post bunion surgery complications

by Donna
(Dunlap, TN)

Two weeks after surgery I am experiencing swelling. there is redness that started at the bottom joint of the big toe and is now a darker and larger area appearing to be approx 2 to 3 inches below that joint. I am experiencing warmth and tenderness along with this swelling. My search for types of infections etc. after bunion surgery have not been successful. It has gotten progressively worse in the last 12 hrs. I saw my Dr. about 12 hrs ago and she did not think it was an infection. Is this normal?

RESPONSE

Hi Donna,

Most of us would think infection this soon after surgery and I will assume your doctor knows an infection when she sees one.
So, if it is not an infection what else could be causing redness and swelling in the operative site.
I do not know what kind of bunion surgery you had as there are various procedures that we do and some but not all require the insertion of pins, screws and plates into the area. Additionally some people also have bunion implants. I do not know what you had done but for example, if you had an implant you could be having a reaction to the implant in which case it would have to be removed.
Although it is less likely that you are having a reaction to any screws or pins (metal or absorbable) that would also have to be ruled out as well.
Other things I would consider would be the possibility that if you had an osteotomy performed which is the surgical breaking and resetting of bone, that fractured bone may have separated and is causing your symptoms.
Another consideration would be the possibility that if you had a simple bunionectomy and your doctor wants you to start exercising the joint at an early stage then you may have just inflamed the joint and that may explain the redness and swelling.
More remote considerations might include and phlebitis of one of the superficial veins that travels in the area of the bunion. I do not think I have actually ever seen this but there is always the possibility and thus that would have to be ruled out as well.
Included as a final possibility would be a gout attack. I do not know your age, but gout generally occurs in post menopausal women so if you fit that category than that too would have to be ruled out.
Suffice it to say that redness and swelling two weeks after surgery, although not unheard of, is generally not a common finding. Most operated feet will be red and swollen initially after surgery and then by two weeks should be dramatically reduced but not necessarily totally gone. From your story, it sounds like the redness and swelling is a more recent manifestation.
Since this is not a common finding two weeks post-op I think your surgeon needs to come up with a reason and deal with it accordingly.

Marc Mitnick DPM
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