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bunionectomy and k-wires

Posted by Candis on 5/29/01 at hrmin (049194)

Two weeks ago I had both my feet corrected for bunions. The main bone had to be moved back over the seismoids with a wire in each foot. Now that my feet are recovered from the surgery trauma, the wires are extremely annoying, sending pinches of pain unexplicably thru my feet. I'm in a wheel chair and do not walk or weightbear at all, following all instructions and the dr. is pleased with the lack of swelling and recovery. I would like to know 1)if the pain is caused by the pins
2) when will the pins be removed - what criteria is used to make that judgement?
3) why do I wake myself up at night: my legs and feet are stretching involuntarily, causing pain in the feet that aren't supposed to move!? Any way to prevent myself from stretching after I fall asleep? I'm beginning to fear falling asleep!
Thank you for replying.

Re: bunionectomy and k-wires

Dr. Zuckerman on 5/29/01 at 11:21 (049222)

Hi,

Ok . It is possible for the k-wire to pinch the skin . Your doctor can pad this area .

Pins will be in place for about six weeks. X-ray and clinical evaluation will determine the time for removal

May want to take a pain pill or nsaid before going to bed. Heat at the level of the ankle can help..

Rest. May take up to a month for good ambulation with both feet being operated on.

Stretching your ankle for about one minutes before going to sleep

Re: bunionectomy and k-wires

Dr. David S. Wander on 5/30/01 at 14:45 (049367)

I would certainly discuss the discomfort you are having with the surgeon. K-wires can impinge on the skin or on the soft tissues such as tendons, and the surgeon should be aware of your discomfort. I would respectfully disagree with Dr. Zuckerman regarding the use of heat on the ankle to relieve discomfort or spasms at this point post operatively. Since you are only 2 weeks post op, the use of heat may cause swelling, which would cause increased discomfort. Most importantly, speak with your surgeon!

Re: bunionectomy and k-wires

Dr. Zuckerman on 5/30/01 at 18:24 (049392)

I agree that this patient should consult her surgeon to examine the surgical site and postion of the k-wire. I have found that heat is very relaxing and can procedure an analgesic effect. In my experience heat can be very helpful in alleviating spasms. Some ice can do the same thing. I just like the effects that heat produces . Excessive swellin is something to watch for .

Re: bunionectomy and k-wires

Candis Walczyk on 6/01/01 at hrmin (049559)

Thank you for your professional answer! My surgeon says he will remove the pins after 3 weeks. One is already loosening which he says is indicating the bone around it is healed. Now my question becomes should I have a local for the removal? An acquaintance did have a local when a dr. in the same office removed her pin, but mine says it isn't necessary. Heard that before! Any comments on that would be appreciated. I didn't try the heat on my ankles, but only because I started rotating my ankles and stretching my legs before going to bed. That seems to have done the trick.
Thank you, Candis Walczyk

Re: bunionectomy and k-wires

Dr. David S. Wander on 6/01/01 at 10:32 (049577)

If the Kwire is sticking out from your foot, no local anesthesia should be needed. In over 15 years of using K wires, I have never had to give local anesthesia to a patient to have a Kwire removed, if the wire was sticking out from the foot. However, this also depends on whether the K wire is smooth or threaded. If the wire is smooth it will pull out quickly and simply with a quick burning sensation. If the Kwire is threaded, local anesthesia may be required. Surgeons often 'bury' Kwires, which means that it is not sticking out through the skin. In this instance, or in cases that I use a screw, anesthesia must be used since a small incision has to be made. The bottom line is that if the Kwire is smooth, not threaded, and if it is already sticking out through the skin, local anesthesia should not be needed.

Re: bunionectomy and k-wires

Candis W on 6/01/01 at 12:48 (049600)

Thank you! The wire is smooth and protruding from my foot so I should be fine without a local. I feel much better about the procedure now. This is an excellent service you offer!

Re: bunionectomy, hammertoe & bone spur surgery

Dr. Marlene Reid on 7/11/01 at hrmin (052751)

I have my patients stay off their feet for 2 days and rest, ice and elevate and take their pain meds for 2 days whether or not they feel pain. Most of my patients tell me they experience no pain. Expect to be in the surgical shoe 3-4 weeks. It takes a few months to fully heal and rehab.

Re: bunionectomy and k-wires

Dr. Zuckerman on 5/29/01 at 11:21 (049222)

Hi,

Ok . It is possible for the k-wire to pinch the skin . Your doctor can pad this area .

Pins will be in place for about six weeks. X-ray and clinical evaluation will determine the time for removal

May want to take a pain pill or nsaid before going to bed. Heat at the level of the ankle can help..

Rest. May take up to a month for good ambulation with both feet being operated on.

Stretching your ankle for about one minutes before going to sleep

Re: bunionectomy and k-wires

Dr. David S. Wander on 5/30/01 at 14:45 (049367)

I would certainly discuss the discomfort you are having with the surgeon. K-wires can impinge on the skin or on the soft tissues such as tendons, and the surgeon should be aware of your discomfort. I would respectfully disagree with Dr. Zuckerman regarding the use of heat on the ankle to relieve discomfort or spasms at this point post operatively. Since you are only 2 weeks post op, the use of heat may cause swelling, which would cause increased discomfort. Most importantly, speak with your surgeon!

Re: bunionectomy and k-wires

Dr. Zuckerman on 5/30/01 at 18:24 (049392)

I agree that this patient should consult her surgeon to examine the surgical site and postion of the k-wire. I have found that heat is very relaxing and can procedure an analgesic effect. In my experience heat can be very helpful in alleviating spasms. Some ice can do the same thing. I just like the effects that heat produces . Excessive swellin is something to watch for .

Re: bunionectomy and k-wires

Candis Walczyk on 6/01/01 at hrmin (049559)

Thank you for your professional answer! My surgeon says he will remove the pins after 3 weeks. One is already loosening which he says is indicating the bone around it is healed. Now my question becomes should I have a local for the removal? An acquaintance did have a local when a dr. in the same office removed her pin, but mine says it isn't necessary. Heard that before! Any comments on that would be appreciated. I didn't try the heat on my ankles, but only because I started rotating my ankles and stretching my legs before going to bed. That seems to have done the trick.
Thank you, Candis Walczyk

Re: bunionectomy and k-wires

Dr. David S. Wander on 6/01/01 at 10:32 (049577)

If the Kwire is sticking out from your foot, no local anesthesia should be needed. In over 15 years of using K wires, I have never had to give local anesthesia to a patient to have a Kwire removed, if the wire was sticking out from the foot. However, this also depends on whether the K wire is smooth or threaded. If the wire is smooth it will pull out quickly and simply with a quick burning sensation. If the Kwire is threaded, local anesthesia may be required. Surgeons often 'bury' Kwires, which means that it is not sticking out through the skin. In this instance, or in cases that I use a screw, anesthesia must be used since a small incision has to be made. The bottom line is that if the Kwire is smooth, not threaded, and if it is already sticking out through the skin, local anesthesia should not be needed.

Re: bunionectomy and k-wires

Candis W on 6/01/01 at 12:48 (049600)

Thank you! The wire is smooth and protruding from my foot so I should be fine without a local. I feel much better about the procedure now. This is an excellent service you offer!

Re: bunionectomy, hammertoe & bone spur surgery

Dr. Marlene Reid on 7/11/01 at hrmin (052751)

I have my patients stay off their feet for 2 days and rest, ice and elevate and take their pain meds for 2 days whether or not they feel pain. Most of my patients tell me they experience no pain. Expect to be in the surgical shoe 3-4 weeks. It takes a few months to fully heal and rehab.