Recovery with The Sklar Bunionectomy®

So you just had the Sklar Bunionectomy®, what happens next?

Day 0: Immediate Post Sklar Bunionectomy®

Day 0

After our patients have bunion surgery in our state of the art surgical suite, our patients can expect to walk out of surgery pain free in a surgical shoe to their ride home.  When at home a patient can expect to be independent, and are not required to have someone at home with them.  Most patients should sit with their surgical foot elevated for most of the day, but they can get up to make a snack, go to the restroom, or do other small household activities.  

Week 1: Post Sklar Bunionectomy®

Week 1 

Our patients typically begin to experience some pain about 24 hours after having surgery.  We send our patients home with a pain pill, which should make them feel comfortable during that time.  While they are on the pain pill driving is not permitted, however they still can move about as needed.  The pain usually subsides in about three days, and as soon as they come off their pain pill we allow them to drive to their desk jobs.  

Week 2-3

In between two and three weeks we evaluate a patient’s incision to see if their sutures may be removed.  Once we remove the sutures then they may get their foot wet in a shower, and start to wear a recommended gym shoe.  Patients are still to avoid aerobic activity.  Patients at this point usually start to turn a corner in regards to how their foot feels.  Lots of our patients tell us that they are having minimal pain at this point, but their foot is still swollen and may have some nerve sensations like tingling or burning.  

Week 6: Post Sklar Bunionectomy®

Weeks 6-9

Depending on the severity of a patient’s bunion and how they are healing we may allow an increase in activity during this time.  Most patients are able to start with an elliptical or bicycle as soon as 6 weeks.  At 8-9 weeks we typically allow patients to resume their normal activity, like jogging, exercise classes, walking long distances, and dress shoes.  

Week 16: Post Sklar Bunionectomy®

Weeks 12-16

This is another time where our patients seem to tell us that they are turning another corner.  The exercise activities they may have started a few weeks ago have become more normal feeling and comfortable.  Swelling and numbness starts to subside, and strength begins to return to the toes and foot.  Full healing takes six to eighteen months, so from this point on patients will continue to experience improvements to their feet.  We post our best “after” photos usually 6 months to 1 year after surgery, so we don’t expect a full cosmetic result until that point.  

Before and After: The Sklar Bunionectomy®

For additional information or to see how the Doctors at Foot First can drastically transform the look and feel of your feet, check out our before and afters at www.FootFirst.com or on Instagram @FootFirstPod.

The Sklar Bunionectomy® vs. Minimal Incision Bunionectomy

We frequently get asked in our practice, “What is the difference between minimally invasive surgery, and minimal incision surgery?”  Though the two names sound very similar, they are two very different ways to perform bunion surgery.   

Procedure Descriptions

Minimally invasive bunion surgery refers to our procedure, The Sklar Bunionectomy® that is performed at the first metatarsal-phalangeal joint where the bunion deformity takes place. A small hidden incision that measures approximately 3-4cm on the side of the bunion and close to the bottom of the foot is made.  We cut the bone at the head of the first metatarsal, in an area that heals consistently and predictably.  Another cut is made in the proximal phalanx.  The cuts are made using a thin blade with an oscillating saw.  We use two to three screws to fixate this procedure. This is called minimally invasive, because it is much different than traditional bunion surgery that creates long visible scars on top of the foot and potentially excessive hardware.  These long dorsal scars are not only ugly, but can also cause problematic adhesions and scar tissue.

Minimally Incision surgery (MIS) refers to a completely different procedure, in itself.  Small punctures are made around the bunion area so a small burr can be inserted.  The burr is used to break the bone just behind the first metatarsal head.  The number of incisions made and the number of screws used depends on the surgeon and their preference.  The amount of bone that is removed or shifted is determined by intraoperative X-Rays.  

What does this mean to me?

Because we make a small incision instead of punctures, we are able to visualize how we can correct the bunion.  We can accurately see how much bone we are removing, and how much we are shifting the bone into position.  We can see exactly where we are placing the screws, and where exactly all the important soft tissues are so we can avoid and protect them.  Because we can protect the tissues from the saw, our patients have a lot less swelling than the typical minimal incision patient.  Also, because we use a bone saw instead of a burr, we typically have significantly less shortening of the first metatarsal.  With less shortening you get less instances of an elevated big toe that doesn’t touch the ground.

Recovery

With our Sklar Bunionectomy® the recovery is much more manageable.  Our patients are able to step on their feet immediately after surgery.  In fact, our patients walk out of surgery safely to their respective rides to take them home.  They are to be bandaged in a surgical shoe for approximately two weeks, then they are able to wear a tennis shoe comfortably.  We do limit our patient’s walking, however most are able to return to a desk job within about three days.  We also do not restrict driving even if surgery is performed on the right foot.   Return to full activity can be as soon as 8 weeks. 

Although MIS surgery sounds like it would be an easy recovery because of the small incisions, the reality is that MIS relies greatly on bandaging and reduced activity to provide its result.  Depending on the surgeon crutches may be required, however most patients are also able to walk in a surgical shoe.  However, generally patients with MIS are required to have bandaging, or wear a surgical shoe for 6 weeks, and a return to full activity may not be until at least 3-4 months. 

Cosmetic Result

Fixing Feet Beautifully™ is our motto at Foot First because we pride ourselves with not only how our Sklar Bunionectomy® functions, but also how beautiful it leaves a foot.  There is a remarkable difference with how a foot that has healed from an MIS bunionectomy versus with the Sklar Bunionectomy®.  

With the Sklar Bunionectomy® our small scars are hidden to the side of the foot where they cannot be seen.  There is also minimal to no shortening of the big toe to make it look disproportionate to the other digits.  This means that after a patient has recovered from surgery their foot appears as if it had never needed surgery in the first place: naturally beautiful. 

MIS surgery has a less consistent result because the surgeon has less control over what is happening internally by not making an incision.  This can leave the cosmesis to be somewhat abnormal looking, and not the naturally beautiful result a patient can hope for.  This can mean the toe sits elevated, it can be too straight or not straight enough.  Sometimes it can even appear twisted.  

Both the Sklar Bunionectomy® and MIS procedures can undoubtedly offer good results when correcting a bunion, however the journey to the end result is drastically different, as well as the consistency in appearance and functionality.  We at Foot First always recommend patients to read reviews, and ask for before and after pictures when choosing their surgeon and procedure.  To us the obvious choice is always the Sklar Bunionectomy® .

The Sklar Bunionectomy® vs Lapidus Type Procedures

A common question we get here at Foot First Podiatry is what is the difference between the Sklar Bunionectomy® and Lapidus type bunion procedures? 

There are three major differences between these two procedures: the cut in the bone, the cosmetic appearance, and the recovery.

Bone Cut

Lapidus type bunion surgeries typically are performed at the first metatarsal-cuneiform joint, and involves fusing this joint so it no longer moves ever again.  This is done at the base of the first metatarsal closer to the top of the arch of your foot, not near the area of the bunion.  The cut in the bone is usually fixated with screws and plates.  The screws and plates used can be very expensive depending on the system the doctor chooses.  Because this type of procedure fuses a joint it typically requires removal of bone, which in turn shortens the big toe in comparison to the lesser toes.  There are also certain risks that a Lapidus type procedure exposes a patient to, such as higher risk of delayed or nonunion (the bones may not heal together), or elevated positioning of the 1st metatarsal.

The Sklar Bunionectomy®  is a minimally invasive surgery performed at the first metatarsal-phalangeal joint where the bunion deformity takes place.  We use two to three screws to fixate this procedure.  Typically there is much less metal placed in a patients’ body than that is used with Lapidus type procedure.  The cuts in the bone are placed in areas that heal consistently and predictably.

Recovery

The biggest difference between the two procedures is recovery time.  With a Lapidus type bunion surgery most patients are required to be bandaged and in a boot for 4-8 weeks after surgery.  In addition to that, there is a high possibility of not walking and using crutches during this time.  If surgery is performed on the right foot driving is prohibited.  

With our Sklar Bunionectomy® the recovery is much more manageable.  Our patients are able to step on their feet immediately after surgery.  In fact, our patients walk out of surgery safely to their respective rides to take them home.  They are to be bandaged in a surgical shoe for approximately two weeks, then they are able to get into a tennis shoe.  We do limit our patient’s walking, however most are able to return to a desk job within about three days.  We also do not restrict driving even if surgery is performed on the right foot.   

Cosmetic Appearance

Fixing Feet Beautifully™ is our motto at Foot First Podiatry because we pride ourselves with not only how our Sklar Bunionectomy® functions, but also how beautiful it leaves a foot.  There is a remarkable difference with how a foot that has healed from a Lapidus type bunionectomy has healed than with the Sklar Bunionectomy®.  This is mostly due to the scarring that is left after surgery.

With the Sklar Bunionectomy® our small scars are hidden to the side of the foot where they cannot be seen.  There is also minimal to no shortening of the big toe to make it look disproportionate to the other digits.  This means that after a patient has recovered from surgery their foot appears as if it had never needed surgery in the first place: naturally beautiful.  

With Lapidus type procedures there are typically one very long scar or multiple scars on top of the foot.  Scars on top of the foot are not only unsightly, but can also create problematic scar tissue that can affect the end functional result of surgery as well.  And also as stated above, there can be remarkable shortening of the big toe, causing an awkward looking appearance after surgery.

Below are two examples of Lapidus type surgical results: 

Lapidus Type Scarring

Following that image of the two examples of Lapidus Type surgical results are comparisons of patients who have had the Sklar Bunionectomy® on one foot, and a Lapidus type procedure on the other:

The Sklar Bunionectomy vs Lapidus Type Surgical Results

The Sklar Bunionectomy vs Lapidus Type Surgical Results

Both the Sklar Bunionectomy® and Lapidus type procedures can offer good results when correcting a bunion, however the journey to the end result is drastically different, as well as the appearance.  We at Foot First always recommend patients to read reviews, and ask for before and after pictures when choosing their surgeon and procedure.  To us the obvious choice is always the Sklar Bunionectomy®.

Both procedures:

• Involve cutting the bone and using hardware

• Can offer correction of bunions of many shapes and sizes

• May need removal of hardware 

Lapidus type procedures:

• More scarring/visible scarring 

• Shortening of the big toe

• More internal hardware used

• Longer and more involved recovery

• Fuses a joint

Sklar Bunionectomy®:

• No visible scars 

• Minimal shortening of the big toe

• Manageable recovery
  

If you are thinking about having foot surgery, please explore our website at www.footfirst.com or connect with us on our Instagram handle @footfirstpod. You have choices when it comes to the type of surgical procedures you can have, so why not choose the one that makes recovery easy and your foot looking beautiful.