Bunion surgery is typically performed in order to treat the pain and deformity that accompanies bunions. Bunions are bone spurs that develop over the inner aspect of the first metatarsal foot bone just before the joint of the great toe, and occur as a result of such factors as wearing footwear that is too narrow. Patients should be aware of the risks of this type of surgery.
Infection
Infection at a surgical site or incision is a risk factor for any surgery, not just bunion procedures. According to the Centers for Disease Control, or CDC, approximately 500,000 surgical site infections occur each year out of an estimated 27 million surgical procedures.
Bacteria can live on the human skin under normal circumstances, and are usually not a problem. When a break in the integrity of the skin occurs, these microorganisms take advantage of this opportunity to invade the body. Infections can cause longer hospital stays, tissue destruction and possible failure of the surgery.
Nerve Damage
A nerve--called the sensory branch of the first dorsal cutaneous nerve--passes along the medial, or inner, side of the foot along the first metatarsal foot bone and crosses the big toe joint as it travels to the toe. If proper care is not taken to identify and protect the nerve during bunion surgery, it can be severed, leading to persistent numbness along the inner portions of the great toe joint and the toe itself.
Stiff Toe Joint
Another potential danger of bunion surgery is the development of a potentially permanent stiffness involving the first metatarsal-phalangeal joint of the big toe. This joint is where bunions are traditionally located. Stiffness generally occurs as a result of the formation of scar tissue, as well as the soft tissue capsule that surrounds the joint becoming thickened. Other stiffness causes include prolonged immobilization of the toe after surgery.
Blood Clots / Deep Vein Thromboses
Deep vein thromboses, or DVTs, are blood clots that form within the deep veins of the lower extremities. While there are many reasons for these to form, surgery carries a definite risk level, especially with procedures that involve the legs and feet.
One major concern regarding DVTs is the potential for these clots to break away from their location and travel to the heart or lungs. When this happens, the patient develops what is known as a pulmonary embolism, or PE. Pulmonary emboli can be extremely serious and, although rarely, fatal.
Bunion Recurrence
Bunions can re-occur. One frequent reason for this is a return to wearing ill-fitting shoes. If the big toe joint is already arthritic, the chances for recurrence increase. If patients don't adhere to proper post-surgical activity restrictions, chances of recurrence can increase as well.
Over-correction
In an effort to obtain maximum correction of the angular deformity, there is a risk of too much correction. This results in a condition known as hallux varus, where the big toe now points toward the opposite foot instead of the opposite direction.
