28296 Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with distal metatarsal osteotomy, any method

Name of the Procedure:

Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with distal metatarsal osteotomy

Summary

This surgical procedure, commonly known as a bunionectomy, involves correcting a bunion (hallux valgus) by realigning the toe joint and removing part of the bone (osteotomy) to improve foot function and relieve pain. If necessary, the surgeon may also remove the sesamoid bones (sesamoidectomy).

Purpose

The procedure addresses hallux valgus, a deformity causing the big toe to angle towards the other toes, forming a bunion. The goals are to alleviate pain, improve toe alignment, and enhance foot function.

Indications

• Persistent pain and inflammation in the big toe joint unresponsive to conservative treatments.
• Severe deformity of the big toe impacting daily activities.
• Chronic shoe discomfort due to the bunion.
• No relief from non-surgical treatments like orthotics, medication, or physical therapy.

Preparation

• Fasting for 6-8 hours prior to surgery.
• Discontinuing certain medications as advised by the surgeon.
• Pre-operative diagnostic tests like X-rays to assess the extent of the deformity.
• Arranging for someone to drive the patient home post-surgery.

Procedure Description

1. The patient is given anesthesia, usually general or regional.
2. An incision is made over the bunion.
3. The bunion (excess bone) is removed.
4. An osteotomy is performed, cutting and realigning the metatarsal bone.
5. Sesamoids are removed if necessary.
6. The bones are fixed in their new position using screws, pins, or plates.
7. The incision is closed with sutures and dressed.

Duration

The procedure typically takes 1-2 hours.

Setting

Performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologist

Risks and Complications

• Infection at the surgical site.
• Blood clots.
• Nerve damage leading to numbness or tingling.
• Recurrence of bunion.
• Delayed bone healing or nonunion.

Benefits

• Significant reduction in foot pain.
• Improved alignment and function of the big toe.
• Enhanced ability to wear shoes comfortably.
• Better overall foot appearance.

Recovery

• Keeping the foot elevated and applying ice to reduce swelling.
• Pain management with prescribed medications.
• Gradually bearing weight on the affected foot, based on the surgeon's advice.
• Wearing a surgical boot for several weeks.
• Physical therapy if recommended.
• Follow-up appointments to monitor healing.
• Full recovery typically takes 6-12 weeks.

Alternatives

• Non-surgical treatments such as orthotic devices, anti-inflammatory medications, and physical therapy.
• Pros: Non-invasive, minimal recovery time.
• Cons: May not provide lasting relief or correct severe deformities.

Patient Experience

• Patients may feel groggy and experience mild pain post-surgery, manageable with medication.
• Swelling and limited mobility initially.
• Gradual improvement in pain and function over several weeks.