A
bunion is the deformation of the big toe joint (joint between
the proximal phalanx of the first toe and the head of the
first metatarsal). It is generally caused by faulty mechanics
related to flattening of the transverse arch of the foot.
Constant pressure leads to development of chronic bursitis
at the inner-lateral joint surface resulting in thickening
of the wall of the bursa. Periodic exacerbation of the inflammation
leads to an increase of the already present pain.
Treatment options
There are a number of surgical solutions to the problem.We perform removal of
the bursa with the thickened wall and partial resection of the head of the
first metatarsal (Schede surgery) at our clinic. This method is the least demanding
on the patient, and even though it does not correct the joint's deformation,
speaking from years of experience, we feel it is the ideal solution to stop
the pain.
One day surgery
"One day surgery" means,
that patients can leave the outpatient center on their
own feet, accompanied by a helper, within 24
hours of
surgery (usually after few hours of observation), and
continue the healing process in the familiar confines
of their own home. "One day surgery" requires
strict professional, social, and various other preconditions
that are discussed at the stage of the consultation when
the need for surgery becomes clear. (I.e.: good general
health, absence of serious systemic disease, patient
must take responsibility for arrangement of transportation,
home care, must have phone to contact the clinic or the
surgeon if necessary, etc).
Preparation for surgery
Surgery is always preceded
by evaluation of the orthopedic surgeon. Next the patient
is informed whether one day surgery is feasible from
a surgical standpoint. It is at this point that the patient
is acquainted with the concept of one day surgery. It
is also here, that the patient is informed about laboratory
and other accessory studies (Imaging, ECG, medical exam
etc.) that might be required for surgery, options for
anesthesia, possible complications, home care-related
issues, stages of recuperation, i.e. all the information
that is relevant for the patient to make a decision on
which treatment method, or surgery to choose.
Bunion surgery
On the day of the surgery,
the patient signs the consent form, then the necessary
lab tests are done and the surgery fee is paid. Immediately
before the operation, the patient is premedicated with
an injection containing analgesic and sedatives. The
operation may be performed under local, spinal
or general anesthesia. The majority of our surgeries are performed
with local anesthesia, which means infiltration of the
surgical field with 1% Lidocain.
During surgery, we make
a longitudinal arced incision around the deformity.
Then the chronically inflamed subcutaneous bursa is completely
removed. The capsule of the big toe joint is opened
parallel
to the incision on the skin and the bony outgrowth
on the inner surface of the metatarsal head is removed.
After hemostasis, the joint capsule is closed with
absorbable
sutures. We use cosmetic sutures to close the skin.
Possible complications
No doctor can guarantee
a complication-free surgery. Complications can arise
even following the most carefully performed procedures.
Possible early complications: post-operative bleeding
and inflammation, are easily treatable. If you experience
even the slightest indication of complications (for example,
bleeding or fever), you can contact your surgeon day
or night, who will take the necessary steps to remedy
any of the complications.
Post-surgery care
The surgery is commonly
followed by 6-8 hours of observation,
during which time the vital functions stabilize (blood
pressure, urine
output), the sedative effects of the premedications wear
off, and patients are able to leave the center on their
own feet, with the help of an assistant. Once at home,
rest is recommended during the first few days with analgesics
taken as needed for pain. The patient's ability to walk
is not affected in general just temporarily limited by
pain. Sutures are removed at the one week follow-up.
Complete recovery takes about four weeks.
Fees
Charge for examination and consultation:
10.000 HUF > Euro
Surgery using local
anesthesia: 150.000 - 170.000 HUF > Euro
Charge for general anesthesia: 80.000 HUF > Euro
Charge for overnight stay: 30.000 HUF > Euro
50% of the total cost has to be paid as a deposit before
surgery.
These prices are only representative, the final amount
will also depend on the severity of the condition.
Appointments:
Monday-Friday, 8 am - 8 pm.
Telephone: + (36 1) 266-7766
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