Silver bunionectomy

Silver bunionectomy:
Removal of medial prominence – “bumpectomy”. Commonly used in conjunction with other procedures (osteotomies). Only used as isolated procedure if large exostosis is present and IM <10°. Indicated when “bump” pain is the presenting problem; range of motion should be adequate and no crepitus. Does not affect hallux position (patient should be aware of this pre-operatively).Procedure: • 5cm incision centred over eminence • Dissect to identify dorsomedial cutaneous nerve • L-shaped capsulotomy • Expose medial eminences resected with microsaggital san blade- also do adductor tenotomy and lateral capsule releasePost op- compression dressing; stitches removed at 2 weeks; passive extension exercises started; stiff soled post op shoe for 4 weeks; sport at 8 weeksRecurrence can be common, as pathomechanics not addressed (can be combined with Akin osteotomy for better result – especially in the young and active)

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