support the wound dressings.
  • Maintain personal hygiene while keeping your dressings dry (hint: place your foot in a plastic bag and tape this securely to your leg).
  • Expect post-operative swelling to last up to four to six months. This may affect the type of shoe that can be worn. Wear jogging shoes with a wide toe box or orthopaedic shoes.

What to avoid

  • Driving your car while your foot is immobilised in a cast or boot.
  • Wearing high heels and tight fitting or pointed shoes following the removal of your dressing.
  • Keeping on your feet for a prolonged period of time.

Contacts

Please contact either your General Practitioner (GP); the Mater Hospital Brisbane Procedure Unit on 07 3163 8496; or the Mater Hospital Brisbane Emergency Department on telephone 07 3163 8111, immediiately if you experience any of the following after discharge:

  • you develop fever and chills
  • you experience constant or increased pain at the surgical site
  • your toes are cool, swollen, have a change in colour or decrease in sensation
  • swelling is noticed in the calf above the operated foot
  • there is redness or a swelling of the wound
  • there is an increase in drainage or foul odour from the wound
  • the dressing becomes wet and falls off.

Safe use of crutches

Crutches are not usually required but if your surgeon recommends them the physiotherapist will instruct you on their use before you go home.

Standing

To stand, place your crutches forward and in a straight line leaning on your hands and your un-operated leg.

Walking

Non-weight bearing: with your crutches forward, lean on your hands and hop through, taking weight through your good leg.

Partial weight bearing: tour doctor will let you know when to start taking some weight through your operated leg and when to increase the weight gain.

Sitting

Move backward to the chair until it can be felt by your un-operated leg. Slide the crutches out and hold them in one hand. With your other hand, hold the arm of the chair with your other hand and gently sit. Place your operated leg on a stool when sitting to prevent swelling.

Stairs

Never vary this sequence when using the stairs.
Going up the stairs: un-operated leg—operated leg—crutches.
Going down the stairs: crutches—operated leg—un-operated leg.

Seek medical advice immediately if you develop pins and needles in your hands or fingers.

Remember, if your doctor wants you to use crutches he does so for a good reason—follow their advice strictly.

All crutches are the property of Mater Hospital Brisbane, Returning them promptly, when you no longer require them allows this service to continue for others.

Contact

Mater Hospital Brisbane

Raymond Terrace, South Brisbane Q 4101

Telephone: 07 3163 8111

South Brisbane campus

Acknowledgments

Staff of Mater Hospital Brisbane, Raymond Terrace, South Brisbane, Q 4101

© 2010 Mater Misericordiae Ltd. ACN 096 708 922

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-420009
Last modified 09/8/2017.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 11/8/2015
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