The Chevron bunionectomy is a procedure commonly performed in cases of a mild to moderate bunion deformity. An incision is made over the big toe joint and soft-tissue is released, and the bump of bone from the side of the first metatarsal head is removed. Once this is completed, an osteotomy (bone cut) is performed through the first metatarsal that will allow shifting the bone and realigning the joint. A pin or screw is used to hold the cut bone in the corrected position while it heals. Any sharp points are then removed to avoid future irritation and provide smooth motion of the joint.
Post-operative care consists of rest, elevation and ice for the first 3-5 days. Some walking may be done in a special shoe or walking brace after the procedure. A check-up is performed in the office and the bandage is changed. Often patients will return to work after 3-7 days, depending on the requirements of the job. Skin usually heals in two weeks and at this time the stitches are removed. Bone takes 6-8 weeks to heal. Taking x-rays at regular intervals will assess the healing progress of the bone. Any bunion surgery results in some stiffness. Physical therapy starts at the second or third week to minimize this stiffness, usually home exercises are sufficient. If these exercises are not performed, a poor result may occur due to excessive stiffness. The swelling gradually decreases and at two months, providing sufficient healing of the bone has occurred, regular shoes may be worn. Regular activities can often be resumed at two to three months as tolerated. Some swelling may be present for six months or more. The recovery period varies according to procedure and each individual’s rate of healing. Some factors such as circulation, smoking, bone quality and general health can also have an effect. Bunion surgery does not always correct the cause of the deformity. Orthotics may be advised after the surgery to correct the abnormal motion that caused the deformity in the first place, and to decrease the likelihood of recurrence.
Complications of bunion surgery are not common, but include infection of soft tissue and/or bone, slow healing of skin or bone, irritation from fixation pins or screws, nerve entrapment, reaction to the foreign material (suture material, pins or screws), excessive swelling, excessive scarring, excessive stiffness (some stiffness is unavoidable), over-correction (hallux varus) and recurrence of the deformity. Rarely, some complications may require a second surgery to correct the problem. While these complications are rare, they should be weighed against the difficulty that you are experiencing to determine whether surgery is an acceptable risk for your condition. This is an important part of the process.