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Two weeks post op after bunion and hammer toe surgery

by Karen
(Canada)

After the above surgery I returned to see the Dr. two weeks post op. I was told by the Dr. not to remove the dressing.

When I went in and had the dressing removed they found my big toe had gone black.
They stated the dressing had been too tight and the big toe was strangled. The big toe was removed to the first joint.
I am devestated and angry. Does this normally happen?
I feel like I should be suing.
I live in Canada.
Thanking you in advance.
My foot is dressed so i cannot take pictures at this time.

RESPONSE

Hi Karen,

I am terribly sorry to hear about your situation. In answer to your question, this is not a normal complication of foot surgery.
Correction of an abnormally aligned bunion or hammertoe in the vast majority of cases is an elective procedure, meaning it is not a life or even a limb threatening condition. Many people live normal functional lives having a bunion and hammertoe and never have surgery. The only time the argument could be had that this is not an elective procedure is when there is either trauma to the toes or there is a severe infection that threatens the overall health of the individual. In these types of cases there is no choice but to operate on the toes but in general the surgery is usually an amputation.
I will assume therefore, that your surgery was an elective procedure. You were having pain in the bunion joint and with the hammertoe. You tried various types of shoes and did not seem to get sufficient relief, so you decided to go ahead with the surgery.
With elective surgery of this nature, the patients are usually in very good health. You would not do these procedures in people with compromised circulation such as uncontrolled diabetics, long time smokers, or elderly patients who may have circulation issues.
So, once again I am assuming you do not fall into this category.
Without the luxury of actually examining you, I would have to assume for something like this to happen you either have very poor circulation, in which case you should have never had the surgery, or the dressing was wrapped so tight it was like a tourniquet around your toe. If you had the dressing wrapped that tight, I would have thought you would have complained to the surgeon that the dressing was very uncomfortable. The only exception here would be if you suffer from some type of neuropathy which prevents you from actually feeling your feet.
Typically right after surgery, the foot swells, which is normal, this can make the dressing feel tighter than it should. But within a couple of days some of the swelling subsides and in most cases will actually loosen the dressing somewhat.
I have no idea what the standard of care is in Canada, but we never leave dressings on for two weeks. The main reason is to check the wound for possible infection. I generally change the dressings on my patients 2-3 days after surgery but it is not uncommon to leave the dressing on for a week.
I cannot tell you if you have been wronged by your doctor as there may be extenuating circumstances that I am not aware of.

Marc Mitnick DPM
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