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Surgical Correction of Tailors Bunion Deformity
The surgical correction of a tailor's bunion deformity is closely related to the surgical correction of bunion deformity about the big toe.
A tailor's bunion is the enlargement of the outside of the foot just
behind the little toe. Behind each toe is a long bone in the foot.
These bones are called metatarsals and numbered one through five with
the fifth metatarsal being behind the little toe. A tailors bunion
exists when the fifth metatarsal or tissues surrounding the fifth
metatarsal are prominent on the outside of the foot causing irritation
in shoe gear or pain with walking. Surgical Correction Surgical
correction of a tailor's bunion is directed at reducing the prominence
surrounding the fifth metatarsal. This can be accomplished by a variety
of methods depending on the cause of the prominence. Soft tissue
enlargements such as a bursa, neuroma or ganglion
can be the cause and easily removed in a simple surgery. More commonly
this soft tissue enlargement is associated with an abnormality in the
fifth metatarsal bone. The fifth metatarsal bone
can be prominent when the end of the bone, called the head, is enlarged
near the base of the little toe. Surgical correction involves shaving
the enlarged portion of the bone. The fifth metatarsal bone can also be
prominent if it bows in the center. Similar to a bunion this is
corrected by either shaving off a portion of the metatarsal or creating
a surgical fracture and realigning the bone. In most instances the
patient is allowed to walk in a surgical shoe following surgery. In
extreme cases it may be necessary for the patient to use crutches for
up to 6 weeks before allowing full weight bearing on the foot. As with
nearly all foot surgeries, the patient is instructed to limit the
amount of walking and standing the first few weeks following surgery to
better ensure a good result. Typically the patient is instructed to
keep the foot elevated during the day when possible. Return to work can
be as short as one week and as long as six weeks depending on the
amount of walking and standing required. Because surgery does not
correct the cause of the deformity it is often recommened that
following the surgery the patient wear a functional foot orthotic.These devices can be worn in normal shoes and correct the underlying cause of the deformity. Anesthesia Most
often the surgery is performed in an outpatient surgery center or
hospital. Some surgeons may perform this surgery in their office.
Anesthesia for the surgery can be done under strict local anesthesia
where that portion of the foot is anesthetized similar to a tooth
during dental work. If performed in a hospital or surgery center the
local anesthesia is combined with intra-venous sedation to make the
patient drowsy. General anesthesia can also be used if preferred. Possible Complications Possible
complications associated with surgical correction may include:
infection, over or under-correction of the deformity, joint stiffness,
healing of the bone in the wrong position, delays in healing and non healing of the bone
and soft tissue. Following the surgeon's instructions carefully will
decrease the risk of complications. Keeping the dressings or cast dry
is also essential to prevent infection. Infections are most common in
the first three days following surgery, but can occur later in the
recovery period.
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