bunion returned 3 months after chevron osteotomy

by amanda
(lebanon ohio)

i had/have bunions on both feet. the right was much more severe than the left...my big toe was starting to cross under my 2nd toe. i had a chevron osteotomy with distal soft tissue something or other in september. there was a pin between the big toe and the 2nd toe holding the bones in place during healing and i was in a darco boot that kept me from putting pressure on the forefoot. after i was recovered, my foot looked great other than some bruising and slight swelling that just wanted to hang on. my toe was nice and straight. it was a little stiff, but nothing too bad. i am very flexible everywhere, so the reduction in range of motion just made my toe move like normal people. 3 months later my toe has started to drift back over and he protrusion seems to have gotten bigger and my toes pops more now. whenever i move my big toe out to stretch it, the joint pops. after i was allowed to wear shoes again i got a pair of very wide, flat comfy plush lined boots that felt like houseshoes and put no pressure on my healing foot. i have worn those everyday since. did i do something wrong, did the surgeon not do a good job or am i just cursed to have old lady feet in my 30's? i know bunion surgery sometimes has to be repeated, but only 3 months later? i thought years.

RESPONSE

Hi Amanda,

You are right, bunions should not return after three months, particularly procedures where an osteotomy (surgical breaking and re-aligning of bone) has been performed.

If you followed your surgeon's advice from day one until the time he told you to go about your business and resume your life, then whatever problems you are having are probably not your fault.

If I could see an x-ray, I probably could be more helpful in advising you, as the x-ray will tell a better "story" of what is going on here.

You mention that the big toe is moving back towards the second toe. I have to say, in most bunion procedures the big toe does drift somewhat closer to the second toe over time, but if your big toe is back under the second toe, or approaching that position then there is a problem.

I would also be curious to know if there is any pain associated with your corrected foot, besides the popping.

One could make the argument that if you are not having pain and the big toe has only drifted a small amount and is not back under the second toe, then the procedure should be considered a success.

If, however, the big toe has moved back a great deal and there is pain, then there is a problem. At seven months post op, it is not uncommon to still have some discomfort, but if your foot really hurts especially in dressier shoes, then you have issues.

Here is your dilemma and I cannot be of much help without seeing x-rays. Because of the amount of time that passed before the toe started to drift back, I would guess there is no problem with the actual osteotomy. If the osteotomy failed you would probably be having a lot of pain (and the toe would be drifting back).

Instead of me sitting here trying to guess what is going on, my best suggestion would be to get a second opinion from a surgeon in your area. You need someone involved who can give an unbiased opinion of what is going on and many times you will not get an honest opinion from your original surgeon.

If it ends up that the osteotomy is fine and there is minimal to no pain, then I would suggest you live with what you have. You may require surgery years down the road, simply because you are so young, but the one thing you do not want to get involved with is surgery after surgery, because in spite of what you might be told, multiple surgeries in the same area have a higher propensity for failure due to the normal scarring that occurs after each surgery.

Marc Mitnick DPM