Question
Dear Dr. Katz,
I hope you can offer me some advice. I had bunion surgery (simple procedure just shaving the bony protrusion) 14 weeks ago, and am still having problems. There is a protrusion at the site of the bunion that is at least as large (although not the same shape) as before surgery. My physiotherapist says the bone may still be inflamed. However, it hasn't changed at all in the last 8 weeks, so I wonder if it is likely to reduce any more. Also, there is a protrusion of bone on the top of the foot where there was none before. Could this be a bone splinter that was caused by the shaving of nearby bone? I think there may be nerve entrapment at this point too - it is very painful to touch, and it sends a stinging/pins-and-needles sensation down my toe. I am also getting a burning pain on the top of my big toe (which I think may be nerve damage?), and there is still pain at the joint too.
If you could offer any advice, I would be very grateful. What can be done for the nerve pain and the bone splinter? Would I need additional surgery to repair these? Also, although I did not get the surgery for cosmetic reasons, I'm disappointed that the shape of my foot is no better. Is it unreasonable to expect it to be straighter (the bunion was pretty small to begin with)?
I see my orthopaedic surgeon again in 3 weeks, but would like to know what I should be asking him, as the pressures on the National Health Service here in the UK means that I will only get a few minutes of his time, and am not confident of getting the answers I want.
Thanks for your time.
Anna

Answer
Hi Anna,

Hopefully you had pain prior to your surgery.  In my practice I tell patients that no surgery is done unless there is significant pain.  Simple shaving of the bone is not typically a long-term solution to bunion correction.  Unfortunately following a bunion procedure you may have prolonged swelling and pain for many months.  

When the proper bunion procedure is performed, you should have a straighter toe and minimal to no bump.

In some cases, the nerve can be damaged or surrounded by scar tissue and this can cause burning and pain unless it is treated.  

I would talk to your surgeon about this and if the answers and not satisfactory, I would get another opinion.

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com


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