Open Excision of heel bump
Removal of bony or grissly bumps from the edge of the heel where shoes can rub is a fairly small piece of surgery but it can take several months for recovery to be complete. This is because prominence of the area is the very cause of symptoms and the post-operative swelling (oedema) caused by the operation initially can cause just as much of a prominence as the original one. The difference is that the post-operative swelling eventually settles.
The incision itself has to be made over the bump in order to remove it. This is of course where the shoes were rubbing so there is potential for the scar itself to generate discomfort. Most scars heal well without any complications but around the heel is somewhere that slow wound healing or infections can occur in any one even with a healthy circulation. This is a risk that has to be weighed up when you and your surgeon decide whether to embark on the surgery.
Excision of heel bumps is normally done on a daycase basis under general anaesthetic supplemented by local anaesthetic to freeze the area before the end of the operation. A bandage is applied, usually full weight bearing is acceptable from the outset and you will be provided with information as to when to remove the bandage.
We often use dissolving stitches supported by adhesive steristrips. Dressings on such a wound are usually left in place for 10-12 days even if the bandage can be removed sooner than that. Therefore we will apply an adhesive dressing over the wound beneath the bandages so that the wound is still covered once those bandages are removed at home.
Occasionally a large bony spur involves the area where the Achilles tendon is attached. Under these unusual circumstances a significant portion of the tendon might have to be detached from bone and then reattached once the prominence has been removed. If we are worried that there might be too much strain on the remaining tendon while the reattached portion heals back with full strength we might apply a temporary plaster cast or protective boot for a few weeks. This would all be discussed with you prior to surgery.