Pros/Cons of Having Surgery on Both Feet at the Same Time

We've had a request recently to discuss the advantages/disadvantages of having surgery on both feet at the same time (for bunions).

Bunion surgery often requires realigning the first metatarsal.  This means that there is bone healing.  This is very similar to fracture healing, and this involves the first metatarsal or possibly bone healing involving the base of the first metatarsal.  Whenever there is fracture healing or bone healing, there are several different considerations.  These are often time-dependent.  Typical bone healing takes 8–10 weeks. 
 
It can be shorter the younger you are (for example a teenager) and it can be longer the older you are (for example those patients who are over 50 or 60 years old).  Typically for fracture to heal we would recommend a cast boot or a regular fiberglass cast.  The good news is that there is often full weightbearing allowed with either the cast boot or the fiberglass cast.  The time spent in the cast allows for protection and bone healing with proper immobilization.  This means that it may be hard to drive with the right foot until there is at least some initial bone healing.  It also means that for longer distances it may be helpful to use either a scooter or crutches. 
 
When surgery is just done on 1 foot at a time, the opposite foot can compensate and help protect the surgical side.  This can make it easier to drive and get around.  It also means if there is any discomfort from the surgery it's just surgery from 1 foot instead of 2.  When you have physical therapy you can really concentrate and focus on regaining normal range of motion on 1 foot instead of doubling the time and effort spent on two feet.  It is nice to have 1 good foot and leg for best possible balance instability.  You don't want to have an injury or fall during her initial postoperative healing.
So to summarize: The advantage for 1 foot at a time:

-Allows for postoperative driving
-Allows for better balance
-Allows for 100% attention to postprocedure rehabilitation on 1 foot at a time
 
Considerations of having both feet at the same time:

-You're combining the postoperative timeframe.
-High risk of falling or compromising one or both surgical sites from injury
-Bone healing postoperative nutrition supplements are only taken one suspended twice.
-The need for outside help (family or close friend) is only needed one time instead of 2. 
 
Most patients who have 1 foot done like to wait approximately 6 months or even a year before the have the next foot done.
 
It is our general recommendation that only 1 foot be done at a time.  There have been a few exceptions over the years were we have done both feet at once.  We would be happy to further discuss these options.  If you would like a consultation with either Dr. Nelson or myself please contact our office.  It would make most sense to review this in person and especially with x-rays available.
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