Pain after Bunionectomy on April 4, 2008

by Patty Mercurio
(Rome, New York, USA)

I have been having persistant pain in the ball of foot for well over a year when I had surgery on April 4, 2008. I had an Austin/Akin procedure with a shortening of the 2nd metatarsal. When the podiatrist went in to do the surgery he shaved the bunion and there was a cystic area not found on the x-ray. He had to put a staple in the bone that was larger than normally put in the foot. I am still having pain dispite going to physical therapy for 2 months and wearing prescription orthotics that the podiatrist made for me after all the swelling in the foot was gone. I went to another doctor for a 2nd opinion. The first words out of his mouth when he looked at the x-rays were "you have to go back to the operating room, this is not good." He said the staple was reducing my range of motion and I should have the hardware removed as soon as possible if I was to obtain optimal range of motion. I am having the hardware removed (all but the screw in the big toe for the Austin) on October 10. Please give me your opinion of all this. I am worried that the wrong procedure was chosen and that is the reason for the pain and not the hardware. I am only 48 and was VERY active prior to this and this pain is ruining my life! Plus, I have foot number 2 to worry about! I have heredity bunions from my mother. Please help!

Hi Patty,
Not to pass the buck, but unless I could actually examine you I do not know if I can offer you specific advice. I would actually have to see where the hardware is sitting, see if the head of the metatarsal bone is positioned correctly, palpate where your exact pain is, etc. etc.
I think a third opinion is necessary based on your obvious concern.
If the third doctor agrees with the second then you will have some comfort in knowing you are probably making the correct decision.
It would seem to me, in broad terms, that if you have orthotics and have had physical therapy and are still having pain, then some sort of invasive procedure will be necessary.
Good luck.
Marc Mitnick DPM