DATE OF SURGERY: MM/DD/YYYY
PREOPERATIVE DIAGNOSIS: Bunion, right great toe.
POSTOPERATIVE DIAGNOSIS: Bunion, right great toe.
OPERATION: Chevron bunionectomy, right great toe.
SURGEON: John Doe, MD
ASSISTANT: Jane Doe, PA
ANESTHESIA: General.
POSTOPERATIVE CONDITION: Satisfactory.
INDICATIONS FOR SURGERY: This patient had chevron bunionectomy on her left foot last year, did very well, and the right foot was resistant to all conservative measures and surgery was indicated.
DESCRIPTION OF PROCEDURE: With the patient under satisfactory general anesthesia, supine on the operating table, the right foot was prepped with DuraPrep and draped into a sterile field for Chevron bunionectomy.
After the proper surgical consent form, surgical site marking, surgical time-out and infusion of preoperative antibiotics were performed and documented, the right leg was elevated. The tourniquet was applied to a pressure of 350 mmHg.
Medial incision was made over the MP joint. Dissection was carried out down to the capsule. The capsule was entered through a V incision based proximally and retracted distally as the capsule was dissected off the metatarsal head.
The saw was used to perform a bunionectomy and chevron cut was made. The metatarsal head was displaced laterally 4 mm and secured with an absorbable K-wire.
The remaining part of the shaft that was around medially was then removed with the saw and a drill hole was placed through the metatarsal shaft.
The wound was irrigated and the toe was held in a few degrees of varus and plantarflexion, and the capsule was reattached to the drill hole with interrupted PDS suture. The PDS was used on the superior and inferior capsule to reinforce the suture line. Vicryl was used to reinforce that. Vicryl was used on the subcutaneous, and the skin was closed with nylon suture.
A splint was applied. A dry, sterile dressing was applied. The tourniquet was released and normal circulation was noted to return to the toes.
The patient was taken to the recovery room in satisfactory condition after the completion of the Chevron bunionectomy.
