戴着拇外翻辅助夹板的妇女
戴着拇外翻辅助夹板的妇女
戴着拇外翻辅助夹板的妇女

Bunion Surgery

What is bunion surgery?

Bunion surgery is done to reduce the pain and correct the deformity caused by a bunion. A bunion (hallux valgus) is a deformity of the bone or tissue around the joint at the base of the big toe or at the base of the little toe. The one at the small toe is called a "bunionette" or "tailor's bunion.“拇囊炎通常在关节长时间受压时形成. 大多数拇外翻形成于女性, 主要是因为女性可能更倾向于穿紧身衣服, pointed, and confining shoes. 拇囊炎可能作为一种家族特征遗传. 拇囊炎也可能由关节炎引起. 这通常会影响大脚趾关节.

Your healthcare provider may first advise wearing comfortable, well-fitting footwear. This means shoes that conform to the shape of your foot and don't put pressure on any areas. 他们也可能建议使用夹板和矫形器. 这是为你的脚定做的特殊鞋垫. 这些可以重新定位大脚趾并提供填充物. For bunions caused by arthritis, medicines may help reduce pain and swelling.

If these treatments don’t help, your healthcare provider may advise surgery. 这通常能解决问题. The goal of surgery is to relieve pain and correct as much deformity as possible. 这个手术不是整容手术. 这并不是为了改善脚的外观.

手术的类型取决于以下因素:

  • 拇外翻的严重程度

  • Your age

  • Your general health

  • Your activity level

  • 骨骼和结缔组织的状况

选择手术的其他因素包括:

  • Mild bunion. For this type of surgery, the surgeon may remove the enlarged portion of bone. They may realign the muscles, tendons, and ligaments around the joint.

  • Moderate bunion. The surgeon may cut the bone and shift it to its correct position. 这取决于畸形的严重程度和位置. The tendons and ligaments around the area may also need to be repositioned.

  • Severe bunion. 手术可以切除增大的部分骨, cut and realign the bone, 矫正肌腱和韧带的位置.

  • 关节炎性拇外翻或大脚趾关节. 患关节炎时,关节可能受损无法修复. 在这种情况下,它可能需要融合. 这让骨头一起愈合. 它停止运动和疼痛. In some cases, joint replacement implants may be used to rebuild the big toe joint.

为什么我可能需要拇外翻手术?

如果你有以下任何一种情况,你可能需要进行拇外翻手术:

  • Severe foot pain even when walking or wearing flat, comfortable shoes

  • Chronic big toe inflammation and swelling not helped with rest or medicines

  • Toe deformity

  • 大脚趾向小脚趾弯曲

  • 无法弯曲和伸直大脚趾

Your healthcare provider may have other reasons to advise bunion surgery.

拇外翻手术有哪些风险?

All surgery has risks. 这种手术的风险包括:

  • Stiffness

  • Numbness

  • Swelling

  • Delayed healing

  • Infection

其他并发症可能包括:

  • The bunion comes back

  • Nerve damage

  • Continued pain

  • The big toe extends away from the other toes (called overcorrection)

There may be other risks. 这取决于你的健康状况. Discuss any concerns with your healthcare provider before the procedure.

如何为拇外翻手术做准备?

  • 您的医疗保健提供者将向您解释手术过程. 问一下你对手术过程有什么问题.

  • 你将被要求签署一份同意书. 这是你做手术的许可. Read the form carefully and ask questions if something is not clear.

  • 您的医疗保健提供者将询问您的健康史. 他们会给你做全面的身体检查. This is to make sure that you are in good health before having the procedure. 你可能要做血液检查或其他检查.

  • Tell your healthcare provider if you are sensitive to or are allergic to any medicines. This includes latex, tape, and anesthetic agents (local and general).

  • 告诉你的医疗保健提供者所有的药物, vitamins, 还有你正在服用的草药补充剂. 这包括处方药和非处方药.

  • Tell your healthcare provider if you have a history of bleeding disorders. Tell them if you are taking any anticoagulant (blood-thinning) medicines, aspirin, 或者其他影响血液凝固的药物. 你可能需要在手术前停用这些药物.

  • If you are pregnant or think you could be, tell your healthcare provider.

  • Follow any directions you are given for not eating or drinking before the procedure.

  • 在手术前你可能会服用镇静剂. This is to help you relax. Because it may make you drowsy, you will need to plan to have someone to drive you home.

  • Based on your medical condition, your healthcare provider may ask for other specific preparation.

拇外翻手术会发生什么?

拇囊炎手术可以在门诊进行. 这意味着你当天就可以回家. 在极少数情况下,你可能会在医院过夜. Procedures may vary depending on your condition and your healthcare provider’s practices.

大多数拇外翻手术是在踝关节阻滞麻醉下进行的. 这意味着你的脚是麻木的,但你是清醒的. 在某些情况下,使用全身麻醉或脊髓麻醉.

拇囊炎手术通常遵循这个过程:

  1. You will be asked to remove clothing and will be given a medical gown to wear.

  2. 可以在你的手臂或手上进行静脉注射.

  3. The skin over the bunion will be cleansed with an antiseptic solution.

  4. If a local anesthetic is used, you will feel a needle stick when the anesthetic is injected. 这可能会引起短暂的刺痛感. If general anesthesia is used, you will be put to sleep using IV medicine.

  5. The surgeon will cut, realign, 可能还会取出部分骨头, ligaments, and tendons of the affected foot based on the severity of the bunion.

  6. The surgeon will close the opening with stitches and apply a sterile bandage or dressing.

拇外翻手术后会发生什么?

手术后,你将被带到恢复室. Your recovery process will vary depending on the type of anesthesia you had. 脚部的血液流动和感觉将被记录下来. Once your blood pressure, pulse, 呼吸稳定,你也很清醒, 你将被送往医院病房或出院回家.

Your healthcare provider will give you specific instructions for caring for your foot at home during the first few weeks after surgery. You may be discharged from the hospital wearing a special surgical shoe or cast to protect your foot.

一旦你回到家,你就需要休息. Keep your foot raised (elevated) as much as possible for the first few days after surgery and apply ice as recommended by your healthcare provider. 这有助于减轻疼痛和肿胀. 不要直接在皮肤上敷冰. 用薄毛巾把冰块包起来,防止皮肤受伤.

这取决于你做的手术类型, you may be advised to limit walking and limit the amount of and weight you put on your foot. 您可能会被建议使用辅助设备, such as crutches, a cane, 手术后的助行器或助行器.

保持敷料的清洁和干燥是很重要的. 按照医疗保健提供者的指示洗澡. You may be advised to cover the dressing with a plastic bag or plastic wrap and tape it with plastic tape when showering. Or take a sponge bath. 缝线将在随访中拆除. 这通常安排在手术后2周.

Take a pain reliever for soreness as advised by your healthcare provider. Aspirin or certain other pain medicines may increase the chance of bleeding. 一定要只服用批准的药物. 你的医生也可能会给你开抗生素. 这是为了防止手术后感染.

如果你有以下任何一种情况,告诉你的医疗保健提供者:

  • Fever of 100.4°F(38°C)或更高,或按照您的医疗保健提供者的指示

  • Chills

  • Redness, swelling, bleeding, or other fluid leaking from the incision site

  • 切口周围疼痛加剧

  • 患足小腿肿胀

Your healthcare provider will advise you about safe activities after surgery. Your foot may need ongoing support from dressings or a brace for 6 to 8 weeks or longer after surgery. Driving may be restricted for a period of time after surgery until your bones are healed. 尤其是手术是在你的右脚上做的.

Exercises or physical therapy may be advised to help your foot recover its strength and range of motion after surgery. 在你的医疗保健提供者批准之前,不要穿高跟鞋. They may recommend that you never return to wearing high-heeled shoes. 

Your healthcare provider may give you additional or alternate instructions after the procedure.

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