The Surgeons Perspective

I first met Charlotte Chandler in clinic in February 2021. She had a classic bunion which is also called hallux valgus. She had had the lump removed in a procedure called a bunionectomy in London 7 years before but unfortunately the lump had come back as they often do with this procedure.

She was a good candidate for surgery in every respect except for one. She suffered from chronic lymphoedema in both legs as a complication of previous illness. Following foot and ankle surgery, and bunion operations in particular, swelling is a significant risk. This can result in pain, leaky wounds and if you are very unlucky infection.

Bunion Surgery

For this reason most foot and ankle surgeons are insistent on a period of elevation post op to reduce this risk. In my clinic we insist on elevation of the foot, higher than ones bottom, for 50 minutes of every hour for 2 weeks. Because of this the majority of patients do not need painkillers and our infection rate is as low as 1%.

I was concerned for Mrs Chandler as her feet were permanently swollen and she had had a previous operation. These are both factors that increase the risk of post -operative infection.

Bunion surgery can be performed with an open approach through long incisions or minimally invasively through several 3-4mm incisions. There aren’t many advantages to the minimally invasive approach. The bones get cut, moved and fixed into better positions with screws with both procedures but with a minimally invasive approach the chance of wound problems is reduced if the foot is very swollen.

She was a great candidate for a minimally invasive bunion operation which we performed at the Winterbourne Hospital at the end of March 2021.

By mid-May she was back in her normal footwear and progressing well. Following this type of surgery it always takes a minimum of 9-12 months to fully recover and lose all the minor irritating symptoms. Good examples of these minor symptoms are wound tenderness, mild swelling, cold intolerance of toes and minor aches and pains as the rest of your foot adjusts to being a new shape. With this in mind I am due her to see her for a final visit in the autumn.

Find out more about what I can do here.

The Patient’s Perspective

Having suffered from a very sore bunion for about three years I realised it was time for action. I was very worried about the procedure, recovery and healing process as following cancer treatment I suffer from chronic lymphoedema in my legs.

Nick Savva was very helpful and calm, he explained the procedure options, the risks and particularly in relation to post-operation healing and threat of infection. Nick decided that a standard bunion operation performed minimally invasively would be the most effective and safest.  Following the successful operation I did exactly as I was told to help the healing process and kept my foot up for 50 out of every 60 minutes for 3 weeks and then as much as possible for the following three weeks, which although tedious and frustrating, was worth it as the wound healed well and without infection.

My foot is now looking and feeling much more comfortable and I am very much looking forward to being able to wear glamorous shoes again!