Recovery and associated risks: What to expect following keyhole bunion surgery

Written by: Mr Hisham Shalaby
Edited by: Sophie Kennedy

When preparing for any type of surgery, it’s essential to be aware of the potential risks associated with your procedure and what to expect from the recovery period to follow. Fortunately, thanks to modern, minimally invasive techniques, risks of complications are rare and for patients, the road to recovery is smoother than ever. We invited highly respected consultant orthopaedic surgeon Mr Hisham Shalaby to share his expertise in this informative guide on recovery from minimally invasive bunion surgery and the potential risks to be aware of.



How long is the recovery period after keyhole bunion surgery? What can I expect during the healing process?


The operation is done as a day case and after surgery, the foot is wrapped in a bandage which stays on for the first two weeks. You can expect to be fully weight-bearing straight away. Patients are given a Velcro shoe to accommodate the bandage as well as crutches if needed. At the two week mark, they attend the treatment room to have the sutures removed and at six weeks, they come again for a follow-up appointment and X-rays.


In the postoperative period, it's quite important to have the leg elevated because that reduces swelling considerably and helps a lot with recovery. Patients can gradually build up their walking distances from there, and activities like non-impact sports, such as swimming and cycling, can be introduced at the six week postoperative mark.


In terms of returning to work, this will very much depend on the type of work you do. If the patient works from home, they can be back to work as soon as just a couple of days after surgery. If the job is generally sedentary, patients can usually go back to work after two weeks but for a more physical job, six to eight weeks can be required before the bones start to heal.


Even with minimally invasive surgery, healing of the bone still takes time. Much like with open surgery, the bone becomes sticky after six weeks and solid at around 12 weeks. During that period, swelling can still come and go, so this is something that patients also need to take in to consideration.


Are there any potential risk or complications associated with minimally invasive bunion surgery?


Just like any operation, keyhole bunion surgery has its own risks, the most common being swelling. Swelling can last for a long period of time, coming on and off for a good while before ultimately fading away.


There is also a risk of infection, which usually happens as a superficial infection that demands some treatment with antibiotics. Another potential risk is wound healing problems. Sometimes the use of the burs in surgery can generate some heat, which can cause some focal burn or injury to the skin. This is a technical problem that should be avoided as much as possible by the surgeon but it’s important to be aware that wound healing problems can happen. They might require dressings on and off for a while until the wound is healed.


In addition, issues like haematoma formations or blood collections can happen when the patient dangles their foot down for long periods in the very initial postoperative stage. For this reason, we always advise that patients keep their foot elevated. There is also a small nerve that runs on the top of the big toe which can be injured or irritated. Usually, this irritation is caused by swelling and so once this subsides, the nerve typically recovers.


We also consider the level of the correction made during the procedures, and under correction and over correction are possible problems, as well as recurrence of the deformity. Bunions or deviation of the big toe can recur in around 5 per cent of patients, particularly if patients choose to wear shoes that can squish the toes together, such as stilettos. As such, patients should avoid these styles of shoes as much as possible.


Very rarely, the cuts that we make in the bone can fail to heal. This tends to happen in patients who are heavy smokers. Aside from these, any other risks are just the generic risks of any surgical procedure. Overall, all types of risks are far reduced in patients who are fit and healthy and particularly those who are non-smokers.



If you require bunion surgery and wish to discuss the available treatment options, visit Mr Hisham Shalaby's Top Doctors profile to schedule a consultation.

By Mr Hisham Shalaby
Orthopaedic surgery

Mr Hisham Shalaby is a respected consultant orthopaedic surgeon based in Edinburgh, who specialises in foot, ankle and limb reconstruction surgery. His expertise in this area covers arthroscopy and sports injuries alongside foot pain, ankle instability and deformity correction. He privately practises at Spire Murrayfield Hospital, Spire Shawfield Park Hospital and Nuffield Health's The Edinburgh Clinic. Furthermore, he is a consultant foot and ankle and limb reconstruction surgeon for NHS Lothian.

Mr Shalaby has an impressive education and has had esteemed training. He has an MBBS from Ain Shams University in Cairo, Egypt, and went on to develop his specialist skills at a major orthopaedic unit in the city as well as ones in Edinburgh and Liverpool. He also has an MD based on his thesis "Correction of Complex Foot & Ankle Deformities", completed an advanced deformity correction fellowship in Liverpool and a trauma fellowship in Nottingham. In addition, Mr Shalaby was awarded for his work done on the Amsterdam Ankle Arthroscopy course.

Mr Shalaby prides himself in mastering the full spectrum of foot and ankle pathologies, including the latest techniques including the Scarf/Akin osteotomies for bunion correction, ankle arthroscopy and endoscopic planter fascia release alongside ankle replacement, gradual correction of ankle and foot deformity, ankle joint distraction for early arthritis. He also has a special interest in correction of flat foot and pathological high arch.

Mr Shalaby is also an expert in all limb reconstruction tools including the Ilizarov frame, the Taylor Spatial frame and the Sheffield Hybrid fixator, alongside the Orthofix LRS monolateral fixators and Intramedullary lengthening nails.

He is a respected name in clinical academia; he has had various research papers published in peer-reviewed journals while he is also a reviewer for various international journals. Mr Shalaby is on the faculty of several foot and ankle and limb reconstruction courses around the world, conducted on an annual basis.

Mr Shalaby is also a member of various professional organisations including the Royal College of Surgeons of Edinburgh (FRCS Ed Tr & Orth), British Orthopaedic Association (BOA) and British Orthopaedic Foot & Ankle Society (BOFAS), as well as British Limb Reconstruction Society (BLRS), The World Orthopaedic Organisation (SICOT) and Association for Study & Application of Methods of Ilizarov (ASAMI International).

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