NEUROMA SURGERY

WHAT TO EXPECT WITH NEUROMA SURGERY

 

 

Many patients considering bunion surgery have come into contact with other individuals who have already gone through the process and have shared their experiences, some good and some bad. As a physician it is my job to explain the process of having bunion surgery on a daily basis and regularly explain how it is very difficult in comparing apples to apples when it comes to bunion surgery. There are many different variables regarding bunion surgery as it relates from one patient to the next and hopefully the following can help answer your questions if you are deciding on having bunion surgery in the future.

THE BASICS

The best time to remove a painful neuroma is if conservative treatment such as shoe modifications, orthotics, and cortisone injections have failed to give any relief. If the pain is continual, affecting your activities of daily living, and has not improved with time, surgically removing the nerve may be a beneficial option for you.

There are a variety of different techniques that have been performed to remove the symptomatic nerve. The specific technique chosen for you will have an impact on your post-operative recovery period including the protective device that you will need, weight-bearing status, and ability to return to your normal activities. This procedures generally takes less than an hour to complete, is performed under twilight sleep (IV only), and are done in an out patient setting. Due to the IV sedation, you are not permitted to eat or drink after midnight the night before surgery and you are not permitted to drive yourself home after the surgery. Lastly, a prescription for pain medicine and an anti-inflammatory will be given before the surgery and it is recommended that these are filled so that you have these ready after your surgery. 

THE SURGERY

In general, most individuals having neuroma surgery have a procedure similar to that described in the above video. This procedure essentially removes a portion of the inflamed nerve and as the video describes, you will typically experience numbness in the are where the nerve once was. The video demonstrates removing the nerve from the top of the foot, which is the traditional method to access the nerve. I personally prefer to remove the nerve from the bottom of the foot where there is less overall dissection in order to get the nerve. The nerve is located closer to the bottom of the foot and therefore a plantar approach limits the amount of dissection and thus reduces post-opertative swelling and pain. Once the nerve is identified and removed, sutures will be used to re-approximate the skin, which will require removal two to three weeks post-operatively. 

AFTER SURGERY

The post-operative course for this surgery includes a sterile dressing and protective shoe or walking boot. The dressing is not to be changed or tampered with until seen by your doctor one week after surgery and is not to get wet. Patients are permitted to walk on the operative foot as tolerated immediately after surgery, however, it is important to keep the foot dry for the first two weeks. At two weeks after surgery, all bandages are removed, sutures are removed, and patients are permitted to wet the foot while bathing. It is at this point that patients can transition back to a supportive athletic shoe as tolerated. In general, I advise individuals to decrease their normal activities for six weeks as post-operative pain and swelling is correlated to patient activities. Although everyone heals at a different rate, in some cases swelling can occur for up to a year after surgery. Patients are advised to take a minimum of one week off from work to recover from the anesthesia and the procedure.  

IF YOU ARE CONSIDERING SURGERY FOR A PAINFUL NEUROMA, CALL TODAY TO FIND OUT MORE ABOUT YOUR OPTIONS: 770.979.0900

 


NEUROMA SURGERY: BEFORE & AFTER